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Drugs and Health Products

Monograph: Feverfew

This monograph is intended to serve as a guide to industry for the preparation of Product Licence Applications (PLA) and labels for natural health product market authorization. It is not intended to be a comprehensive review of the medicinal ingredient. It is a referenced document to be used as a labelling standard. Notes: (i) Text in parentheses is additional optional information which can be included on the PLA and product labels at the applicant's discretion. The solidus (/) indicates that the terms are synonyms or that the statements are synonymous. Either term or statement may be selected by the applicant. (ii) Claims for traditional use must include the term "Herbal Medicine".

Date: 2010-10-15


Tanacetum parthenium (USDA 2008)

Proper Name(s)

Tanacetum parthenium (L.) Sch. Bip. (Asteraceae/Compositae) ( USDA 1997 )

Common Name(s)

Feverfew ( McGuffin et al. 2000 )

Source Material

Route Of Administration


Dosage Form(s)

  • For digestive aid and headache relief claims: the acceptable pharmaceutical dosage forms include, but are not limited to chewables (eg. gummies, tablets), caplets, capsules, strips, lozenges, powders or liquids where the dose is measured in drops, teaspoons or tablespoons. This monograph is not intended to include foods or food-like dosage forms such as bars, chewing gums or beverages.
  • For migraine prevention/prophylaxis claims: dried leaf or dried aerial parts, containing a minimum of 90% dried leaf, are only allowed in tablet, capsule, or caplet dosage form (Pittler and Ernst 2004; Awang 1993). This monograph is not intended to include foods or food-like dosage forms such as bars, chewing gums or beverages.

Use(s) or Purpose(s)

Statement(s) to the effect of:



Digestive aid; Relieve headache
Preparation: Dry, Powder, Decoction & Infusion + All Non-Standardised Extracts

Dose(s): 50 - 250 Milligrams per day, dried herb tops or leaf
Directions For Use: Take with or after food (Barnes et al. 2007, McGuffin et al. 1997, Johnson et al. 1985)

Migraine prevention; Migraine prophylaxis
Preparation: Dry & Powder Standardised

Dose(s): 50 - 250 Milligrams per day, dried herb tops or leaf 0.2-2 Percent Parthenolide
Directions For Use:

  • Note: The daily dose is not to exceed 4 mg of parthenolide (Curry et al. 2004).
  • 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

Migraine prevention: Use for a minimum of 4-6 weeks to see beneficial effects  (Palevitch et al. 1997, Murphy et al. 1988)
Migraine prophylaxis: Use for a minimum of 4-6 weeks to see beneficial effects  (Palevitch et al. 1997, Murphy et al. 1988)
Consult a health care practitioner for use beyond 4 months  (Awang 1993)

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 breastfeeding  (Boon 2000)
  • Consult a health care practitioner prior to use if you are taking blood thinners  (Brinker 2001, Biggs et al. 1982)


Known Adverse Reaction(s):

Non-medicinal ingredients

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


  • 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).
  • For migraine prevention/prophylaxis: Products must contain a minimum of 90% dried leaf (Awang 1993).
  • Migraine prevention/prophylaxis products must contain a minimum of 90% dried leaf (Awang 1993)
  • Note: Information detailed in this section is not to be submitted with the compendial PLA, although it may be requested at the NHPD's discretion.
  • The medicinal ingredient may comply with the specifications outlined in the following pharmacopoeial monographs: 'Feverfew' from the British Pharmacopoeia (BP), 'Feverfew' of the European Pharmacopoeia (Ph. Eur.) or 'Feverfew' and 'Powdered Feverfew' of the US Pharamcopoeia (USP).

