Butcher’s broom (Ruscus aculeatus)

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • Aculeoside A, aculeoside B (2), benzofuran euparone, bisdesmosidic spirostanol saponin, box holly, butchers broom, butchers’ broom, butchersbroom, campesterol, chrysophanic acid, coumarins, Cyclo 3 Fort®, Fabroven®, Fagorutin Ruscus, flavonoids, FLEBS CREMA®, furanostanol saponins, glycolic acid, Jew’s myrtle, kapseln, knechulver, knee holly, kneeholly, kneeholm, Liliaceae, lily family, neoruscogenin, pettigree, Phelbodril®, RAES, Ruscaceae, Rusci
    aculeate, Rusci aculeati rhizoma, Rusci aculeati rhizome, ruscin, ruscodibenzofuran, ruscogenin, ruscogenin diglycoside, ruscoside, Ruscus aculeatus L. extract, rutin, sitosterol, sparteine, spirostanol saponins, steroidal sapogenins, sterols, stigmasterol, sulfated steroidal saponins, sweet broom, tetracosanoic acid, triterpenes, triterpines, tyramine.

  • Note: May be confused with Scotch broom flower, Scotch broom herb, or Spanish broom. These are not topics of this monograph.

  • Selected combination products: Cyclo 3 Fort® and Fabroven®, a combination of root extract of the Ruscus aculeatus plant (150mg per capsule), hesperidin methyl chalcone (150mg), and ascorbic acid (100mg); Phelbodril®, a combination of trimethylhesperidin chalcone, a flavonoid, and Ruscus extract; FLEBS CREMA® (extracts of Ruscus aculeatus and Melilotus officinalis).

Background

  • Butcher’s broom is a small evergreen shrub that grows throughout Europe and North Africa. Historically, European butchers may have used the leaves and twigs of the Ruscus aculeatus plant to clean and scrub their chopping blocks, hence the name “butcher’s broom.” The rhizome shoots of butcher’s broom may be eaten as food in many cultures. Both the root and the stem are used as part of herbal preparations.

  • Butcher’s broom may have been used for the past 2,000 years for its beneficial effects on the circulatory system. These beneficial effects may include promoting vein narrowing and improving the tone of blood vessel walls. The chemicals found in butcher’s broom may attach to and strengthen certain parts of blood vessels, especially collagen, resulting in a tightening of blood vessels, which allows blood to circulate throughout the body and provides greater flexibility to blood vessel walls.

  • Today, butcher’s broom is most frequently used in combination with hesperidin methyl chalcone (150mg) and vitamin C (100mg) in a product known as Cyclo 3 Fort®, which is used to treat certain circulatory diseases, particularly chronic venous insufficiency (CVI).

  • Butcher’s broom has also been studied as a treatment for other diseases and conditions, including varicose veins, secondary lymphedema (swelling due to excess fluid) of the upper arm after breast cancer treatment, and premenstrual syndrome symptoms, and for healing sprains and contusions. However, most of these studies have evaluated butcher’s broom herbal combinations, so the effect of butcher’s broom alone is still unclear. Further research is required.

  • Butcher’s broom may have been used by the ancient Greeks as a diuretic (an agent that promotes urine) and laxative. Historically, throughout Europe, it may have been used to regulate menstrual periods, to get rid of jaundice and headaches, and to heal broken bones. Butcher’s broom has also been used to increase sweating, to treat gout and kidney stones, and to promote improved blood flow.

Scientific Evidence

Uses

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.

Chronic venous insufficiency (reduced vein function)

Limited studies suggest that butcher’s broom in combination with hesperidin methyl chalcone and vitamin C may improve circulation and relieve symptoms of chronic venous insufficiency (CVI), a disorder in which the veins do not pump blood well. However, additional evidence is needed to confirm this effect. Also, the effect of butcher’s broom alone is not clear at this time.

Diabetic retinopathy (inflammation of the retina)

According to limited research, butcher’s broom may help reduce complications associated with diseases of small blood vessels, including diabetic retinopathy (an inflammatory disorder of the retina). Limited research in humans has found that butcher’s broom was more effective in alleviating symptoms of diabetic retinopathy in type 2 diabetic patients when compared to troxerutin. However, additional studies would need to be conducted in order to fully confirm these results.

Edema (swelling)

Limited research suggests that butcher’s broom may help reduce edema (buildup of fluid in tissues). In humans, butcher’s broom may reduce edema in patients taking calcium antagonist agents for the treatment of high blood pressure. However, more studies are needed to confirm these results.

Hemorrhoids

According to limited research in humans, it has been determined that a commercial preparation of butcher’s broom, Cyclo 3 Fort®, may have good or excellent activity in reducing hemorrhoids. Additional studies are needed in order to verify these results. Also, the effect of butcher’s broom on hemorrhoids is not clear at this time, since currently available studies have used a combination product.

