feverfew

n.
An aromatic plant (Chrysanthemum parthenium) native to Eurasia, having clusters of buttonlike, white-rayed flower heads.

[Middle English feverfu, from Old English feferfuge and from Anglo-Norman *fevrefue, both from Late Latin febrifugia : febris, fever + fuga, flight.]

Brand names: Dr. Art Ulenes Herbal Formulas® Standardized Feverfew, Migra-Lieve™, Migraban™, MigraCare®, MygraFew™, MygraFree™, Nomigraine™, PharmAssure™ Migraplex™

Chemical formula:

Español:
• Altamisa o Tanacetum parthenium en sus formas de dosificación oral

Feverfew, Tanacetum parthenium oral dosage forms

What is feverfew?

FEVERFEW, Tanacetum parthenium (Migraban(TM), Migracare®, Migra-Lieve(TM) , MygraFew(TM), MygraFree(TM), Nomigraine(TM), PharmAssure Migraplex(TM), Tanacet(TM) and others) is a dietary supplement (herbal remedy) that is being promoted for its ability to decrease the occurrence of migraine headaches. Some evidence suggests the herb may be useful for this purpose. Feverfew is not helpful in relieving an acute migraine attack. Feverfew is sometimes used for arthritis symptoms, but is not known to be effective for this purpose. Feverfew is also not FDA-approved for any purpose. Those who suffer from migraine or arthritis should seek a health care professional with the proper experience with treating these conditions for advice and supervision prior to self-use of feverfew. Many products containing feverfew are available.

What should I tell my health care provider before I take this medicine?

It is important for you to tell your prescriber or other health care professional that you are using feverfew. Some herbs exert potent effects and may interact with other drugs you are taking.

You should discuss feverfew with your health care professional BEFORE taking it if you have any of these conditions:
• blood or bleeding disorder, such as hemophilia or difficulty clotting
• hayfever or skin allergies
• head injury
• kidney disease
• liver disease
• stroke
• taking blood-thinning medications
• an unusual or allergic reaction to feverfew, other herbs, plants, medicines, foods, dyes, or preservatives
• pregnant or trying to get pregnant
• breast-feeding

How should I use this medicine?

Feverfew is usually taken orally (i.e., swallowed). Follow the directions on the package labeling, or talk to your health care professional.

Contact your pediatrician or health care professional regarding the use of this herb in children. Special care may be needed.

What if I miss a dose?

If you miss a dose, simply resume taking it on your previous schedule. Do not take double doses to catch up, however.

What drug(s) may interact with feverfew?

• antiinflammatory drugs (NSAIDs), such as ibuprofen, used to treat fever, headache, pain, or inflammation
• aspirin
• clopidogrel
• cilostazol
• dalteparin, enoxaparin or other injectable blood thinners
• dipyridamole
• heparin
• herbal products like danshen, dong quai, garlic pills, ginger, ginkgo biloba, horse chestnut, willow bark, and others
• medications used to treat an acute migraine attack, such as ergot-type drugs (examples include Cafergot® or Migranal®), or eletriptan (Relpax®), naratriptan (Amerge®), rizatriptan (Maxalt®, Maxalt-MLT(TM)), sumatriptan (Imitrex®) and zolmitriptan (Zomig®)
• medications used to prevent migraines, such as methysergide (Sansert®) or propranolol (Inderal®)
• ticlopidine
• warfarin

For many herbs, interactions with other medications are unknown. That is why you should always be careful when mixing herbal remedies with traditional medications. If you take any other medications, consult with your health care professional prior to taking feverfew.

Tell your prescriber or health care professional about all other medicines you are taking, including non-prescription medicines, nutritional supplements, or herbal products. Also tell your prescriber or health care professional if you are a frequent user of drinks with caffeine or alcohol, if you smoke, or if you use illegal drugs. These may affect the way your medicine works. Check with your health care professional before stopping or starting any of your medicines.

What should I watch for while taking feverfew?

It may take several weeks of feverfew use before you notice an improvement in your symptoms. You should also contact your health care professional for advice prior to prolonged use of feverfew.

Since feverfew is derived from a plant, allergic reactions are possible. Stop using this herb if you develop a rash. You may need to see your health care professional, or inform them that this occurred. Report any unusual side effects to your health care provider.

