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Feverfew

Other Name(s):

Altamisa, Bachelor's Buttons, Chrysanthème Matricaire, Chrysanthemum parthenium, Chrysanthemum praealtum, Featerfoiul, Featherfew, Featherfoil, Flirtwort Midsummer Daisy, Grande Camomille, Leucanthemum parthenium, Matricaria, Matricaria eximia, Matricaria parthenium, Partenelle, Pyrèthre Doré, Pyrèthre Mousse, Pyrethrum parthenium, Santa Maria, Tanaceti Parthenii, Tanacetum Parthenium, Tanaisie Commune.

Overview

Feverfew is a plant that is native to Asia Minor and the Balkans, but is now common throughout the world. Feverfew leaves are normally dried for use in medicine. Fresh leaves and extracts are also used.

People take feverfew by mouth for the prevention and treatment of migraine headaches.

People also take feverfew by mouth for fever, irregular menstrual periods, arthritis, a skin disorder called psoriasis, allergies, asthma, ringing in the ears (tinnitus), dizziness, and nausea and vomiting.

Some people take feverfew by mouth for difficulty getting pregnant or fathering a child (infertility). It is also taken by mouth for "tired blood" (anemia), cancer, common cold, earache, liver disease, prevention of miscarriage, muscular tension, bone disorders, swollen feet, diarrhea, upset stomach, and intestinal gas.

Feverfew is sometimes applied directly to the gums for toothaches or to the skin to kill germs. It is also applied to the skin for itching and to prevent insect bites.

Some people also use feverfew as a general stimulant and for intestinal parasites.

How does it work?

Feverfew leaves contain many different chemicals, including one called parthenolide. Parthenolide or other chemicals decrease factors in the body that might cause migraine headaches.

Uses & Effectiveness

Possibly Effective for...

  • Preventing migraine headache. Some research using different feverfew products (Mig-RL, Naturveda-Vitro-Bio Research Institute, Issoire, France; LipiGesic M, PuraMed BioScience, Inc., Schofield, WI; GelStat Migraine, GelStat Corporation) shows that taking feverfew by mouth can reduce the frequency of migraine headaches and reduce pain, nausea, vomiting, and sensitivity to light and noise when they do occur. Feverfew may be more effective in people with more frequent migraine attacks. But there are also studies that concluded that feverfew doesn't work for migraines. The difference in results may be explained by the differences in feverfew products that were tested. The Canadian government allows manufacturers of a certain feverfew formulation (containing 0.2% of a chemical called parthenolide) to claim that their product can be used to prevent migraines.

Possibly Ineffective for...

  • Rheumatoid arthritis (RA). Taking feverfew by mouth doesn't seem to reduce the symptoms of RA.

Insufficient Evidence to Rate Effectiveness for...

  • Itching (pruritus). Early research shows that applying a cream containing feverfew (Aveeno Ultra-Calming Cream, Johnson & Johnson) to the skin improves skin itching in people with a skin disease called prurigo nodularis.
  • Allergies.
  • Asthma.
  • Bone disorders.
  • Cancer.
  • Common cold.
  • Dizziness.
  • Earache.
  • Fever.
  • Intestinal parasites.
  • Liver disease.
  • Menstrual irregularities.
  • Miscarriage prevention.
  • Muscle tension.
  • Nausea.
  • Psoriasis.
  • Ringing in the ears.
  • Swollen feet.
  • Toothaches.
  • Upset stomach.
  • Vomiting.
  • Other conditions.
More evidence is needed to rate the effectiveness of feverfew for these uses.

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).

Side Effects

Feverfew is LIKELY SAFE when taken by mouth appropriately in the short-term (up to four months). Side effects might include upset stomach, heartburn, diarrhea, constipation, bloating, flatulence, nausea, and vomiting. Other reported side effects include nervousness, dizziness, headache, trouble sleeping, joint stiffness, tiredness, menstrual changes, rash, pounding heart, and weight gain.

The safety of feverfew beyond 4 months' use has not been studied.

Feverfew is POSSIBLY UNSAFE when fresh leave are chewed. Chewing unprocessed feverfew leaves can cause mouth sores; swelling of the mouth, tongue, and lips; and loss of taste.

Special Precautions & Warnings

Pregnancy and breast-feeding: Feverfew is POSSIBLY UNSAFE when taken by mouth during pregnancy. There is concern that it might cause early contractions and miscarriage. Don't use feverfew if you are pregnant. There is not enough reliable information about the safety of taking feverfew if you are breast feeding. Stay on the safe side and avoid use.

