feverfew

Feverfew, Tanacetum parthenium, is a plant belonging to the daisy family (Asteraceae) that grows in gardens and roadsides, in many parts of the world.

Feverfew is a medicinal plant traditionally used to prevent migraine headaches, and in the treatment of fevers, rheumatoid arthritis, skin disorders, and other conditions. Feverfew may reduce the intensity and frequency of migraine headaches, but there is no scientific evidence to support most of its other uses.

The therapeutic effects of feverfew are believed to be from the chemicals found in the leaves. Feverfew leaves contain sesquiterpene lactones including parthenolide, flavonoids, and volatile oils. Studies show these compounds have anti-inflammatory, antioxidant, anticancer and anticoagulant properties.

Feverfew works by inhibiting the release and synthesis of inflammatory substances in the body including prostaglandins. Feverfew also inhibits the release of histamine and serotonin from platelets and leukocytes, which play a role in inflammation. Feverfew is available over the counter (OTC) as fresh, freeze-dried, or dried leaves, capsules, tablets, or liquid extracts. 

In addition to prevention of migraines, suggested uses of feverfew include treatment of:

• Allergies
• Arthritis
• Rheumatoid arthritis
• Fevers
• Headaches
• Menstrual irregularities
• Psoriasis
• Ringing in the ears (tinnitus)
• Vertigo
• Cancer

• Do not take feverfew if you are hypersensitive to:
  • Chrysanthemums, daisies or marigolds
  • Plants from the aster family (Asteraceae) or daisy family (Compositae)
• Do not use feverfew if you have ragweed allergies.
• Do not use feverfew if you are pregnant or breastfeeding.
• Feverfew may slow down the blood clotting process, so avoid taking it if you are on blood thinning medications or if you have any bleeding disorder. Stop taking feverfew at least 2 weeks before any scheduled surgery.
• Dried feverfew leaf or feverfew extract may be safe to take orally, chewing fresh leaves may cause swelling and ulcerations in the mouth and loss of taste.

Common side effects of feverfew include:

• Allergic reaction
• Mouth ulcers
• Loss of taste
• Swelling of lips, tongue and mouth
• Nausea
• Vomiting
• Abdominal pain
• Indigestion
• Heartburn
• Gas (flatulence) and bloating
• Diarrhea
• Menstrual changes

Chronic use can cause post-feverfew syndrome with symptoms that include

• Nervousness
• Anxiety
• Insomnia
• Fatigue
• Joint pain (arthralgia)
• Muscle and joint stiffness

Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:

• Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
• Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
• Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
• Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

There is insufficient information on what might be appropriate dosages of feverfew, follow manufacturer’s instructions.

Suggested dosage:

Migraine, Prophylaxis

Extract

• 50-100 mg orally daily

Fresh leaf

• 2.5 leaves orally daily

Freeze-dried leaf

• 50-150 mg orally once or twice daily

• There is not enough information on feverfew overdose. There are no reports of severe adverse effects from the use of feverfew. Overdose may cause gastrointestinal symptoms and oral ulceration which should resolve with discontinuation of feverfew.
• Long-term use may cause post-feverfew syndrome with symptoms that include headache, insomnia, joint and muscle pain/stiffness, fatigue, and anxiety.
• Overdose treatment may be symptomatic care.

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Feverfew has no known severe or serious interactions with other drugs.
• Feverfew has moderate interactions with at least 73 different drugs.
• Feverfew has mild interactions with at least 49 different drugs.

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

• Feverfew may induce uterine contractions, do not take if you are pregnant.
• There is little information about the safety of feverfew use in nursing mothers, avoid taking if you are breastfeeding.
• Check with your healthcare provider before taking any herbal supplement, including feverfew, if you are pregnant or breastfeeding.

• Freeze-dried feverfew and extracts are possibly safe for most adults when taken orally in recommended doses for a short period.
• Check with your healthcare provider before taking any supplement, including feverfew.
• Use feverfew exactly as per label instructions.
• Herbal products often contain many ingredients. Check labels for the components in the feverfew product you choose.
• Feverfew is marketed as an herbal supplement and is not regulated by the FDA. Products may differ in formulations and strengths, and labels may not always match contents; exercise caution in choosing your product.
• Store safely out of reach of children.
• In case of overdose, seek medical help immediately or report to Poison Control.