Notes: Avoid confusion with gravel root (Eupatorium purpureum), which is also known as boneset. Snakeroot is a common name used for poisonous Eupatorium species, but boneset should not be confused with Ageratina spp., which are more commonly known as snakeroot.
Background
Boneset (Eupatorium perfoliatum) is native to eastern North America and was used by Native Americans to treat fevers, including dengue fever and malaria. Today, boneset is used primarily in homeopathic medicine for fevers, influenza (flu), digestive problems, and liver disorders. However, the use of boneset is limited because other drugs generally are more effective.
Boneset may be effective when taken by mouth as an immunostimulant and an anti-inflammatory agent. However, there is insufficient reliable information available about the effectiveness of boneset for its other uses.
Products containing boneset have been placed in the "Herbs of Undefined Safety" category by the U.S. Food and Drug Administration (FDA).
Evidence
DISCLAIMER:
These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.
Colds/flu:
Traditionally, boneset has been used to treat fevers and infectious diseases, such as colds and influenza. Preliminary study indicates that boneset may treat cold symptoms. Additional study is needed to confirm these results.
Grade: C
Tradition
WARNING:
DISCLAIMER:
The below uses are based on tradition, scientific theories, or limited research. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider. There may be other proposed uses that are not listed below. Animal bite (reptile), anti-inflammatory, antipyretic (fever reducer), antispasmodic, antiviral, arthritis, astringent, bitter tonic, broken bones, bronchitis (acute), carminative (digestive aid), catarrh (inflammation of mucous membrane), cathartic (relieves constipation), cholagogue (stimulates bile flow), constipation, coughs, dengue (fever), diaphoretic (promotes sweating), diuretic, dysentery (severe diarrhea), dyspepsia (upset stomach), edema (swelling), emetic (induces vomiting), emmenagogue (stimulates menstruation), fevers (chronic), gastrointestinal distress, headache, HIV/AIDS, immunomodulator, jaundice, laxative, liver disease, malaria, migraine, muscle weakness, musculoskeletal pain, nasal inflammation, night sweats, parasites and worms, pneumonia, respiratory congestion, rheumatism, skin conditions, stimulant, tonic, typhoid, yellow fever.
Dosing
Adults (18 years and older):
There is no proven safe or effective dose for boneset. Boneset is used in the dried form and is available commercially as dried flowers and leaves, as a tincture (an alcohol solution), and in tablets and capsules. Boneset is usually taken as an infusion (tea) or tincture. Some sources state that boneset should not be taken for longer than two weeks at a time. Others say that continual use of boneset should be limited to a few weeks, at the most. No form of boneset is recommended for chronic use that lasts longer than six months. High quality scientific evidence is lacking in this area.
Children (younger than 18 years):
There is no proven safe or effective dose for boneset in children.
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
Avoid in individuals with a known allergy or hypersensitivity to boneset (Eupatorium perfoliatum), any of its constituents, or related members of the Asteraceae/Compositae family such as dandelion, goldenrod, ragweed, sunflower, and daisies.
Side Effects and Warnings
There are currently no high quality studies on the medicinal applications of boneset, and the following information is based on traditional use and expert opinion. Boneset may cause nausea, vomiting, and diarrhea in large doses, and may even cause coma or death. Boneset may also contain hepatotoxic (liver damaging) unsaturated pyrrolizidine alkaloids. Products containing boneset have been placed in the "Herbs of Undefined Safety" category by the U.S. Food and Drug Administration (FDA).
Use cautiously as boneset is known to cause both vomiting and diarrhea, which may increase the chance of dehydration in small children, elderly individuals, or individuals suffering from a chronic condition.
Use cautiously in patients sensitive to boneset or Asteracae/Compositae plants, such as dandelion, goldenrod, ragweed, sunflower, and daisies, as boneset may cause contact dermatitis.
Use cautiously even in the amounts recommended by manufacturers, as boneset may promote sweating, the production of urine, and catharsis. All of these effects could cause excessive fluid loss from the body, possibly also decreasing the body's potassium supplies. Low potassium levels can result in muscle weakness and potentially dangerous changes in heart rhythm.