You may need to see a doctor if your condition does not improve. Seek medical attention if your headache has gotten worse over the past few days or weeks, your headaches come on suddenly, if you experience weakness, numbness in an arm or leg or a change in hearing or sight, if over-the-counter analgesics do not relieve the headache pain, if you experience changes in memory or mood with the headaches, or if the headache is accompanied by a stiff neck, rash, nausea, vomiting, fever, breathing problems, or a history of head injury.

If you have been taking feverfew regularly for a long period of time, you may need to slowly decrease your intake of the herb. You may notice headaches or tension, difficulty sleeping, muscle/joint pain or fatigue when you stop taking this herb.

Different brands of feverfew might contain different amounts of active ingredient, so be careful to use the same brand. It is recommended that you use a brand from a reliable manufacturer. A standardized product is more likely to contain the same amount of herb from dose to dose. Your health care professional or pharmacist can assist you in finding a reliable product.

If you are scheduled to have surgery or dental work, remember to tell your dentist, surgeon and anesthesia specialist that you are taking feverfew. In some cases they may want you to discontinue taking the feverfew supplement prior to the surgery.

What side effects may I notice from using feverfew?

Side effects that you should report to your prescriber or health care professional as soon as possible:
• any unusual bleeding or bruising
• difficulty breathing, shortness of breath, or wheezing
• irregular heartbeat or palpitations
• itching
• menstrual irregularity or unusual vaginal bleeding
• skin rash or blisters
• sores or blisters in the mouth, eyes, lips, or nose
• swelling of any area of the lips, throat, tongue, skin, or body

Side effects that usually do not require medical attention (report to your prescriber or health care professional if they continue or are bothersome):
• mild stomach upset
• nervousness
• unpleasant taste in the mouth

Where can I keep my medicine?

Keep out of the reach of children.

Store at room temperature, protected from heat and moisture. Throw away any unused herb after the expiration date. If no expiration date is present, throw any unused product away after 9 months; feverfew products generally have a very short shelf-life.

GENERAL INFORMATION REGARDING DIETARY SUPPLEMENTS:
Dietary supplements include amino acids, vitamins, minerals, herbs, botanicals, and other plant-derived substances, and extracts of these substances. These products are easy to identify as they must state "Dietary Supplement" on the label. A "Supplement Facts" panel is provided on the label for most products. Supplements are not drugs and are not regulated like drugs. You should note that rigid quality control standards are not required for dietary supplements. Differences in the potency and purity of these products can occur. Scientific data to support the use of a dietary supplement for a certain disease or ailment may not be available. This product is not intended to diagnose, treat, cure or prevent any disease.

The Food and Drug Administration suggests the following to help consumers protect themselves:
• Always read product labels and follow directions.
• "Natural" doesn't mean a product is safe for humans to take.
• Look for products containing ingredients with the "USP" notation. This indicates the manufacturer followed the standards of the US Pharmacopoeia.
• Supplements produced or distributed by a nationally known food or drug company are more likely to be made under tight controls as these companies have standards in place for their other products. You can write to the company for more information about how the product was made.

Last updated: 7/1/2002

Important Disclaimer: The drug information provided here is for educational purposes only. It is intended to supplement, not substitute for, the diagnosis, treatment and advice of a medical professional. This drug information does not cover all possible uses, precautions, side effects and interactions. It should not be construed to indicate that this or any drug is safe for you. Consult your medical professional for guidance before using any prescription or over the counter drugs.

Description

Feverfew (Chrysanthemum parthenium or Tanacetum parthenium) is named for one of the herb's traditional medicinal uses as a febrifuge, from the Latin febrifugia, indicating its fever-reducing action. This European native of the Compositae (Asteraceae) or aster family has naturalized throughout North and South America, escaping from cultivation. It can be found along roadsides and along the borders of wooded areas. Other common names include featherfew, febrifuge plant, featherfoil, mid-summer daisy, and wild chamomile.

Feverfew is a bushy and herbaceous perennial that grows from a branched and tapering root to produce erect, round and slightly grooved stems. The feathery, aromatic and bitter-tasting leaves are arranged alternately along the length of the many-branched stem. They are a yellow-green, stalked, and bipinnate with deeply cut, toothed segments in an oval shape. Flowers bloom in mid to late-summer in flat-topped clusters at the end of stems that may reach to a height of three feet. Smaller than daisies, and without the protruding central disk of chamomile, feverfew blossoms have yellow centers consisting of tightly-bunched tubular florets surrounded by creamy white rays. Bees seem to avoid feverfew, deterred by its pungent aroma. The plant self-seeds freely, and thrives in full sun or partial shade in most soil.

