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Uzara root extract is a botanical drug derived from the dried underground parts of the South African plant *Xysmalobium undulatum*. It is primarily used for the treatment of acute nonspecific diarrhea and has been investigated for primary dysmenorrhea. The extract contains cardiac glycosides, such as uzarin and xysmalorin, which differ from digitalis glycosides by exerting an antispasmodic effect on smooth muscle rather than a cardiotonic effect at therapeutic doses. Its primary biological mechanism involves the inhibition of visceral smooth muscle motility, similar to papaverine, and the inhibition of active chloride secretion in the intestinal lumen. Traditionally used by native South Africans for digestive and urogenital complaints, it is approved by Commission E for diarrhea. Clinical development for dysmenorrhea has been conducted by Ain Shams University Maternity Hospital in Egypt.
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