Usage
- Eucalyptol is prescribed for symptomatic relief of cough and cold symptoms, and as a mucolytic to help thin and loosen mucus in the respiratory tract. It’s also used as a mild antiseptic. It has shown some efficacy in managing the symptoms of bronchitis, asthma, and inflammation of the throat. It can be used as a component of topical preparations for muscle aches and pains. In dentistry, it’s used as a solvent for gutta-percha during root canal procedures.
- Pharmacological Classification: Decongestant, Mucolytic, Antiseptic, Topical analgesic.
- Mechanism of Action: Eucalyptol acts on the respiratory tract by stimulating the secretory glands in the bronchial mucosa, thereby increasing fluid secretion and making the mucus less viscous and easier to expectorate. Its antiseptic properties may also help inhibit bacterial growth in the respiratory tract. As a topical agent, it provides a warming sensation and may act as a counterirritant, reducing pain perception.
Alternate Names
- 1,8-Cineole
- Cajeputol
- Cineole
How It Works
- Pharmacodynamics: Eucalyptol’s primary effect is to thin mucus secretions and facilitate expectoration. It can also reduce inflammation in the respiratory tract and exhibits some antiseptic activity. Topically, it causes vasodilation leading to a sensation of warmth.
- Pharmacokinetics: When ingested, eucalyptol is readily absorbed from the gastrointestinal tract. It’s metabolized in the liver, primarily by oxidation to hydroxycineole, which is then conjugated with glucuronic acid and excreted in urine. It can also be excreted in bile. When inhaled, it is absorbed through the lungs. Topical application leads to local absorption.
- Mode of Action: The precise mechanism of action of eucalyptol at the cellular level is not fully understood. Its mucolytic activity is thought to be due to its ability to stimulate the secretion of chloride ions into the airways, drawing water into the mucus and reducing its viscosity. Its antiseptic effect may be attributed to its ability to disrupt bacterial cell membranes. As a topical counterirritant, it may modulate pain signals through TRP channels.
- Elimination Pathways: Primarily renal excretion as glucuronide conjugates, some hepatic excretion.
Dosage
Standard Dosage
Adults:
- Oral: 100-200 mg, 2-5 times daily. Alternatively, 0.3-0.6 ml daily.
- Inhalation: A few drops in hot (not boiling) water for steam inhalation, repeated every 4 hours if needed.
- Topical: A few drops applied to the affected area and massaged in as needed.
Children:
- Oral administration to children under 2 years is not recommended.
- For children over 3 months, inhalation can be considered with careful monitoring: add one 5ml spoonful of a 2% menthol and 10% eucalyptus oil suspension to a pint of hot (not boiling) water for inhalation. Repeat every 4 hours, if needed.
- Topical application on children should be avoided, especially on the face or nose of a child under 2.
Special Cases:
- Elderly Patients: Dose adjustments may be needed based on renal and hepatic function.
- Patients with Renal Impairment: Dosage reduction may be necessary.
- Patients with Hepatic Dysfunction: Dosage reduction may be necessary.
- Patients with Comorbid Conditions: Caution is advised, especially with diabetes (eucalyptus may lower blood sugar) and asthma (inhalation may trigger bronchospasm).
Clinical Use Cases
- The provided sources do not offer specific dosage recommendations for clinical settings such as intubation, surgical procedures, mechanical ventilation, ICU use, or emergency situations.
Dosage Adjustments
- Dose adjustments should be considered in patients with renal or hepatic impairment, diabetes, or other metabolic disorders. Genetic polymorphisms affecting drug metabolism may also warrant dose modification.
Side Effects
Common Side Effects
- Skin irritation, redness, burning with topical use.
- Nausea, vomiting, diarrhea with oral ingestion.
Rare but Serious Side Effects
- Seizures, especially in children.
- CNS depression (drowsiness, dizziness, ataxia, coma).
- Respiratory depression, apnea, bronchospasm.
- Hypotension, arrhythmias.
- Allergic reactions (rash, itching, swelling, anaphylaxis).
- Multi-organ failure (in severe cases of overdose).
Long-Term Effects
- Chronic skin irritation with prolonged topical use.
