Broadleaf Plantain
PlantaginaceaePlantago major
Also known as: Greater Plantain, Common Plantain, White Man's Footprint
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
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
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
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)
车前草 (Che Qian Cao)
Nature: cold
- 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
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.
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.
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.
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.
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.
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
- wound healing
- cough
- sore throat
- skin inflammation
- urinary tract inflammation
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
- constipation
- IBS
- diverticular disease
- bulk laxative
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
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)
Plantago major contains vitamin K which may interfere with warfarin therapy. Consistent use of large amounts may affect INR.
Toxicity
No significant toxicity at standard therapeutic doses. Very high doses of seeds may cause GI obstruction (due to mucilage).
Very rare: GI obstruction with large amounts of seeds; allergic reactions in pollen-sensitized individuals
Discontinue for allergic reactions. For GI obstruction from seeds: ensure adequate fluid intake. Supportive care.
Adverse Effects
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)
Class: Mood Stabilizer
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).
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.
Warfarin / Oral Anticoagulants (Heparin, Apixaban, Rivaroxaban)
Class: Anticoagulant
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.
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.
Antidiabetic Agents (Metformin, Sulfonylureas, Insulin)
Class: Antidiabetic
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.
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.
Immunosuppressants (Cyclosporine, Tacrolimus, Azathioprine)
Class: Immunosuppressant
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.
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.
Antihypertensive Agents (ACE Inhibitors, ARBs, Calcium Channel Blockers, Beta-Blockers)
Class: Antihypertensive
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.
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.
Oral Drugs (all narrow therapeutic index drugs)
Class: General Drug Class
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.
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.
hub Combinations
Synergistic pairings can enhance therapeutic outcomes, while knowing suitable substitutes helps when specific herbs are unavailable or contraindicated.
Synergistic Combinations
2Elderberry
Limited EvidenceComplementary respiratory and immune support. Plantain (expectorant, anti-inflammatory, mucilage) soothes irritated airways while Elderberry (antiviral, immune-stimulating) targets the viral cause of respiratory infection.
Traditional combination for coughs and colds; each herb has independent clinical evidence for respiratory conditions.
Yarrow
Traditional UseClassical 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.
Traditional pairing across Western herbalism and indigenous medicine; complementary haemostatic and regenerative mechanisms.
science Studies
Efficacy and safety of Plantago major seeds in patients with diabetic nephropathy: A randomized open-labeled controlled clinical trial
RCTThis 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.
Effect of Plantago major on cough severity in acute bronchitis: A double-blind randomized clinical trial
RCTThis 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.
medication Dosing
tea
2-3 tsp (3-9 g) dried leaf per cup
2-3x/day
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
Fresh leaf poultice or 10% extract ointment
Apply to wound 2-4x/day
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.
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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