Bleeding disorders: Feverfew might slow blood clotting. In theory, taking feverfew could increase the risk of bleeding in some people. Until more is known, use feverfew cautiously if you have a bleeding disorder.

Allergy to ragweed and related plants: Feverfew may cause an allergic reaction in people who are sensitive to the Asteraceae/Compositae plant family. Members of this family include ragweed, chrysanthemums, marigolds, daisies, and many others. If you have allergies, be sure to check with your healthcare provider before taking feverfew.

Surgery: Feverfew might slow blood clotting. It might cause bleeding during and after surgery. Stop taking feverfew at least 2 weeks before a scheduled surgery.

Interactions


Medications changed by the liver (Cytochrome P450 1A2 (CYP1A2) substrates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Some medications are changed and broken down by the liver. Feverfew might decrease how quickly the liver breaks down some medications. Taking feverfew along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking feverfew, talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications that are changed by the liver include amitriptyline (Elavil), haloperidol (Haldol), ondansetron (Zofran), propranolol (Inderal), theophylline (Theo-Dur, others), verapamil (Calan, Isoptin, others), and others.


Medications changed by the liver (Cytochrome P450 2C19 (CYP2C19) substrates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Some medications are changed and broken down by the liver. Feverfew might decrease how quickly the liver breaks down some medications. Taking feverfew along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking feverfew, talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications that are changed by the liver include omeprazole (Prilosec), lansoprazole (Prevacid), and pantoprazole (Protonix); diazepam (Valium); carisoprodol (Soma); nelfinavir (Viracept); and others.


Medications changed by the liver (Cytochrome P450 2C8 (CYP2C8) substrates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Some medications are changed and broken down by the liver. Feverfew might decrease how quickly the liver breaks down some medications. Taking feverfew along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking feverfew, talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications that are changed by the liver include amiodarone (Cardarone), paclitaxel (Taxol); nonsteroidal anti-inflammatory drugs (NSAIDs) such as diclofenac (Cataflam, Voltaren) and ibuprofen (Motrin); rosiglitazone (Avandia); and others.


Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Some medications are changed and broken down by the liver. Feverfew might decrease how quickly the liver breaks down some medications. Taking feverfew along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking feverfew, talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications that are changed by the liver include diclofenac (Cataflam, Voltaren), ibuprofen (Motrin), meloxicam (Mobic), and piroxicam (Feldene); celecoxib (Celebrex); amitriptyline (Elavil); warfarin (Coumadin); glipizide (Glucotrol); losartan (Cozaar); and others.


Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Some medications are changed and broken down by the liver. Feverfew might decrease how quickly the liver breaks down some medications. Taking feverfew along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking feverfew, talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications that are changed by the liver include tricyclic antidepressants such as imipramine (Tofranil) and amitriptyline (Elavil); antipsychotics such as haloperidol (Haldol), risperidone (Risperdal), and chlorpromazine (Thorazine); beta-blockers such as propranolol (Inderal), metoprolol (Lopressor, Toprol XL), and carvedilol (Coreg); tamoxifen (Nolvadex); and others.


Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Some medications are changed and broken down by the liver. Feverfew might decrease how quickly the liver breaks down some medications. Taking feverfew along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking feverfew, talk to your healthcare provider if you are taking any medications that are changed by the liver.

Some medications changed by the liver include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and many others.


Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.

Feverfew might slow blood clotting. Taking feverfew along with medications that also slow clotting might increase the chances of bruising and bleeding.

Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.

Dosing

The following doses have been studied in scientific research:

BY MOUTH:

  • For migraine headaches: 50-150 mg of feverfew powder taken once daily for up to 4 months has been used. A dose of 2.08-18.75 mg of a carbon dioxide extract of feverfew (MIG-99, Schaper & Brümmer GmbH & Co, Salzgitter, Germany) taken three times daily for 3 to 4 months has been used. Mig-RL (Naturveda-Vitro-Bio Research Institute, Issoire, France), a combination of 300 mg of feverfew and 300 mg of white willow, taken twice daily for 3 months has been used. Specific combination products containing feverfew and ginger (GelStat Migraine, GelStat Corporation; LipiGesic M, PuraMed BioScience, Inc., Schofield, WI) have been used to treat migraines. Two 2-mL doses have been given under the tongue 5 minutes apart. Each dose has been held under the tongue for 60 seconds before swallowing. A second and possibly third treatment have been used one hour and possibly 24 hours later if the migraine headache pain continues.