FEVERFEW - TANACETUM PARTHENIUM

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This monograph is intended to serve as a guide to industry for the preparation of Product Licence Applications (PLAs) and labels for natural health product market authorization. It is not intended to be a comprehensive review of the medicinal ingredient.

Notes

Date

July 8, 2022

Proper name(s), Common name(s), Source information

Table 1. Proper name(s), Common name(s), Source information
Proper name(s) Common name(s) Source information
Source material(s) Part(s) Preparation(s)

Tanacetum parthenium

Feverfew

Tanacetum parthenium

  • Herb top
  • Leaf

Dry

References: Proper name: USDA 2019; Common name: McGuffin et al. 2000; Source information: Barnes et al. 2007, Bradley 1992.

Route of Administration

Oral

Dosage Form(s)

This monograph excludes foods or food-like dosage forms as indicated in the Compendium of Monographs Guidance Document.

Digestive aid; Headache relief

Acceptable dosage forms for oral use are indicated in the dosage form drop-down list of the web-based Product Licence Application form for Compendial applications.

Migraine prevention; Reduction of severity, frequency and symptoms of migraines when taken as a prophylactic

The only acceptable dosage forms are: Capsules; Tablets.

Use(s) or Purpose(s)

Note

Claims for traditional use must include the term "Herbal Medicine", "Traditional Chinese Medicine", or "Ayurveda".

Dose(s)

Subpopulation(s)

Adults 18 years and older

Quantity(ies)

Digestive aid; Headache relief

Methods of preparation: Powdered, Non-Standardized Ethanolic Extracts (Extract dry, Tincture)

50 - 250 milligrams of dried herb top and/or leaf, per day (Barnes et al. 2007; Sweetman 2007; Hoffmann 2003; Williamson 2003; Mills and Bone 2000; Palevitch et al. 1997; Awang 1993; Bradley 1992; Murphy et al. 1988; Johnson et al. 1985).

Digestive aid; Headache relief; Migraine prevention; Reduction of severity, frequency and symptoms of migraines when taken as a prophylactic

Method of preparation: Powdered standardized

50 - 250 milligrams of dried leaf per day, standardized to 0.2 - 2 % parthenolide (dry weight); Not to exceed 4 milligrams of parthenolide, per day (Awang 2010; (Curry et al. 2004; Hoffmann 2003; Awang 1993).

Direction(s) for use

All products

Duration(s) of Use

All products

Consult a health care practitioner/health care provider/health care professional/doctor/physician for use beyond 4 months (Awang 1993).

Migraine prevention; Reduction of severity, frequency and symptoms of migraines when taken as a prophylactic

Use for at least 4-6 weeks to see beneficial effects (Palevitch et al. 1997; Murphy et al. 1988).

Risk Information

Caution(s) and warning(s)

Contraindication(s)

Do not use this product if you are pregnant (Brinker 2001; McGuffin et al. 1997).

Known adverse reaction(s)

Non-medicinal ingredients

Must be chosen from the current Natural Health Products Ingredients Database (NHPID) and must meet the limitations outlined in the database.

Storage conditions

Must be established in accordance with the requirements described in the Natural Health Products Regulations (NHPR).

Specifications

References Cited

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Awang DVC. 1993. Feverfew Fever: A Headache for the Consumer. Herbalgram 29:34-36.

Barnes J, Anderson LA, Philipson JD. 2007. Herbal Medicines, 3rd edition. London (GB): The Pharmaceutical Press.

Biggs MJ, Johnson ES, Persaud NP, Ratcliffe DM. 1982. Platelet aggregation in patients using feverfew for migraine. Lancet 2(8301):776.

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Curry EA, Murry DJ, Yoder C, Fife K, Armstrong V, Nakshatri H, O'Connell M, Sweeney CJ. 2004. Phase I dose escalation trial of feverfew with standardized doses of parthenolide in patients with cancer. Investigational New Drugs 22:299-305.

ESCOP 2003: ESCOP Monographs: The Scientific Foundation for Herbal Medicinal Products, 2nd edition. Exeter (GB): European Scientific Cooperative on Phytotherapy and Thieme.

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Hoffmann D. 2003. Medical Herbalism: The Science and Practice of Herbal Medicine. Rochester (VT): Healing Arts Press.

Johnson ES, Kadam NP, Hylands DM, Hylands PJ. 1985. Efficacy of feverfew as prophylactic treatment of migraine. British Medical Journal 291(6495):569-573.

McGuffin M, Hobbs C, Upton R, Goldberg A, editors. 1997. American Herbal Products Association's Botanical Safety Handbook. Boca Raton (FL): CRC Press.

