YARROW -- Achillea millefolium L. (Asteraceae/Compositae) ++

HERBAL

MEDICINAL

PLANT

 

 

 

 

 

 

 

 

  

 

                                                                    

 

YARROW

YARROW

Achillea millefolium L. (Asteraceae/Compositae) ++

 

 BY

 

RETTODWIKART THENU

YARROW

(ya-row)

 

Achillea millefolium L. (Asteraceae/Compositae) ++  

 

 

SUMMARY AND PHARMACEUTICAL COMMENT

 

The chemistry of yarrow is well-documented although there has been some disagreement over the major component in

the volatile oil. Various pharmacological actions have been reported in animal studies which support many of the reputed herbal uses, although robust clinical research assessing the efficacy and safety of yarrow is limited. Yarrow is considered to be relatively non-toxic although allergic reactions in susceptible individuals have been documented. The volatile oil is contra-indicated in pregnancy and in view of the lack of safety information, use of yarrow should be avoided during lactation.(G58)

 

TRADE NAMES

Yarrow Flowers, Yarrow Extract, Alcohol-Free Yarrow Flowers

 

OTHER COMMON NAMES

Bloodwort, Gordaldo, Milfoil, Old Man’s Pepper, Sanguinary, Soldier’s Woundwort, Stanchgrass, Thousand-Leaf

Band Man's Plaything, Bloodwort, Carpenter's Weed, Devil's Nettle, Devil's Playtning, Milfoil, Nose

Bleed, Staunchweed, Thousand Weed, Yarroway, Thousand Seal, Noble Yarrow, Knight's Milfoil

 

DESCRIPTION

MEDICINAL PARTS: The dried flower clusters and above-ground parts of the herb are used medicinally.

FLOWER AND FRUIT: The plant has white, pink or purple composite flowers in dense cymes with small capitula. The bracts are imbricate, long, thorn-tipped and taper to a point. There are 5 white female florets. The disc florets are tubular, yellowish-white and androgynous. The fruit is 1.5 to 2 mm long.

LEAVES, STEM AND ROOT: Achillea millefolium are 0.1 to 1.5 m high plants with hardy, horizontal rhizomes, which grow from underground runners. The stem is simple, erect and hairy. The leaves are lanceolate and multi-pinnate with short acute tips.

HABITAT: The numerous subspecies of the Achillea millefolium group are found in various regions. They mainly grow in regions of eastern, southeastern and central Europe, as well as on the southern edge of the Alps from Switzerland to the Balkans.

PRODUCTION: Yarrow herb consists of the fresh or dried, above-ground parts of Achillea millefolium, harvested at flowering season. Yarrow flower consists of the dried inflorescence of Achillea millefolium.

 

SPECIES (FAMILY)

Achillea millefolium L. (Asteraceae/Compositae) ++

 

SYNONYM(S)

Milfoil, Millefolium

A. borealis Bong., A. lanulosa Nutt., A. magna auct., A. millefolium subsp. Borealis (Bong.) Breitung, A. millefolium subsp. lanulosa (Nutt.) Piper, A. millefolium var. occidentale DC.

 

ORIGIN

Yarrow is found in Asia, Europe, and North America.

 

PHARMACOPODIAL AND OTHER MONOGRAPHS

BHC 1992(G6)

BHP 1996(G9)

BP 2007(G84)

Complete German Commission E(G3)

Martindale 35th edition(G85)

Ph Eur 2007(G81)

 

LEGAL CATEGORY (LICENSED PRODUCTS)

 GSL(G37)

 

CONSTITUENTS

The following is compiled from several sources, including General References G2 and G6.

ACIDS Amino acids (e.g. alanine, aspartic acid, glutamic acid, histidine, leucine, lysine, proline, valine),(1, 2) fatty acids (e.g. linoleic, myristic, oleic, palmitic, stearic),(3, 4) and others including ascorbic acid,(5) caffeic acid,(6) folic acid,(5) salicylic acid and succinic acid.(1)

ALKALOIDS/bases Betonicine and stachydrine (pyrrolidine),(1, 7) trigonelline (pyridine),(1, 7) betaine and choline (bases).(1, 7) Uncharacterised alkaloids include achiceine, achilleine(8) (possible synonym for L-betonicine), which is stated to yield achilletine(7) on alkaline hydrolysis, and moscatine/moschatine,(7) stated to be an ill-defined glucoalkaloid.

