Concern With Taking Cissus Quadrangularis Before Surgery
In our latest question and answer, the pharmacist discusses concerns a reader has regarding a supplement containing Cissus quadrangularis.
Hello, I have been taking Osteo MD to help with the prevention of osteoporosis. It has the ingredient Calzbone which is made from cissus quadrangularis. I take the recommended dose, which would be 750mg of the Calzbone, but I am having sinus surgery in 2 days and now am worried if this will affect blood clotting. I am not on any blood thinners, not even aspirin. I am letting the doctor know, but as a pharmacist, are there any concerns I should have now? I don't want to have to reschedule the surgery if I don't have to. Thanks.
May 06, 2024- Cissus quadrangularis appears to be well tolerated with little evidence of clinically significant interactions with most medications or effects on blood coagulation.
- You should speak with your surgeon before surgery to get their specific instructions about what is safe to take before your procedure.
Answer
Thank you for reaching out to us!
Calzbone, one of the ingredients in 'Osteo MD' is a patented extract of 'Cissus quadrangularis', a vine that belongs to the grape family.
Dietary supplements containing Cissus quadrangularis are marketed for a wide variety of conditions, including supporting weight loss and bone health.
Calzbone, in particular, has been studied for its effects on bone fracture healing time.
One study, published in the journal 'Antiseptic,' although very small (I've included the reference at the end of this answer), reported that Calzbone, 250 mg orally three times daily, decreased the average fracture healing time of long bones of the leg from 16-20 weeks to 12-14 weeks. Again, this was a small study, but it at least shows some potential as a positive measure for healing fractures.
Calzbone (Cissus Quadrangularis) Interactions
I could find little evidence of clinically significant interactions between Cissus quadrangularis and prescription medications. Additionally, it appears to be very well tolerated based on the studies I reviewed. It has been reported to cause some minor gastrointestinal issues as well as insomnia, but the rates of these side effects were essentially the same, or less, than what was reported in those taking a placebo. I did not see any reports of bleeding.
Our own herbal interaction checker only lists interactions with antidiabetic agents. For example, we list an interaction between Cissus quadrangularis and Januvia (an antidiabetic drug) based on the fact that Cissus quadrangularis may lower blood sugar (which could have additive effects when combined with other antidiabetic agents).
Based on my research, I did not see any evidence that Cissus quadrangularis affects blood coagulation or would be a concern prior to having sinus surgery. Having said that, there is certainly only very limited data to go off of, so I strongly suggest talking to your surgeon regarding instructions pre-surgery. They should provide clear instructions regarding what is, and is not, safe to take before surgery.
Final Words
Thank you again for your question, and I hope you found this helpful.
References & sources
- Effect of herbal combination containing cissus quadrangularis in fracture healing. The Antiseptic 2002;99(9):345-347.
- Clinical evaluation of Cissus quadrangularis as osteogenic agent in maxillofacial fracture: A pilot study — PubMed
- The use of a Cissus quadrangularis formulation in the management of weight loss and metabolic syndrome — PubMed
Glossary — Terms in This Answer
- Cissus quadrangularis
- A vine plant from the grape family whose extract is used in dietary supplements for various health purposes.
- Dietary supplements
- Products containing vitamins, minerals, herbs, or other ingredients intended to supplement the diet and support health.
- Patented extract
- A specially prepared concentrated form of a plant ingredient that is legally protected by a patent.
- Fracture healing time
- The length of time it takes for a broken bone to repair and become strong again.
- Antidiabetic agents
- Medications used to lower blood sugar levels in people with diabetes.
- Blood coagulation
- The process by which blood clots to stop bleeding.
- Gastrointestinal
- Related to the stomach and digestive system.
- Additive effects
- When two substances combined produce a stronger effect than either one would produce alone.
Dr. Brian Staiger, PharmD
Doctor of Pharmacy, board certified clinical pharmacist (BCPS), American Herbalist Guild, Medication Therapy Management certified
Brian Staiger, PharmD, BCPS, is a licensed pharmacist with more than 13 years of experience across retail pharmacy, clinical pharmacy, medication safety, pharmacy program development, and healthcare administration. He is the founder of HelloPharmacist.com, where he helps patients...
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