- Bachelor's button
- Santa Maria
- wild chamomile
- wild quinine
For Patients & Caregivers
Bottom Line: Feverfew may benefit patients with migraine headaches.
One or more compounds found in feverfew are thought to prevent migraines. One such compound, parthenolide, was found to block the formation of inflammatory proteins. A feverfew extract was shown to reduce the number of migraine attacks and also decrease the mild headache that occurs before a migraine attack.
Feverfew also showed anticancer effects in lab studies. Human studies are needed.
- To prevent migraine headaches
Some clinical trials support this use. Post-feverfew withdrawal syndrome (consisting of muscle stiffness, anxiety, headaches, nausea, and vomiting) can occur after patients discontinue using this herb.
- To treat arthritis
Although compounds in feverfew show anti-inflammatory activity in the laboratory, a clinical trial did not support this use.
- To relieve painful and heavy menstruation
No scientific evidence supports this use.
- To treat psoriasis
Although compounds in feverfew show anti-inflammatory activity in the laboratory, human data are lacking.
In one study, 170 patients with migraine were randomized to receive feverfew CO2-extract 6.25 mg or placebo three times a day for 16 weeks following a baseline period of 4 weeks. Results showed that the frequency of migraines decreased by 1.9 attacks in the treatment group and by 1.3 attacks in those on placebo from 4.79 attacks per month. This difference was found to be statistically significant. The feverfew extract was well tolerated with nonspecific adverse effects that were seen in the placebo group as well. Researchers conclude that feverfew is effective in reducing the frequency of migraine attacks in patients.
You are allergic to ragweed, chrysanthemums, marigolds, or other members of the Compositae family.
You are taking Cytochrome P450 3A4 substrate drugs: Feverfew may increase the risk of side effects of these drugs.
You are taking anticoagulant/antiplatelet drugs: Feverfew may increase the risk of bleeding.
For Healthcare Professionals
Feverfew is a plant that belongs to the daisy/sunflower family of flowering plants. It is widely used in traditional medicine for the treatment of fevers, migraine headaches, rheumatoid arthritis, stomach ache, toothache, insect bites and infertility.
Although much of its activity is attributed to the compound parthenolide, a parthenolide-free extract of feverfew demonstrated free radical-scavenging properties, affording protection against UV-induced sun damage (1). Feverfew extracts also possess antiprotozoal (2), antibacterial (3), anti-inflammatory (1)(4), and antioxidant (5) properties.
In clinical trials, a feverfew extract reduced the frequency of migraine attacks (6) and a feverfew/ginger formulation prevented mild headache before the onset of moderate to severe headache in patients with migraine (7). In another study, a combination of feverfew and acupuncture treatments led to greater improvements in quality of life in women with migraine, compared with feverfew or acupuncture alone (8). Despite anti-inflammatory benefits, a clinical trial did not find benefit for patients with rheumatoid arthritis (9).
Parthenolide from feverfew has demonstrated anticancer effects in vitro (10)(11)(12)(13)(14)(15)(16)(17). A phase I clinical study involving cancer patients showed that up to 4 mg of parthenolide was well tolerated; however, parthenolide could not be detected in the plasma (18). Consequently, a synthetic analog dimethylamino-parthenolide (DMAPT), a more hydrophilic form of parthenolide, with greater bioavailability has been identified. Oral administration of DMAPT was found to be safe and resulted in increased plasma concentrations in an animal model (19). More studies are warranted.
- Sesquiterpene lactones: Parthenolide, artecanin, artemorin, balchanin, canin, costunolide, 10-epicanin, epoxyartemorin, 1-beta-hydroxyarbusculin, 3-beta-hydroxycostunolide, 8-alpha-hydroxyestagiatin, 8-beta hydroxyreynosinn, 3-beta-hydroxyparthenolide, manolialide, reynosin, santamarine, epoxysantamarine, secotanaparthenolide A, secotanaparthenolide B, tanaparthin-alpha-peroxide, and 3,4-beta-epoxy-8-deoxycumambrin B
- Volatile oils: Camphor, camphene, p-cymene, and bornyl acetate
- Flavonoids: 6-hydroxykaempferol 3,6-dimethyl ether, 6-hydroxykaempferol 3,6,4′-trimethyl ether (tanetin), quercetagetin 3,6-dimethyl ether, quercetagetin 3,6,3′-trimethyl ether (accompanied by isomeric 3,6,4′-trimethyl ether), quercetin, apigenin (also apigenin 7-glucuronide), luteolin (also luteolin 7-glucuronide), chrysoeriol, santin, jaceidin, and centaureidin
The sesquiterpene lactones, particularly parthenolide, are the active constituents responsible for feverfew’s beneficial effects. Parthenolide attenuates activation of the NF-kappa B complex to block transcription of inflammatory proteins (21). The inhibition of this pathway also leads to decreased platelet activity (22). Other mechanisms that produce antiplatelet activity by parthenolide include sulfhydryl group alterations, changes in protein kinase C interactions, and arachidonic acid metabolism (22)(23)(24). The flavonol content also has anti-inflammatory effects (25)(26).
In vitro studies suggest various activities induced by parthenolide can produce antiproliferative effects. In colorectal cancer cells, it suppresses angiogenesis by reducing VEGF and VEGF-receptor expression.(10) In cervical and breast cancer cell lines, parthenolide modulates apoptosis-regulating gene expression (11) and activates both apoptosis pathway and AMPK-autophagy survival pathway through ROS generation (12). In glioblastoma cells, it induces caspase 3/7-mediated apoptosis independent of NF-kappa B suppression (27). Parthenolide sensitizes the tumor necrosis factor-related apoptosis-inducing ligand (TRAIL) leading to apoptosis via activation of both caspases 8 and 3 in hepatocellular carcinoma cells (17).
Common: Minor gastrointestinal distress; oral ulcerations from chewing fresh feverfew leaves; airborne contact dermatitis (28); exacerbated dermatitis following use of a moisturizer containing feverfew (29).
Withdrawal symptoms: Muscle stiffness, anxiety, and moderate pain usually occur following cessation of long-term feverfew use (post-feverfew syndrome) (25).
Cytochrome P450 3A4 substrates: Feverfew inhibits CYP1A2/2C8/2C9/2C19/2D6 and 3A4, and can affect the intracellular concentration of drugs metabolized by these enzymes (30).
Diener HC, et al. Efficacy and safety of 6.25 mg t.i.d. feverfew CO2-extract (MIG-99) in migraine prevention – A randomized, double-blind, multicentre, placebo-controlled study. Cephalalgia 2005; 25:1031-1041.
In this study, 170 patients with migraine were randomized to receive 6.25 mg feverfew CO2-extract or placebo three times a day for 16 weeks following a baseline period of 4 weeks. Results showed that the frequency of migraines decreased by 1.9 attacks in the treatment group and by 1.3 attacks in those on placebo from 4.79 attacks per month. This difference was found to be statistically significant. The feverfew extract was well tolerated with nonspecific adverse effects that were seen in the placebo group as well. Researchers concluded that feverfew is effective in reducing the frequency of migraine attacks.