Harpagophytum: benefits, dosage, contraindications
Other name(s)
Harpagophyton; Devil's Claw; Uncaria procumbens
Scientific name(s)
Harpagophytum procumbens
Family or group:
Plants
Active ingredients:
Harpagosides
Flavonoids
Phytosterols
Iridoids
Indications
Scoring methodology
EFSA approval.
Osteoarthritis ✪✪✪✪✪
Oral intake of harpagophytum, alone or in combination with nonsteroidal anti-inflammatory drugs (NSAIDs), appears to help reduce pain related to osteoarthritis. Patients taking devil's claw also seem to be able to reduce NSAID use for pain relief. These studies used a root-based Harpagophytum extract containing 2% of the constituent harpagoside (9.5 mg/capsule) and 3% total iridoid glycosides (14.5 mg per capsule). Another extract of 2400 mg per day providing 60 mg of the constituent harpagoside has also been used. Some possible synergies: studies have evaluated other combinations; 300 mg of harpagophytum, 200 mg of turmeric and 150 mg of bromelain per capsule, taken as two or three capsules three times a day for two months, significantly improve acute and chronic pain in patients with osteoarthritis. The combination of harpagophytum, nettle, rosehip and vitamin D taken orally daily for 12 weeks improves overall symptoms by an additional 28% and pain scores by an additional 32.7% compared with placebo in adults with knee osteoarthritis.
Posologie
Oral: root
900 - 2700 mg
2 months
Adults
standardized extract, ethanolic extract, dry extract
Synergies
Harpagophytum Procumbens in the Treatment of Knee and Hip Osteoarthritis. Four-month Results of a Prospective, Multicenter, Double-Blind Trial Versus Diacerhein
Efficacy and Tolerance of Harpagophytum Procumbens Versus Diacerhein in Treatment of Osteoarthritis
A complex of three natural anti-inflammatory agents provides relief of osteoarthritis pain.
Systematic Review on the Safety of Harpagophytum Preparations for Osteoarthritic and Low Back Pain
Anti-inflammatory and Analgesic Effects of an Aqueous Extract of Harpagophytum Procumbens
Evaluation of acute and chronic treatments with Harpagophytum procumbens on Freund's adjuvant-induced arthritis in rats.
Comparison of Outcome Measures During Treatment With the Proprietary Harpagophytum Extract Doloteffin in Patients With Pain in the Lower Back, Knee or Hip
Treatment of patients with arthrosis of hip or knee with an aqueous extract of devil's claw (Harpagophytum procumbens DC.).
A Complex of Three Natural Anti-Inflammatory Agents Provides Relief of Osteoarthritis Pain
The quality of clinical trials with Harpagophytum procumbens
Low back pain ✪✪✪✪✪
Oral administration of harpagophytum appears to alleviate nonspecific low back pain. Some clinical research shows that taking an oral extract of harpagophytum at doses of 30 to 100 mg of the constituent harpagoside per day for one year may reduce low back pain in the same way as other nonsteroidal anti-inflammatory drugs.
Posologie
Oral: root
600 - 2400 mg
1 - years
Adults
standardized extract, ethanolic extract, dry extract
Efficacy and Tolerance of Harpagophytum Extract LI 174 in Patients With Chronic Non-Radicular Back Pain
Effectiveness of Harpagophytum Extract WS 1531 in the Treatment of Exacerbation of Low Back Pain: A Randomized, Placebo-Controlled, Double-Blind Study
Chrubasik S, Zimpfer C, Schutt U, and et al. Effectiveness of Harpagophytum procumbens in treatment of acute low back pain. Phytomedicine 1996;3(1):1-10.
[Effects of Harpagophytum Procumbens LI 174 (Devil's Claw) on Sensory, Motor Und Vascular Muscle Reagibility in the Treatment of Unspecific Back Pain]
Comparison of Outcome Measures During Treatment With the Proprietary Harpagophytum Extract Doloteffin in Patients With Pain in the Lower Back, Knee or Hip
A 1-year Follow-Up After a Pilot Study With Doloteffin for Low Back Pain
Joint pain ✪✪✪✪✪
The EMA recognizes the traditional use of harpagophytum for the relief of minor joint pain. In addition, several clinical studies have demonstrated the benefit of harpagophytum in relieving people suffering from arthritis, notably due to its analgesic and anti-inflammatory properties.
Posologie
Orally: root
600 - 2.4 mg
Adults
standardized extract, ethanolic extract, dry extract
Harpagophytum Procumbens in the Treatment of Knee and Hip Osteoarthritis. Four-month Results of a Prospective, Multicenter, Double-Blind Trial Versus Diacerhein
Efficacy and Tolerance of Harpagophytum Procumbens Versus Diacerhein in Treatment of Osteoarthritis
A complex of three natural anti-inflammatory agents provides relief of osteoarthritis pain.