FLAVONOIDS Predominantly flavone glycosides apigenin- and luteolin-7-glycosides,(9) with lesser quantities of artemetin, casticin, 5-hydroxy-3,6,7,4-tetramethoxyflavone and isorhamnetin.(6) Rutin (a flavonol glycoside).(5)

TANNINS Condensed and hydrolysable,(3, 10) with glucose as the carbohydrate component of the latter(2)

VOLATILE OILS Numerous identified components include borneol, bornyl acetate (trace), camphor, 1,8-cineole, eucalyptol, limonene, sabinene, terpinen-4-ol, terpineol and a-thujone (monoterpenes), caryophyllene (a sesquiterpene), achillicin, achillin, millefin and millefolide (sesquiterpene lactones), azulene and chamazulene (sesquiterpene lactone- derived) and isoartemisia ketone. The relative composition of the components varies greatly between Achillea species, especially the azulene content. Azulene has been reported as the major component.(11) However, true yarrow (A. millefolium) is thought to be hexaploid and azulene-free, whereas closely related species, such as Achillea lanulosa Nutt. And Achillea collina Becker, are tetraploid and contain up to 50% azulene in their volatile oil.(5, 10, 11) It is possible that the tetraploid species may be supplied for A. millefolium. The azulenes are not present in the fresh herb: they are formed as artefacts during steam distillation of the oil, from unstable precursors called proazulenes (e.g. achillin and achillicin), via equally unstable azulene–carboxylic acid intermediates.(12)

OTHER CONSTITUENTS Unknown cyanogenetic compound,(13) sugars including arabinose, galactose, dextrose, dulcitol, glucose, inositol, maltose, mannitol and sucrose.(1, 2)

 

CHEMICAL COMPONENTS

VOLATILE OIL (0.2-1.0%): chief components (rendered through steam distillation) are chamazulene (blue, 6-19%, maximum 40%), camphor (up to 20%), beta-pinene (up to 23%), 1,8- cineole (up to 10%), caryophyllene (up to 10%), alphapinene (up to 5%), isoartemisiaketon (up to 8%). The composition depends greatly on the variety, and the volatile oil of some strains is free of chamazulene.

SESQUITERPENE LACTONES: Mainly guaianolides including, achillicin, 8-alpha-angeloyloxy-10-epi-artabsin, 2,3-dihydrodesacetoxy-matricin, alpha-peroxyachifolide. There are also germacranolides such as millefoild and 3-oxaguaianolides.

Some sesquiterpenes are transformed through steam distillation into chamazulene (proazulenes).

POLYYNES: including pontica epoxide

ALKAMIDS: including tetradeca-4,6-diin-10,12-dien acetyl isobutylamides

FLAVONOIDS: including apigenine-7-O-glucoside, luteolin-7- O-glucoside, rutin

BETAINE: including L-stachydrine, L-hydrostachydrine (betonicine)

 

 

USES

USES

Yarrow is used internally to treat respiratory, gastrointestinal, urinary tract, and reproductive conditions. It is used topically to promote wound healing and to treat eczema and other skin disorders.

 

FOOD USE

Yarrow is listed by the Council of Europe as a natural source of food flavouring (herb, flowers, essential oil and other preparations: category 4, with limits on camphor, eucalyptol and thujone) (see Appendix 3).(G17) Previously, in the USA, yarrow was only approved for use in alcoholic beverages, and the finished product had to be thujone free.(G41)

 

HERBAL USE

Yarrow is stated to possess diaphoretic, antipyretic, hypotensive, astringent, diuretic and urinary antiseptic properties. Traditionally, it has been used for bruises, swellings, strains, fevers, common cold, essential hypertension, amenorrhoea, dysentery, diarrhoea, and specifically for thrombotic conditions with hypertension, including cerebral and coronary thromboses.(G2, G6, G7, G8, G64)

 

 

  

 

Figure 1. Yarrow (Achillea millefolium).

