| Due to the pharmacology, speculative theories suggest that feverfew should not be consumed with anticoagulants or antiplatelet agents like aspirin or warfarin (Brinker, 2001; Bratman and Kroll, 1999). However, these theories have not been proven in a clinical or scientific setting (Boon and Smith, 1999).
American Herbal Products Association (AHPA) Safety Rating
Class 2b: Not to be used during pregnancy (McGuffin et al, 1997). NOTE: Mouth ulceration and gastric disturbances have been reported in 6-15% of users, usually in the first week of use (McGuffin etal, 1997). |
Francois Couplan, Ph.D.
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 Tanacetum p.), feverfew - originally from S. Eur. & W Asia. The aromatic but bitter flower heads are made into tea and reportedly used as a flavoring for wines and pastries.
The plant contains an essential oil and a bitter principle.
It is stimulant, carminative, stomachic and emmenagogue. feverfew i; sometimes employed instead of chamomile.
The flowers have also been used as an insecticide like those of pyrethrurr (C. cinerariaefolium = Tanacetum cinerariifolium).
C. segetum, corn chrysanthemum - naturalized from Eurasia. |
Mark Blumenthal
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 Many commercial feverfew preparations are standardized based on parthenolide content (0.1% [French regulatory authorities] to 0.2% [Canadian authorities] are suggested as minimum contents for quality control purposes) (Bruneton, 1999; Evans, 1998). However, different commercial preparations can vary widely in parthenolide content depending upon the geographical location from which the seeds were derived, the vegetative cycle of the plant at the time of harvest, the parts of the plant used, and the duration and conditions of storage (Bruneton, 1999; Evans, 1998; Heptinstall, 1992). |
The Life Extension Editorial Staff
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 In addition, feverfew contains apigenin (a flavonoid) and melatonin, both COX-2 inhibitors (Mutch et al. 1997). An intriguing revelation is that the same COX-2-inhibiting hormone expressed by the pineal gland in the brain is also found in a few plants (Hattori et al. 1995).
Researchers at Childten's Hospital Medical Center (Cincinnati, OH) recently explained another of par-thenolide's anti-inflammatory traits: its ability to inhibit NF-kB, the parent of a number of potentially damaging cytokines (Sheehan et al. 2002). |
Gary Null, Ph.D.
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 Results showed an association between feverfew intake and a reduced severity of migraine attacks and degree of vomiting.
—J.J. Murphy, et al., "Randomised Double-blind Placebo-controlled Trial of feverfew in
Migraine Prevention," Lancet, 2(8604), July 23, 1988, p. 189-192.
¦ FLAX
Cancer
Results of this study showed that 4 weeks of flaxseed flour feeding or defatted flaxseed meal (5% or 10%) in a high-fat diet to male rats led to a significant decrease in the formation of aberrant crypts and foci, and epithelial cell proliferation in the colon. |
Janet Zand, LAc, OMD, Allan N. Spreed, MD, CNC, James B. LaValle, RPh, ND
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 Taken regularly, this herb can ward off migraines. feverfew is a documented preventive, but its effects are cumulative. Don't expect immediate relief. Take 150 milligrams of freeze-dried feverfew-leaf extract or 200 to 400 milligrams of the herb two to three times daily. Allow sufficient time for the effects to build.
Note: Do not use this herb if you are allergic to plants in the daisy family.
¦ Ginger and/or peppermint tea is helpful for either a tension or a migraine headache that is located in the front of the head. |
the Editors of PREVENTION
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 For red, swollen eyes caused by allergies, this hefty dose of feverfew can bring some much-needed relief, says C. Leigh Broadhurst, Ph.D., a nutrition consultant and herbalist based in Clovery, Maryland. Since this is a heavy dose, you should use it only when you need immediate relief, she says, and then only for a few days. If your allergies are less severe, however, take one capsule of feverfew extract three times a day or one to two cups of tea daily. |
Heather Boon, BScPhm, PhD and Michael Smith, BPharm, MRPharmS, ND
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 Note: For optimal results in the management of recurrent migraines, it is advisable to that feverfew be taken continuously for a minimum of 4-6 weeks. |
| Current Medicinal Use
While not conclusive, results from a number of clinical trials show that feverfew extracts standardized to parthenolide content may be effective in preventing migraines.9 Claims for its activity in managing arthritis conditions have not been substantiated.
