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Drugs and Health Products

Monograph: Devil's Claw

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Date: 2008-05-09

NHPID Name

Harpagophytum procumbens (USDA 2008)

Proper Name(s)

Harpagophytum procumbens (Burch) DC. ex Meisn. (Pedaliaceae) ( USDA 2008 )

Common Name(s)

Devil's claw ( McGuffin et al. 2000 )

Source Material

Secondary root tuber ( ESCOP 2003 , Blumenthal et al. 2000 , Bradley 1992 )

Route Of Administration

Oral

Dosage Form(s)

Those suited to the allowable route(s) of administration. This monograph is not intended to include food-like dosage forms such as bars, chewing gums or beverages.

Use(s) or Purpose(s)

Statement(s) to the effect of:

Dose(s)

Adults:

For relief of digestive disturbances
Preparation: Dry, Powder, Decoction & Infusion + All Non-Standardised Extracts

Dose(s): 0.6 - 4.5 Grams per day, dried secondary root tubers
For relief of joint pain associated with osteoarthritis
Preparation: Dry, Powder, Decoction & Infusion + All Non-Standardised Extracts

Dose(s): 0.6 - 7.5 Grams per day, dried secondary root tubers
For stimulation of appetite
Preparation: Dry, Powder, Decoction & Infusion + All Non-Standardised Extracts

Dose(s): 0.6 - 1.5 Grams per day, dried secondary root tubers

See Appendix 1 for examples of appropriate dosage preparations and frequencies of use, according to cited references. The purpose of Appendix 1 is to provide guidance to industry.

Duration of use

For relief of joint pain associated with osteoarthritis: Use for a minimum of 2 - 3 months to see beneficial effects  (ESCOP 2003)

Risk Information

Statement(s) to the effect of:

Caution(s) and Warning(s):
  • Consult a health care practitioner if symptoms persist.
  • Consult a health care practitioner if symptoms worsen.
  • Consult a health care practitioner prior to use if you are pregnant or breastfeeding

Contraindication(s):
No statement is required

Known Adverse Reaction(s):
No statement is required

Non-medicinal ingredients

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

Specifications

  • The finished product specifications must be established in accordance with the requirements described in the NHPD Quality of Natural Health Products Guide.
  • The medicinal ingredient must comply with the requirements outlined in the Natural Health Products Ingredient Database (NHPID).
  • The medicinal ingredient may comply with the specifications outlined in the Devil's Claw Root Monograph published in the European or British Pharmacopoeias.

References cited

  • Blumenthal M, Goldberg A, Brinckmann J, editors. Herbal Medicine: Expanded Commission E Monographs. Boston (MA): Integrative Medicine Communications; 2000.
  • Bradley PR, editor. 1992. British Herbal Compendium: A Handbook of Scientific Information on Widely Used Plant Drugs, Volume 1. Bournemouth (GB): British Herbal Medicine Association.
  • ESCOP 2003: ESCOP Monographs: The Scientific Foundation for Herbal Medicinal Products, 2nd edition. Exeter (UK): European Scientific Cooperative on Phytotherapy and Thieme; 2003.
  • Hoffmann D. 2003. Medical Herbalism: The Science and Practice of Herbal Medicine. Rochester (VT): Healing Arts Press.
  • McGuffin M, Kartesz JT, Leung AY, Tucker AO, editors. 2000. Herbs of Commerce, 2nd edition. Austin(TX): American Herbal Products Association.
  • Mills S, Bone K. 2005. The Essential Guide to Herbal Safety. St. Louis (MO): Elsevier Churchill Livingstone.
  • USDA 2008: ARS, National Genetic Resources Program. Germplasm Resources Information Network (GRIN). National Germplasm Resources Laboratory, Beltsville (MD). [Accessed 2008-01-21]. Available at http://www.ars-grin.gov/cgi-bin/npgs/html/tax_search.pl

