HERBAL
MEDICINAL
PLANT
---------------------------------------------
PULSATILLA
Pulsatilla vulgaris Mill.
(Ranunculaceae)
BY
RETTODWIKART THENU
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PULSATILLA
(puhl-suh-til’uh)
Pulsatilla vulgaris Mill. (Ranunculaceae)
SUMMARY AND PHARMACEUTICAL COMMENT
Pulsatilla
is widely used in both herbal and homeopathic preparations, although little
documented chemical and pharmacological information is available to assess its
effects. There is a lack of robust clinical research assessing the efficacy and
safety of pulsatilla. The fresh plant is known to be irritant; it contains a
toxic principle (protoanemonin) and should not be ingested. The dried plant material
is not considered to be toxic, but allergic reactions have been documented. In
view of this and the lack of safety information, the use of pulsatilla during
pregnancy and lactation should be avoided.
DESCRIPTION
MEDICINAL PARTS: The medicinal
part is the whole fresh plant collected during the flowering season.
FLOWER AND FRUIT: The flowers are
solitary and almost always nodding. They have 6 campanulate, close, brightviolet
tepals. These are usually thickly silky-haired on the outside with revolute
tips, and are 1.5 to 3 cm long. The stamens are yellow and numerous; the longer
ones are at least two-thirds the length of the tepals. The carpels with the style
are as long as the tepals. The ripe fruit is oblong and densely pubescent. The
protruding style is up to 6 cm long.
LEAVES, STEM AND ROOT: The plant is a
perennial, 7 to 50 cm high with a strong, dark, usually divided, rhizome. The
basal leaves usually appear after the flowers and are not hardy. They are 3 to
4 pinnate with narrow linear acuminate end sections that, along with the
petioles, are thickly white villous. The stems are erect and densely pubescent
with 3 whorled high leaves, divided into linear, pubescent tips.
CHARACTERISTICS: The plant is
poisonous.
HABITAT: The plant originated
in southwestern Europe and now also grows in central and eastern Europe.
PRODUCTION: Pasque Flower
herb consists of the dried, aboveground parts of Pulsatilla vulgaris and/or
Pulsatilla pratensis.
SPECIES (FAMILY)
*Pulsatilla vulgaris Mill.
(Ranunculaceae)
†Pulsatilla pratensis (L.)
Mill.
‡Pulsatilla patens (L.)
Mill.
SYNONYM(S)
*Anemone pulsatilla L.,
Pulsatilla ucrainica (Ugr.) E.D.
Wissjul, Pasque Flower
†Anemone pratensis L.,
Pulsatilla nigricans Störck, Small
Pasque Flower
‡Anemone patens (L.)
Mill.
OTHER COMMON NAMES
Crowfoot, Easter fl ower,
kubjelle, meadow anemone, meadow windfl ower, pasque flower, prairie anemone,
smell fox, stor, wind fl ower
ORIGIN
Pulsatilla is a perennial found
in Europe.
PHARMACOPODIAL AND OTHER MONOGRAPHS
BHC 1992(G6)
BHP 1996(G9)
Martindale 35th edition(G85)
LEGAL CATEGORY (LICENSED PRODUCTS)
GSL(G37)
CONSTITUENTS
The
following is compiled from several sources, including General Reference G6.
Flavonoids Delphinidin
and pelargonidin glycosides.
Saponins Hederagenin
(as the aglycone).
Volatile oils Ranunculin (a glycoside);
enzymatic hydrolysis yields the unstable lactone protoanemonin which readily
dimerises to anemonin.
Other constituents Carbohydrates (e.g.
arabinose, fructose, galactose, glucose, rhamnose), triterpenes (e.g. b-amyrin)
and bsitosterol.
USES
USES
Pulsatilla traditionally has been used as a sedative and
diuretic, as well as to treat insomnia, cough, genitourinary disorders, menstrual
irregularities, headache, otitis media, and eye conditions including cataract,
glaucoma, iritis, and scleritis. Topically, pulsatilla is used for boils and
skin eruptions (Jellin et al, 2008).
INDICATIONS
AND USAGE
UNPROVEN USES: Pasque Flower is
used for diseases and functional disorders of genital organs; inflammatory and infectious
diseases of skin and mucosa; diseases and functional disorders of the
gastrointestinal tract and the urinary tract; neuralgia; migraine; and general
restlessness. It has also been used to treat iritis, scleritis, gray cataract
and glaucoma.
HOMEOPATHIC USES: Homeopathic uses
include inflammation of the respiratory tract, digestive organs, female genital
organs, bladder, eyes, middle ear, menstruation complaints, problems during
pregnancy and nursing, rheumatism, problems with voiding urine, headaches,
insomnia, measles, mumps and depressive states.
FOOD USE
Pulsatilla is not used in foods.
