Broadleaf Plantain

Plantaginaceae

Plantago major

Also known as: Greater Plantain, Common Plantain, White Man's Footprint

Pregnancy A
Lactation A

clinical_notes Clinical Summary

Broadleaf Plantain (Plantago major) is one of the world's most widely distributed medicinal herbs, used across virtually every traditional healing system for wound healing, respiratory complaints, and urinary tract conditions.

Key bioactives are aucubin (anti-inflammatory iridoid), allantoin (wound-healing, promotes fibroblast proliferation), plantamajoside (antioxidant, anti-inflammatory), and mucilage (demulcent).

A case-control clinical trial confirmed efficacy for second-degree burn wound healing comparable to silver sulfadiazine.

German Commission E approves it for cough and skin inflammation.

Its excellent safety profile (Grade A in pregnancy and lactation) and accessibility as a common weed make it a practical first-aid herb.

Pregnancy Safety

A

Greater plantain is considered very safe, including during pregnancy and lactation. German Commission E and traditional herbalists recommend it as a gentle herb suitable for all populations including pregnant and breastfeeding women and children.

Lactation Safety

A

Considered safe during lactation at traditional doses. No known adverse effects. One of the safest herbs for all populations.

warning Contraindications

  • Known allergy to Plantaginaceae family or psyllium (contraindicated)
    Clinically Proven
  • Anticoagulants (warfarin) (caution)
    Theoretical

vital_signs Clinical Profile

Primary Indications

  • check_circle wound healing
  • check_circle burn wound care
  • check_circle cough
  • check_circle bronchitis
  • check_circle upper respiratory infection
  • check_circle sore throat
  • check_circle urinary tract inflammation
  • check_circle gastric ulcer
  • check_circle diarrhea
  • check_circle insect bites
  • check_circle skin inflammation

Therapeutic Actions

vulneraryanti-inflammatoryantimicrobialexpectorantdemulcentastringentantitussiveantiulcerativediuretichaemostaticimmunomodulatory

System Affinities

  • check_circle respiratory
  • check_circle integumentary
  • check_circle urinary
  • check_circle digestive
  • check_circle immune

labs Active Constituents

aucubin

catalpol

plantamajoside

verbascoside

allantoin

caffeic acid

chlorogenic acid

sorbitol

mucilage polysaccharides

ursolic acid

flavonoids

tannins

history_edu Traditional Use

Traditional Chinese Medicine (TCM)

Chinese Name

车前草 (Che Qian Cao)

Properties

Nature: cold

sweetbland
Meridians / Channels
LiverKidneyLungSmall IntestineBladder
TCM Indications
  • Damp-Heat in Bladder causing difficult urination
  • Diarrhea from Damp-Heat
  • Cough from Lung Heat with phlegm
  • Liver Heat rising causing eye redness
  • Jaundice from Damp-Heat
Zang-Fu Organ Patterns
Damp-Heat in BladderDamp-Heat DiarrheaLung Heat with PhlegmLiver Yang RisingKidney Deficiency with Damp-Heat
Classical Formulas
Zhu Ling TangBa Zheng SanChe Qian Zi San
Notes

In TCM, Che Qian Cao (the whole plant) and Che Qian Zi (seeds) are used differently. The seeds are the primary TCM medicinal (stronger diuretic and clearing effects). The whole plant is used more topically and for respiratory conditions. The TCM species used is primarily Plantago asiatica or P. depressa.

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Traditional Uses Across Healing Systems

While many herbs lack controlled clinical trials, centuries of traditional practice across cultures provide valuable insight into their therapeutic applications.

Western Herbal Europe, North America
Described by Dioscorides (1st century CE) for wound healing; documented in Viking sagas as healing herb; mentioned in Shakespeare (Romeo and Juliet, 1597)

Topical wound healing and first-aid herb; expectorant and antitussive for bronchitis and cough; demulcent for urinary tract inflammation and gastric ulcers

German Commission E approves Plantago major for internal use to ease coughs and mucous membrane irritation of upper respiratory tract, and topically for skin inflammations. Known as White Man's Footprint by Native Americans as it spread with European colonization.