Relevant Research
Preventative and Therapeutic Effects
CONSTITUENTS3 810
þ sesquiterpene lactones: germacranolides (including parthenolide, artemorin and chrysan-themonin), eudesmanolides (including santamarin, reynosin and magnolialide) and guaianolides (including chrysartemin A, partholide and chrysanthemolide). |
| Dried Aerial Parts: 50-200 mg daily
þ Tincture (1:5 in 25% ethanol): 5-20 drops daily
Note: For optimal results in the management of recurrent migraines, it is advisable that feverfew be taken continuously for a minimum of 4-6 weeks.
Introduction
Family
þ Asteraceae (also known as Compositae)
Synonyms
þ Featherfew
þ Featherfoil
þ Motherherb
þ Flirtwort
þ Midsummer daisy
þ Pyrethrum
þ Febrifuge plant
þ Altamisa
þ Chrysanthemum parthenium (L.) Bernh.
þ Leucanthemum parthenium (L. |
| German chamomile, feverfew) have been shown to have allergic potential.25 Calendula should be used with caution in pregnancy due to a reputed action on the menstrual cycle.2
DRUG INTERACTIONS
None reported; however, calendula has been noted to extend the duration of action of hexo-barbitol in rats.1 The implication to pharmacy practice is unknown.
DOSAGE REGIMENS Internal
þ dried florets: 1-4 g (infusion) three times daily.2
þ tincture (1:5,90% alcohol): 0.3-1.2 mL three times daily.2
þ liquid extract (1:1 in 40% alcohol): 0.5-1.0 mL three times daily. |
Bill Gottlieb
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 In the 1980s, several British studies proclaimed feverfew's ability to reduce the severity and frequency of migraine headaches. Scientists believe that parthenolide, one of the active ingredients of feverfew, inhibits the release of serotonin and prostaglandin, hormones that may trigger migraines.
Garlic. Ancient Egyptians were serious garlic fans. They fed the odoriferous bulb to their slaves to keep them healthy. Now research shows that garlic can lower blood pressure and blood cholesterol levels and may even help heart attack survivors live longer. |
Heather Boon, BScPhm, PhD and Michael Smith, BPharm, MRPharmS, ND
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| Following a one-month single-blind placebo run-in, the volunteers were given either 1 capsule of feverfew daily (mean weight 82mg equivalent to 2.19 mmol parthenolide) or placebo. The treatment was continued for 4 months and patients were then transferred to the other option. Conventional migraine medications were stopped at the beginning of the trial. A symptom diary was used to record number and duration of individual attacks, severity of headache and any associated symptoms. |
Ray Strand, M.D.
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 Herbal medicines to avoid while taking Coumadin are angelica root, anise, borage-seed oil, devil's claw, papain, ginseng, ginger, ginkgo, horse chestnut, alfalfa, red clover, clove oil, feverfew, passionflower herb, salvia root (danshen), willow bark, cinchona bark, turmeric, garlic, coquinone, and dong quai.
Occasionally patients on Coumadin suffer a serious adverse drug reaction, possibly even a life-threatening bleed. How often does your doctor or pharmacist give you an entire list of drugs to avoid if you are taking this medication? |
The Life Extension Editorial Staff
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| Mygracare is a stabilized form of feverfew which contains 600 meg of the active ingredient parthenolide.
Ginger. Ginger, commonly used as a spice in foods, has anti-inflammatory and antipain effects. It has long been used to prevent and relieve migraine headaches (Mustafa et al. 1990). Ginger is a versatile substance that has also been used to treat headache, nausea, and vomiting (Chandra et al. 2002). It is thought to have antioxidant and antidepressant properties as well. Ginger may be added to foods, brewed in teas, or taken in capsules. |
| Feverfew contains a lactone or chemical compound called parthenolide according to Newmark et al. (2000). Researchers at Children's Hospital Medical Center (Cincinnati, OH) determined that parthenolide inhibits nuclear factor-kB activity (Sheehan et al. 2002).