HERBAL USE
Pulsatilla is stated to possess sedative, analgesic,
antispasmodic and bactericidal properties. Traditionally, it has been used for dysmenorrhoea,
orchitis, ovaralgia, epididymitis, tension headache, hyperactive states,
insomnia, boils, skin eruptions associated with bacterial infection, asthma and
pulmonary disease, earache, and specifically for painful conditions of the male
or female reproductive system.(G6, G7, G8, G64) Pulsatilla is widely used in homeopathic
preparations as well as in herbal medicine.
Figure 1. Pulsatilla Flower
ACTIONS
ACTIONS
Pulsatilla has shown promise in the treatment of otitis
media in children. Herbalists have used this plant for many years to treat this
condition (Friese et al, 1997). However, little primary research is available
to support this use. Protoanemonin is known to be a central nervous system
depressant and to induce abortions.
PHARMACOLOGICAL ACTIONS
IN VITRO AND ANIMAL STUDIES
Utero-activity
(stimulant and depressant) has been documented for pulsatilla.(1, 2, G30) In
vivo sedative and antipyretic properties in rodents have been documented for
anemonin and protoanemonin.(3)
Cytotoxicity
(KB tumour system) has been reported for anemonin.(G22)
CLINICAL STUDIES
There
is a lack of clinical research assessing the effects of pulsatilla and rigorous
randomised clinical trials are required.
ACTIVITIES
Abortifacient
(1; APA); Allergenic (1; APA); Alterative (f; CRC; PNC); Analgesic (f; CAN);
Antibacterial (1; APA); Antidote (f; CRC); Antimotility (1; PH2); Antipyretic (1;
APA); Antiseptic (1; PH2); Antispasmodic (f; APA; PNC); Candidicide (1; HH2);
Carcinogenic (1; HH2); Diuretic (f; CRC); Emmenagogue (f; CRC); Expectorant (f;
CRC); Fungicide (1; HH2); Nervine (f; PNC); Poison (1; PH2); Sedative (1; APA;
CAN); Teratogenic (1; APA); Uterotonic (1; APA; CAN).
INDICATIONS
Amaurosis
(f; MAD); Amblyopia (f; MAD); Amenorrhea (f; CRC; MAD; PNC); Anemia (f; MAD);
Arthrosis (f; MAD); Asthma (f; APA; CRC); Bacteria (1; APA; CRC); Biliousness
(f; CRC); BPH (f; MAD); Bronchosis (f; CRC); Cancer (f; JLH); Candida (1; HH2);
Caries (f; MAD); Cataract (f; APA; PH2); Catarrh (f; CRC; PNC); Childbirth (f;
PH2); Chlorosis (f; MAD); Cholecystosis (f; MAD); Convulsion (f; MAD); Cornea
(f; MAD); Cough (f; APA; HH2); Cramp (f; APA; PNC); Cystosis (f; PH2);
Depression (f; APA; PH2); Dermatosis (f; APA; MAD; PHR; PH2); Diarrhea (f;
CRC); Dysmenorrhea (f; APA; CRC; MAD; PH2); Dyspepsia (f; APA; CRC; MAD);
Earache (f; APA; CRC); Endometriosis (f; MAD); Enterosis (f; APA; PHR; PH2);
Epididymosis (f; CAN); Erysipelas (f; MAD); Escherichia (1; HH2); Exanthema (f;
MAD); Fever (1; APA; MAD); Fungus (1; HH2); Gastrosis (f; APA; CRC; PHR; PH2);
Glaucoma (f; APA; PH2); Gout (f; CRC; MAD); Headache (f; APA; CRC; MAD); Hemicrania
(f; CRC); Hemorrhoid (f; MAD); Hyperactivity (f; APA); Hyperemesis (f; MAD);
Hysteria (f; MAD); Infection (1; APA; HH2; PHR; PH2); Inflammation (f; APA;
PHR; PH2); Insomnia (1; APA; CAN; PH2); Irosis (f; PH2); Itch (f; CRC);
Leukorrhea (f; MAD); Measles (f; CRC; PH2); Migraine (f; APA; CRC; HH2; PH2);
Mucososis (f; PHR; PH2); Mycosis (1; HH2; PH2); Nausea (f; HH2); Nervousness
(1; APA; CAN); Neuralgia (f; APA; CRC; HH2; PHR; PH2); Nyctalopia (f; MAD);
Ophthalmia (f; CRC; PH2); Orchosis (f; CAN; MAD); Otosis (f; PH2); Ovariosis
(f; CAN); Pain (f; CAN; HH2); Paralysis (f; MAD); Parotosis (f; PH2); Pertussis
(f; CRC); Pharyngosis (f; MAD); Pterygium (f; JLH); Pulmonosis (f; APA); Restlessness
(f; APA; PHR; PH2); Rheumatism (f; CRC; PH2); Rhinosis (f; APA; CRC; MAD);
Salmonella (1; HH2); Sclerite (f; PH2); Scrofula (f; MAD); Shigella (1; HH2);
Sore (f; MAD); Sore Throat (f; HH2); Staphylococcus (1; HH2); Stomachache (f;
MAD); Toothache (f; APA; CRC); Tuberculosis (1; HH2); Ulcus cruris (f; MAD);
Uterosis (f; APA); Urogenosis (f; CAN; PH2); Urticaria (f; APA); Uterosis (f;
MAD); Wart (f; APA; CRC; JLH; MAD); Yeast (1; HH2).
