NATURAL PRODUCTS

Feverfew

Feverfew (Tanacetum parthenium) has several actions that have made it useful as a natural product alternative to standard drug therapy.   Its uses include treatment of migraine headache, arthritis, rheumatic diseases, and allergies.  The allergy component is interesting, because it is possible to be allergic to any component of the feverfew extract or any other natural product.  Animal studies have revealed that feverfew can interfere with platelet aggregation (clotting), histamine release, and prostaglandin production by interfering with arachidonic acid production.

Prostaglandins are involved with many actions in the body, but most notably they are cytoprotective, and have actions in pain response, inflammation, and uterine contractions.  Since feverfew inhibits prostaglandin production, it has the potential to augment the antiinflammatory action and side effects of nonsteroidal antiinflammatory drugs (NSAIDs) like Motrin, Naprosyn, Advil, and aspirin, which are also prostaglandin inhibitors.  Clinical studies will be needed to know whether feverfew will have similar effects with the new COX-2 cyclooxygenase inhibitors for arthritis, like Vioxx and Celebrex, which are also classified as NSAIDs.  Feverfew should also be avoided in pregnancy, because prostaglandins, primarily PGF2, are active components in uterine contractions.

People with kidney disease must exercise caution when taking any NSAID drugs, because blocking prostaglandin production and cyclooxygenase may further worsen kidney function and lead to retention of water, sodium, and potassium.  This is one reason most NSAID drugs are sold by prescription only and why the manfuacturer's directions and warnings on over-the-counter NSAID drugs should be followed.   Feverfew use may worsen the already compromised kidney function in such patients.  All people with kidney disease should talk with their physician, prior to using feverfew.

Feverfew also inhibits serotonin release and it is postulated that this effect is responsible for its action in treating migraine headaches.   Unfortunately, studies have reported that a rebound headache can occur when feverfew is discontinued in some people.  Although, not studied, there is the potential that feverfew can interact with many prescription drugs that affect serotonin release or reuptake in the brain.  Such drugs include, selective serotonin reuptake inhibitors for depression, like Prozac, Paxil, Zoloft, Celexa, Serzone, and Effexor.

Due to its interference with blood clotting (inhibition of Thromboxane A2), feverfew should be avoided with any drug that is used to modify blood clotting and platelet function.  Such drugs are commonly used to prevent stroke, heart attack, pulmonary embolism, deep venous thrombosis, and intermittent claudication (pain in the lower legs, especially when walking, due to insufficient blood flow).  A partial list of drugs in these categories to avoid are: Coumadin, Plavix, Persantine, Pletal (possibly), Ticlid, Aspirin, Trental, and NSAIDs like Motrin, Naprosyn, Advil, and Aleve.  Using feverfew with these drugs can potentially lead to an increased tendency to bleed.

Of critical importance, however, is that feverfew should be avoided in people with hemophilia A, hemophilia B, and Von Willebrand disease, because it can potentially lead to an uncontrolled bleed that may require an immediate infusion of blood factors.

The dosage of Feverfew has a wide range (50 - 1,200 mg daily) of the powdered leaf.  Consequently, there is no standard dose for everybody.  Even though a manufacturer may state that their Feverfew is standardized, the appropriate dose is still questionable with such a wide dosage range reported in the literature.

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Legal Info:  Solumedia is not responsible for errors or omissions.  The information provided on the natural product pages is only a guideline based on current literature and the pharmacological action of these products.  It should not be used as the sole source of information on these products.  Many of the drug interactions listed are not found in current literature but are based on likely interactions due to the actions of the interacting drugs.  It is recommended that a qualified and licensed healthcare professional be consulted for additional information.  Although the information provided is from reliable sources, Solumedia has no liability.  This information is provided only as a service.

This page was last updated on 04/29/05.