Drugs A - Z
Meadowsweet (Filipendula ulmaria)
Generic Name: Filipendula ulmaria
CategoryHerbs & Supplements
Ascorbic acid, avicularin, bridewort, brideswort, chalcones, condensed tannins, coumarin, dolloff, dropwort, English meadowsweet, ethylsalicylate, European meadowsweet, Filipendula occidentalis, Filipendula rubra, Filipendula ulmaria, Filipendula vulgaris, flavonoids, gaultherin, hydrolyzable tannins, hyperoside, lady of the meadow, Mädesüss (German), meadow queen, meadow sweet, meadow wart, meadow wort, meadsweet, methoxybenzaldehyde, methylsalicylate, monotropin, mountain spirea, mucilage, nature's aspirin, phenolic acids, phenolic glycosides, phenylcarboxylic acids, philipendula, plant heparin, pride of the meadow, queen of the forest, queen of the meadow, queen of the prairie, Rosaceae (family), rutin, salicin, salicylaldehyde, salicylates, salicylic acid, spiraea flos, spiraea herba, Spiraea ulmaria L., spiraein, spiraeoside, tannins, ulmaire (French), ulmaria (Spanish/Italian), vanillin, volatile oil.
Note: Meadowsweet and its relatives (Filipendula spp.) are not related to water dropwort (Oenanthe crocata) even though members of both genera may be referred to as "dropworts." Filipendula spp. are members of the Roseaceae family, while the Oenanthe spp. are members of the Umbelliferae family.
Meadowsweet (Filipendula ulmaria) is native to Europe and is found as an introduced plant in the northeastern region of the United States. Meadowsweet has historically been used in traditional medicine to treat symptoms of the common cold, stomach complaints, and inflammatory conditions. Herbalists recommend meadowsweet as one of the best digestive herbs for the treatment of ulcers and heartburn. Further research on the uses of meadowsweet is needed.
Two prominent constituents of meadowsweet that are theoretically responsible for much of its pharmacological activity are salicylates and a plant heparin. Meadowsweet also contains high concentrations of phenolics, theoretically responsible for some of its antibacterial activity.
Although meadowsweet shares chemistry, history, and proposed uses with the drug aspirin, its efficacy and place in pharmacotherapy compared to aspirin have not been evaluated in well-designed clinical studies.
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.
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.
Acne, analgesic (pain reliever), antacid, antibacterial, anticoagulation, anti-inflammatory, antineoplastic (tumor inhibiting), antioxidant, antiplatelet (blood thinning), antispasmodic, astringent, bladder inflammation, bronchitis, cellulitis (skin infection), cervical cancer, cervical dysplasia, common cold, congestion, cough, diabetes, diarrhea in children, diuretic (increasing urine flow), dyspepsia (upset stomach), fever, food use, gout (foot inflammation), headache, heart disease, heartburn, inflammation, influenza, intestinal disorders, kidney stones, menorrhagia (heavy menstrual bleeding), menstrual cramps, osteoarthritis, peptic ulcer disease, rheumatic disorders, rheumatoid arthritis, sedative, sinusitis (inflammation of sinuses), stomach disorders, toothache, ulcers, urinary retention (due to prostate enlargement), urinary tract infections, vaginitis (inflammation of vagina), water retention.
Adults (18 years and older):
There is no proven safe or effective dose for meadowsweet in adults. Traditionally, 2-3 (570-milligram) capsules twice daily with water at mealtimes have been used as an antispasmodic, sedative, and anti-inflammatory treatment. One cup of tea (2.5-3.5 grams, about 1-2 teaspoons dried flowers or 4-5 grams of above ground parts steeped in 150 milliliters boiling water for 10 minutes, then strained) ingested several times per day has been used. A liquid extract (1:1 in 25% alcohol) of 1.5-6 milliliters three times per day has been used, as has 2-4 milliliters of tincture (1:5 in 45% alcohol) three times per day.
Children (younger than 18 years):
There is no proven safe or effective dose for meadowsweet in children, and meadowsweet is not recommended. Meadowsweet should not be used in pediatric patients with fevers due to the risk of Reye's syndrome associated with the consumption of salicylates.
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.
