Drugs A - Z
Devil's claw (Harpagophytum procumbens DC)
Generic Name: devil's claw
CategoryHerbs & Supplements
Acteoside, Afrikanische Teufelskralle (German), Algophytum®, ao ao, aromatic acids, arpagofito (Italian), Arthrosetten H®, Arthrotabsm®, Artigel®, artiglio del diavolo, arpagofito (Italian), Artosan®, beta-sitosterol, burdock, caffeic acid, cinnamic acid, Defencid®, Devil's Claw Capsule®, Devil's Claw Secondary Root®, Devil's Claw Vegicaps®, Doloteffin®, duiwelsklou (Afrikaans), ekatata (Ndonga, Kwangali), elyata (Kwanyama), Fitokey Harpagophytum®, grapple plant, griffe du diable (French), gum resins, Hariosen®, Harpadol®, HarpagoMega®, Harpagon®, Harpagophyti radix (Latin), Harpagophytum procumbens, Harpagophytum zeyheri, harpagoquinone, harpagoside, iridoid glycosides, isoacteoside, Jucurba N®, khams, khuripe, kloudoring (Afrikaans), likakata (Gciriku, Shambyu), otjihangatene (Herero), Pedaliaceae (family), procumbide, procumboside, Rheuma-Sern®, Rheuma-Tee®, Salus®, sengaparile (Senegalese), stigmasterol, Südafrikanische Teufelskralle, Trampelklette (German), triterpenes, Venustorn (Danish), Windhoek's root, wood spider, xemta'eisa (Kung bushman), xsamsa-oro6-acetylacteoside.
Devil's claw (Harpagophytum procumbens) originates from the Kalahari and Savannah desert regions of South and Southeast Africa. In these parts of the world, devil's claw has historically been used to treat a wide range of conditions including fever, malaria, and indigestion. The medicinal ingredient of the devil's claw plant is extracted from the dried out roots.
Currently, the major uses of devil's claw are as an anti-inflammatory and pain reliever for joint diseases, back pain, and headache. There is currently widespread use of standardized devil's claw for mild joint pain in Europe.
Potential side effects include gastrointestinal upset, low blood pressure, or abnormal heart rhythms (increased heart rate or increased heart squeezing effects).
Traditionally, it has been recommended to avoid using devil's claw in patients with stomach ulcers or in people using blood thinners (anticoagulants such as warfarin/Coumadin®).
EvidenceDISCLAIMER: 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.
Degenerative joint disease/osteoarthritis :
There is increasing scientific evidence suggesting that devil's claw is safe and beneficial for the short-term treatment of pain related to degenerative joint disease or osteoarthritis (8-12 weeks), it may be equally effective as drug therapies such as non-steroidal anti-inflammatory drugs like ibuprofen (Advil®, Motrin®), and it may allow for dose reductions or stopping of these drugs in some patients. However, most studies have been small with flaws in their designs. Additional well-designed trials are necessary before a firm conclusion can be reached.
Low back pain:
There are several human studies that support the use of devil's claw for the treatment of low back pain. However, most studies have been small with flaws in their designs, and many have been done by the same authors. Therefore, although these results can be considered promising early evidence, additional well-designed trials are necessary before a firm conclusion can be reached. It is not clear how devil's claw compares to other therapies for back pain.
Traditionally, devil's claw was commonly used as an appetite stimulant, and this remains a popular use. However, there is no reliable scientific evidence in this area, and it remains unclear if devil's claw is beneficial as an appetite stimulant.
Cancer (bone metastases):
Devil's claw is used to treat several types of pain, including osteoarthritis and low back pain. One case report indicates it may also be helpful for pain due to bone metastases. More research is needed in this area before a conclusion can be drawn.
Devil's claw is popular as a digestive tonic for the relief of constipation, diarrhea, and flatulence. However, there is no reliable scientific evidence in this area, and it remains unclear if devil's claw is beneficial for these uses.
TraditionWARNING: 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.
Adult Dosing (18 years and older)
In general, a liquid extract (1:1 in 25% ethanol) of 0.10-0.25 milliliter three times daily has been used. For appetite loss or stomach discomfort, 1.5 grams daily in decoction or preparations with adequate bitterness has been used. For low back pain or osteoarthritis, 2-9 grams daily of crude extract or equivalent amounts of extract has been used. As tablets, 600 to 1,200 milligrams (standardized to contain 50 to 100 milligrams of harpagoside) by mouth three times per day has been used. For treatment of painful osteoarthritis, treatment for 2-3 months is often recommended. A doctor should be consulted if symptoms continue for longer.
Children (younger than 18 years)
Not recommended in children. The dosing and safety of devil's claw have not been studied thoroughly in children, and safety is not established.
SafetyDISCLAIMER: 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.
People with allergies to Harpagophytum procumbens should avoid devil's claw products.
Side Effects and Warnings
At recommended doses, devil's claw is traditionally believed to be well tolerated. Whether use of devil's claw for longer than 3-4 months is safe or effective is unknown.
There are reports of headache, ringing in the ears, loss of taste and appetite, gastrointestinal upset, and diarrhea in those taking this herb. Devil's claw may affect levels of acid in the gastrointestinal tract and should be avoided by people with gastric (stomach) or duodenal (intestinal) ulcers. Devil's claw should be used cautiously in patients with gallstones.
Devil's claw may change the rate and force of heartbeats (chronotropic and inotropic effects). Individuals with heart disease or arrhythmias (abnormal heart rhythms) should consult their cardiologist or primary care physician before taking devil's claw.