Avoid in patients with known liver or kidney conditions and patients who ingest moderate to large amounts of alcohol as boneset may contain hepatotoxic (liver damaging) pyrrolizidine alkaloids.
Pregnancy and Breastfeeding
Although not well studied in humans, boneset may be toxic and long term use by pregnant or breastfeeding women should be avoided. Fresh boneset contains tremerol, a toxic chemical, which can cause nausea, vomiting, weakness, muscle tremors, and increased respiration. Higher doses can cause coma and death. Dried boneset is not thought to contain tremerol.
Interactions
Interactions with Drugs
Although not well studied in humans, boneset may have weak antibacterial and anti-inflammatory effects. Caution is advised in patients taking agents that have similar effects.
Homeopathic boneset may have antiviral effects. Caution is advised in patients taking other antiviral agents or immunomodulators.
Boneset may cause excessive fluid loss from the body, possibly also decreasing the body's potassium supplies. Low potassium levels can result in muscle weakness and potentially dangerous changes in heart rhythm.
Unsaturated pyrrolizidine alkaloids are common in the genus of boneset and might be in boneset as well. Caution is advised when taking agents that are potentially liver damaging, as the combination may increase the risk of liver damage.
Interactions with Herbs and Dietary Supplements
Although not well studied in humans, boneset may have weak antibacterial and anti-inflammatory effects. Caution is advised in patients taking herbs or supplements that have similar effects.
Homeopathic boneset may have antiviral effects. Caution is advised in patients taking other antiviral agents or immunomodulators.
Boneset may cause excessive fluid loss from the body, possibly also decreasing the body's potassium supplies. Low potassium levels can result in muscle weakness and potentially dangerous changes in heart rhythm. Caution is advised in patients taking potassium or any herbs or supplements with diuretic effects.
Unsaturated pyrrolizidine alkaloids are common in the genus of boneset and might be in boneset as well. Caution is advised when taking herbs or supplements that are potentially liver damaging, as the combination may increase the risk of liver damage.
Attribution
This information is based on a systematic review of scientific literature, and was peer-reviewed and edited by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Ashley Brigham, PharmD (Northeastern University); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Thuy-Duong Le, PharmD (Oregon State University); Nicole Giese, MS (Natural Standard Research Collaboration); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Catherine Ulbricht, PharmD (Massachusetts General Hospital); Wendy Weissner, BA (Natural Standard Research Collaboration).
Bibliography
DISCLAIMER:
Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.
Gassinger CA, Wunstel G, Netter P. [A controlled clinical trial for testing the efficacy of the homeopathic drug eupatorium perfoliatum D2 inthe treatment of common cold (author's transl)]. Arzneimittelforschung. 1981;31(4):732-736.
Habtemariam S, Macpherson AM. Cytotoxicity and antibacterial activity of ethanol extract from leaves of a herbal drug, boneset (Eupatorium perfoliatum). Phytother.Res. 2000;14(7):575-577.
Herz W, Kalyanaraman PS, Ramakrishnan G. Sesquiterpene lactones of Eupatorium perfoliatum. J Org.Chem 6-24-1977;42(13):2264-2271.
Wagner H, Jurcic, K. [Immunologic studies of plant combination preparations. In-vitro and in-vivo studies on the stimulation of phagocytosis]. Arzneimittelforschung. 1991;41(10):1072-1076.
Remember, keep this and all other medicines out of the reach of children,
never share your medicines with others, and use this medication only for the indication prescribed.
The Healthline Site, its content, such as text, graphics, images, search results, HealthMaps, Trust Marks,
and other material contained on the Healthline Site ("Content"), its services, and any information or material
posted on the Healthline Site by third parties are provided for informational purposes only. None of the
foregoing is a substitute for professional medical advice, examination, diagnosis, or treatment. Always seek
the advice of a physician or other qualified healthcare provider with any questions you may have regarding a
medical condition. Never disregard professional medical advice or delay in seeking it because of something you
have read on the Healthline Site. If you think you may have a medical emergency, call your doctor or 911 immediately.
Please read the Terms of Service
for more information regarding use of the Healthline Site.