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Clove (Eugenia aromatica) and Clove oil (Eugenol)

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Clove and Clove oil
Clove and Clove oil

BackgroundReturn to top

Clove is widely cultivated in Indonesia, Sri-Lanka, Madagascar, Tanzania, and Brazil. It is used in limited amounts in food products as a fragrant, flavoring agent, and antiseptic.

Clinical trials assessing monotherapy of clove are limited, although the expert panel German Commission E has approved the use of clove as a topical antiseptic and anesthetic. Other uses for clove, such as premature ejaculation, dry socket, and fever reduction, lack reliable human clinical evidence.

Clove is sometimes added to tobacco in cigarettes, and clove cigarettes ("kreteks") typically contain 60% tobacco and 40% ground cloves.

Eugenol, a constituent of clove, has been used for analgesic, local anesthetic, anti-inflammatory, and antibacterial effects. It is used in the form of a paste or mixture as dental cement, filler, and restorative material.

Plant oils, including clove, may be used in livestock to inhibit microbial fermentation in waste products. Clove oil may be found in high concentration licorice (glycyrrhizin) products to prevent gel formation in an aqueous solution.

SynonymsReturn to top

2-methoxy-4-(2-propenyl)-phenol,  Caryophylli, Caryophylli atheroleum,  Caryophylli Flos ,  Caryophyllus aromaticus , cengke, cengkeh, chiodo di garofano (Italian), choji, chor boghbojh, chor poghpch, cinnamon nails, clau, clavos, clou de girofle (French), clovas de comer, clove, clove bud, clove bud oil, clove cigarettes, clove essential oil, clove leaf, clove oil, craveiro da india, cravinho, cravo, cravo de olor, cuisoare, ding heung, ding xiang, dinh huong, dok chan, dried clove, Eugenia bud,  Eugenia aromatica ,  Eugenia caryophyllata ,  Eugenia caryophyllus , faranfil,  Flores caryophylli , gahn plu, garifallo, garifalo, garifano, garn ploo, Gewurznelken Nagelein (German), gozdzik, gozdzikow korzenny, graambu, ground clove, gvazdikelia, gvozdika, harilik nelgipuu, hrebicek, iltze kanela, jeonghyang, jeonghyong namu, jonghyang, kabsh qarunfil, kala, kalmpir, kan phou, kan phu, karafuu, karamfil, kariofilla, kariofilo, khan pluu, khlam puu, klabong pako, klincic, klinceky, klincki, krambu, kreteks, krinfud, kruidnagel, krustnaglinas, kryddernellike, kryddnejlikor, kullobu, kurobu, kvapnusis gvazdikmedis, labanga, labango, laung, lavang, lavanga, lavangalu, lavnagamu, lay hnyin, leoung, ley nyim bwint, mikhak, mikhaki, mixaki, moschokarfi, Myrtaceae (family), nageljnove zbice, nagri, negull, neilikka, nelk, nelke, nellik, nellike, nejlikor, oil of clove, oleum caryophylli, pentogen, qalampir, shriisanjnan,  Syzigium aromaricum ,  Syzygium aromaticum  (L) Merr. & Perry. (clove), szegfu, szegfuszeg, tropical myrtle, tsiporen.

Do not confuse clove with: baguacu, black plum,  Eugenia cumini ,  Eugenia edulis ,  Eugenia jambolana ,  Eugenia umbelliflora , Jamun, java apple, java plum, SCE,  Syzigium cordatum ,  Syzygium cumini ,  Syzygium samarangense , water apple, or wax apple.

EvidenceReturn to top

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Uses based on scientific evidenceGrade*
Dental pain

Clove essential oil is commonly used as a dental pain reliever. Early studies have found that a homemade clove gel may be as effective as benzocaine 20% gel. Clove oil combined with zinc oxide paste may be effective for dry socket (inflammation after tooth extraction).
B
Fever reduction

Animal studies suggest that clove can lower fever, but no reliable human studies are available.
C
Mosquito repellent

In lab and field tests, undiluted clove oil repelled multiple species of mosquitoes for up to two hours. However, undiluted clove oil may also cause skin rash in sensitive people.
C
Premature ejaculation

A small amount of human research reports that a combination cream with clove and other herbs may be helpful in the treatment of premature ejaculation. However, well-designed studies of the effectiveness of clove alone are needed before a conclusion can be drawn.
C

*Key to grades
A: Strong scientific evidence for this use;
B: Good scientific evidence for this use;
C: Unclear scientific evidence for this use;
D: Fair scientific evidence against this use;
F: Strong scientific evidence against this use.