5. Genistein, an isoflavone in soy, inhibits both basic and inducible NF-kB activation (Tabary et al. 1999).
6. Green Tea, the EGCG fraction, displays a potent inhibitoty effect on NF-kB expression in hypoxic cells (Yang et al. 1998; Muraoka et al. 2002).
7. |
| Pregnant and lactating women should avoid feverfew, as well as those showing allergic sensitivities.
Qinger (Zingiber officinalis)
From the scores of biologically active components contained in ginger, some are specific for inhibiting COX-2 and others for inhibiting 5-lipooxygenase, enzymes responsible for the formation of proinflammatory agents (prostaglandin E2 and leukotriene B4) from AA. Ginger safely modulates COX-2 activity but also brings balance to COX-1 (an enzyme responsible for gastric mucosal integrity) in a manner vastly superior to synthetic NSAIDs (Newmark et al. |
Gary Null
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 Brett makes the following recommendations: "When feverfew is taken with magnesium, in doses of 250 to 500 mg daily, and Ginkgo biloba, most people notice a significant reduction in the number of migraines, even to the point of disappearance. This includes people who suffered daily. Many people come to me who have had no success with more conventional treatments. After starting them on feverfew and magnesium, they get a significant reduction in the number of headaches and the severity of pain. Even when they have headaches, they tend to be less frequent and less painful. |
Josef A. Brinckmann and Michael P. Lindenmaier
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 Feverfew Leaf Labelling Standard, Health
Canada Therapeutic Products Directorate,
August 6, 1997.
Wichtl
Indexes
List of Indications
The following list makes a connection between the typical indications for herbal drugs and phytopharmaceuticals and the botanicals that are described in this book. The listing provides an overview wherein the herbal drugs listed below appear in a sequential order that corresponds somewhat to their relative importance within each individual indications group. Indications that are predominantly folk medicinal are listed in a separate column. |
Textbook of Natural Medicine 2nd Edition Volume 2Michael T. Murray, ND
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| Parthenolide content and bioactivity of feverfew (Tanacetum parthenium (L.) Schultz-Bip.). Estimation of commercial and authenticated feverfew products. J Pharm Pharmacol 1992; 44: 391-395
66. Kiuchi F, Iwakami S, Shibuya M et al. Inhibition of prostaglandin and leukotriene biosynthesis by gingerols and diarylheptanoids. Chem Pharm Bull 1992; 40: 387-391
67. Srivastava KC. Isolation and effects of some ginger components on platelet aggregation and eicosanoid biosynthesis. Prostaglandins Leurotri Med 1986; 25: 187-198
68. Mustafa T, Srivastava KC. |
Neal Barnard, M.D.
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 The herb feverfew is also sometimes found to be helpful. Typically, one capsule is taken two to three times per day. feverfew should not be taken if you are pregnant. Both of these products are available in health food stores.
Osteoarthritis
Osteoarthritis is very common, but what causes it is still largely unknown. Inside the joints, especially the spine, hands, wrists, hips, knees, feet, and shoulders, cartilage deteriorates and bony spurs develop. The joints hurt and motion becomes more difficult. |
Dr. Gary Null
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 Studies in England suggest that the herbal remedy feverfew can reduce the frequency of migraines. feverfew has sedative qualities and can be taken as a tea. One cup per day is usually effective. In addition, relaxation techniques, such as meditation, progressive muscle relaxation, and yoga can help to reduce stress. Regular moderate exercise, such as swimming or walking, also lowers tension and creates a psychological sense of well-being."