General Use

Feverfew leaves and flowers are used medicinally. Among its many uses, the herb has become a popular and proven herbal remedy for the treatment of migraine headaches. This important use of the plant was recorded as far back as 1633 by the British herbalist Gerard. With frequent use, over time, feverfew can reduce the frequency, severity, and duration of migraine headaches and allay nausea and vomiting. It is most effective when used as a preventive. It acts to inhibit serotonin and histamine, substances that dilate blood vessels, and helps to prevent the spasms in blood vessels that trigger migraine headaches. This much-researched herb has been shown to inhibit production of leukotines and other inflammatory substances. It is an effective remedy for relieving the pain and inflammation of arthritis and alleviating hay fever, asthma and other allergy symptoms.

Other traditional uses of feverfew dating back to ancient Greece and Rome include its use as an emmenagogue, which is an infusion taken in cases of sluggish menstruation to relieve congestion and promote periodic flow. The herb has also been used after childbirth to help expel the placenta.

Feverfew was valued in past centuries for its believed protection against the plague and the bite of mad dogs. In the seventeenth century the herbalist John Parkinson recommended feverfew as a remedy to speed recovery from opium overdose. It has also been used in treating alcoholic delirium tremens, and to expel intestinal worms. The English physician Culpeper recommended an external application of the fresh herb to treat ague, as the disease malaria was once called. Feverfew is a bitter digestive and liver tonic. A hot infusion may reduce fever and congestion from colds. The infusion, taken cold, has tonic properties. Feverfew may relieve mild depression, promote restful sleep, and ease the nerve pain of sciatica and shingles. Externally the strong infusion is an antiseptic skin wash for treatment of insect stings and bites. The wash may also be used as an insect repellent. Feverfew leaves and stems, gathered fresh, may be used as a dye plant, with a chrome mordant, to produce a light green-yellow color in natural fibres such as wool. Feverfew flowers have a purgative action if ingested, and if the blossom heads are carried into areas where bees are located, the insects will fly away.

The active compounds in feverfew include sesquiterpene lactones, predominantly parthenolide. Other phytochemicals include pyrethrin, volatile oils, tannins, bitter resin, and flavonoids.

Preparations

Feverfew should be harvested just as the plant comes into flower and before the blossoms are fully open. Leaves are removed from the stalks and dried on paper-lined trays in a light, airy room, away from direct sunlight. The dried herb should be stored in clearly-labeled, tightly-sealed, dark glass containers.

Capsules: Feverfew leaf in capsule form, at a 250 mg daily dose, is recommended for medicinal use. It may take four to six weeks before the herb provides noticeable relief. Studies of some commercially-prepared capsules revealed that many did not contain a sufficient quantity of the active ingredient to be medicinally effective. Feverfew may be more medicinally potent when gathered fresh. Three to four fresh leaves, taken daily over a period of time are medicinally effective. A certified practitioner can help determine the most effective and safest levels for individual cases.

Syrup: Fresh feverfew leaf can be added to honey, or to a simple sugar syrup. The honey will act as a preservative and mask the bitter taste of the herb.

Infusion: Two to three teaspoons of chopped, fresh feverfew leaves are placed in a warmed container. One cup of fresh, nonchlorinated boiled water is added to the herbs and the mixture is covered. The tea is infused for about 15 minutes, then strained. A stronger infusion, using double the amount of leaf and steeping twice as long, is useful as a skin wash for repelling insects, or soothing inflammations and wounds. The strong infusion has also been used as a mouthwash following tooth extraction. The prepared tea will store for about two days in the refrigerator in an airtight container. Dosage: Feverfew may be enjoyed by the cupful three times a day.

Tincture: Combine four ounces of finely-cut fresh, or powdered dry herb with one pint of brandy, gin, or vodka, in a glass container. The alcohol should be enough to cover the plant parts. Place the mixture away from light for about two weeks, shaking several times each day. Strain and store in a tightly capped, dark glass bottle. A standard dose is 30 drops of the tincture three times a day.

