Salicis cortex

Salicis cortex, also known as willow bark, is a drug made from the whole or cut dried bark of young twigs or from dried pieces of young twigs from the current year. In herbal medicines, the drug is used to treat rheumatic complaints, headaches and cold symptoms, among other things.

The quality is defined in the European Pharmacopoeia.

HMPC monograph: As a quantified herbal preparation in solid dosage form: Well-established use: Low back pain, dosage: see finished product instructions, 393 mg-786 mg twice/day, not suitable for children and adolescents under 18 years. Traditional use: mild joint pain. Fever in colds, headaches.
ESCOP monograph: mild back pain, mild rheumatic complaints; feverish colds, headaches.
Commission e-monograph: febrile illnesses, rheumatic complaints, headaches.

Empirical medicine: osteoarthritis, arthrosis, chronic back pain, musculoskeletal pain

Willow bark contains flavonoids, catechin tannins, caffeic acid derivatives and 1,5 to 11 % salicyl alcohol derivatives, which include salicin, salicortin, fragilin, populin and tremulacin.

Willow bark has antipyretic, antiphlogistic, antioxidant and pain-relieving effects. The drug causes inhibition of inflammatory markers, oxygen radicals and hyaluronidase.

Willow bark is used in the treatment of rheumatic complaints (monograph by Commission E) and joint pain (monograph by ESCOP ), cold symptoms and for the treatment of mild back pain(HMPC).

The average daily dosage is between 0.6 and 1.2 g total salicin. Willow bark is mostly used as a tea infusion.

Proaktiv® is an aqueous extract of willow hay.

In solid form, the drug is usually used as a finished preparation, e.g. Assalix® 1-2Tbl/day; Assplant® 2x2Tbl/day.

Intolerance reactions to salicylates may occur.

Hypersensitivity to the active substance, to salicylates or to other NSAIDs (e.g. angioedema, bronchial spasm or chronic urticaria in response to salicylates or other NSAIDs in history). Asthma associated with sensitivity to salicylates. Active peptic ulcers.

Glucose-6-phosphate dehydrogenase deficiency, children and adolescents under 18 years of age (Reye syndrome), severe hepatic or renal impairment. Coagulation disorders.

Not recommended in the first two trimesters of pregnancy due to lack of data, contraindicated in the third trimester of pregnancy.

1. Knuth S et al,(2013) Catechol conjugates are in vivo metabolites of Salicis cortex. Planta Med 79:1489-1494.
2. Beer AM et al. (2008) Willow bark extract (Salicis cortex) for gonarthrosis and coxarthrosis--results of a cohort study with a control group. Phytomedicine 15:907-913.
3. Gopaul R et al. (2010) An evaluation of the effect of a topical product containing salicin on the visible signs of human skin aging. J Cosmet Dermatol 9:196-201.
4. Kim CS et al. (2015) Salicin derivatives from Salix glandulosa and their biological activities. Fitoterapia 106:147-152.
5. Krivoy N et al.(2001) Effect of saliciscortex extract on human platelet aggregation. Planta Med 67:209-212.
6. Schilcher H (2016) In: Leitfaden Phytotherapie, Urban & Fischer Verlag Munich, pp. 335 f.
7. Verma N et al. (2014) Effect of salicin on gut inflammation and on selected groups of gut microbiota in dextran sodium sulfate induced mouse model of colitis. Inflamm Res 63:161-169.
8. Wagner S et al,(2008) Validated HPTLC methods for the determination of salicin in Salix sp. and of harpagoside in Harpagophytum procumbens. J Pharm Biomed Anal 48:587-591.
9. https://arzneipflanzenlexikon.info/weide.php.
10. https://www.ema.europa.eu/en/documents/herbal-monograph/final-european-union-herbal-monograph-salix-various-species-including-s-purpurea-l-s-daphnoides-vill_en.pdf
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