Devil's Claw (afrikanische teufelskralle, ao ao, arpagofito, Arthrosetten H, Arthrotabsm, artiglio del diavolo, Artosan, Defencid, Doloteffin, duiwelsklou, ekatata, elyata, grapple plant, griffe du diable, Hariosen, Harpadol, HarpagoMega, harpagon, harpagophytum procumbens, harpagoside, Jucurba N, khams, khuripe, klaudoring, likakata, otjihangatene, RheumaSern, RheumaTee, Salus, sengaparile, Sudafrikanische Teufelskralle, Trampelklette, Venustorn, windhoek's root, wood spider, xemta'eisa)

Suggested dosing of afrikanische teufelskralle, ao ao (devil's claw)

 

Osteoarthritis/Low Back Pain

Crude Extract: 2-9 g/d PO

Standardized Tablets: 600-1200 mg (=50-100 mg harpagoside) PO TId

 

Other Information

Anorexia: 1.5 g/day decoction

Elixir (1:1): 0.1-0.25 mL PO TId

 

Suggested uses of afrikanische teufelskralle, ao ao (devil's claw)

Osteoarthritis, lower back pain, appetite loss, cancer pain

 

Efficacy

Increasing evidence of short-term benefit in osteoarthritis; some evidence of benefit in lower back pain; unclear with regards to other uses

Extensively used in Europe for mild joint pain

German Commission E approves the use of Devil's claw root for:

• Appetite loss, dyspepsia, supportive therapy for arthritis

ESCOP approves the use of Devil's claw root for:

• Painful arthrosis, tendinitis, appetite loss, dyspepsia

 

afrikanische teufelskralle, ao ao (devil's claw) adverse (side) effects

Generally well-tolerated

Headache, GI upset, bradycardia, taste loss

 

Warnings

Cautions

Stomach or intestinal ulcer, diabetes, high or low blood pressure, arrhythmia

Safety/efficacy not established for children

 

Pregnancy and lactation

Pregnancy category: N/A

Lactation: N/A

 

Pregnancy categories

A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.

B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk.

C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done.

D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk.

X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist.

NA: Information not available.

 

Pharmacology of afrikanische teufelskralle, ao ao (devil's claw)

Metabolism: N/A

Excretion: N/A

 

Mechanism of action

Unclear; one study found correlation between serum harpagoside levels & leukotriene biosynthesis inhibition; harpagoside may also have analgesic actions

May also have anti-oxidant effects

Constituents include iridoid glucosides (eg, harpagoside), phytosterols, & flavonoids