TCM China
Recorded in Shen Nong Ben Cao Jing (one of the oldest Chinese herbal texts, ~100 CE)

Che Qian Cao - clears Damp-Heat from Bladder (diuretic), cools Blood, expels phlegm from Lung, clears Liver Heat affecting eyes

In TCM the seeds (Che Qian Zi) are the primary medicinal with stronger diuretic action. The whole herb is used for heat-type conditions and external wounds.

Indigenous Worldwide (introduced herb that spread globally with European colonization)
Pre-European use in Europe and Asia; adopted by indigenous peoples worldwide after colonization

Fresh leaf poultice for wounds, insect bites, bee stings, burns, and bruises; tea for coughs, sore throats, and urinary complaints

Named White Man's Footprint by North American indigenous peoples as it grew everywhere Europeans had been. Used as a quick first-aid poultice: fresh leaf is chewed or bruised and applied to wounds and insect bites.

Unani Middle East, Persia, India
Described by Ibn El Beithar (13th century) adopting knowledge from Greek medicine

Warm, dried leaves used for wound healing, urinary complaints, and as an astringent for diarrhea; described in classical Unani texts

Traditional Unani application for treating dysentery, hemoptysis, and urinary tract disorders.

spa Parts Used

leaf

Constituents
aucubincatalpolplantamajosideverbascosideallantoinmucilagecaffeic acidtannins
Indications
  • wound healing
  • cough
  • sore throat
  • skin inflammation
  • urinary tract inflammation
Preparation

Fresh leaves used as direct poultice (bruised or chewed) for wounds, bites, stings. Dried leaves as infusion (2-3 tsp per cup, 3x daily) for respiratory and urinary conditions. Syrup for cough: simmer leaves in honey and water. Commission E approves for internal and topical use.

seed

Constituents
mucilage polysaccharidesplanteoseaucubin
Indications
  • constipation
  • IBS
  • diverticular disease
  • bulk laxative
Preparation

Seeds contain mucilage that swells in water; must be taken with adequate fluid (minimum 250mL per dose). Note: Plantago major seeds are distinct from psyllium (P. ovata/P. psyllium) but have similar bulk-forming properties.

shield Safety

Contraindications — Evidence Basis

Known allergy to Plantaginaceae family or psyllium
contraindicated Clinically Proven

Cross-reactivity within Plantaginaceae (psyllium, plantain). Patients with known psyllium allergy should avoid Plantago major. Risk of allergic respiratory reactions with pollen exposure.

Anticoagulants (warfarin)
caution Theoretical

Plantago major contains vitamin K which may interfere with warfarin therapy. Consistent use of large amounts may affect INR.

Toxicity

Toxic Dose

No significant toxicity at standard therapeutic doses. Very high doses of seeds may cause GI obstruction (due to mucilage).

Symptoms

Very rare: GI obstruction with large amounts of seeds; allergic reactions in pollen-sensitized individuals

Management

Discontinue for allergic reactions. For GI obstruction from seeds: ensure adequate fluid intake. Supportive care.

Adverse Effects

rare allergic reactions (pollen-sensitized individuals)mild GI upset at high dosescontact dermatitis (very rare)

CYP Metabolism

No significant CYP interactions documented. Plantago major compounds are not known to inhibit or induce CYP enzymes at therapeutic doses.

swap_horiz Interactions

Lithium (Lithium Carbonate, Lithium Citrate)

Increased Effect moderate

Class: Mood Stabilizer

Mechanism

Plantago major exhibits documented diuretic activity via iridoid glycoside content. Diuresis can reduce renal sodium and lithium excretion, potentially elevating lithium plasma concentrations into toxic range. Lithium has a narrow therapeutic index (0.6-1.2 mEq/L).

Clinical Guidance

Avoid concurrent use of Plantago major-based diuretic preparations with lithium. If co-use is unavoidable, monitor lithium serum levels frequently and watch for signs of toxicity (tremor, polyuria, nausea, confusion). Ensure adequate hydration.

