What is it?

Khella is an herbal medicine that has been used in the treatment of colic, painful menstruation, angina (chest pain), asthma, psoriasis, vitiligo (unpigmented white patches on skin), atherosclerosis, and high cholesterol levels.

Other names for Khella include: Ammi Visnaga, Ammi, Bishop's Weed, Khellin, Visnaga, and Visnagin.

Ask your doctor, nurse, or pharmacist if you need more information about this medicine or if any information in this leaflet concerns you.

Before Using:

Tell your doctor if you

• are taking medicine or are allergic to any medicine (prescription or over-the-counter (OTC) or dietary supplement)
• are pregnant or plan to become pregnant while using this medicine
• are breastfeeding
• have any other health problems, such as high blood pressure or heart or blood vessel disease

Dosage:

Talk with your caregiver about how much Khella you should take. The amount depends on the strength of the medicine and the reason you are taking Khella. If you are using this medicine without instructions from your caregiver, follow the directions on the medicine bottle. Do not take more medicine or take it more often than the directions tell you to.

To store this medicine:

Keep all medicine locked up and away from children. Store medicine away from heat and direct light. Do not store your medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down and not work the way it should work. Throw away medicine that is out of date or that you do not need. Never share your medicine with others.

Drug and Food Interactions:

Do not take Khella without talking to your doctor first if you are taking:

• Digoxin (Lanoxin(R))

Warnings:

• Before taking Khella, tell your doctor if you are pregnant or breastfeeding
• Cancer of the skin is possible with the use of Khella (1)
• Elevated liver enzymes or permanent jaundice (yellow color to skin) can occur with use of Khella (1)
• Avoid prolonged exposure to sunlight (17)

Side Effects:

Stop taking your medicine right away and talk to your doctor if you have any of the following side effects. Your medicine may be causing these symptoms which may mean you are allergic to it.

• Breathing problems or tightness in your throat or chest
• Chest pain
• Skin hives, rash, or itchy or swollen skin

Other Side Effects:

You may have the following side effects, but this medicine may also cause other side effects. Tell your doctor if you have side effects that you think are caused by this medicine.

• Skin rashes, sleeplessness, dizziness, headache, loss of appetite (hunger), upset stomach, constipation, diarrhea, and vomiting have all been reported (1,10,18)

References:

1. Fetrow C & Avila J: Professional's Handbook of Complementary and Alternative Medicines. Springhouse Corporation, Springhouse, PA;1999.

2. Conn JJ, Kissane RW, Koons RA et al: Treatment of angina pectoris with khellin. Part I. Ann Int Med 1952; 36:1173-1178.

3. Osher HL, Katz KH, Wagner DJ et al: Khellin in the treatment of angina pectoris. N Engl J Med 1951;244:315-321.

4. Anrep GV, Kenawy MR & Darsoum GS: Coronary vasodilator action of khellin. Am Heart J 1949;37:531-542.

5. Conn JJ, Kissane RW, Koon RA et al: Treatment of angina pectoris with Khellin. Part II. Ann Int Med 1953;38:23-27.

6. Armburst CA, Levine SA: Treatment of angina pectoris with preparations of khellin (Ammi visnage). Am J Med Sci 1950; 220:127-132.

7. Werbach MR & Murray MT: Botanical influences on Illness: a sourcebook of clinical research. Third Line Press, Tarzana, CA; 1994.

8. Ortel B, Tanew A, Honigsmann H: Treatment of vitiligo with khellin and ultraviolet A. J am Acad Dermatol 1988;18(4 Pt 1):693-701.

9. Abdel-Fattah A,Aboul-Enein MN, Wassel GM et al: An approach to the treatment of vitiligo by khellin. Dermatologica 1982;165(2):136-140.

10. Morliere P, Honigsmann H, Averbeck D, et al: Phototherapeutic, photobiologic, and photosensitizing properties of khellin. J Invest Dermatol 1988;90(5):720-724.

11. Tritrungtasna O, Jerasutus S, Suvanprakorn P et al: Treatment of alopecia areata with khellin and UVA. Int J Dermatol 1993; 32(9):690.

12. Weiss RF: Herbal Medicine. Beaconsfield Publishers Ltd., Beaconsfield, England; 1988: 179, 221-222.

13. Harvengt C & Desager JP: HDL-cholesterol increase in normolipaemic subjects on khellin: a pilot study. Int J Clin Pharm Res III 1983; III(5):363-366.

14. Abdel-Fattah A, Aboul-Enein MN, Wassel G et al: Preliminary report on the therapeutic effect of khellin in psoriasis. Dermatol 1983; 167(2):109-110.

15. Orecchia G & Giordano F: A new preparation of khellin in the topical treatment of vitiligo. J Invest Dermatol 1996; 106(4):944.

16. Farnsworth NR, Bingel AS, Cordell GA et al: Potential value of plants as sources of new antifertility agents I. J Pharm Sci 1975; 64(4):535-598.

17. Hudson J & Towers GHN: Phytomedicines as antivirals. Drugs Fut 1999; 24(3):295-320.

18. Rosenman RH, Fishman AP, Kaplan SR et al: Observations on the clinical use of visammin (khellin). JAMA 1950; 143(2):160-165.

19. Morliere P, Honigsmann H, Averbeck D et al: Phototherapeutic, photobiologic, and photosensitizing properties of khellin. J Invest Dermatol 1988; 90(5): 720-724.

20. Varonos DD, Voukydes PC & Nikitopoulou: Digitoxin antagonism by visnadin. J Pharm Sci 1962; 51(10):1013-1014.

21. Varonos DD, Voukydes PC & Nikitopoulou: Digitoxin antagonism by visnadin. J Pharm Sci 1962; 51(10):1013-1014.