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How to use Wild Quinine

Scientific Name: Feverfew

Other Names: Altamisa, Chrysanthemum parthenium, Featherfew, Flirtwort, Pyrethrum parthenium, Tanacetum parthenium, Wild Chamomile, Wild Quinine

Who is this for?

As its name suggests, feverfew has been used historically to control fevers associated with infectious conditions. More recently, feverfew has been studied for preventing migraine headaches. In several studies, both the frequency and the severity of migraines were reduced among study participants who took feverfew daily as a preventive measure. However, active migraine headaches were not relieved by taking feverfew. For years, researchers believed that parthenolide, one of the chemicals in feverfew, was responsible for most of feverfew's effects. Recently, however, parthenolide's actual effects are being questioned after a study showed no difference in the number, intensity, or length of migraines suffered by individuals taking a dried feverfew preparation that was standardized to contain a specific amount of parthenolide and those taking placebo (sugar pills). Some researchers now believe that several of feverfew's components act together to prevent migraine symptoms and that products made from fresh feverfew may be more active than those made from dried feverfew. Much more research is needed to prove or disprove feverfew's place in migraine prevention and treatment.

Feverfew has also been used for relieving the pain and inflammation of arthritis. It is known that chemicals in feverfew may reduce the body's production of substances that initiate and prolong inflammation, which is the body's response to irritation, injury, or infection. Inflammation usually includes pain, redness, and swelling in the area of the damage ,and it can occur within body tissues as well as on the surface of the skin. Chemicals in feverfew are thought to prevent blood components called platelets from releasing inflammatory substances. Feverfew may also reduce the body's production of prostaglandins, hormone-like substances made in the body and involved in regulating a number of body functions including blood pressure, blood vessel tone, and temperature, as well as inflammation. All of these effects could help relieve fever, arthritis, and migraine. More studies are needed, however, to confirm feverfew's effectiveness.

When should I be careful taking it?

Feverfew may tighten muscles in the uterus, which may cause a miscarriage in a pregnant woman. Therefore, pregnant women should avoid taking feverfew.

Precautions

Not enough is known about how feverfew might affect an infant to recommend its use while breast-feeding. It should not be given to children less than 2 years old.

What side effects should I watch for?

Chemicals in feverfew may increase the heart rate, potentially causing changes in heart rhythm that could be dangerous.

Less Severe Side Effects

Chewing fresh leaves of feverfew may result in:

  • Altered taste perception
  • Mouth sores
  • Swollen lips or tongue

Some individuals who took feverfew for extended times reported:

  • Joint stiffness
  • Muscle aches
  • Nervousness
  • Sleep disturbance

If feverfew is stopped suddenly after being taken for an extended period of time, rebound headaches may result. Although the exact causes of rebound headaches are not known, they are believed to be associated with interruption of the body's normal pain-signaling process.

Feverfew belongs to the same family of plants that also includes chrysanthemums, daisies, and ragweed. Individuals who are sensitive to any of these types of plants may also be sensitive to feverfew.

When the plants are touched or a feverfew preparation is applied to the skin, a rash may develop.

What interactions should I watch for?

Prescription Drugs

Some human case reports suggest that feverfew may increase the time blood needs to clot. When it is taken with antiplatelet or anticoagulant drugs, the effect of the drug may be increased, resulting in uncontrolled bleeding.

  • Antiplatelets include Plavix and Ticlid
  • Anticoagulants include heparin and warfarin

Non-prescription Drugs

Feverfew may decrease the ability of blood to clot after an injury. Aspirin may also delay clotting, so feverfew should not be taken orally at the same time as aspirin.

Herbal Products

Theoretically, if feverfew is used with other herbs that reduce blood clotting, bleeding may occur. Some of the most common herbal products that might inhibit blood clotting are:

  • Danshen
  • Devil's Claw
  • Eleuthero
  • Garlic
  • Ginger (in high amounts)
  • Ginkgo
  • Horse Chestnut
  • Panax Ginseng
  • Papain
  • Red Clover
  • Saw Palmetto

Some interactions between herbal products and medications can be more severe than others. The best way for you to avoid harmful interactions is to tell your doctor and/or pharmacist what medications you are currently taking, including any over-the-counter products, vitamins, and herbals.

Should I take it?

