Honey-Based Medicinal Formulations: A Critical Review

Abstract

Honey, a concentrated natural product, is produced by honeybees (Apis mellifera) from the nectar of flowers. It contains over 200 compounds that exert various biological or pharmacological activities, ranging from antioxidant, anti-inflammatory, antimicrobial, and antihypertensive to hypoglycemic effects. Due to the presence of a plethora of bioactive compounds, as well as unique physicochemical properties, honey has been widely used as medicine throughout human history along with its extensive utilization as common food and flavoring agent. The application of neat honey for therapeutic purpose, however, poses some difficulties such as the maintenance of a required therapeutic concentration over an adequate timeframe due to the problem of liquefaction and leakage. This has driven researchers to incorporate honey into a range of formulations, for example, hydrogels, dressings, ointments, pastes, or lozenges. After a brief discussion of the chemistry and medicinal use of honey, this review focuses on commercial honey-based medicinal formulations as well as in vitro, in vivo, and clinical studies on noncommercial honey formulations for the treatment of various ailments. In addition to this, it also covers the application of honey formulations and the evidence underpinning their use.

Role of Honey in Advanced Wound Care

“…In clinical practice today, several honey-based wound-care commercial preparations in the form of gels, ointment, and dressings, are approved by the US Food and Drug Administration (FDA) and registered as medical devices [90]. Most of them are formulated with medical-grade Manuka honey, since it is one of the most studied varieties of honey in the world, and it was the first honey type to obtain the status of medical-grade honey.…”

“…However, there are also alternatives that use other types of honey, such as buckwheat, multifloral, and Revamil source honey, among others [8]. For instance, a honey-based gel formula can be prepared with 100 % medical-grade honey without the addition of other ingredient (Table 1) or can be mixed with other agents(s) such as natural emollients (e.g., lanolin, polyethylene glycol, glycerine, myristil myristrate) or different plant waxes and gelling agents [90]. The FDA-approved honey-based devices are indicated in the treatment of different types of wounds, such as low and moderate-to-heavy exuding wounds, diabetic foot ulcers, leg ulcers, pressure ulcers, burns, traumatic wounds, surgical wounds, chronic wounds, or colonized acute wounds, among other indications [18].…”

“…Moreover, the combined treatment with honey-based gels (L-Mesitran Soft) and ointment (L-Mesitran Ointment) has been successfully applied for treatment of infected ulcers in diabetics patients [19]. Indeed, the use of ointments help to entrap water, keep the skin moist, and provide an emollient protective film, which are all crucial elements for wound healing [19,90], while the layer of gel fights infections and optimizes wound healing [19,90].…”

Effects of the Carbohydrate Sources Nectar, Sucrose and Invert Sugar on Antibacterial Activity of Honey and Bee-Processed Syrups

“…Numerous commercial honey-based medicinal formulations recommended for the treatment of different disorders have exhaustedly been listed in a recent review [4]. The market of honey-based formulations grows continuously and, thus, a high demand for honey sources globally can be expected.…”

A Review of the Phytochemistry and Bioactivity of Clover Honeys (Trifolium spp.)

“…Honey products promote many beneficial human responses due to their bioactive constituents, including antimicrobial, antiviral, antioxidant, antiinflammatory and antidiabetic effects [2,3]. Honey is a highly complex mixture of at least 200 phytochemicals with its composition being strongly influenced by multiple factors, including its botanical and geographical origin, the bee species involved in its production, its age, method of storage and processing [4,5].…”