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Evidence Source Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. London: Pharmaceutical Press, 1996:p.207. View source open_in_new

Warfarin / Oral Anticoagulants (Heparin, Apixaban, Rivaroxaban)

Increased Effect moderate

Class: Anticoagulant

Mechanism

Plantago major contains salicylates and flavonoids (aucubin, acteoside) that exhibit mild antiplatelet activity by inhibiting platelet aggregation via thromboxane A2 pathways, potentially augmenting anticoagulant drug effects and increasing bleeding risk.

Clinical Guidance

Monitor for signs of unusual bleeding in patients using Plantago major preparations alongside anticoagulants. INR should be checked more frequently if oral warfarin is co-administered. Advise patients to disclose plantain use before any invasive procedures.

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Evidence Source Adom MB et al. Chemical constituents and medical benefits of Plantago major. Biomed Pharmacother 2017;96:348-360. PMID: 28965848. View source open_in_new

Antidiabetic Agents (Metformin, Sulfonylureas, Insulin)

Increased Effect moderate

Class: Antidiabetic

Mechanism

Plantago major extracts have demonstrated hypoglycaemic activity in animal models attributed to polysaccharides and flavonoids that slow carbohydrate absorption and may increase peripheral insulin sensitivity, producing additive blood glucose-lowering effects when combined with antidiabetic medications.

Clinical Guidance

Patients using Plantago major supplements alongside antidiabetic agents should monitor blood glucose more frequently. Watch for hypoglycemia symptoms (dizziness, sweating, confusion). Dose adjustments of antidiabetic drugs may be required.

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Evidence Source Samuelsen AB. The traditional uses, chemical constituents and biological activities of Plantago major L. A review. J Ethnopharmacol 2000;71(1-2):1-21. PMID: 10904144. View source open_in_new

Immunosuppressants (Cyclosporine, Tacrolimus, Azathioprine)

Antagonistic moderate

Class: Immunosuppressant

Mechanism

Plantago major extracts exhibit immunomodulatory activity, potentiating lymphoproliferation and augmenting immune function via complement pathway activation. This immune-stimulating effect may directly oppose therapeutic immunosuppression required in transplant or autoimmune disease patients.

Clinical Guidance

Patients on immunosuppressive therapy (e.g., post-transplant) should avoid therapeutic doses of Plantago major. Food amounts are unlikely significant, but concentrated supplements should be discontinued. Monitor organ rejection markers if concurrent use occurs.

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Evidence Source Mello JC et al. Hydroalcoholic extracts of Plantago major: immunomodulatory activity. Rev Bras Farmacogn 2010;20(3):344-350. View source open_in_new

Antihypertensive Agents (ACE Inhibitors, ARBs, Calcium Channel Blockers, Beta-Blockers)

Synergistic low

Class: Antihypertensive

Mechanism

Plantago major has demonstrated mild antihypertensive effects in animal studies attributed to vasodilatory flavonoid content and diuretic iridoids. Combined use may produce additive blood pressure-lowering effects, potentially causing symptomatic hypotension in susceptible patients.

Clinical Guidance

Monitor blood pressure when initiating Plantago major supplements alongside antihypertensive medications. This combination is generally low-risk but caution is warranted in patients prone to orthostatic hypotension. No dose adjustment typically needed.

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Evidence Source Uncini Manganelli RE, Chericoni S, Baragatti B. Ethnopharmacobotany in Tuscany: plants used as antihypertensives. Fitoterapia 2000;71(Suppl 1):S95-100. View source open_in_new

Oral Drugs (all narrow therapeutic index drugs)

Decreased Effect low

Class: General Drug Class

Mechanism

Plantago major mucilage (polysaccharide fraction) forms a viscous gel layer on the GI tract, similar to psyllium. This gel-forming property may impair absorption and reduce bioavailability of co-administered oral medications by slowing gastric transit and binding drug molecules in the gut.

