Honey

(USAN, rINN)
Synonyms: Clarified Honey; Gereinigter Honig; Honung; Hunaja; Madu; Med; Medus; Mel; Mel Depuratum; Mel Despumatum; Miel; Miel Blanc; Miel purificada; Purified Honey; Strained Honey.
Cyrillic synonym: Мёд.

💊 Chemical information

Pharmacopoeias.

In Chin., Eur., and Jpn. Also in USNF.

Ph. Eur. 6.2

(Honey; Mel). It is produced by bees (Apis mellifera) from the nectar of plants or from secretions of living parts of plants, which the bees collect, transform by combining with specific substances of their own, deposit, dehydrate, store, and leave in the honey comb to ripen and mature. If the bee has been exposed to treatment to prevent or cure diseases or to any substance intended for preventing, destroying, or controlling any pest, unwanted species of plants or animals, appropriate steps are taken to ensure that the levels of residues are as low as possible. It is an almost white to dark brown, viscous liquid which may be partly crystalline.

USNF 26

(Purified Honey). It is obtained by purification of honey from the comb of the bee, A. mellifera and all subspecies of A. mellifera. The honey is extracted by centrifugation, pressure, or other suitable procedures. Specific gravity 1.400 and 1.435 at 20°. Store in airtight containers. It is not intended for infants under one year of age unless it is free from Clostridium spp.

💊 Profile

Honey, which contains about 70 to 80% of glucose and fructose, is used as a demulcent and sweetening agent, especially in linctuses and cough mixtures. Preparations containing honey are used in the management of skin ulcers, wounds, and burns.

Contamination.

Honey has been identified as a source of Clostridium botulinum spores and thus recommendations have been made that honey should not be given to infants under 1 year because of the risk of causing infant botulism.1,2 Honey produced from certain species of Rhododendron plants has been found to contain grayanotoxins. Grayanotoxin I is responsible for honey poisoning, manifest as bradycardia, cardiac arrhythmias, hypotension, gastrointestinal disturbances, dizziness, loss of consciousness, blurred vision, chills, cyanosis, sweating, and salivation.3,4 Convulsions have also been reported.4
1. Arnon SS, et al. Honey and other environmental risk factors for infant botulism. J Pediatr 1979; 94: 331–6
2. Tanzi MG, Gabay MP. Association between honey consumption and infant botulism. Pharmacotherapy 2002; 22: 1479–83
3. Özhan H, et al. Cardiac emergencies caused by honey ingestion; a single centre experience. Emerg Med J 2004; 21: 742–4
4. Dilber E, et al. A case of mad honey poisoning presenting with convulsion: intoxication instead of alternative therapy. Turk J Med Sci 2002; 32: 361–2.

Wounds.

Anecdotal reports and traditional usage dating back to ancient Egypt suggest that honey may be of some value as a wound dressing. Its antibacterial properties are attributed both to high osmolality and the liberation of hydrogen peroxide, but may vary with the source:1-4 in Europe, some of the best activity has been seen with lime-flower honey.2 Sterilised manuka honey was reported to heal a leg ulcer infected with meticillin-resistant Staphylococcus aureus,5 although a randomised open-label study found no evidence that dressings impregnated with manuka honey improved the healing of venous leg ulcers at 12 weeks compared with usual care.6 In a preliminary study, honey obtained from the tea plant significantly reduced the incidence of grade 3 and 4 radiation-induced oral mucositis.7 A group from India8 has reported that the properties of honey offer a potentially simple and cheap means of preserving skin grafts in developing countries, with 100% uptake of reconstituted grafts stored for up to 6 weeks and 80% uptake of those stored for 7 to 12 weeks. In comparison with sulfadiazine silver, occlusive honey dressings were also found to be more effective for the treatment of superficial partial thickness thermal burns.9 However, concern has been expressed since honey may contain not only chemical contaminants but clostridial spores (see also above), and it has been suggested2 that to be medically acceptable, honey must be sterile, residue-free, and of measured antibacterial activity. Sugar has been used similarly to honey in treating wounds.
1. Greenwood D. Honey for superficial wounds and ulcers. Lancet 1993; 341: 90–1
2. Postmes T, et al. Honey for wounds, ulcers, and skin graft preservation. Lancet 1993; 341: 756–7
3. Molan PC. Re-introducing honey in the management of wounds and ulcers - theory and practice. Ostomy Wound Manage 2002; 48: 28–40
4. Booth S. Are honey and sugar paste alternatives to topical antiseptics? J Wound Care 2004; 13: 31–3
5. Natarajan S, et al. Healing of an MRSA-colonized, hydroxyureainduced leg ulcer with honey. J Dermatol Treat 2001; 12: 33–6
6. Jull A, et al. Honey as Adjuvant Leg Ulcer Therapy trial collaborators. Randomized clinical trial of honey-impregnated dressings for venous leg ulcers. Br J Surg 2008; 95: 175–82
7. Biswal BM, et al. Topical application of honey in the management of radiation mucositis: a preliminary study. Support Care Cancer 2003; 11: 242–8
8. Subrahmanyam M. Storage of skin grafts in honey. Lancet 1993; 341: 63–4
9. Subrahmanyam M. A prospective randomised clinical and histological study of superficial burn wound healing with honey and silver sulfadiazine. Burns 1998; 24: 157–61.

💊 Preparations

Proprietary Preparations

Austral.: Antibacterial Honey Barrier; Ital.: Oramil; Neth.: Melrosum; UK: Medihoney Antibacterial Wound Gel; Mesitran. Multi-ingredient: Arg.: Expectosan Hierbas y Miel; Austral.: Logicin Natural Lozenges†; Braz.: Calmatoss†; Elixir de Inhame†; Expectomel; Melagriao; Melxi†; Peitoral Martel†; Canad.: Mielocol; Chile: Fray Ro mano; Jarabe Palto Compuesto con Miel Adulto; Jarabe Palto Compuesto con Miel Infantil; Mielax; Mielito; Paltomiel; Paltomiel Plus; Pulmosina; Fr.: Feromiel; Taido; Indon.: Pectum; Sirec; Irl.: Venos Honey & Lemon; Ital.: Alvear con Ginseng; Apiserum con Telergon 1; Bebimix; Bioton; Fon Wan Eleuthero†; Fon Wan Ginsenergy; Liozim; Nepiros; Nerex; Nutrigel†; Pollingel Ginseng†; Mex.: Guayalin-Plus†; NZ: Lemsip Dry Cough†; Robitussin Honey Cough; Pol.: Babicum; Rus.: Bronchicum Husten (Бронхикум Сироп от Кашля); S.Afr.: Choats Extract of Lettuce Cough Mixture; Enzian Anaemodoron Drops; Switz.: Neo-Angin au miel et citron; UK: Adult Meltus for Chesty Coughs & Catarrh; Beehive Balsam; Buttercup Syrup (Honey and Lemon flavour); Herb and Honey Cough Elixir; Honey & Molasses; Jackson’s Lemon Linctus; Jackson’s Troublesome Coughs; Lemsip Cough & Cold Dry Cough; Lockets; Lockets Medicated Linctus; M & M; Meltus Expectorant; Meltus Honey & Lemon; Potters Children’s Cough Pastilles; Potters Gees Linctus; Regina Royal Five; Sanderson’s Throat Specific; Throaties Pastilles; Venos Honey & Lemon; Zubes Honey & Lemon; Venez.: Jengimiel; Jengimiel Sabila; Perebron con Miel†.
Published January 04, 2019.