Grading rationale

Uses based on tradition or theory
The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Abdominal pain, acaricidal (an agent that destroys mites), allergies, antibacterial, antifungal, antihistamine, antimicrobial, antimutagenic, antioxidant, antiseptic, antispasmodic, antiviral, aphrodisiac, asthma, atherosclerosis (hardening of the arteries), athlete's foot, bad breath, blood purifier, blood thinner, cancer, cavities, colic, cough, counterirritant, decreased gastric transit time, dental plaque and gingivitis (mouthwash), diabetes, diarrhea, dyspepsia, expectorant, flavoring (for food and cigarettes), food preservative, gout, hernia, herpes simplex virus, hiccups, high blood pressure, inflammation, insecticidal, insulin mimetic, gas, lice, lipid-lowering, mouth and throat inflammation, mouthwash, muscle relaxant, nausea or vomiting, pain, neurodegeneration, oral candidiasis (thrush), muscle spasm, oral edema, parasites, smooth muscle relaxant (clove oil), stomach pain, tooth or gum pain, toxicity (prevention of arsenite-induced toxicity), ulcers, vaginal candidiasis (prevention and treatment), vasorelaxant (clove oil).

DosingReturn to top

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)
There is not enough scientific evidence available to recommend a specific dose of clove by mouth, on the skin, or by any other route.

Children (younger than 18 years)
There is not enough scientific evidence available to recommend a specific dose of clove by mouth, on the skin, or by any other route.

SafetyReturn to top

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

Allergies
Allergic reactions to clove, its component eugenol have been reported, including possible severe reactions (anaphylaxis). Signs of allergy may include rash, itching or shortness of breath. Eugenol or clove can cause allergic rashes when applied to skin or inside the mouth. Hives have been reported in clove cigarette smokers. Individuals with known allergy to clove, its component eugenol, or to Balsam of Peru should avoid the use of clove by mouth, inhaled from cigarettes, or applied to the skin.

Side Effects and Warnings
Clove is generally regarded as safe for food use in the United States. However, when clove is taken by mouth in large doses, in its undiluted oil form, or used in clove cigarettes, side effects may occur including vomiting, sore throat, seizure, sedation, difficulty breathing, fluid in the lungs, vomiting of blood, blood disorders, kidney failure, and liver damage or failure. People with kidney or liver disorders or who have had seizures should avoid clove. Serious side effects are reported more often in young children, even with small doses, and therefore clove supplements should be avoided in children and pregnant or nursing women.

Clove or clove oil may cause an increased bleeding risk, based largely on laboratory research. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary. It is not clear what doses or methods of using clove may increase this risk. Clove use should be stopped before surgery.

When applied to the skin or inside of the mouth, clove can cause burning, loss of sensation or painful sensation, local tissue damage, dental pulp damage, higher risk of cavities, or sore lips. Undiluted clove oil has a high risk of causing contact dermatitis (rash) and even burns if applied to the skin at full strength. The application of clove combination herbal creams to the penis has been said to cause episodes of difficulty with erection or ejaculation.

Clove oil taken by mouth may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a healthcare provider, and medication adjustments may be necessary.

Contamination can occur if clove is improperly stored.

Pregnancy and Breastfeeding
Not enough information about safety is available to recommend the use of clove supplements in pregnant or breastfeeding women.

InteractionsReturn to top

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs
Based on laboratory research, clove theoretically may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. It is not clear what doses or methods of using clove may increase this risk. Some examples of drugs that increase bleeding risk include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

Clove oil taken by mouth may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare provider. Medication adjustments may be necessary.

When applied to the skin, eugenol, a component of clove, may reduce the ability to feel and react to painful stimulation. Therefore, use of clove products on the skin with other numbing or pain-reducing products such as lidocaine/prilocaine cream (Emla®) theoretically may increase effects.

Clove may also react with antifungals, anti-inflammatories, antihistamines, antineoplastics, and drugs taken for cardiovascular conditions. Clove may also affect the way in which the liver breaks down certain drugs.

Interactions with Herbs and Dietary Supplements
Based on laboratory research, clove may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. It is not clear what doses or methods of using clove may increase this risk. Multiple cases of bleeding have been reported with the use of  Ginkgo biloba , some cases with garlic, and fewer cases with saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

Clove may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

When applied to the skin, eugenol, a component of clove, may reduce the ability to feel and react to painful stimulation. Therefore, use with other numbing or pain-reducing products such as capsaicin cream (Zostrix®) may in theory cause exaggerated effects.