Precautions

Since herbal preparations are not regulated by the Food and Drug Administration (FDA), consumers in the United States should check the labels of commercial products carefully for dosage instructions and the part(s) of the plant used for or contained in the product. A 2002 study of commercial feverfew preparations found wide variations in the recommended dosages and parthenolide contents of the products that were tested. The researchers found that ".. intake of parthenolide would range from 0.06 to 9.7 mg/day, a 160-fold variation." Any adverse effects from feverfew preparations or any other herbal products sold as dietary supplements should be reported to the FDA's Center for Food Safety and Applied Nutrition, listed under Resources.

Feverfew should not be used by pregnant or lactating women. Children under two years of age should not be given feverfew. Chewing the fresh leaves may irritate the mucous membranes in the mouth causing mouth ulcers in some persons. Traditionally the fresh herb was enclosed between slices of bread to minimize the irritation and mask the bitter taste of the fresh leaves. Persons on prescribed blood-thinning drugs should not ingest feverfew as it might interfere with the rate of blood clotting.

Side Effects

Feverfew is a safe herb of proven medicinal value. No side effects are reported when taken in designated therapeutic doses. Some cases of contact dermatitis and airborne dermatitis, however, have been reported by researchers in Denmark and the United States.

Interactions

According to the PDR For Herbal Medicines, feverfew may interact with anti-thrombotic medications, including aspirin and warfarin. The tannins in feverfew have been reported to interfere with iron absorption in persons who take supplemental iron.

Taking NSAIDs together with feverfew will decrease the beneficial effects of the herb.

Resources

Books

Duke, James A., Ph.D. The Green Pharmacy. Emmaus, PA: Rodale Press, 1997.

Hoffmann, David. The New Holistic Herbal. 3rd ed. Boston: Element Books, Inc., 1991.

McIntyre, Anne. The Medicinal Garden. New York: Henry Holt and Company, Inc., 1997.

PDR for Herbal Medicines. Montvale, NJ: Medical Economics Company, 1998.

Pelletier, Kenneth R., MD. The Best Alternative Medicine, Part I: Western Herbal Medicine. New York: Simon & Schuster, 2002.

Prevention's 200 Herbal Remedies. Emmaus, PA: Rodale Press, Inc., 1997.

Schar, Douglas. The Backyard Medicine Chest, An Herbal Primer. Washington, DC: Elliott & Clark Publishing, 1995.

Tyler, Varro E., Ph.D. Herbs Of Choice, The Therapeutic Use of Phytomedicinals. New York: The Haworth Press, Inc., 1994.

Weiss, Gaea and Shandor. Growing & Using The Healing Herbs. New York: Wings Books, 1992.

Periodicals

Craig, Winston J. "Feverfew: For the Relief of Migraines." Vibrant Life 18 (July-August 2002): 40-41.

Nelson, M. H., S. E. Cobb, and J. Shelton. "Variations in Parthenolide Content and Daily Dose of Feverfew Products." American Journal of Health-System Pharmacy 59 (August 15, 2002): 1527-1531.

Paulsen, E., L. P. Christensen, and K. E. Andersen. "Do Monoterpenes Released from Feverfew (Tanacetum parthenium) Plants Cause Airborne Compositae Dermatitis?" Contact Dermatitis 47 (July 2002): 14-18.

Pfaffenrath, V., H. C. Diener, M. Fischer, et al. "The Efficacy and Safety of Tanacetum parthenium (Feverfew) in Migraine Prophylaxis—A Double-Blind, Multicentre, Randomized Placebo-Controlled Dose-Response Study." Cephalalgia 22 (September 2002): 523-532.

Organizations

American Botanical Council. 6200 Manor Road, Austin, TX 78714-4345. (512) 926-4900. .

Herb Research Foundation. 1007 Pearl St., Suite 200, Boulder, CO 80302. (303) 449-2265. .

United States Food and Drug Administration (FDA), Center for Food Safety and Applied Nutrition. 5100 Paint Branch Parkway, College Park, MD 20740. (888) SAFEFOOD. .

Other

"Feverfew." HolisticOnLine. http://www.holistic-online.com/Herbal-Med.

[Article by: Clare Hanrahan; Rebecca J. Frey, PhD]

tanacetum (Chrysanthemum) parthenium.

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