 

 

Figure 2. Yarrow – dried drug substance (flowerhead).

 

ACTIONS

Several actions have been proposed for yarrow, including contraceptive, antitumor, and antiplaque actions.

Contraceptive Action

One study showed that antispermatogenesis occurred in mice when an extract of yarrow was given at 200 mg/kg/day intraperitoneally for 20 days (Montanari et al, 1998).

Antitumor Action

One group of researchers who were observing cell division noted that an increase in tumor growth occurred during metaphase that may be due to the cytotoxic effects of yarrow (Montanari et al, 1998). Another study evaluated the antitumor properties of yarrow (Tozyo et al, 1994). The sesquiterpenoids were found to be active against leukemia in the mouse.

Antiplaque Action

One study proposed that the use of yarrow slows plaque formation and the development of gingivitis; however, no changes were noted in the control group (Van der Weijden et al, 1998).

Other Actions

Actions that are hepatoprotective, antispasmodic, and calcium antagonistic were identifi ed (Yaeesh et al, 2006). When the extract was used in laboratory animals with induced hepatitis, the mortality rate decreased to 40% from 100% of those untreated.

 

PHARMACOLOGICAL ACTIONS

Some activities documented for yarrow are associated with the azulene constituents, although it is now thought that azulene is absent from true yarrow (see Constituents). It is possible that some of the documented pharmacological studies have used Achillea species other than A. millefolium.(14)

 

IN VITRO AND ANIMAL STUDIES

Anti-inflammatory activity has been documented for an aqueous extract of yarrow using mouse(15) and rat(16) paw oedema models, with inflammation induced by yeast(15) and various inflammatory substances,(16) including histamine, carrageenan and prostaglandin. In mouse studies, the active fraction was reported as a series of protein–carbohydrate complexes. Topical anti-inflammatory activity in rabbits has also been documented for the aqueous extract.(15) In general, anti-inflammatory properties are associated with azulenes (see Chamomile, German). Anti-inflammatory activity has been described for the azulene components documented for the volatile oil of yarrow.(5)

A diuretic effect was also noted in mice administered an aqueous extract of yarrow,(15) but only at a dose more than double that required for an anti-inflammatory effect.(15) Terpinen-4-ol, the diuretic principle in juniper, has been reported as a component of yarrow volatile oil.

CNS-depressant activity has been documented for the volatile oil: a dose of 300 mg/kg decreased the spontaneous activity of mice and lowered the body temperature of rats. In addition, 300– 600 mg/kg doses inhibited pentetrazole-induced convulsions and prolonged sleep induced by a barbiturate preparation.(17)

Moderate antibacterial activity has been documented for an ethanolic extract of the herb against Staphylococcus aureus, Bacillus subtilis, Mycobacterium smegmatis, Escherichia coli, Shigella sonnei and Shigella flexneri.(18) Antimicrobial properties have been documented for the sesquiterpene lactone fraction.(5) Achilleine 0.5 g/kg by intravenous injection has been noted to decrease the blood clotting time in rabbits by 32%.(8) The haemostatic action persisted for 45 minutes with no observable toxic effects.

Antispasmodic activity on the isolated rabbit intestine has been documented for a flavonoid-containing fraction of yarrow.(9) Antispasmodic activity is generally associated with azulene constituents (see Chamomile, German).

Antipyretic and hypotensive actions have been reported for the basic fraction (alkaloid/base);(G41) the sesquiterpene lactone fraction is stated to possess cytotoxic activities,(5) although no further details were located. Tannins are known to possess astringent activity.

 

CLINICAL STUDIES

There is a lack of clinical research assessing the effects of yarrow and rigorous randomised controlled clinical trials are required.