Adverse Drug Reactions (ADR)
- Anaphylaxis.
- Respiratory arrest.
Contraindications
- Hypersensitivity to eucalyptol or other components of eucalyptus oil.
- Infants and young children (oral use and topical application on the face).
- Pregnancy and breastfeeding (safety is not established for anything beyond food amounts).
- Acute intermittent porphyria.
Drug Interactions
- Amphetamines: Eucalyptus may reduce amphetamine levels.
- Pentobarbital: Eucalyptus may reduce pentobarbital levels.
- Medications metabolized by CYP450 enzymes (CYP1A2, CYP2C19, CYP3A4): Eucalyptus may inhibit these enzymes, leading to increased levels of other drugs.
- Antidiabetic drugs: Eucalyptus may enhance the blood sugar-lowering effects of these medications.
- Alcohol: Concurrent use may potentiate CNS depressant effects.
Pregnancy and Breastfeeding
- Eucalyptus is likely safe for pregnant and breastfeeding women when consumed in food amounts. However, eucalyptus oil should be avoided. There is insufficient reliable information to determine the safety of eucalyptus oil during pregnancy or breastfeeding.
Drug Profile Summary
- Mechanism of Action: Mucolytic, antiseptic, topical counterirritant.
- Side Effects: Skin irritation, nausea, vomiting, diarrhea, seizures, CNS depression, respiratory depression, hypotension, allergic reactions.
- Contraindications: Hypersensitivity, infants, young children (oral and facial topical use), pregnancy, breastfeeding (beyond food amounts), acute intermittent porphyria.
- Drug Interactions: Amphetamines, pentobarbital, CYP450 substrates, antidiabetic drugs, alcohol.
- Pregnancy & Breastfeeding: Likely safe in food amounts; eucalyptus oil should be avoided.
- Dosage: See detailed dosage guidelines above.
- Monitoring Parameters: Respiratory rate, blood pressure, heart rate, blood glucose levels (in diabetics).
Popular Combinations
- Menthol: Often combined with eucalyptol in cough and cold remedies. Provides a cooling and soothing sensation.
Precautions
- General Precautions: Pre-existing respiratory conditions (asthma, COPD), liver or kidney disease, diabetes.
- Specific Populations: See above.
- Lifestyle Considerations: Avoid excessive alcohol intake.
FAQs (Frequently Asked Questions)
Q1: What is the recommended dosage for Eucalyptol?
A: See detailed dosage guidelines above.
Q2: Can children use eucalyptol?
A: Oral administration of eucalyptus oil is not recommended for children under 2 years old. Inhalation and topical use should be done with extreme caution and under medical supervision. Avoid applying on the face, especially in children under 2.
Q3: Is eucalyptol safe during pregnancy and breastfeeding?
A: Consuming eucalyptus in food amounts is considered safe during pregnancy and breastfeeding. However, eucalyptus oil, including oral ingestion, topical application, and inhalation, should be avoided during pregnancy and breastfeeding as its safety has not been established.
Q4: What are the serious side effects of eucalyptol?
A: Seizures, CNS and respiratory depression, hypotension, allergic reactions, and multi-organ failure are rare but serious side effects.
A: It is metabolized in the liver, mainly through oxidation to hydroxycineole, followed by glucuronidation. It’s primarily excreted in urine and some in bile.
Q6: Can eucalyptol interact with other medications?
A: Yes, it can interact with amphetamines, pentobarbital, drugs metabolized by CYP450 enzymes, antidiabetic medications, and alcohol. Consult the drug interaction section for details.
Q7: What precautions should be taken when using eucalyptol topically?
A: Avoid contact with eyes and mucous membranes. Dilute eucalyptus oil before applying to the skin, as undiluted oil can cause irritation. Avoid use on broken or damaged skin. Perform a patch test before widespread application to check for allergic reactions.
Q8: How should eucalyptol be stored?
A: Store in a cool, dry place, away from direct sunlight and out of reach of children. Keep the container tightly closed to prevent volatilization.
Q9: What should I do in case of suspected eucalyptol overdose?
A: Seek immediate medical attention. Supportive care may include gastric lavage, administration of activated charcoal, and management of seizures and respiratory depression.
