Feverfew is a bushy perennial herb. The dried leaves are used in capsules, tablets, and liquid extracts. Parthenolides and glycosides are thought to be the components responsible for its purported anti-inflammatory effects and relaxant effects on smooth muscle.
Claims for Feverfew
Feverfew is said to be effective in the prevention of migraine headaches and useful for relieving menstrual pain, asthma, and arthritis. In vitro, feverfew inhibits platelet aggregation (1).
Evidence for Feverfew
A Cochrane review of feverfew for migraines evaluated 6 trials including 561 patients (2). The 5 earlier studies showed varying results, but the most recently added study was larger and more robust and showed a significant decrease of 0.6 attacks per month in migraines versus placebo. Differences among study findings may result from differences in formulations of feverfew used and dosage. Studies evaluating combination treatments of feverfew, magnesium, and CoQ10 for episodic migraines have shown mixed results (3). Evaluations of feverfew on rheumatoid arthritis are few. One study showed no apparent benefit from oral feverfew in rheumatoid arthritis (4).
Adverse Effects of Feverfew
Mouth ulcers, contact dermatitis, dysgeusia, and mild gastrointestinal symptoms may occur. Abrupt discontinuation may worsen migraines and cause nervousness and insomnia.
Owing to potential bleeding, feverfew should be discontinued 2 weeks prior to surgery.
Feverfew is contraindicated in pregnant women as it may cause the uterus to contract. Feverfew is not recommended for children or for women who are breastfeeding.
Drug Interactions with Feverfew
Feverfew should be avoided in patients taking other antimigraine medications, nonsteroidal anti-inflammatory drugs (NSAIDs), antiplatelets, or warfarin. (See also table Feverfew should be avoided in patients taking other antimigraine medications, nonsteroidal anti-inflammatory drugs (NSAIDs), antiplatelets, or warfarin. (See also tableSome Possible Dietary Supplement–Medication Interactions.)
References
1. Groenewegen WA, Heptinstall S. A comparison of the effects of an extract of feverfew and parthenolide, a component of feverfew, on human platelet activity in-vitro. J Pharm Pharmacol. 42:553-557, 1990. doi:10.1111/j.2042-7158.1990.tb07057.x
2. Wider B, Pittler MH, Ernst E. Feverfew for preventing migraine. Cochrane Database Syst Rev. 4:CD002286, 2015. doi: 10.1002/14651858.CD002286.pub3
3. Wells RE, Beuthin J, Granetzke L. Complementary and Integrative Medicine for Episodic Migraine: an Update of Evidence from the Last 3 Years. Curr Pain Headache Rep. 2019 Feb 21;23(2):10. doi: 10.1007/s11916-019-0750-8
4. Pattrick M, Heptinstall S, Doherty M:. Feverfew in rheumatoid arthritis: a double-blind, placebo-controlled study. Ann Rheum Dis. 48:547-549, 1989. doi:10.1136/ard.48.7.547
More Information
The following English-language resource may be useful. Please note that The Manual is not responsible for the content of this resource.
Drugs Mentioned In This Article
