Dong Quai, Chinese Angelica : Safety, Part 2

by MedlinePlus

(Page 3 of 3)

Safrole, a volatile oil in Dong Quai, may be carcinogenic (cancer-causing). Long-term use should therefore be avoided, and suntan lotions that contain Dong Quai often limit the amount of Dong Quai to less than one percent.

Dong Quai has traditionally been associated with gastrointestinal symptoms (particularly with prolonged use), including laxative effects/diarrhea, upset stomach, nausea, vomiting, loss of appetite, burping, or bloating. Published literature is limited in this area.

Dong Quai preparations may contain high levels of sucrose, and should be used cautiously by patients with diabetes or glucose intolerance.

Various other side effects have rarely been reported with Dong Quai taken alone or in combination with other herbs. However, side effects have not been evaluated in well-designed studies. These include: headache, lightheadedness/dizziness, sedation/drowsiness, insomnia, irritability, fever, sweating, weakness, abnormal heart rhythms, blood pressure abnormalities, wheezing/asthma, hot flashes, worsening premenstrual symptoms, reduced menstrual flow, increased male breast size (gynecomastia), kidney problems (nephrosis), or skin rash.

The safety of Dong Quai injected into the skin, muscles, or veins is not known and should be avoided. Essential oil of Dong Quai injected under the skin of dogs has stopped breathing.

Pregnancy and Breastfeeding

Dong Quai is not recommended during pregnancy due to possible hormonal and anticoagulant/anti-platelet properties. Animal research has noted conflicting effects on the uterus, with reports of both stimulation and relaxation. There is a published report of miscarriage in a woman taking Dong Quai, although it is not clear that Dong Quai was the cause. Dong Quai is traditionally viewed as increasing the risk of abortion. There is insufficient evidence regarding the safety of Dong Quai during breastfeeding.

Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

Interactions with Drugs

Dong Quai may increase the risk of bleeding due to anticoagulant and anti-platelet effects, and may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®). There is a report of the effects of warfarin (Coumadin®) being increased in a woman taking 565 milligrams of Dong Quai once or twice daily, as measured by 2.5-fold increases in values of blood tests for prothrombin time (PT) and international normalized ratio (INR).

It remains unclear if Dong Quai has the same effects on the body as estrogens, blocks the activity of estrogens, or has no significant hormonal effects. It is not known if taking Dong Quai increases or decreases the effects of oral contraceptives or hormone replacement therapy such as Premarin® which contain estrogen, or on the anti-tumor effects of selective estrogen receptor modulators (SERMs) such as tamoxifen.

Chemicals in Dong Quai may cause increased sun sensitivity with a risk of severe skin reactions (photosensitivity), and Dong Quai should be avoided with other drugs that cause photosensitivity, such as tretinoin (Retin-A®, Renova®), and some types of anti-depressants, cancer drugs, antibiotics, or anti-psychotic medications. Patients taking medications should check with their doctor or pharmacist before starting Dong Quai.

Based on laboratory research, Dong Quai may increase the effects of drugs that affect heart rhythms, such as digoxin, beta-blockers such as metoprolol (Lopressor®, Toprol®), calcium channel blockers such as nifedipine (Procardia®) or other anti-arrhythmic drugs. Animal studies and one human report have noted reduced blood pressure after administration of Dong Quai, and Dong Quai should be used cautiously in individuals taking blood pressure-lowering medications.

Interactions with Herbs and Dietary Supplements

In theory, due to anticoagulant and anti-platelet effects, components of Dong Quai may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba , and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases. Some examples include: alfalfa, American ginseng, angelica, anise, Arnica montana , asafetida, aspen bark, bilberry, birch, black cohosh, bladderwrack, bogbean, boldo, borage seed oil, bromelain, capsicum, cat's claw, celery, chamomile, chaparral, clove, coleus, cordyceps, danshen, devil's claw, EPA (eicosapentaenoic acid, found in deep-sea fish oils), evening primrose oil, fenugreek, feverfew, fish oil, flaxseed/flax powder (not a concern with flaxseed oil), ginger, grapefruit juice, grapeseed, green tea, guggul, gymnestra, horse chestnut, horseradish, licorice root, lovage root, male fern, meadowsweet, nordihydroguairetic acid (NDGA), onion, papain, Panax ginseng, parsley, passionflower, poplar, prickly Ash, propolis, quassia, red clover, reishi, Siberian ginseng, sweet clover, rue, sweet birch, sweet clover, turmeric , vitamin E, white willow, wild carrot, wild lettuce, willow, wintergreen, and yucca.

It remains unclear if Dong Quai has the same effects on the body as estrogens, blocks the activity of estrogens, or has no significant hormonal effects. The effects of agents believed to have estrogen-like properties may be altered, such as alfalfa, black cohosh, bloodroot, burdock, hops, kudzu, licorice, pomegranate, red clover, soy, thyme, white horehound, and yucca.

Chemicals in Dong Quai may cause increased sun sensitivity with a risk of severe skin reactions (photosensitivity), and Dong Quai should not be taken with products containing Hypericum perforatum (St. John's wort) or capsaicin, which are also reported to cause photosensitivity.

About the Author

medlineplus.gov
MedlinePlus will direct you to information to help answer health questions. MedlinePlus brings together authoritative information from NLM, the National Institutes of Health (NIH), and other government agencies and health-related organizations. MedlinePlus also has extensive information about drugs, an illustrated medical encyclopedia, interactive patient tutorials, and latest health news.