Lymphedema (swelling from excess fluid)

According to limited research in humans, it has been determined that Cyclo 3 Fort® may decrease lymphedema (swelling due to excess fluid) of the upper arm in patients that had previously undergone treatment for breast cancer. However, additional studies would need to be conducted in order to fully confirm these results.

Premenstrual syndrome

According to limited research in humans, butcher’s broom may be able to relieve the symptoms associated with premenstrual syndrome (PMS), particularly swelling. Limited research has shown that butcher’s broom may reduce breast pain and ankle swelling, as well as improve mood in women with premenstrual syndrome. However, more studies are needed to confirm these results.

Soft tissue injuries

Limited evidence suggests that butcher’s broom may decrease swelling associated with soft tissue injuries. Limited research indicates that butcher’s broom in combination with sweet clover cream may relieve swelling and pain from sprains and contusions. However, the effects of butcher’s broom alone are unclear.

Varicose veins

Limited evidence suggests that butcher’s broom may decrease the appearance of varicose veins by tightening blood vessels. According to limited research, butcher’s broom may improve various factors associated with varicose veins. The commercial preparation of butcher’s broom, Cyclo 3 Fort®, has been shown to decrease the width of deep veins and to increase blood flow. Additional studies are needed to confirm these results.

*Key to grades:

Tradition

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 health care professional.

  • Antibiotic, antifungal, anti-inflammatory, blood clots, bone fractures, breathing, cosmetic uses, constipation, decreased perspiration (decreased sweating), expectorant (mucus thinner), gallstones, gout, headache, jaundice, kidney stones, laxative, leukemia, orthostatic hypotension (dizzy spells when standing caused by low blood pressure).

Dosing

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)

  • In general, 0.5-1.5 milliliters of the alcohol extract of the whole butcher’s broom plant has been given by mouth three times daily. Decoctions of the root, which include one pint of boiling water to one ounce of twigs, or 1/2 ounce of the bruised fresh root (sometimes mixed with honey), and infusions have been given by mouth as a tea.

  • For long-term venous disorders, 16 milligrams of butcher’s broom extracts have been given by mouth, while 64-96 milligrams of extract has been applied to the skin daily.

  • Two to three commercial butcher’s broom capsules (known as Cyclo 3 Fort®, Phlebodril®, and Fabroven®), which contain 30-150 milligrams of butcher’s broom root combined with trimethyl hesperidin chalcone and vitamin C, have been given by mouth three times daily.

  • To improve breathing and when used as an expectorant, infusions containing one pint of boiling water to one ounce of the twigs of butcher’s broom or 1/2 ounce of bruised fresh root, sweetened with honey, have been taken by mouth as a tea.

  • For chronic (long-term) venous insufficiency, 72-75 milligrams of dried extract of butcher’s broom has been given by mouth daily for 12 weeks. Two capsules containing 150 milligrams of butcher’s broom extract have been given by mouth daily for 60 days. Two capsules containing 16.5 milligrams of butcher’s broom extract have been given by mouth three times daily for two months. Butcher’s broom extract (150 milligrams) has been taken by mouth daily for 90 days. FLEBS CREMA® has been applied to the skin of both legs 2-3 times daily for three weeks

  • For diabetic retinopathy (disease of the retinas), 0.0375 grams of butcher’s broom extract (Fagorutin-Ruscus, Fink GmbH) has been given by mouth twice daily for three months.

  • For lymphedema (swelling due to excess fluid) of the upper arm, three capsules of Cyclo 3 Fort® have been given by mouth three times daily for 90 days.

  • For varicose veins, an unknown dose of Phlebodril® has been given by mouth for two weeks. Three capsules of Cyclo 3 Fort® have been given by mouth daily for approximately seven days.

Children (under 18 years old)

  • There is no proven safe or effective dose for butcher’s broom in children.

Safety

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

  • Avoid using in individuals with a known allergy or sensitivity to butcher’s broom, its parts, or members of the Ruscaceae family.

  • Butcher’s broom may cause contact dermatitis (skin inflammation) when applied to the skin.

Side Effects and Warnings

  • Although negative side effects are limited, individuals should speak with a qualified healthcare provider before using butcher’s broom.

  • Butcher’s broom may cause abdominal pain, contact dermatitis (skin inflammation), narrowing of blood vessels, nausea, and stomach or intestinal discomfort.

  • Butcher’s broom may interact with alpha-blockers, antidepressants, blood pressure-lowering agents, lithium, and monoamine oxidase inhibitors (MAOIs).

