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Complementary and Alternative Medicine - Herb

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Feverfew

Also listed as: Tanacetum parthenium

Overview
Plant Description
What's It Made Of?
Medicinal Uses and Indications
Available Forms
 
How to Take It
Precautions
Possible Interactions
Supporting Research

Overview

Feverfew (Tanacetum parthenium), a member of the sunflower family, has been used for centuries in European folk medicine as a remedy for headaches, arthritis, and fevers. The name feverfew comes from a Latin word meaning "fever reducer."

Feverfew is used most often today to treat migraine headaches.

Plant Description

Native to southeastern Europe, feverfew is now widespread throughout Europe, North America, and Australia. Feverfew is a short perennial that blooms between July and October, and gives off a strong and bitter odor. Its yellow-green leaves are alternate (the leaves grow on both sides of the stem at alternating levels), and turn downward with short hairs. The small, daisy-like yellow flowers are arranged in a dense flat-topped cluster.

What's It Made Of?

Feverfew products usually contain dried feverfew leaves, but all parts of the plant that grow above ground may be used. Researchers thought a substance called parthenolide, which helps relieve spasms in smooth muscle tissue, was what made feverfew effective against migraines. However, after more studies researchers aren’t sure which part of the herb may best treat or prevent migraines. Parthenolide may also act as an anti-inflammatory and may inhibit cancer cell growth.

Medicinal Uses and Indications

Feverfew is used mostly to treat and prevent certain headaches.

Migraine Headaches

Feverfew was popular in Great Britain in the 1980s as an alternative treatment for migraine headaches. A survey of 270 people with migraines in Great Britain found that more than 70% of them felt much better after taking an average of 2 - 3 fresh feverfew leaves daily. Several human studies have used feverfew for migraine prevention and treatment. Overall, these studies suggest that taking dried leaf capsules of feverfew daily may reduce the number of migraines in people who have chronic migraines.

One study used a combination of feverfew and white willow (Salix alba), which contains aspirin-like chemicals. Participants who took the combination twice a day for 12 weeks had fewer migraines and they didn’t last as long or hurt as much.

Another study found that people who took a carbon dioxide extract of feverfew had fewer average number of migraine attacks per month compared to people who took placebo. A 3-month study with 49 people found that a combination of feverfew, magnesium, and vitamin B2 led to a 50% decrease in migraine attacks.

Not all studies have found that feverfew worked for migraines, however. Whether it reduces migraine pain and frequency may depend on which feverfew supplement you take. Talk to your health care provider.

Rheumatoid Arthritis

Some laboratory tests show that feverfew can reduce inflammation, so it has been proposed as a potential treatment for rheumatoid arthritis. But a human study found that feverfew was no better than placebo in improving rheumatoid arthritis symptoms.

Available Forms

Feverfew supplements are available fresh, freeze-dried, or dried. They can be purchased in capsule, tablet, or liquid extract forms. Feverfew supplements used in clinical studies contain a standardized dose of parthenolide. Feverfew supplements should be standardized to contain at least 0.2% parthenolide.

How to Take It

Pediatric

Don’t give feverfew to children under 2.

In older children, ask your doctor whether feverfew is appropriate for your child. Your doctor will determine the right dose.

Adult

For migraine headaches: Take 100 - 300 mg, up to 4 times daily, standardized to contain 0.2 - 0.4% parthenolides. Feverfew may be used to prevent or stop a migraine headache. Feverfew supplements may also be carbon dioxide extracted. For these, take 6.25 mg, 3 times daily, for up to 16 weeks.

For rheumatoid arthritis: 120 - 60 drops, 2 times daily of a 1:1 w/v fluid extract, or 60 - 120 drops 2 times daily of 1:5 w/v tincture.

Precautions

The use of herbs is a time-honored approach to strengthening the body and treating disease. Herbs, however, contain components that can trigger side effects and that can interact with other herbs, supplements, or medications. For these reasons, herbs should be taken with care, under the supervision of a health care provider qualified in the field of botanical medicine.

Side effects from feverfew can include abdominal pain, indigestion, gas, diarrhea, nausea, vomiting, and nervousness. Mouth ulcers, loss of taste, and swelling of the lips, tongue, and mouth may happen in some people who chew raw feverfew leaves. Rarely, allergic reactions to feverfew have also been reported. People with allergies to chamomile, ragweed, or yarrow may be allergic to feverfew and should not take it.

Feverfew may increase the risk of bleeding, especially if you take blood-thinning medications such as warfarin (Coumadin) or aspirin. Ask your doctor before taking feverfew if you take blood-thinners.

Pregnant and nursing women as well as children under 2 years of age should not take feverfew.

If you are scheduled for surgery, be sure to tell your doctor if you are taking feverfew. It may interact with anesthesia.

Do not abruptly stop taking feverfew if you have used it for more than 1 week. Stopping feverfew too quickly may cause rebound headache, anxiety, fatigue, muscle stiffness, and joint pain.

Possible Interactions

Feverfew may alter the effects of some prescription and nonprescription medications. If you are currently being treated with any of the following medications, you should not use feverfew without first talking to your health care provider.

Blood-thinning medications -- Feverfew may increase the risk of bleeding. Ask your doctor before taking feverfew if you take blood-thinners such as warfarin (Coumadin) or aspirin.

Medications metabolized by the liver -- Feverfew can interact with some medications that are processed by the liver. If you take any prescription medications, ask your doctor before taking feverfew.