Feverfew is a perennial that grows wild along roadsides and in other uncultivated areas of land. Common in most temperate climates, it resembles miniature daisy plants, with multiple dime-sized flowers that have flat, golden yellow centers surrounded by short white petals. Plants are usually about 2 feet tall and they have fuzzy stems and feathery, light green leaves. Although feverfew is often planted in flower gardens — especially in Europe — it has a strong, somewhat unpleasant smell. Because of its smell, it has been used as an insect repellant and gardeners may plant it around roses to help keep pests out of the garden.

For use in medicine, the leaves of feverfew are collected before the flowers bloom. Traditionally, the leaves were used fresh, but preparations made from dried feverfew are more common today. Occasionally, feverfew tea has been used as a mouth rinse to relieve toothaches.

Dosage and Administration

Historically, feverfew has been taken by chewing two or three fresh leaves — usually one after the first and last meals of the day or one after each meal. Because chewing fresh feverfew may cause mouth and stomach irritation, taking it after a meal may reduce the likelihood of these side effects. More readily available feverfew preparations now include capsules, extracts, and tablets made from dried feverfew leaves. These commercial preparations generally do not irritate mouth or stomach tissue. Although dosages differ greatly, common doses used in studies to prevent migraines were 50 mg or 100 mg per day. Daily doses up to 250 mg have been used without apparent side effects. Full effectiveness in preventing migraines may not be evident until feverfew has been taken for 4 to 6 weeks.

Commercial feverfew products may be standardized to contain between 0.2% and 0.7% of parthenolide. Standardization by the manufacturer should assure the same amount of active ingredient in every batch of the commercial preparation. Standardization of herbal products is not required by the U.S. Food and Drug Administration (FDA), so not every product will contain the same amounts of active ingredients.

Feverfew tea may be made by soaking about one teaspoonful of dried feverfew leaves in 5 to 8 ounces of boiling water for 5 to 10 minutes. Once the solids have been strained out, this tea may be consumed as often as desired. It may also be cooled and applied to the skin as an insect repellant.

Summary

Despite its name, feverfew is most often used to prevent migraine headaches. In the past, however, it was used as a treatment for inflammation as well as fever.

Risks

Feverfew may cause miscarriage, so pregnant women should not take it. It should also be avoided by small children and breast-feeding women.

Side Effects

Chewing the fresh leaves of feverfew may result in mouth irritation and loss of taste. All oral forms of feverfew may cause insomnia, muscle or joint discomfort, or nervousness.

Interactions

Taking feverfew may increase the effects of drugs and herbals that decrease blood clotting.

Last Revised June 2, 2004

References

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Awang DVC. Feverfew trials: the promise of — and the problem with — standardized botanical extracts. HerbalGram. 1997;41:16-18.

Barsby RW, Salan U, Knight DW, Hoult JR. Feverfew extracts and parthenolide irreversibly inhibit vascular responses of the rabbit aorta. Journal of Pharmacy and Pharmacology. 1992;44:737-740.

Collier HO, Butt NM, McDonald-Gibson WJ, Saeed SA. Extract of feverfew inhibits prostaglandin biosynthesis. Lancet. 1980;2:922-923.

de Weerdt GJ, Bootsman HPR, Hendriks H. Herbal medicines in migraine prevention. Randomized double-blind, placebo-controlled, crossover trial of a feverfew preparation. Phytomedicine. 1996;3:225-30.

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HealthNotes, Inc. Feverfew. 2002. Available at: http://www.mycustompak.com/healthNotes/Herb/Feverfew.htm Accessed October 14, 2003.

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Heptinstall S, Groenewegen WA, Spangenberg P, Losche W. Extracts of feverfew may inhibit platelet behaviour via neutralization of sulphydryl groups. Journal of Pharmacy and Pharmacology. 1987;39(6):459-465.

Heptinstall S, White A, Williamson L, Mitchell JR. Extracts of feverfew inhibit granule secretion in blood platelets and polymorphonuclear leucocytes. Lancet. 1985;1:1071-1074.

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Jain NK, Kulkarni SK. Antinociceptive and anti-inflammatory effects of Tanacetum parthenium L. extract in mice and rats. Journal of Ethnopharmacology. 1999;68:251-259.

Jellin JM, Gregory P, Batz F, Hitchens K, et al, eds. Pharmacist's Letter/Prescriber's Letter. Natural Medicines Comprehensive Database, 3rd Edition. Stockton CA: Therapeutic Research Facility, 2000.

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(Note: The above information is not intended to replace the advice of your physician, pharmacist, or other healthcare professional. It is not meant to indicate that the use of the product is safe, appropriate, or effective for you.)

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