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Murphy JJ, Heptinstall S, Mitchell JR. 1988. Randomized double-blind placebo-controlled trial of feverfew in migraine prevention. Lancet 2(8604):189-192.

Palevitch D, Earon G, Carasso R. 1997. Feverfew (Tanacetum parthenium) as a prophylactic treatment for migraine: a double-blind placebo-controlled study. Phytotherapy Research 11:508- 511.

Paulsen E, Anderson KE and Hausen BM. 2001. Sensitization and cross-reaction patterns in Danish Compositae-allergic patients. Contact Dermatitis 45(4):197-204.

Pittler MH, Ernst E. 2004. Feverfew for preventing migraine (Review). The Cochrane Database of Systematic Reviews, Issue 1. Art. No.: CD002286.pub2. DOI: 10.1002/14651858.CD002286.pub2.

Sweetman SC, editor. 2007. Martindale: The Complete Drug Reference, 35th edition. London (GB): Pharmaceutical Press.

USDA 2019: United States Department of Agriculture, Agricultural Research Service, National Genetic Resources Program. Germplasm Resources Information Network (GRIN) [online database]. Tanacetum parthenium (L.) Sch. Bip. Beltsville (MD): National Germplasm Resources Laboratory. [Accessed 2019 June 28] Available from: https://npgsweb.ars-grin.gov/gringlobal/taxon/taxonomysimple.aspx

Williamson EM. 2003. Potter's Herbal Cyclopaedia: The Authoritative Reference work on Plants with a Known Medical Use. Saffron Walden (GB): The C.W. Daniel Company Limited.

Winston D, Kuhn MA. 2008. Winston and Kuhn's Herbal Therapy and Supplements: A Scientific and Traditional Approach, 2nd edition. Philadelphia (PA): Lippincott Williams and Wilkins.

References Reviewed

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Awang DVC, Dawson BA, Kindack DG. 1991. Parthenolide content of feverfew (Tanacetum parthenium) assessed by HPLC and 1H-NMR spectroscopy. Journal of Natural Products 54(6):1516-1521.

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Berry MI. 1984. Feverfew faces the future. Pharmaceutical Journal 232:611-614.

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Blumenthal M. 2003. ABC Clinical Guide to Herbs. New York (NY): Theime.

Brinker F. 2008. Online Updates and Additions to Herb Contraindications and Drug Interactions, 3rd edition. Sandy (OR): Eclectic Medical Publications. Available from: http://www.eclecticherb.com/emp/updatesHCDI.html [Accessed 05 September 2008].

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Brown D, Gaby A, Reichert R. 1997. Clinical applications of natural medicine: migraine. American Journal of Natural Medicine 4(9):18-20.

Colodny L, Bryan N, Luong S, Rooney J. 2003. Magnesium, feverfew, and riboflavin: therapeutic use in migraine prevention. Journal of American Nutraceutical Association 6(4):35- 48.

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Diener HC, Pfaffenrath V, Schnitker J, Friede M, Henneicke-von Zepelin HH. 2005. Efficacy and safety of 6.25 mg t.i.d. feverfew CO2-extract (MIG-99) in migraine prevention -- a randomized, double-blind, multicentre, placebo-controlled study. Cephalalgia: An International Journal of Headache 25(11):1031-1041.

Draves AH, Walker SE. 2003. Parthenolide content of Canadian commercial feverfew preparations: label claims are misleading in most cases. Canadian Pharmaceutical Journal/La Revue Pharmaceutique Canadienne 136(10):23-30.

Ernst E, Pittler MH. 2000. The efficacy and safety of feverfew (Tanacetum parthenium L.): an update of a systematic review. Public Health Nutrition 3(4A):509-514.

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Hausen BM, Osmundsen PE. 1983. Contact allergy to parthenolide in Tanacetum parthenium (L.) Schulz-Bip. (feverfew, Asteraceae) and cross-reactions to related sesquiterpene lactone containing Compositae species. Acta Dermato-Venereologica 63(4):308-314.

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Heptinstall S, Awang DV, Dawson BA, Kindack D, Knight DW, May J. 1992. Parthenolide content and bioactivity of feverfew (Tanacetum parthenium (L.) Schultz-Bip.). Estimation of commercial and authenticated feverfew products. Journal of Pharmacy and Pharmacology 44(5):391-395.

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Jain NK, Kulkarni SK. 1999. Antinociceptive and anti-inflammatory effects of Tanacetum parthenium L. extract in mice and rats. Journal of Ethnopharmacology 68(1-3):251-259.

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