Clove may also react with anti-inflammatory, antifungal, antihistamine, and antineoplastic herbs, and herbs taken for cardiovascular conditions. Clove may also affect the way in which the liver breaks down certain herbs.

Methodology Return to top

This information is based on a professional level monograph edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Ethan Basch, MD (Memorial Sloan-Kettering Cancer Center); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Anait Gasparyan, PharmD (Northeastern University); Nicole Giese, MS (Natural Standard Research Collaboration); Sadaf Hashmi, MD, MPH (Johns Hopkins School of Hygiene and Public Health); Jenna Hollenstein, MS, RD (Natural Standard Research Collaboration); Michelle Miranda, PharmD (University of Rhode Island); David Sollars MAc, HMC (New England School of Acupuncture); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Mamta Vora, PharmD (Northeastern University); Wendy Weissner, BA (Natural Standard Research Collaboration).

Methodology details

Selected references Return to top

  1. Alqareer A, Alyahya A, Andersson L. The effect of clove and benzocaine versus placebo as topical anesthetics. J Dent 2006;34(10):747-50.
  2. Chami N, Bennis S, Chami F, et al. Study of anticandidal activity of carvacrol and eugenol in vitro and in vivo. Oral Microbiol.Immunol 2005;20(2):106-111.
  3. Darshan S. Doreswamy R. Patented antiinflammatory plant drug development from traditional medicine. Phytother.Res 2004;18(5):343-357.
  4. Dragland, S., Senoo, H., Wake, K., Holte, K., and Blomhoff, R. Several culinary and medicinal herbs are important sources of dietary antioxidants. J Nutr. 2003;133(5):1286-1290.
  5. Eisen JS, Koren G, Juurlink DN, et al. N-acetylcysteine for the treatment of clove oil-induced fulminant hepatic failure. J Toxicol Clin Toxicol 2004;42(1):89-92.
  6. Jadhav BK, Khandelwal KR, Ketkar AR, et al. Formulation and evaluation of mucoadhesive tablets containing eugenol for the treatment of periodontal diseases. Drug Dev Ind Pharm 2004;30(2):195-203.
  7. Janes SE, Price CS, Thomas D. Essential oil poisoning: N-acetylcysteine for eugenol-induced hepatic failure and analysis of a national database. Eur J Pediatr 2005;164(8):520-2.
  8. Kim SI, Yi JH, Tak JH, et al. Acaricidal activity of plant essential oils against Dermanyssus gallinae (Acari: Dermanyssidae). Vet.Parasitol 4-15-2004;120(4):297-304.
  9. Li Y, Xu C, Zhang Q, et al. In vitro anti-Helicobacter pylori action of 30 Chinese herbal medicines used to treat ulcer diseases. J Ethnopharmacol 4-26-2005;98(3):329-333.
  10. Miyazawa M, Hisama M. Antimutagenic activity of phenylpropanoids from clove (Syzygium aromaticum). J Agric Food Chem 10-22-2003;51(22):6413-6422.
  11. Natural Standard Research Collaboration, Chief Editors: Ulbricht C, Basch E, Natural Standard Herb and Supplement Reference - Evidence-Based Clinical Reviews, USA: Elsevier/Mosby, 2005.
  12. Somova LO, Nadar A, Rammanan P, et al. Cardiovascular, antihyperlipidemic and antioxidant effects of oleanolic and ursolic acids in experimental hypertension. Phytomedicine 2003;10(2-3):115-121.
  13. Taguchi Y, Ishibashi H, Takizawa T, et al. Protection of oral or intestinal candidiasis in mice by oral or intragastric administration of herbal food, clove (Syzygium aromaticum). Nippon Ishinkin Gakkai Zasshi 2005;46(1):27-33.
  14. Tajuddin A, Ahmad S, Latif A, et al. Aphrodisiac activity of 50% ethanolic extracts of Myristica fragrans Houtt. (nutmeg) and Syzygium aromaticum (L) Merr. & Perry. (clove) in male mice: a comparative study. BMC.Complement Altern Med 10-20-2003;3(1):6.
  15. Trongtokit Y, Rongsriyam Y, Komalamisra N, et al. Comparative repellency of 38 essential oils against mosquito bites. Phytother Res 2005;19(4):303-9.

January 01, 2008.


Natural Standard Logo This evidence-based monograph was prepared by the Natural Standard Research Collaboration. The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. Talk to your health care provider before taking any prescription or over the counter drugs (including any herbal medicines or supplements) or following any treatment or regimen. Copyright© 2008 Natural Standard (www.naturalstandard.com). All Rights Reserved.