General

Pronunciation
AL-oh

Trade Name(s)

• Aloe vera

• cape

• zanzibar

• socotrine

• curacao

Action

• PO: Exerts a laxative effect by increasing colonic motility, reducing water absorption from the bowel and stimulating bowel, chloride secretion and water content

• Topical: May help accelerate wound healing, although the evidence is inconsistent. May have some activity against gram-positive and -negative bacteria and yeast

Pharmacokinetics

Absorption: Unknown

Distribution: Unknown

Metabolism and Excretion: Unknown

Half-life: Unknown

TIME/ACTION PROFILE

Contraindication/Precautions

Contraindicated in:

• Intestinal obstruction

• Inflammatory intestinal diseases (including Crohn's disease)

• Appendicitis and abdominal pain of unknown origin

• OB: Safety not established

• Pedi: Oral aloe not appropriate for children <12 years

• Cardiac or renal disease

• Fluid or electrolyte abnormalities

• Alcohol containing products should be used cautiously in patients with known intolerance or liver disease

• Pedi: Cautious use in children >12 years old

Adverse Reactions/Side Effects

Derm: Contact dermatitis, skin irritation.

F and E: HYPOKALEMIA, dehydration.

GI: Cramping, diarrhea, laxative dependence (chronic use).

GU: red-colored urine.

*CAPITALS indicates life-threatening.
*italic indicates most frequent.

Interactions

Natural Products-Drug

• Combining oral aloe with potassium-wasting drugs (e.g, diuretics, other laxatives, corticosteroids, cisplatin, amphotericin B) may worsen hypokalemia. Hypokalemia may increase risk of toxicity from digoxin and some antiarrythmics

• Alcohol -containing preparations may interact with disulfuram and metronidazole

Route/Dosage

• PO (Adults):
Capsules—20–30 mg hydroxyanthracene daily;
gel—30 ml tid;
tincture (1:10, 50% alcohol)—15–60 drops daily. Do not use for >1–2 weeks without medical advice;
juice—1 teaspoonful tid after meals.

• Topical (Adults): Aloe gel can be applied liberally to affected areas 3–5 times daily.

Availability

• Alone or in combination with other herbal medicinals^OTC

• Capsules^OTC

• Juice^OTC

• Tincture (1:10 in 50% alcohol)^OTC

• Toical or gel or applied directly from cut plant

Assessment

• Perform baseline skin assessment prior to applying aloe to minor wounds, burns, and abrasions. Observe the size, character, and location of the affected area prior to the application of aloe

• Note topical response assessing for increased inflammation, drainage, pain, warmth, and/or pruritus

• Assess for abdominal distention, presence of bowel sounds, and usual pattern of elimination

• Assess color, consistency, and amount of stool produced

• Monitor serum potassium in patients with chronic use and CBC in patients who self medicate and experience bloody diarrhea or have ulcerative colitis, Crohn's disease, and so forth

• Severe hemorrhagic diarrhea, kidney damage, and possible death from overdose may occur. Treat supportively

Potential Nursing Diagnoses

• Constipation

• Impairedskin integrity

• Deficient knowledge, related to medication regimen

Implementation

• PO: Administer laxative at bedtime to induce a bowel movement in the morning upon arising

• Topical: Wash hands and then apply liberally to affected area of skin. Cover broken areas of skin with a light nonadhering dressing (e.g, band-aid dressing with Telfa lining) to facilitate keeping area clean. Do not apply an occlusive dressing over site of application

Patient/Family Teaching

• Instruct patients with preexisting intestinal disorders (e.g, ulcerative colitis, Crohn's disease, irritable bowel syndrome, and so forth) not to take aloe juice without the advice of a health care provider

• Counsel patients that the oral juice should not be taken if they are experiencing abdominal pain, nausea, vomiting, or fever

• Teach patients that occasional constipation may not be an issue but persistent constipation may represent a more serious health problem and that their health care provider should be consulted

• Tell patients to expect laxative response to the oral juice in 8–12 hr

• Warn patients that the cathartic effects may be dramatic and that accompanying dehydration and electrolyte imbalances may occur. If severe diarrhea occurs or persists, seek out treatment from their health care provider

• Advise patients other than those with spinal cord injury that laxatives should only be used for short-term therapy. Although this is considered by some to be a natural way of correcting constipation it still carries the risk of electrolyte imbalance and dependency with chronic use

• Encourage patients to use other forms of bowel regulation: increasing bulk in the diet, increasing fluid intake, and increasing mobility, as appropriate. Normal bowel habits are individualized and may vary from 3 times/day to 3 times/wk

• Teach patients to consume a 1500–2000 ml/day during therapy to prevent dehydration

• Direct patients with a known cardiac history not to take this herbal supplement without the advice of their health care provider because of the risk of hypokalemia worsening arrhythmias

• Warn patients with cardiac history to avoid straining during bowel movements (Valsalva maneuver)

• Advise patients that topical applications should only be used for minor burns, abrasions, or wounds. Wounds of larger size or more serious burns should be treated by a health care provider

• Teach patients the signs and symptoms of allergic response (redness, rash, itching, serous drainage) to the topical formulation and to discontinue use promptly if these symptoms develop. If allergic response does not improve after discontinuing the product seek out a health care provider

• Instruct patients using topical application on a nonintact skin surface about signs and symptoms of infection (milky or discolored drainage, redness, warmth, swelling, pain) and to promptly seek out treatment of a health care provider if this occurs

• Counsel patients that if improvement in the wound is not occurring or it worsens, stop treatment with Aloe vera and seek the advice of a health care provider

• Warn patients with risk factors for delayed wound healing (e.g, diabetic patients, vascular disease) not to self-medicate with Aloe vera with out the approval of their health care provider

Evaluation/Desired Outcomes

• A soft, formed bowel movement

• Evacuation of the colon

• Relief of sunburn pain

• Wound healing in small localized burns or abrasions

aloe (aloe vera l., a. perryi baker, a. barbadensis, a. vera miller) is a sample topic found in Davis's Drug Guide. All other sections of this record are viewable by clicking on the index in the left column, or by clicking on "Display all Sections" in the "Content Manager".

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