  • Butcher’s broom may cause narrowing of blood vessels, leading to high blood pressure. Caution is advised in people with high blood pressure or those experiencing benign prostate hyperplasia (prostate enlargement).

  • Use cautiously in people taking antidepressants, particularly lithium and MAOIs.

  • Avoid using butcher’s broom in pregnant or breastfeeding women or in children.

Pregnancy and Breastfeeding

  • There is currently a lack of scientific evidence on the use of butcher’s broom during pregnancy or breastfeeding.

Interactions

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

  • Butcher’s broom may cause narrowing of the veins, leading to an increased risk of high blood pressure when taken with drugs used to reduce blood pressure. Examples include the alpha-adrenergic antagonist drugs prazosin and terazosin.

  • Butcher’s broom may interact with alpha-blockers, antidepressants, diuretic agents (agents that increase urination), lithium, and monoamine oxidase inhibitors (MAOIs).

Interactions with Herbs and Dietary Supplements

  • Butcher’s broom may cause narrowing of the veins, leading to an increased risk of high blood pressure when taken with herbs or supplements that are used to reduce blood pressure.

  • Butcher’s broom may interact with antidepressant herbs or supplements and herbs or supplements that increase urination.

Author Information

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

  1. Archimowicz-Cyrylowska B. Clinical effect of buckwheat herb, Ruscus extract and troxerutin on retinopathy and lipids in diabetic patients. Phytotherapy Res 1996;10:659-662.
  2. Beltramino R, Penenory A, Buceta AM. An open-label, randomised multicentre study comparing the efficacy and safety of CYCLO 3 FORT versus hydroxyethyl rutoside in chronic venous lymphatic insufficiency. Int Angiol. 1999;18(4):337-342. View Abstract
  3. Bennani A, Biadillah MC, Cherkaoui A. Acute attack of hemorrhoids: Efficacy of. Cyclo 3 Fort® based on results in 124 cases reported by specialists. Phlebologie 1999;52:89-93.
  4. Boyle P, Diehm C, Robertson C. Meta-analysis of clinical trials of Cyclo 3 Fort in the treatment of chronic venous insufficiency. Int Angiol. 2003;22(3):250-262. View Abstract
  5. Cappelli R, Nicora M, Di Perri T. Use of extract of Ruscus aculeatus in venous disease in the lower limbs. Drugs Exp Clin Res 1988;14(4):277-283. View Abstract
  6. Cluzan RV, Alliot F, Ghabboun S, Pascot M. Treatment of secondary lymphedema of the upper limb with CYCLO 3 FORT. Lymphology 1996;29(1):29-35. View Abstract
  7. Lagrue G, Behar A, Chaabane A., and Laurent, J. Edema induced by calcium antagonists. Effects of Ruscus extract on clinical and biological parameters. In: Vanhoutte, P. M. Return Circulation and Norepinephrine: An Update. Paris: John Libbey Euretext;1991.
  8. Landa N, Aguirre A, Goday J, Raton JA, Diaz-Perez JL. Allergic contact dermatitis from a vasoconstrictor cream. Contact Dermatitis 1990;22(5):290-291. View Abstract
  9. MacKay D. Hemorrhoids and varicose veins: a review of treatment options. Altern Med Rev 2001;6(2):126-140. View Abstract
  10. Monteil-Seurin J. Efficacy of Ruscus extract in the treatment of the premenstrual syndrome. In: Vanhoutte, P. M. Return Circulation and Norepinephrine: An Update. Paris: John Libbey Euretext;1991.
  11. Parrado F, Buzzi A. A Study of the Efficacy and Tolerability of a Preparation Containing Ruscus aculeatus in the Treatment of Chronic Venous Insufficiency of the Lower Limbs. Clinical Drug Investigation, 1999;8(4):255.
  12. Redman DA. Ruscus aculeatus (butcher’s broom) as a potential treatment for orthostatic hypotension, with a case report. J Altern Complement Med 2000;6(6):539-549. View Abstract
  13. Rudofsky G. [Improving venous tone and capillary sealing. Effect of a combination of Ruscus extract and hesperidine methyl chalcone in healthy probands in heat stress]. Fortschr.Med 6-30-1989;107(19):52, 55-52, 58. View Abstract
  14. Vanscheidt W, Jost V, Wolna P, et al. Efficacy and safety of a Butcher’s broom preparation (Ruscus aculeatus L. extract) compared to placebo in patients suffering from chronic venous insufficiency. Arzneimittelforschung 2002;52(4):243-250. View Abstract
  15. Weindorf N, Schultz-Ehrenburg U. [Controlled study of increasing venous tone in primary varicose veins by oral administration of Ruscus aculeatus and trimethylhespiridinchalcone]. Z.Hautkr. 1-1-1987;62(1):28-38. View Abstract

The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.