References cited

  • Awang DVC. 1993. Feverfew Fever: A Headache for the Consumer. Herbalgram 29:34-36
  • Awang DVC. Feverfew. In: Coates PM, Betz JM, Blackman MR, Cragg GM, Levine M, Moss J, White JD, editors. Encyclopedia of Dietary Supplements. Second Edition. New York (NY): Informa Healthcare; 2010. p. 267-273.
  • Barnes J, Anderson LA, Philipson JD. 2007. Herbal Medicines, 3rd edition. London (GB): Pharmaceutical Press.
  • Biggs MJ, Johnson ES, Persaud NP, Ratcliffe DM. 1982. Platelet aggregation in patients using feverfew for migraine. Lancet 2(8301):776.
  • Boon H, Smith MJ. 2004. The Complete Natural Medicine Guide to the 50 Most Common Medicinal Herbs, 2nd edition. Toronto (ON): Robert Rose Inc.
  • Boon H. 2000. Feverfew. In: Chandler F, editor. Herbs: Everyday Reference for Health Professionals. Ottawa (ON): Canadian Pharmacists Association and the Canadian Medical Association.
  • 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.
  • Brinker F. 2001. Herb Contraindications and Drug Interactions, 3rd edition. Sandy (OR): Eclectic Medical Publications.
  • Cook WH. 1869. The Physio-Medical Dispensatory: A Treatise on Therapeutics, Materia Medica, and Pharmacy, in Accordance with the Principles of Physiological Medication. Cincinnati (OH): WH Cook. Reprint version by Medical Herbalism: Journal for the Clinical Practitioner. [Accessed 2010 April 20]. Available from:
  • 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 (UK): European Scientific Cooperative on Phytotherapy and Thieme; 2003.
  • Felter HW, Lloyd JU. King's American Dispensatory, Volume 1, 18th edition. Sandy (OR): Eclectic Medical Publications; 1983 [Reprint of 1898 original].
  • Hausen BM. A 6-year experience with compositae mix. American Journal of Contact Dermatitis 1996;7(2):94-99.
  • 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.
  • 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. 2000. Principles and Practice of Phytotherapy. Toronto (ON): Churchill Livingstone.
  • 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 K, Hausen B. Sensitization and cross-reaction patterns in Danish Compositae-allergic patients. Contact Dermatitis 2001;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. Martindale: The Complete Drug Reference, 35th edition. London (UK): Pharmaceutical Press; 2007.
  • USDA 2008: ARS, National Genetic Resources Program. Germplasm Resources Information Network (GRIN). National Germplasm Resources Laboratory, Beltsville (MD). [Accessed 2008-01-21]. Available at
  • Williamson EM. Potter's Herbal Cyclopaedia: The Authoritative Reference work on Plants with a Known Medical Use. Saffron Walden (UK): The C.W. Daniel Company Limited; 2003.
  • 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