Systematic Review on the Safety of Harpagophytum Preparations for Osteoarthritic and Low Back Pain
Anti-inflammatory and Analgesic Effects of an Aqueous Extract of Harpagophytum Procumbens
Effectiveness and Safety of Devil's Claw Tablets in Patients With General Rheumatic Disorders
Comparison of Outcome Measures During Treatment With the Proprietary Harpagophytum Extract Doloteffin in Patients With Pain in the Lower Back, Knee or Hip
Treatment of patients with arthrosis of hip or knee with an aqueous extract of devil's claw (Harpagophytum procumbens DC.).
A Complex of Three Natural Anti-Inflammatory Agents Provides Relief of Osteoarthritis Pain
The quality of clinical trials with Harpagophytum procumbens
Arthritis ✪✪✪✪✪
The majority of clinical studies indicate that Harpagophytum is a noteworthy analgesic and anti-inflammatory in situations of acute or chronic inflammation, helping to relieve pain and improve mobility in various rheumatological conditions.
Posologie
Oral: root
900 mg
Adults
standardized extract, ethanolic extract, dry extract
Harpagophytum Procumbens in the Treatment of Knee and Hip Osteoarthritis. Four-month Results of a Prospective, Multicenter, Double-Blind Trial Versus Diacerhein
Efficacy and Tolerance of Harpagophytum Procumbens Versus Diacerhein in Treatment of Osteoarthritis
A complex of three natural anti-inflammatory agents provides relief of osteoarthritis pain.
Systematic Review on the Safety of Harpagophytum Preparations for Osteoarthritic and Low Back Pain
Anti-inflammatory and Analgesic Effects of an Aqueous Extract of Harpagophytum Procumbens
Effectiveness and Safety of Devil's Claw Tablets in Patients With General Rheumatic Disorders
Comparison of Outcome Measures During Treatment With the Proprietary Harpagophytum Extract Doloteffin in Patients With Pain in the Lower Back, Knee or Hip
Treatment of patients with arthrosis of hip or knee with an aqueous extract of devil's claw (Harpagophytum procumbens DC.).
A Complex of Three Natural Anti-Inflammatory Agents Provides Relief of Osteoarthritis Pain
The quality of clinical trials with Harpagophytum procumbens
Digestive disorders ✪✪✪✪✪
The effects of harpagophytum on digestion have not been the subject of robust studies. Its use for this indication is based on the fact that, like other bitter herbs, harpagophytum stimulates bile production (choleretic effect). Furthermore, the EMA recognizes its traditional use to relieve mild digestive disorders such as bloating and flatulence, and in cases of loss of appetite.
Posologie
Oral: root
200 - 960 mg
Adults
standardized extract, ethanolic extract, dry extract
Stimulate appetite ✪✪✪✪✪
The EMA indicates that harpagophytum is recommended for minor digestive disorders such as bloating, flatulence and temporary loss of appetite. The EMA recommends a maximum treatment duration of two weeks.
Posologie
Oral: root
200 - 960 mg
Adults
standardized extract, ethanolic extract, dry extract
Properties
Anti-inflammatory
The root of Harpagophytum is rich in bioactive compounds called harpagosides. These compounds are recognized for their potential anti-inflammatory effects. Research has shown that harpagosides act by inhibiting inflammatory pathways associated with two key enzymes: cyclooxygenase (COX) and lipoxygenase. These pathways are crucial in the inflammatory process, notably involving COX-2 and nitric oxide synthase, known modulators of inflammation. Preliminary studies suggest that harpagoside may modulate inflammation by interfering with these enzymes. However, results in humans are mixed: some studies have not found a significant effect of Harpagophytum on arachidonic acid metabolism, a polyunsaturated fatty acid involved in inflammatory responses. In contrast, in vitro studies indicate that Harpagophytum extract, or isolated harpagosides, can inhibit arachidonic acid metabolic pathways, notably by reducing the expression and/or activity of the COX-2 enzyme. Another interesting aspect of Harpagophytum's action is its ability to reduce the synthesis of pro-inflammatory cytokines. These cytokines are cellular messengers that play a vital role in the initiation and maintenance of inflammation. The plant extract has also been observed to suppress the activity of matrix metalloproteinases, enzymes that degrade various components of the extracellular matrix and can contribute to inflammation and tissue breakdown.
Usages associés
Analgesic
In animals, administration of harpagophytum extracts has been shown to have an analgesic effect. This effect would be similar to that of a nonsteroidal anti-inflammatory drug. These studies show that administration of harpagoside at 20 mg/kg produces an analgesic effect similar to that of phenylbutazone (a nonsteroidal anti-inflammatory drug) at 50 mg/kg.