Dr. |
| Brett makes the following recommendations: "When feverfew is taken with magnesium, in doses of 250 to 500 mg daily, and Ginkgo biloba, most people notice a significant reduction in the number of migraines, even to the point of disappearance. This includes people who suffered daily. Many people come to me who have had no success with more conventional treatments. After starting them on feverfew and magnesium, they get a significant reduction in the number of headaches and the severity of pain. Even when they have headaches, they tend to be less frequent and less painful. |
Dr. Michael Heinrich, Joanne Barnes, Simon Gibbons and Elizabeth M. Williamson
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 Ergotamine is a potent drug used as a last resort in attacks of migraine. feverfew is sometimes used to prevent attacks, and will be discussed briefly.
In cases of dementia and Alzheimer's disease, new natural compounds have been developed, such as galan-thamine (from the snowdrop, Galanthus nivalis) and derivatives of physostigmine (e.g. rivastigmine), which are cholinesterase inhibitors. Some older herbs, such as sage and rosemary, have similar but milder effects and are being investigated for memory improvement. |
Dr. Gary Null
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| Results of a double-blind, placebo-controlled trial demonstrated that 17 migraine patients who ate fresh feverfew leaves daily prevented the worsening of attacks.
E. S. Johnson et al., "Efficacy of feverfew as Prophylactic Treatment of Mig raine," British Medical Journal 291, no. 6495 (August 31, 1985): 569-73.
Noting that most migraine drugs have side effects that limit their use, some researchers propose ginger as an alternative since it is known in Ayurvedic and Tibb systems of medicine to be helpful in treating neurological disorders.
T. Mustafa and K. C. |
Andrew Pengelly
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 Parthenolide from feverfew (Tanacetum parthenium) has been widely acclaimed for its benefits in treatment and prevention of migraine headaches, while artemisinin, from sweet Annie (Artemisia annua), is widely used to treat malaria. In the latter compound the presence of the endoperoxide group attached to the guaianolide-type sesquiterpene structure is responsible for the antiparasitic action. Recently artemisinin has also been found to elicit antitumour activity in vitro (Beekman et al. 1998). Antibiotic action has been demonstrated for alantolactone from Inula helenium (Boatto et al. 1994). |
Josef A. Brinckmann and Michael P. Lindenmaier
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| The Health Canada Therapeutic Products Directorate published a Labelling Standard monograph in 1997 for feverfew Leaf in the form of encapsulated or tabletized crude dried leaves, labeled as Traditional Herbal Medicines (THM), for migraine headache prophylaxis. The adult daily dosage must provide the equivalent of 250 ug to 1,000 ug parthe-nolide. The parthenolide content of the dosage form must be not less than 0.2%, and the drug may not contain more than 10% stems and/or flowerheads [16]. |
Bill Gottlieb
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 Both feverfew and elderberry have long been used to help calm fevers, says Rashid AN Buttar, D.O., an osteopathic physician who practices emergency and preventive medicine in Charlotte, North Carolina. He recommends taking 250 milligrams of feverfew two or three times a day in pill or capsule form. If you choose elderberry, drink some tea every few hours. gering the production of virus-fighting T cells, says Nedra Downing, D.O., an osteopathic physician who practices alternative medicine in Clarkston, Michigan. |
volker schulz and Rudolf Hansel
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 Persons allergic to other members of the Asteraceae (daisy family) should be cautious in consuming feverfew.
The development of a standardized extract of the rhizome of purple butterbur (Peta-sites hybridus L.) has led to a new clinical approach to the management of migraine headache (Donald and Brown, 2003).
Two randomized, placebo-controlled, double-blind clinical trials tested the efficacy of the standardized butterbur extract (Petadolex®, Weber 8c Weber International GmbH & Co., Germany) in the treatment of migraines. In the first trial, 60 migraine patients (mean age 28. |
Earl Mindell, R.Ph., Ph.D.
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 In contrast, the patients taking feverfew reported a noticeable decline of those symptoms. Two patients in the placebo group had to withdraw from the study because of their recurring migraine headaches.
In another double blind study at the University of Nottingham, seventy-two patients were randomly given either a placebo or feverfew daily. After four months patients had their supplements switched and tests were continued for another four months. |
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