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Safety

DISCLAIMER: Many complementary techniques are practiced by healthcare professionals with formal training, in accordance with the standards of national organizations. However, this is not universally the case, and adverse effects are possible. Due to limited research, in some cases only limited safety information is available.

Allergies

Feverfew may cause allergy in people allergic to chrysanthemums, daisies, marigolds, or other members of the Compositae family, including ragweed. There are multiple reports of allergic skin rashes after contact with feverfew.

Side Effects and Warnings

Few side effects are reported in human studies of feverfew. The side effects that do occur are usually mild and reversible. Mouth inflammation or ulcers, including swelling of the lips, tongue irritation, bleeding of the gums, and loss of taste have been reported, which usually occur after direct contact of the mouth with the leaves, although some people report burning after swallowing a capsule containing dried leaf. Photosensitivity (sensitivity to sunlight or sunlamps) has been reported with other herbs in the Compositae plant family, and may be possible with feverfew as well. Indigestion, nausea, flatulence, constipation, diarrhea, abdominal bloating, and heartburn have been reported rarely in human studies. Gardeners may develop skin irritation at sites of contact with feverfew plants. Feverfew can also cause allergic rashes. One small study reported increased heart rate in some patients.

Long-term feverfew users who stop treatment suddenly may experience feverfew withdrawal symptoms, including rebound headaches, anxiety, difficulty sleeping, muscle stiffness, and joint pain.

Laboratory tests suggest that feverfew affects blood platelets, and in theory may increase the risk of bleeding. However, this has not been clearly shown in humans. Nonetheless, caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary. Use caution prior to some surgeries or dental procedures, due to a theoretical increase in bleeding risk.

Pregnancy and Breastfeeding

There is not enough information about safety to recommend feverfew during pregnancy or breastfeeding. Traditional experience suggests that feverfew may stimulate menstrual flow and induce abortion, and therefore should be avoided.

Interactions

Interactions with Drugs

Based on laboratory research, feverfew theoretically may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. However, this has not been clearly shown in humans. 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®).

Sun sensitivity caused by certain drugs like doxycycline or Retin A® may be increased by feverfew. Feverfew may also alter the way that certain drugs are broken down by the liver.

Interactions with Herbs and Dietary Supplements

In theory, feverfew may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. This is based on laboratory research, and has not been reported clearly in humans. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, fewer cases with garlic, and two cases with saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

Sun sensitivity caused by certain herbs and supplements may be increased by feverfew. Feverfew may alter the way that certain herbs and supplements are broken down by the liver.