Usages associés
Choleretic
The effects of harpagophytum on digestion have not been the subject of convincing studies. Its use for this indication is based on the fact that, like other bitter plants, harpagophytum stimulates bile production.
Usages associés
Safe dosage
Adults (18 years and older): 200 mg - 2400 mg (powder, dry extract)
Harpagophytum appears to be well tolerated. However, the EMA recommends not exceeding 4 weeks. If joint pain is accompanied by swelling, redness, or fever, it should be evaluated by a doctor.
Interactions
Médicaments
Cytochrome P450 2C19: moderate interaction
There is preliminary evidence that hapagophytum may inhibit cytochrome P450 2C19 (CYP2C19). So far, this interaction has not been reported in humans. However, monitor for increased levels of drugs metabolized by CYP2C19 in patients taking harpagophytum-based supplements.nnSome drugs metabolized by CYP2C19 include proton pump inhibitors such as omeprazole (Prilosec), lansoprazole (Prevacid), and pantoprazole (Protonix); diazepam (Valium); carisoprodol (Soma); nelfinavir (Viracept); and others.
Cytochrome P450 2C9: moderate interaction
Preliminary evidence suggests that harpagophytum (devil's claw) may inhibit cytochrome P450 2C9 (CYP2C9). To date, this interaction has not been reported in humans.nnSome drugs metabolized by CYP2C9 include nonsteroidal anti-inflammatory drugs (NSAIDs) such as diclofenac (Cataflam, Voltaren), ibuprofen (Motrin), meloxicam (Mobic), and piroxicam (Feldene); celecoxib (Celebrex); amitriptyline (Elavil); warfarin (Coumadin); glipizide (Glucotrol); losartan (Cozaar); and others. Use devil's claw with caution or avoid it in patients taking these medications.
Cytochrome P450 3A4: moderate interaction
Preliminary evidence suggests that harpagophytum (devil's claw) may inhibit the cytochrome P450 3A4 (CYP3A4) enzyme. To date, this interaction has not been reported in humans. However, be alert for increased levels of drugs metabolized by CYP3A4 in patients taking harpagophytum.nnSome drugs metabolized by CYP3A4 include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and many others. Use devil's claw with caution or avoid it in patients taking these medications.
H2 antihistamines: minor interaction
Theoretically, harpagophytum (devil's claw) may increase gastric acid. Thus, the plant could reduce the effectiveness of H2 antihistamines. H2 agents include cimetidine (Tagamet), ranitidine (Zantac), nizatidine (Axid), and famotidine (Pepcid).
P-glycoprotein substrate: minor interaction
Preliminary in vitro research suggests that harpagophytum may inhibit the multidrug transport protein, P-glycoprotein. Some drugs transported by P-glycoprotein include etopos, paclitax, vinblastine, vincristine, vindesine, ketoconazole, itraconazole, amprenavir), cyclosporine, loperamide (Imodium), quinidine and others.
Proton pump inhibitor: weak interaction
Theoretically, harapagophytum may increase gastric acid. Thus, it could reduce the effectiveness of proton pump inhibitors (PPIs), which include omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix) and esomeprazole (Nexium).
Warfarin: weak interaction
Harpagophytum should be avoided or used with caution in patients taking warfarin. Indeed, such a combination can cause coagulation disorders.
Digoxin: weak interaction
Use caution if being treated with antiarrhythmics or digoxin, as harpagophyton may affect the rhythm and strength of heart contractions.
Precautions
Breastfeeding women: avoid
For breastfeeding women, this plant is not recommended due to insufficient information.
Children up to 18 years: avoid
Harpagophytum should be avoided due to insufficient reliable information.
Gallstones: avoid
Patients with gallstones should consult a physician before using harpagophytumnn
Cardiovascular disease: use with caution
Because harpagophytum can affect heart rhythm, cardiac contractility, and blood pressure, it could have adverse effects on people with cardiovascular conditions. Use with caution.nn
Type 2 diabetes: use with caution
Harpagophytum may lower blood glucose and have additive effects with antidiabetic medications. Dose adjustments may be necessary.nn
Gastric ulcer: avoid
Harpagophytum could increase gastric acid secretion and may affect people with a gastric or duodenal ulcer. Avoid using the herb in this case.nn
Contraindications
Pregnancy: contraindicated
Anecdotal evidence suggests that harpagophytum has oxytocic effects in women. Furthermore, in vitro research has shown that moderate to high doses induce contractions of isolated uterine muscle in pregnant and nonpregnant female rats.nn