INDICATIONS AND USAGE
Approved by
Commission E:
Liver and
gallbladder complaints Spastic discomfort in the area of the gallbladder and
bile ducts, as well as the gastrointestinal tract.
Unproven Uses: In folk
medicine, the herb has been used for skin diseases, constipation, cystitis,
arteriosclerosis, rheuma tism, arthritis, as a blood purifier, hypoglycemia and
for infections.
Homeopathic
Uses: for
chronic, itching eczema resulting from liver disease.
PRODUCT AVAILABILITY
Dried herb, fl uid extract,
homeopathic products, tincture
PLANT PARTS USED: Dried leaves, fl owers, stems
DOSAGES
DOSAGES
Dosages
for oral administration (adults) for traditional uses recommended in standard
herbal reference texts are given below.
·
Dried
herb 0.12–0.3 g as an infusion or decoction three times daily.(G6,
G7)
·
Liquid extract 0.12–0.3 mL (1 : 1 in 25%
alcohol) three times daily.(G6, G7)
·
Tincture 0.3–1.0
mL (1 : 10 in 40% alcohol) three times daily.(G6, G7)
DOSAGES
Isolated Mouth
and Throat Ulcers (Aphthae)
·
Myrrh Tincture
Apply a few drops of myrrh tincture 1 :
5 to the affected sites, 2 to 3 times a day.
DOSAGES
·
Adult PO fl uid extract:
0.1-0.3 mL tid (1:1 dilution in 25% alcohol)
·
Adult PO infusion: 0.1-0.3 g
dried herb infusion tid
·
Adult PO tea: 1⁄2 tsp dried
herb in 1 cup boiling water, let stand 15 min, drink tid
·
Adult PO tincture: 0.5-3 mL tid
(1:10 dilution in 25% alcohol)
Figure 2. Powder and Extract Pulsatilla
DOSAGES
Don’t take it! (APA); 0.12–0.3 g herb, or in tea, 3 ×/day (CAN); 0.1–0.4 g powdered herb (MAD); 0.12–0.3 mL
liquid herb extract (PNC); 0.12–0.3 mL liquid herbal extract (1:1 in 25%
ethanol) 3 ×/day (CAN); 0.3–1.0 mL herb
tincture (1:10 in 40% ethanol) 3 ×/day (CAN); 0.3–2 mL herb tincture (PNC).
DOSAGES
Mode of Administration: Whole, cut and
powdered forms of the drug are used, as are homeopathic forms for internal use.
Daily Dosage: A single dose of
a decoction/liquid extract/ infusion is 0.12 to 0.3 g taken 3 times daily. The
usual single dose of the drug is 0.2 g; Powder 0.1 to 0.4 g; Tincture: single
dose: 0.3 to 1 ml.
Conditions of the inner eye: 1 to 3 pills 3
times daily (from powder and extract at 50 g /75 pills).
Homeopathic Dosage: From D2: 5 to 10
drops, 1 tablet or 5 to 10 globules 1 to 3 times a day; from D3: 1 suppository
2 to 3 times a day; from D4: 1 ml injection solution sc twice weekly and 3 to 4
nose drops 3 to 5 times a day (HAB1).
OVERDOSAGE
Death by asphyxiation following
the intake of large quantities of protoanemonine-forming plants has been
observed in animal experiments.
Symptomatic treatment for external
contact should consist of mucilaginosa, after irrigation with diluted potassium
permanganate solution; in case of internal
CONTRAINDICATIONS, INTERACTIONS, AND SIDE EFFECTS
Not covered (AHP).
Hazards and/or side effects not known for proper therapeutic dosages of the
dehydrated herbs” (PH2). Commission E reports higher doses of herb may irritate
the kidneys and urinary tract, and pregnancy is an absolute contraindication
(AEH). CAN does not recommend it for internal use and caution protanemonin is
allergenic and irritant. Pulsatilla contact has caused hyperpigmentative
vesicles. Because it is an irritant (fresh plant), and reputed to affect the menstrual
cycle and cause uterine activity, in vitro and in vivo, its use
in pregnancy and lactation is to be avoided. Inhalation of EO can irritate conjunctiva and nasal mucosa
(CAN).