Clinical Guidance

Advise patients to take narrow therapeutic index medications (levothyroxine, digoxin, anticoagulants) at least 1-2 hours before or after Plantago major preparations. Routine separation of timing is sufficient for most patients.

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Evidence Source Plantago ovata drug interactions review. Fernandez N et al. Eur J Drug Metab Pharmacokinet 1994;19:161-168. View source open_in_new

hub Combinations

info

Synergistic pairings can enhance therapeutic outcomes, while knowing suitable substitutes helps when specific herbs are unavailable or contraindicated.

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Synergistic Combinations

2
Elderberry
Limited Evidence
Rationale

Complementary respiratory and immune support. Plantain (expectorant, anti-inflammatory, mucilage) soothes irritated airways while Elderberry (antiviral, immune-stimulating) targets the viral cause of respiratory infection.

Clinical Evidence

Traditional combination for coughs and colds; each herb has independent clinical evidence for respiratory conditions.

Yarrow
Traditional Use
Rationale

Classical wound-healing and haemostatic combination. Plantain (allantoin, mucilage) promotes tissue regeneration; Yarrow (achillin, flavonoids) stops bleeding and has antimicrobial properties. Both used together for cuts, wounds, and ulcers.

Clinical Evidence

Traditional pairing across Western herbalism and indigenous medicine; complementary haemostatic and regenerative mechanisms.

science Studies

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Efficacy and safety of Plantago major seeds in patients with diabetic nephropathy: A randomized open-labeled controlled clinical trial

RCT
2024 |Al-Zubaidy MHK et al. J Ethnopharmacol. 2024

This randomized open-label controlled trial enrolled 60 patients with diabetic nephropathy, assigning them to receive standard treatment (Losartan 25 mg twice daily) alone or combined with Plantago major seed powder (10 g sachet twice daily) for 60 days. Primary outcomes included 24-hour urinary protein, fasting blood sugar, BUN, and serum creatinine. The plantain-supplemented group showed improvements in proteinuria and kidney function markers compared to the control group. The study represents the first clinical investigation of P. major for diabetic nephropathy, with the herb added safely alongside a standard RAAS inhibitor. Findings suggest potential nephroprotective properties consistent with traditional Persian medicine uses.

Urinary Tract Health
nephroprotectiveanti-inflammatoryantioxidantlipid-lowering
View source open_in_new

Effect of Plantago major on cough severity in acute bronchitis: A double-blind randomized clinical trial

RCT
2024 |Moeini R et al. Complement Ther Clin Pract. 2024;57:101886

This double-blind, placebo-controlled RCT evaluated the effect of Plantago major syrup (PMS) on cough severity in 80 patients with acute bronchitis diagnosed using a Bronchitis Severity Scale score ≥5. Patients were randomly assigned to receive PMS or placebo (30 mL/day) for 10 days, with assessment at days 5 and 10. The primary outcome was the Bronchitis Severity Scale (BSS) score, and the secondary outcome was quality of life via the Leicester Cough Questionnaire. PMS significantly reduced BSS scores compared to placebo, suggesting a clinically meaningful antitussive benefit. These findings support the traditional use of Plantago major in managing acute respiratory tract cough symptoms.

CoughUpper respiratory tract infection (URTI)
anti-inflammatorymucolyticexpectorant
View source open_in_new

medication Dosing

tea

Dose Range

2-3 tsp (3-9 g) dried leaf per cup

Frequency

2-3x/day

Notes

Steep 10-15 min covered. For respiratory and urinary conditions. Can add honey for cough syrup effect. Commission E approved for cough associated with upper respiratory tract infections.

topical

Dose Range

Fresh leaf poultice or 10% extract ointment

Frequency

Apply to wound 2-4x/day

Notes

Fresh leaf: crush or bruise 2-3 fresh leaves and apply directly to wound, bite, or irritated skin. For burns or larger wounds: 10% aqueous extract ointment used in clinical trial vs silver sulfadiazine.

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Disclaimer: This information is largely AI-generated and reviewed by human experts at Evara Health. It is intended for educational and clinical reference purposes only and should not replace professional medical advice.

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