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
Rating methodology
EFSA approval.
Osteoarthritis ✪✪✪✪✪
Oral intake of harpagophytum, alone or in combination with non-steroidal anti-inflammatory drugs (NSAIDs), seems 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 harpagophytum root-based extract containing 2% harpagoside (9.5 mg/capsule) and 3% total iridoid glycosides (14.5 mg per capsule). Another extract providing 60 mg harpagoside per day was also used. Some possible synergies: studies evaluated other combinations; 300 mg harpagophytum, 200 mg turmeric, and 150 mg 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 improved general symptoms by an additional 28% and pain scores by 32.7% compared to the 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
Lower Back Pain ✪✪✪✪✪
Oral intake of harpagophytum seems to alleviate non-specific lower back pain. Some clinical research shows that taking an oral harpagophytum extract at doses of 30 to 100 mg harpagoside per day for a year can reduce lower back pain similarly to other non-steroidal 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 acknowledges traditional use of harpagophytum for the relief of minor joint pain. Furthermore, several clinical studies have demonstrated the benefits of harpagophytum in relieving individuals suffering from arthritis, thanks notably to its analgesic and anti-inflammatory properties.
Posologie
Oral: 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 an interesting analgesic and anti-inflammatory in situations of acute or chronic inflammation, helping to relieve pain and improve mobility in various rheumatologic pathologies.
Posologie
Oral route: 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 Issues ✪✪✪✪✪
The effects of Harpagophytum on digestion have not been solidly studied. Its use for this indication is based on the fact that, like other bitter plants, Harpagophytum stimulates bile production (choleretic effect). Moreover, the EMA recognizes its traditional use to relieve mild digestive disorders such as bloating and flatulence, and in cases of appetite loss.
Posologie
Oral route: root
200 - 960 mg
Adults
standardized extract, ethanolic extract, dry extract
Appetite Stimulation ✪✪✪✪✪
The EMA indicates that Harpagophytum is recommended for minor digestive issues such as bloating, flatulence, and temporary appetite loss. The EMA recommends a maximum treatment duration of two weeks.
Posologie
Oral route: root
200 - 960 mg
Adults
standardized extract, ethanolic extract, dry extract
Properties
Anti-inflammatory
The root of harpagophytum is rich in bioactive compounds known as harpagosides. These compounds are recognized for their potential anti-inflammatory effects. Research has revealed that harpagosides act by inhibiting inflammatory pathways associated with two key enzymes: cyclooxygenase (COX) and lipoxygenase. These pathways are crucial in the inflammatory process, particularly involving COX-2 and nitric oxide synthase, known modulators of inflammation. Preliminary studies suggest that harpagoside can 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. On the other hand, in vitro studies indicate that harpagophytum extract, or isolated harpagosides, can inhibit the metabolic pathways of arachidonic acid, 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 may contribute to inflammation and tissue degradation.
Usages associés
Analgesic
In animals, the administration of harpagophytum extracts has demonstrated an analgesic effect. This effect is similar to that of a non-steroidal anti-inflammatory. Research shows that administering harpagoside at 20 mg/kg produces an analgesic effect similar to that of Phenylbutazone (a non-steroidal anti-inflammatory) at 50 mg/kg.
Usages associés
Choleretic
The effects of harpagophytum on digestion have not been convincingly studied. Its use in this indication is based on the fact that, like other bitter plants, harpagophyton stimulates bile production.
Usages associés
Safety dosage
Adult from 18 years: 200 mg - 2400 mg (powder, dry extract)
Harpagophytum appears to be well tolerated. However, the EMA recommends not exceeding 4 weeks. If joint pains are accompanied by swelling, redness, or fever, they should be examined by a doctor.
Interactions
Médicaments
Cytochrome P450 2C19: moderate interaction
There is preliminary evidence that Harpagophytum could inhibit cytochrome P450 2C19 (CYP2C19). To date, this interaction has not been reported in humans. However, be aware of an increase in levels of medications metabolized by CYP2C19 in patients taking Harpagophytum supplements. Some medications 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
There is preliminary evidence that Harpagophytum could inhibit cytochrome P450 2C9 (CYP2C9). To date, this interaction has not been reported in humans. Some medications metabolized by CYP2C9 include non-steroidal 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 450 3A4: moderate interaction
There is preliminary evidence that Harpagophytum could inhibit the cytochrome P450 3A4 enzyme (CYP3A4). To date, this interaction has not been reported in humans. However, be aware of an increase in levels of medications metabolized by CYP3A4 in patients taking Harpagophytum. Some medications 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: low interaction
Theoretically, Harpagophytum can increase gastric acid. Thus, the plant could decrease the effectiveness of H2 antihistamines. H2 anti-agents include cimetidine (Tagamet), ranitidine (Zantac), nizatidine (Axid), and famotidine (Pepcid).
P-GLYCOPROTEIN Substrate: low interaction
Preliminary in vitro research suggests that Harpagophytum can inhibit the multidrug transport protein, P-glycoprotein. Some drugs carried by glycoprotein include etoposide, paclitaxel, vinblastine, vincristine, vindesine, ketoconazole, itraconazole, amprenavir; cyclosporine, loperamide (Imodium), quinidine, and others.
Proton pump inhibitor: low interaction
Theoretically, Harpagophytum can increase gastric acid. Therefore, it could decrease the effectiveness of proton pump inhibitors (PPI), which include omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix), and esomeprazole (Nexium).
Warfarin: low interaction
Harpagophytum should be avoided or used with caution in patients taking warfarin due to the potential for coagulation disorders.
Digoxin: low interaction
Use caution in the case of treatment with antiarrhythmics or digoxin as Harpagophytum can affect the rhythm and force of heart contractions.
Precautions
Breastfeeding women: avoid
For breastfeeding women, this plant is not recommended due to a lack of information.
Children under 18 years: avoid
Harpagophytum should be avoided due to insufficient reliable information.
Gallstones: avoid
Patients with gallstones should consult a doctor before using Harpagophytum.
Cardiovascular diseases: use with caution
Since Harpagophytum can affect heart rate, heart contractility and blood pressure, it could have adverse effects on individuals with cardiovascular conditions. Use with caution.
Type 2 diabetes: use with caution
Harpagophytum can lower blood sugar and have additive effects with antidiabetic drugs. Dose adjustments may be necessary.
Stomach ulcer: avoid
Harpagophytum may increase gastric acid secretion and could affect individuals with gastric or duodenal ulcers. Avoid using the plant in such cases.
Contraindications
Pregnant women: prohibited
Anecdotal evidence suggests that Harpagophytum has oxytocic effects on women. Furthermore, in vitro research has shown that moderate to high doses induce contractions of isolated uterine muscle in pregnant and non-pregnant rats.