CONTRAINDICATIONS
Because it is an abortifacient, pulsatilla should not
be used during pregnancy.
Until more research is available, this herb should not
be used during breastfeeding.
Persons who are hypersensitive to pulsatilla should not
use it.
SIDE
EFFECTS/ADVERSE REACTIONS
GI: Nausea, vomiting, anorexia; burning of the tongue,
throat (chewing)
GU: Albuminuria,
hematuria, irritation
INTEG: Hypersensitivity reactions
Toxicity: Seizures,
dizziness, blurred vision, sneezing paralysis, irritation of nasal passages and
throat, vomiting, abdominal cramping and pain, diarrhea, nephrotoxicity
SIDE-EFFECTS, TOXICITY
CLINICAL DATA
There
is a lack of clinical safety and toxicity data for pulsatilla and further
investigation of these aspects is required. Fresh pulsatilla is poisonous because
of the toxic volatile oil component, protoanemonin. Protoanemonin rapidly
degrades to the non-toxic anemonin. Inhalation of vapour from the volatile oil may
cause irritation of the nasal mucosa and conjunctiva.(G51)
Allergic
reactions to pulsatilla have been documented and patch tests have produced
vesicular reactions with hyperpigmentation.(G51)
PRECLINICAL DATA
Cytotoxicity
has been documented for anemonin (see Pharmacological Actions, In vitro and
animal studies).
CONTRA-INDICATIONS, WARNINGS
Fresh
pulsatilla is poisonous and should not be ingested. External contact with the
fresh plant should be avoided. The toxic principle, protoanemonin, rapidly
degrades to the non-toxic anemonin during drying of the plant material.
Individuals may experience an allergic reaction to pulsatilla, especially those
with an existing hypersensitivity.
Drug interactions None
documented. However, the potential for preparations of pulsatilla to interact
with other medicines administered concurrently, particularly those with similar
or opposing effects, should be considered. There is limited evidence from
preclinical studies that certain constituents of pulsatilla (e.g. anemonin)
have sedative activity. The clinical relevance of this is not known.
Pregnancy and lactation Pulsatilla is reputed to
affect the menstrual cycle.(G22) Utero-activity has been documented for pulsatilla
(see Pharmacological Actions, In vitro and animal studies). In view of this,
the use of pulsatilla during pregnancy and lactation should be avoided.
CLIENT CONSIDERATIONS
ASSESS
·
Assess for hypersensitivity
reactions. If present, discontinue the use of this herb and administer an
antihistamine or other appropriate therapy.
·
Assess for toxicity: seizures,
dizziness, blurred vision, sneezing paralysis, irritation of nasal passages and
throat, vomiting, abdominal cramping and pain, diarrhea, and nephrotoxicity.
ADMINISTER
·
Instruct the client to store
pulsatilla in a cool, dry place, away from heat and moisture.
TEACH
CLIENT/FAMILY
·
Caution the client not to use
pulsatilla during pregnancy because it is an abortifacient. Until more research
is available, caution the client not to use this herb during breastfeeding.
·
Because of its toxicity, advise
the client not to touch the pulsatilla plant.
PREPARATIONS
PROPRIETARY MULTI-INGREDIENT PREPARATIONS
Australia:
Bioglan Cirflo; Calmo; Lifesystem Herbal Formula 4 Women's Formula; Proflo;
Women's Formula Herbal Formula 3. Brazil: Eviprostat. Czech Republic: Cicaderma.
France: Hepatoum; Histo-Fluine P. Germany: Eviprostat N. Japan: Eviprostat. South
Africa: Cough Elixir. Singapore: Eviprostat. UK: Anased; Calmanite Tablets;
Fenneherb Prementaid; Menopause Relief; Napiers Back Ache Tea; Napiers Monthly Calm
Tea; Nytol Herbal; Period Pain Relief; Prementaid; Roberts Alchemilla Compound
Tablets. USA: Eye Support Formula.
REFERENCE
Barnes, J., Anderson, L. A., and Phillipson, J. D.
2007. Herbal Medicines Third Edition. Pharmaceutical
Press. Auckland and London.
Duke, J. A. with Mary Jo Bogenschutz-Godwin, Judi
duCellier, Peggy-Ann K. Duke. 2002. Handbook of Medicinal Herbs 2nd
Ed. CRC Press LLC. USA.
Gruenwald, J., Brendler, T., Jaenicke, Ch. 2000. PDR for Herbal Medicines. Medical Economics Company, Inc. at Montvale, NJ 07645-1742. USA
Linda S-Roth. 2010. Mosby’s Handbook Of
Herbs & Natural Supplements, Fourth Edition. Mosby Elsevier. USA
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