References reviewed

  • Brien S, Lewith GT, McGregor G. Devil's claws (Harpagophytum procumbens) as a treatment for osteoarthritis: A review of efficacy and safety. The Journal of Alternative and Complimentary Medicine 2006;12(10):981-993.
  • Brinker F. 2010. Online Updates and Additions to Herb Contraindications and Drug Interactions, 3rd edition. Sandy (OR): Eclectic Medical Publications. [Updated 2010 July 13; Accessed 2013 January 30]. Available from: http://www.eclecticherb.com/emp/updatesHCDI.html
  • Chantre P, Cappelaere A, Leblan D, Guedon D, Vandermander J, Fournie B. Efficacy and tolerance of Harpagophytum procumbens versus diacerhein in treatment of osteoarthritis. Phytomedicine 2000;7(3):177-83.
  • Chrubasik JE, Roufogalis BD, Chrubasik S. Evidence of effectiveness of herbal antiinflammatory drugs in the treatment of painful osteoarthritis and chronic low back pain. Phytotherapy Research: PTR 2007;21(7):675-683.
  • Chrubasik S, Chrubasik C, Kunzel O, Black A. Patient-perceived benefit during one year of treatment with Doloteffin. Phytomedicine 2007;14(6):371-376.
  • Chrubasik S, Conradt C, Black A. The quality of clinical trials with Harpagophytum procumbens. Phytomedicine 2003;10(6-7):613-623.
  • Chrubasik S, Conradt C, Roufogalis BD. Effectiveness of Harpagophytum extracts and clinical efficacy. Phytotherapy Research: PTR 2004;18(2):187-189.
  • Chrubasik S, Model A, Black A, Pollak S. A randomized double-blind pilot study comparing Doloteffin and Vioxx in the treatment of low back pain. Rheumatology 2003:42(1):141-148.
  • Chrubasik S, Thanner J, Kunzel O, Conradt C, Black A, Pollak S. Comparison of outcome measures during treatment with the proprietary Harpagophytum extract Doloteffin in patients with pain in the lower back, knee or hip. Phytomedicine 2002;9(3):181-194.
  • Gagnier JJ, vanTulder M, Berman B, Bombardier C. Herbal medicine for low back pain: a Cochrane review. Spine 2008;32(1):82-92.
  • Grant L, McBean DE, Fyfe L, Warnock AM. A review of the biological and potential actions of Harpagophytum procumbens. Phytotherapy Research: PTR 2007;21(3):199-209.
  • Gregory PJ, Sperry M, Friedman Wilson A. Dietary supplements for osteoarthritis. American Family Physician 2008;77(2):177-184.
  • Laudahn D, Walper A. Efficacy and tolerance of Harpagophytum extract LI 174 in patients with chronic non-radicular back pain. Phytotherapy Research 2001;15(7):621-4.
  • Leblan D, Chantre P, Fourniť B. Harpagophytum procumbens in the treatment of knee and hip osteoarthritis. Four-month results of a prospective, multicenter, double-blind trial versus diacerhein. Joint, bone, spine : revue du rhumatisme 2000;67(5):462-7.
  • McGuffin M, Hobbs C, Upton R, Goldberg A, editors. 1997. American Herbal Products Association's Botanical Safety Handbook. Boca Raton (FL): CRC Press.
  • Mills S, Bone K. 2000. Principles and Practice of Phytotherapy. Toronto (ON): Churchill Livingstone.

Appendix 1: Examples of appropriate dosage preparations, frequencies of use and directions for use

For stimulation of appetite:

Dried secondary root tuber:

1.5 g, per day (Blumenthal et al. 2000)

Decoction:

  • 0.5 g dried secondary root tubers, 3 times per day (Blumenthal et al. 2000; Bradley 1992)
  • Directions for use: Place dried secondary root tubers in 150 ml of water, bring to a boil, and simmer (Blumenthal et al. 2000).

Fluidextract:

0.5 g dried equivalent, 3 times per day (1:1, 0.5 ml) (Blumenthal et al. 2000)

Tincture:

0.2 g dried equivalent, 3 times per day (1:5, 25% alcohol, 1 ml) (Bradley 1992)

For relief of digestive disturbances:

Dried secondary root tuber:

4.5 g, per day (Blumenthal et al. 2000)

Infusion:

  • 1.5 g dried secondary root tubers, 3 times per day (Blumenthal et al. 2000)
  • Directions for use: Pour 300 ml of boiling water over 4.5 g dried secondary root tubers and steep for 8 hours. Drink 100 ml, 3 times per day (Blumenthal et al. 2000).

Decoction:

  • 1.5 g dried secondary root tubers, 3 times per day (Blumenthal et al. 2000)
  • 0.5 g dried secondary root tubers, 3 times per day (Bradley 1992)
  • Directions for use: Place dried secondary root tubers in 150 ml of water, bring to a boil, and simmer (Blumenthal et al. 2000).

Fluidextract:

1.5 g dried equivalent, 3 times per day (1:1, 1.5 ml) (Blumenthal et al. 2000)

Tincture:

0.2 g dried equivalent, 3 times per day (1:5, 25% alcohol, 1 ml) (Bradley 1992)

For the relief of joint pain associated with osteoarthritis:

Dried secondary root tuber:

  • 1.5-6 g, per day (Mills and Bone 2005)
  • 2-5 g, per day (ESCOP 2003)
  • 4.5 g, per day (Blumenthal et al. 2000)

Infusion:

  • 1.5 g dried secondary root tubers, 3 times per day (Blumenthal et al. 2000)
  • Directions for use: Pour 300 ml of boiling water on 4.5 g dried secondary root tubers and steep for 8 hours. Drink 100 ml, 3 times per day (Blumenthal et al. 2000).

Decoction:

  • 1.5-6 g dried secondary root tubers, per day (Mills and Bone 2005)
  • 1.5 g dried secondary root tubers, 3 times per day (Blumenthal et al. 2000)
  • 1.5-2.5 g dried secondary root tubers, 3 times per day (Bradley 1992)
  • Directions for use: Place dried secondary root tubers in 150 ml of water, bring to a boil, and simmer (Blumenthal et al. 2000).

Fluidextract:

  • 1.5 g dried equivalent, 3 times per day (1:1, 1.5 ml) (Blumenthal et al. 2000)
  • 1-2 g dried equivalent, 3 times per day (1:1, 25% ethanol, 1-2 ml) (Bradley 1992)

Tincture:

0.2-0.4 g dried equivalent, 3 times per day (1:5, 40% alcohol, 1-2 ml) (Hoffmann 2003)