Supporting Research

Chen CF, Leung AY. Gene response of human monocytic cells for the detection of antimigraine activity of feverfew extracts. Can J Physiol Pharmacol. 2007;85(11):1108-15.

Curry EA 3rd, Murry DJ, Yoder C, et al., Phase I dose escalation trial of feverfew with standardized doses of parthenolide in patients with cancer. Invest New Drugs. 2004;22(3):299-305.

De Weerdt CJ, Bootsma HPR, Hendriks H. Herbal Medicines in migraine prevention. Randomized double-blind placebo controlled crossover trial of a feverfew preparation. Phytomedicine. 1996;3:225–230.

Diener HC, Pfaffenrath V, Schnitker J, Friede M, Henneicke-von Zepelin HH. Efficacy and safety of 6.25 mg t.i.d. feverfew CO2-extract (MIG-99) in migraine prevention -- a randomized, double-blind, multicentre, placebo-controlled study. Cephalalgia. 2005;25(11):1031-41.

Ernst E, Pittler MH. The efficacy and safety of feverfew (Tanacetum parthenium L.): an update of a systematic review. [Review] Public Health Nutr. 2000;3(4A):509-514.

Evans RW, Taylor FR. "Natural" or alternative medications for migraine prevention. Headache. 2006;46(6):1012-8.

Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm. 2000;57(13):1221-1227.

Henneicke-von Zepelin HH. Feverfew for migraine prophylaxis. Headache. 2006;46(3):531

Johnson ES, Kadam NP, Hylands DM, Hylands PJ. Efficacy of feverfew as prophylactic treatment of migraine. Br Med J. 1985;291:569–573.

Klepser TB, Klepser ME. Unsafe and potentially safe herbal therapies. Am J Health Syst Pharm. 1999;56(2):125-138; quiz 139-141.

Lesiak K, Koprowska K, Zalesna I, Nejc D, Düchler M, Czyz M. Parthenolide, a sesquiterpene lactone from the medical herb feverfew, shows anticancer activity against human melanoma cells in vitro. Melanoma Res. 2010 Feb;20(1):21-34.

Maizels M, Blumenfeld A, Burchette R. A combination of riboflavin, magnesium, and feverfew for migraine prophylaxis: a randomized trial. Headache. 2004;44(9):885-90.

Martin K, et al. Parthenolide-depleted Feverfew (Tanacetum parthenium) protects skin from UV irradiation and external aggression. Arch Dermatol Res. 2008;300(2):69-80.

Mauskop A. Alternative therapies in headache. Is there a role? [Review] Med Clin North Am. 2001;85(4):1077-1084.

Miller L. Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Arch Intern Med. 1998;158(20):2200-2211.

Murphy JJ, Heptinstall S, Mitchell JR. Randomised double-blind placebo-controlled trial of feverfew in migraine prevention. Lancet. 1988;2:189-192.

Palevitch D, Earon G, Carasso R. Feverfew (Tanacetum parthenium) as a prophylactic treatment for migraine: a double-blind controlled study. Phytotherapy Res. 1997;11:508-–511.

Pattrick M, Heptinstall S, Doherty M. Feverfew in rheumatoid arthritis: a double-blind, placebo controlled study. Ann Rheum Dis. 1989;48:547-549.

Pfaffenrath V, Diener HC, Fischer M, et al. The efficacy and safety of Tanacetum parthenium (feverfew) in migraine prophylaxis--a double-blind, multicentre, randomized placebo-controlled dose-response study. Cephalalgia. 2002;22(7):523-532.

Pittler MH, Vogler BK, Ernst E. Feverfew for preventing migraine. [Review] Cochrane Database Syst Rev. 2000;(3):CD002286.

Schiapparelli P, Allais G, Castagnoli Gabellari I, Rolando S, Terzi MG, Benedetto C. Non-pharmacological approach to migraine prophylaxis: part II. Neurol Sci. 2010 Jun;31 Suppl 1:S137-9. Review.

Shrivastava R, Pechadre JC, John GW. Tanacetum parthenium and Salix alba (Mig-RL) combination in migraine prophylaxis: a prospective, open-label study. Clin Drug Investig. 2006;26(5):287-96.

Silberstein SD. Preventive treatment of headaches. Curr Opin Neurol. 2005;18(3):289-92.

Won YK, Ong CN, Shi X, Shen HM. Chemopreventive activity of parthenolide against UVB-induced skin cancer and its mechanisms. Carcinogenesis. 2004;25(8):1449-58.

Wu C, Chen F, Rushing JW, Wang X, Kim HJ, Huang G, Haley-Zitlin V, He G. Antiproliferative activities of parthenolide and golden feverfew extract against three human cancer cell lines. J Med Food. 2006;9(1):55-61.

Yao M, Ritchie HE, Brown-Woodman. A reproductive screening test of feverfew: is a full reproductive study warranted? Reprod Toxicol. 2006;22(4):688-93.

Zhang S, Lin ZN, Yang CF, Shi X, Ong CN, Shen HM. Suppressed NF-kappaB and sustained JNK activation contribute to the sensitization effect of parthenolide to TNF-alpha-induced apoptosis in human cancer cells. Carcinogenesis. 2004;25(11):2191-9.


Review Date: 12/13/2010
Reviewed By: Steven D. Ehrlich, NMD, Solutions Acupuncture, a private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.
The information provided herein should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed medical professional should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Links to other sites are provided for information only -- they do not constitute endorsements of those other sites. © 1997- A.D.A.M., Inc. Any duplication or distribution of the information contained herein is strictly prohibited.
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