 

ACTIVITIES

Abortifacient (f; CRC); Analgesic (1; APA; CRC); Antibacterial (2; APA; KOM; PIP); Antiedemic (1; APA; CAN; PH2); Antiinflammatory (1; APA; PH2; PNC; WAM); Antiperspirant (f; PHR); Antipyretic (1; BGB; CRC; PNC); Antiseptic (2; APA; BGB; KOM); Antispasmodic (2; BGB; KOM; SHT); Antiviral (f; CRC); Aperitif (2; APA; KOM); Astringent (2; KOM; SHT); Carminative (f; PED); Cholagogue (1; BGB; PH2); Choleretic (2; APA; KOM; PIP); CNS Depressant (1; APA; CAN); Culicide (1; CRC); Diaphoretic (1; APA; BGB; WAM); Diuretic (1; APA; CAN; PNC); Emmenagogue (f; CRC); Expectorant (1; FAD; PED); Hemostat (2; APA; CAN; WAM); Hypoglycemic (f; PED); Hypotensive (1; BGB; CRC; PNC); Insecticide (1; CRC); Laxative (f; CRC); Sedative (1; APA; CRC); Stimulant (f; CRC; PED); Swelling (1; APA; CAN; PH2); Urinary Antiseptic (1; CAN); Vermifuge (f; CRC).

 

INDICATIONS

Alopecia (f; CRC); Amenorrhea (PNC); Anorexia (2; APA; KOM; PIP; PH2); Arthrosis (1; APA); Backache (1; APA); Bacteria (2; APA; CRC; KOM; PIP); Bleeding (2; APA; CAN; FAD; FNF; PHR; WAM); Burn (1; APA); Cancer (f; CRC; JLH); Cancer, breast (f; JLH); Cancer, foot (f; JLH); Cancer, liver (f; JLH); Cancer, penis (f; JLH); Cancer, spleen (f; JLH); Cancer, uterus (f; JLH); Catarrh (1; BGB; PNC); Chickenpox (f; WAM); Cholecystosis (2; APA; PH2; PNC); Cold (1; BGB; FAD; WAM); Colic (PIP); Condylomata (f; CRC); Congestion (1; APA); Constipation (f; CRC); Convulsion (f; PH2); Cough (1; APA); Cramp (2; APA; BGB; KOM; SHT); Dermatosis (1; BGB; WAM); Diarrhea (1; CRC; JAD); Dysmenorrhea (2; APA; KOM; SHT); Dyspepsia (2; APA; KOM; PH2; PIP); Dysuria (f; CRC); Earache (f; CRC); Enterorrhagia (2; FAD); Enterosis (2; APA; BGB; FAD; KOM; PHR); Epilepsy (f; CRC); Epistaxis (1; APA); Fever (1; APA; BGB; CRC; PNC; WAM); Fistula (f; CRC); Flu (1; BGB; CRC; WAM); Gas (f; PED); Gastrosis (2; APA; BGB; FAD; KOM; PHR); Grippe (f; BGB); Headache (f; BGB; CRC); Hematoma (f; CRC); Hemorrhoid (1; CRC; FNF; PHR); Hepatosis (2; JLH; PHR; PH2); High Blood Pressure (f; APA; BGB; CRC; PNC); Hyperglycemia (f; PED); Hysteria (f; CRC); Incontinence (f; CRC); Induration (1; CRC; JLH); Infection (1; APA); Inflammation (1; APA; PHR; PH2; PNC; WAM); Insomnia (1; APA; CRC); Leukorrhea (f; CRC); Measles (f; CRC); Melancholy (f; CRC); Menorrhagia (f; CRC); Mucososis (1; APA); Nerve (f; CRC); Nervousness (1; APA; CRC); Pain (1; APA; CRC; PHR); Pleurisy (f; CRC); Poison Ivy (f; WAM); Pneumonia (f; CRC); Rash (f; APA; CRC; WAM); Respirosis (f; BGB); Rheumatism (f; CRC); Sclerosis (f; JLH); Smallpox (f; CRC); Sore Throat (f; CRC); Splenosis (f; JLH); Swelling (1; APA; CAN; PH2); Thrombosis (1; CAN); Toothache (f; CRC); Tuberculosis (f; CRC); Tumor (f; JLH); Ulcer (f; CRC); UTI (1; APA); Varicosis (f; PH2); Virus (f; CRC); Wart (f; CRC); Water Retention (1; APA; CAN; PNC); Wen (f; CRC); Worm (f; CRC); Wound (1; APA; BGB; PHR). And I wouldn’t touch this one with a ten foot tub: Painful, cramp-like conditions of psychosomatic origin in the lower part of the female pelvis, as a sitz bath (KOM; PH2).