In theory, devil's claw may lower blood sugar levels. Caution is advised in patients with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Serum glucose levels may need to be monitored by a healthcare provider, and medication adjustments may be necessary.
In theory, devil's claw may increase the risk of bleeding. Caution is advised in patients with bleeding disorders or taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary. Patients may need to stop taking devil's claw before some surgeries, and should discuss this with their primary healthcare provider.
Devil's claw products may be contaminated with other herbs, pesticides, herbicides, heavy metals, or drugs.
Pregnancy and Breastfeeding
Devil's claw may stimulate contractions of the uterus and cannot be recommended during pregnancy and breastfeeding. Patients should be aware that many tinctures contain high levels of alcohol and should be avoided during pregnancy.
Interactions with Drugs
Devil's claw may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. A qualified healthcare provider should monitor patients taking drugs for diabetes by mouth or insulin closely. Medication adjustments may be necessary.
Devil's claw may increase stomach acidity and therefore may affect drugs used to decrease the amount of acid in the stomach, such as antacids, sucralfate, ranitidine (Zantac®), and esomeprazole (Nexium®). Individuals taking any of these drugs should consult a qualified healthcare professional, including a pharmacist, before taking devil's claw.
Because devil's claw may affect heart rhythm, heart rate, and the force of heartbeats, individuals taking prescription drugs such as antiarrhythmics or digoxin (Lanoxin®) should consult their healthcare providers before taking devil's claw.
In theory, devil's claw may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. 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®).
Interactions with Herbs and Dietary Supplements
In theory, devil's claw may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.
In theory, devil's claw may interfere with other herbs and dietary supplements that affect heart rhythm, heart rate, and the force of heartbeats. Notably, bufalin/Chan Suis is a Chinese herbal formula that has been reported as toxic or fatal when taken with cardiac glycosides.
Devil's claw may add to the effects of herbs and dietary supplements that are used for pain or inflammation. Devil's claw may also interact with herbs or supplements used to treat malaria.
In theory, devil's claw may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.
This information is based on a systematic review of scientific literature, and has been edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com): Ethan Basch, MD (Memorial Sloan-Kettering Cancer Center); Thomas Brendler (PlantaPhile); Dawn Costa, BA, BS (Natural Standard Research Collaboration); Nicole Giese, MS (Natural Standard Research Collaboration); Joerg Gruenwald, PhD (Phytopharm Research); Kerri MacWhorter, PharmD (University of Rhode Island); Adrianne Rogers, MD (Boston Medical Center); Erica Seamon, PharmD (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); Jen Woods, BS (Natural Standard Research Collaboration).
BibliographyDISCLAIMER: 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.
Chantre P, Cappelaere A, Leblan D, et al. Efficacy and tolerance of Harpagophytum procumbens versus diacerhein in treatment of osteoarthritis. Phytomedicine 2000;7(3):177-183.
Chrubasik S, Model A, Black A, et al. A randomized double-blind pilot study comparing Doloteffin® and Vioxx® in the treatment of low back pain. Rheumatology 2003;42:141-148.
Chrubasik S, Sporer F, Wink M. [Harpagoside content of different powdered dry extracts from Harpagophytum procumbens]. Forsch Komplmentarmed 1996;3:6-11.
Chrubasik S, Sporer F, Wink M, et al. Zum wirkstoffgehalt in arzneimitteln aus harpagophytum procumbens. Forsch Komplementärmed 1996;3:57-63.
Chrubasik S, Conradt C, Black A. The quality of clinical trials with Harpagophytum procumbens. Phytomedicine 2003;10(6-7):613-623.
Chrubasik S, Conradt C, Roufogalis BD. Effectiveness of Harpagophytum extracts and clinical efficacy. Phytother Res 2004;18(2):187-189.
Chrubasik S, Junck H, Breitschwerdt H, et al. Effectiveness of Harpagophytum extract WS 1531 in the treatment of exacerbation of low back pain: a randomized, placebo-controlled, double- blind study. Eur J Anaesthesiol 1999;16(2):118-129.
Circosta C, Occhiuto F, Ragusa S, et al. A drug used in traditional medicine: Harpagophytum procumbens DC. II. Cardiovascular activity. J Ethnopharmacol 1984;11(3):259-274.
Ernst E, Chrubasik S. Phyto-anti-inflammatories. A systematic review of randomized, placebo-controlled, double-blind trials. Rheum Dis Clin North Am 2000;26(1):13-27.
Grant L, McBean DE, Fyfe L, et al. A review of the biological and potential therapeutic actions of Harpagophytum procumbens. Phytother Res 2007;21(3):199-209.
Gagnier JJ, van Tulder MW, Berman B, et al. Herbal medicine for low back pain: a Cochrane review. Spine 1-1-2007;32(1):82-92.
Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm 2000;57(13):1221-1227.
Lanhers MC, Fleurentin J, Mortier F, et al. Anti-inflammatory and analgesic effects of an aqueous extract of Harpagophytum procumbens. Planta Med 1992;58(2):117-123.
Laudahn D, Walper A. Efficacy and tolerance of Harpagophytum extract LI 174 in patients with chronic non-radicular back pain. Phytother Res 2001;15(7):621-624.
Wegener T, Lupke NP. Treatment of patients with arthrosis of hip or knee with an aqueous extract of devil's claw (Harpagophytum procumbens DC.). Phytother Res 2003;17(10):1165-1172.
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.