  • Abebe W. 2002. Herbal medication: potential for adverse interactions with analgesic drugs. Journal of Clinical Pharmacy and Therapeutics 27(6):391-401.
  • Anderson D, Jenkinson PC, Dewdney RS, Blowers SD, Johnson ES, Kadam NP. 1988. Chromosomal aberrations and sister chromatid exchanges in lymphocytes and urine mutagenicity of migraine patients: a comparison of chronic feverfew users and matched non-users. Human Toxicology 7(2):145-152.
  • 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.
  • Bedard M. 2002. Feverfew and migraine prophylaxis. Canadian Pharmaceutical Journal/La Revue Pharmaceutique Canadienne 4:24-25.
  • Berry MI. 1984. Feverfew faces the future. Pharmaceutical Journal 232:611-614.
  • BHP 1996: British Herbal Pharmacopoeia. Bournemouth (UK): British Herbal Medical Association; 1996.
  • Blumenthal M, Hall T, Goldberg A, Kunz T, Kinda K, editors. 2003. The ABC Clinical Guide to Herbs. Austin (TX): American Botanical Council
  • 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:
  • Brown AM, Edwards CM, Davey MR, Power JB, Lowe KC. 1997. Pharmacological activity of feverfew (Tanacetum parthenium (L.) Schultz-Bip.): assessment by inhibition of human polymorphonuclear leukocyte chemiluminescence in-vitro. Journal of Pharmacy and Pharmacology 49(5):558-561.
  • 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.
  • De Weerdt CJ, Bootsma HPR, Hendricks H. 1996. Herbal medicines in migraine prevention: Randomized double-blind placebo-controlled crossover trial of a feverfew preparation. Phytomedicine 3(3):225-230.
  • 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.
  • Farnsworth NR, Bingel AS, Cordell GA, Crane FA, Fong HH. 1975. Potential value of plants as sources of new antifertility agents I. Journal of Pharmaceutical Sciences 64(4):535-598.
  • Gawel MJ. 1995. The use of feverfew in the prophylaxis of migraine attacks. Today's Therapeutic Trends 13(2):79-86.
  • Grieve M. 1971. A Modern Herbal, Volume 1. New York (NY): Dover Publications [Reprint of 1931 Harcourt, Brace & Company publication].
  • 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.
  • 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.
  • Heptinstall S. 1988. Feverfew-an ancient remedy for modern times? Journal of the Royal Society of Medicine 81(7):373-374.
  • 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.
  • Klepser TB, Klepser ME. 1999. Unsafe and potentially safe herbal therapies. American Journal of Health-System Pharmacy 56(2):125-138.
  • Kwok BH, Koh B, Ndubuisi MI, Elofsson M, Crews CM. 2001. The anti-inflammatory natural product parthenolide from the medicinal herb Feverfew directly binds to and inhibits IkappaB kinase. Chemistry & Biology 8(8):759-766.
  • Makheja AN, Bailey JM. 1982. A platelet phospholipase inhibitor from the medicinal herb feverfew (Tanacetum parthenium). Prostaglandins, Leukotrienes, and Medicine 8(6):653-660.
  • Meyer JE. The Herbalist. Glenwood (IL): Meyerbooks; 1993.
  • Miller LG. 1998. Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Archives of Internal Medicine 158(20):2200-2211.
  • Mills S. The Dictionary of Modern Herbalsim. Wellingborough (UK): Thorsons Publishers Ltd; 1985.
  • Nelson MH, Cobb SE, Shelton J. 2002. Variations in parthenolide content and daily dose of feverfew products. American Journal of Health-System Pharmacy 59(16):1527-1531.
  • Pattrick M, Heptinstall S, Doherty M. 1989. Feverfew in rheumatoid arthritis: a double blind, placebo controlled study. Annals of the Rheumatic Diseases 48(7):547-549.
  • Paulsen E, Andersen KE, Hausen BM. 1993. Compositae dermatitis in a Danish dermatology department in one year (I). Results of routine patch testing with the sesquiterpene lactone mix supplemented with aimed patch testing with extracts and sesquiterpene lactones of Compositae plants. Contact Dermatitis 29(1):6-10.
  • Tilgner S. Herbal Medicine from the Heart of the Earth. Creswell (OR): Wise Acre Press; 1999.
  • Williamson EM, Evans FJ, Wren RC. Potter's New Cyclopaedia of Botanical Drugs and Preparations. Saffron Walden (GB): C.W. Daniel Company Limited; 1988.
  • Wren RC. 1907. Potter's Cyclopedia of Botanical Drugs and Preparations. London (GB): Potter and Clark.

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

Dried leaf:

  • 50 mg, per day (Barnes et al. 2007)
  • 250 mg, per day (Sweetman 2007)
  • 50-100 mg, per day (Hoffmann 2003)
  • 100 mg, per day (Palevitch et al. 1997)
  • 250 mg, per day (Awang 1993)
  • 82 mg, standardized to contain the equivalent of 0.54 mg parthenolide, per day (Murphy et al. 1988)
  • 50 mg, per day (Johnson et al. 1985)

Dried aerial parts:

  • 50 mg, per day (Williamson 2003)
  • 150 mg, standardized to contain a minimum of 0.6 mg parthenolide, 1-2 times per day (Mills and Bone 2000)
  • 50-200 mg (Bradley 1992), equivalent to 0.2-0.6 mg parthenolide, per day (Barnes et al. 2007)