 

INDICATIONS AND USAGE

Approved by Commission E:

• Loss of appetite

• Dyspeptic complaints

• Liver and gallbladder complaints

UNPROVEN USES: Externally, the herb is used as a sitz bath for painful, cramp-like conditions of psychosomatic origin in the lower part of the female pelvis. Yarrow is also used externally as a palliative treatment for liver disorders and for the healing of wounds. In folk medicine, it is used for bleeding hemorrhoids, menstrual complaints, and as a bath for the removal of perspiration. It is contained in other cholagogic preparations and biliary tract therapeutic agents. It is also used as an adjuvant in preparations for many other indications such as laxatives, cough treatments, gynecological agents, cardiac agents and preparations for varicose veins.

HOMEOPATHIC USES: Achillea millefolium is used in varicose veins, arterial bleeding, convulsions.

.

 

 

PRODUCT AVAILABILITY

Capsules, fluid extract, powder, tea, tincture

Plant Parts Used: Dried leaves, flowering tops

 

DOSAGES

 

 

DOSAGES

• Adult PO Fluid Extract: 1-2 mL tid (1:1 dilution in 25% alcohol)

• Adult PO Tea: 2-4 g tid

• Adult PO Tincture: 2-4 mL tid (1:5 dilution in 45% alcohol)

• Adult Topical Sitz Bath: 100 g herb/5 gal hot water, soak 10-20 min, rinse

 

DOSAGES

Dosages for oral administration (adults) for traditional uses recommended in standard herbal reference texts are given below.

·         Dried Herb   2–4 g as an infusion three times daily.(G6,G7)

·         Liquid Extract   2–4mL (1 : 1 in 25% alcohol) three times daily.(G6, G7)

·         Tincture   2–4mL (1 : 5 in 45% alcohol) three times daily.(G6, G7)

 

DOSAGES

·         1–2 tsp herb/cup water 3–4 ×/day (APA); 4.5 g herb (KOM); 2–4 tbsp fresh herb (PED); 3–6 g dry herb (PED);

·         2–4 mL liquid herb extract (PNC); 2–4 mL liquid herb extract (1:1 in 25% ethanol) 3 ×/day (CAN);

·         2–4 mL herb tincture (1:5 in 45% ethanol) 3 ×/day (CAN); 0.5–1 tsp herb tincture (APA);

·         3 tsp herb juice (APA, KOM); 2–4 g flower head, or in tea, 3 ×/day (CAN); 1 g flower (KOM);

·         4.5 g dry flower:22 mL alcohol/23 mL water (PED).

 

DOSAGES

HOW SUPPLIED:

·         Capsules — 340mg, 350 mg

·         Liquid^— 1:1, 250 mg/mL

 

MODE OF ADMINISTRATION: As a comminuted drug for teas and other galenical preparations for internal use and for sitz baths. The pressed juice of fresh plants is used internally. The drug is contained in standardized preparations of cholagogic and gallbladder therapeutics and as an adjunct in many other preparations, such as laxatives, antitussives, gynecological products, cardiac remedies and preparations for varicose veins.

 

PREPARATION: To make a tea, place 2 gm of finely cut drug in boiling water, cover, leave to steep for 10 to 15 minutes, and then strain. For sitz baths, use 100 gm Yarrow per 20 liters of water.

 

DAILY DOSAGE:

·         Infusion — 4.5 gm Yarrow herb or 3 gm Yarrow flowers.

·         Tea — A cup of freshly made tea to be drunk 3 to 4 times daily between meals.

·         External application — 100 gm Yarrow to be drawn in 1 to 2 liter of water for 20 minutes and added to the bath water.

 

HOMEOPATHIC DOSAGE: 5 to 10 drops 1 to 3 times daily; 1 tablet or 5 to 10 globules: injection solution 1 mL 1/week sc (HAB1).

 

STORAGE: The herb must be protected from light and moisture. The essential oil should not be stored in synthetic containers.

 

PRECAUTIONS AND ADVERSE REACTIONS

 

No health hazards or side effects are known in conjunction with the proper administration of designated therapeutic dosages. The drug possesses a weak to medium-severe potential for sensitization resulting in contact dermatitis. The main compound responsible for the sensitization is a sespuiterpene lactone, alpha-peroxyachfolid (Hausen, 1991; Rucker, 1991).

PREGNANCY: The drug is not to be used during pregnancy.

. 

CONTRAINDICATIONS, INTERACTIONS, AND SIDE EFFECTS

CLASS 2B. Emmenagogue and uterotonic (AHP), hence contraindicated in pregnancy (PH2; WAM). “Hazards and/or side effects not known for proper therapeutic dosages” (PH2). Commission E reports hypersensitivity to milfoil and other Asteraceae (KOM). Other sources report hypersensitivity to sesquiterpene lactones. Rare contact allergy (AEH). CAN reports that the sesquiterpene lactones are allergenic and can cause dermatosis. Because the thujone in the oil is reputed to be abortifacient and to affect the menstrual cycle, its use in pregnancy and lactation is to be avoided (CAN). Contraindicated in allergies dermatosis, and epilepsy. Excessive doses may interfere with or augment anticoagulant, blood pressure, diuretic, and sedative medications (CAN).

 

CONTRAINDICATIONS

Contraindications include allergy to Yarrow and other composites

 

CONTRA-INDICATIONS, WARNINGS

Yarrow may cause an allergic reaction in sensitive individuals, especially those with an existing hypersensitivity to other

members of the Asteraceae/ Compositae.(19)

Drug Interactions None documented. However, the potential for preparations of yarrow 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 achilleine, a constituent of yarrow, has anticoagulant activity, although the clinical relevance of this, if any is not clear.

Pregnancy And Lactation Yarrow should not be taken during pregnancy. It is reputed to be an abortifacient and to affect the menstrual cycle,(G30) and the volatile oil contains trace amounts (0.3%) of the abortifacient principle thujone. In view of the lack of safety information use of yarrow should be avoided during lactation.

 

CONTRAINDICATIONS

Pregnancy category is 4; Breastfeeding category is 3A.

Yarrow should not be used by persons with hypersensitivity to this plant or other members of the Compositae family, such as Chamomilla recutita, Tanacetum parthenium, or Tanacetum vulgare.

 

SIDE EFFECTS/ADVERSE REACTIONS

CNS: Drowsiness, sedation

GI: Nausea, vomiting, anorexia

GU: Uterine stimulation

INTEG: Hypersensitivity reactions, contact dermatitis, photosensitivity

 

INTERACTIONS

Drug

Antacids, H2-blockers, proton pump inhibitors: Yarrow may decrease the action of these agents (Jellin et al, 2008).

Anticoagulants (heparin, warfarin), antiplatelets, salicylates: Use of yarrow with anticoagulants, antiplatelets, salicylates may result in an increased risk of bleeding; do not use concurrently.

Antihypertensives: Use of yarrow with antihypertensives may result in increased hypotension; do not use concurrently.

CNS depressants (sedatives/hypnotics, alcohol, opiates, barbiturates): Use of yarrow with central nervous system depressants may cause increased sedation; avoid concurrent use.

Iron salts: Yarrow tea may decrease the absorption of iron salts; separate by 2 hours.

 

EFFECTS

The herb has a cholagogue (stimulates the flow of bile) effect due to the guaianolide and germacranolide content. proazulene fraction has an anti-edema and anti-inflammatory effect. The effect probably results from the interaction of

various structured bonds with the chamazulene and flavonoids. The plant has similar effects to those observed in Chamomile flowers, since some of their components are identical.

 

SIDE-EFFECTS, TOXICITY

CLINICAL DATA

Allergic reactions to yarrow (e.g. dermatitis) have been documented, and positive patch tests have been produced in individuals sensitised to other plants.(5, G33, G51) An instance of yarrow tea causing a generalised eruption in a sensitised individual was reported in 1929. The allergenic properties of some sesquiterpene lactones are well documented, although none of those present in yarrow are recognised sensitisers.(G51) Yarrow has been suspected of being a photosensitiser, although extracts have been reported to lack phototoxicity and to be devoid of psoralens, compounds with known photosensitising properties.(G51)

PRECLINICAL DATA

Yarrow is considered to be of low toxicity. In mice LD50 values have been reported of up to 3.65 g/kg (by mouth), 3.1 g/kg (by intraperitoneal injection), and greater than or equal to 1 g/kg (by subcutaneous injection).(15, 17) In rats, an LD50 (subcutaneous injection) has been recorded as 16.86 g/kg, with corresponding LD0 and LD100 values reported as 12 and 20 g/kg, respectively.(16) By comparison, an ED25 for anti-inflammatory activity has been estimated as about 0.43 g/kg.(16) The known toxic principle thujone has been documented as a minor component of yarrow volatile oil, although concentrations present are probably too low to represent a risk to human health. A single report of animal poisoning has been documented for yarrow in which a calf died following the ingestion of a single plant.(5) No additional reports of animal toxicity were located.

 

CLIENT CONSIDERATIONS

ASSESS

·         Assess for hypersensitivity reactions, including contact dermatitis. If present, discontinue the use of yarrow and administer an antihistamine or other appropriate therapy.

·         Determine whether the client is taking anticoagulants, antihypertensives, or CNS depressants (see Interactions).

 

ADMINISTER

·         Instruct the client to store yarrow products in a cool, dry place, away from heat and moisture.

 

TEACH CLIENT/FAMILY

·         Inform the client that pregnancy category is 4 and breastfeeding category is 3A.

·         Advise the client who is allergic to other plants of the Compositae herb family not to use yarrow.

·         Inform the client to monitor for bleeding and bruising and to discontinue use of yarrow if these are present.

·         Advise the client not to perform hazardous activities such as driving or operating heavy machinery until physical response to the herb can be evaluated.

·         Advise the client to use sunscreen and wear protective clothing, or to stay out of the sun, while using yarrow. Yarrow may cause photosensitivity.

 

 

PREPARATIONS

 

PROPRIETARY SINGLE-INGREDIENT PREPARATIONS

Czech Republic: Gallentee; Nat Rebricku; Rebrickovy Caj, Rebrickova Nat. Mexico: Blancaler.

 

PROPRIETARY MULTI-INGREDIENT PREPARATIONS

Australia: Flavons. Austria: Abfuhrtee St Severin; Amersan; Gallen- und Lebertee St Severin; Mariazeller; Menodoron. Canada: Original Herb Cough Drops. Czech Republic: Amersan; Cajova Smes pri Redukcni Diete; Cicaderma; Hemoral; Hertz- und Kreislauftee; Perospir; Projimava; Species Urologicae Planta; Stomatosan; Ungolen; Zaludecni Cajova Smes. France: Gonaxine; Tisane Hepatique de Hoerdt. Germany: Alasenn; Amara-Tropfen; Floradix Multipretten N; Gallexier; Kamillan Plus; Sedovent; Stomachysat N; Tonsilgon. Hungary: Hemorid; Noditran. Italy: Forticrin; Lozione Same Urto; Pik Gel. Portugal: Cicaderma; Fade Cream. Russia: Liv 52 (Лив 52); Liv 52 (Лив 52); Original Grosser Bittner Balsam (Оригинальный Большой Бальзам Биттнера); Tonsilgon N (Тонзилгон Н). South Africa: Amara; Clairo; Menodoron. Spain: Jaquesor; Menstrunat; Natusor Circusil; Natusor Gastrolen; Natusor Jaquesan. Switzerland: Gastrosan; Kernosan Heidelberger Poudre; Pommade au Baume; Tisane hepatique et biliaire; Tisane pour l'estomac. UK: Catarrh-eeze; Drops of Life Tablets; Rheumatic Pain Remedy; Rutin Compound Tablets; Tabritis; Tabritis Tablets; Wellwoman.

 

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

 

 

 

Figure 3. Primary Chemical Components and Possible Actions

(Linda, S-R. 2010)