Avoid in individuals with a known allergy or hypersensitivity to meadowsweet, salicylates, and those with aspirin allergy. Meadowsweet may also exacerbate asthma. If this occurs it may be due to the presence of the aspirin triad, a common co-occurrence of asthma, rhinitis, and aspirin allergy.
Side Effects and Warnings
In general, there is very little scientific information about the adverse effects of meadowsweet. Care should be taken to ensure that only meadowsweet cultivated on land suitable for agriculture is consumed. Meadowsweet has been shown to be efficient in the uptake of the heavy metals zinc, copper, cadmium, and lead when grown in wetland areas contaminated with these metals. Most adverse effects are theoretical or based on expert opinion. Meadowsweet contains salicylate constituents, so adverse effects and toxicity normally associated with salicylates could occur.
Meadowsweet may decrease vascular permeability, cause skin rash, increase uterine or intestinal tone, or cause gastrointestinal bleeding, nausea, vomiting, and other stomach complaints. Constituents found in meadowsweet may acidify the urine causing renal (kidney) irritation or nephrotoxicity (damage to the kidneys), or cause tinnitus (ringing in the ears). This herb may also induce muscle relaxation and decrease motor activity.
Meadowsweet may increase bronchial tone or cause bronchospastic activity. It may also exacerbate asthma, especially if the aspirin triad (of asthma, rhinitis, and aspirin allergy) is present. In theory, meadowsweet may lower body temperature. However, hyperthermia could be a sign of salicylate toxicity.
Avoid in patients who are allergic to aspirin, or need to avoid aspirin due to other medications or medical conditions.
Avoid use in pediatric patients with fevers, due to the risk of Reye's syndrome associated with the consumption of salicylates.
Avoid use in patients with bleeding disorders, diabetes, and/or compromised kidney or liver function due to salicylate content. Meadowsweet may increase the risk of bleeding. Caution is advised in patients taking agents that may increase the risk of bleeding. Dosing adjustments may be necessary.
Use alcohol tinctures cautiously in patients with gastric ulcerations due to the alcohol content that may irritate the gut.
Pregnancy and Breastfeeding
Avoid use during pregnancy. Meadowsweet may increase uterine tone and might stimulate uterine activity. Due to its salicylate content, meadowsweet taken during the third trimester theoretically may induce abnormalities in the fetus. Many tinctures contain high levels of alcohol, and should be avoided during pregnancy.
Meadowsweet is not recommended in breastfeeding women due to a lack of available scientific evidence.
Interactions with Drugs
Acetaminophen (Tylenol®) or certain antibiotics such as tetracycline or penicillin may interact with meadowsweet and increase the risk of bleeding. The incidence of nephrotoxicity (kidney damage) may be augmented when acetaminophen and meadowsweet are used in combination due to salicylate content of meadowsweet. Meadowsweet may also 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®).
Due to its salicylate content, meadowsweet may cause drug interactions similar to those of the salicylates or aspirin. The use of meadowsweet with other salicylates may potentiate both therapeutic and adverse effects. The adverse effects of salicylates may include impairing the effects of beta-adrenergic blockers, ACE inhibitors, loop diuretics, thiazide diuretics, probenecid, and sulfinpyrazone. High salicylate levels may increase the effects or toxicity of alcohol, anticoagulants, antiplatelet agents (e.g., ticlopidine, clopidogrel, and IIb/IIa antagonists), carbonic anhydrase inhibitors, heparin and low molecular weight heparins, methotrexate, older sulfonylureas (i.e., tolazamide, tolbutamide), and valproic acid.
Anithistamines, such as diphenhydramine, chlorpheniramine, and brompheniramine, or intravenous nitroglycerin may interact with meadowsweet and decrease the anticoagulant effects in meadowsweet. Consult with a qualified healthcare professional, including a pharmacist, before combining any medications.
Many tinctures contain high levels of alcohol, and may cause nausea or vomiting when taken with metronidazole (Flagyl®) or disulfiram (Antabuse®). Also, combination of alcohol with meadowsweet may increase risk of gastric mucosal damage. Caution is advised.
Interactions with Herbs and Dietary Supplements
Meadowsweet 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.
In theory, taking meadowsweet for more than six months may interfere with calcium absorption.
Meadowsweet may induce muscle relaxation and potentiate narcotic effects. Caution is advised when taking with herbs or supplements with muscle relaxing effects or narcotic effects.
The use of meadowsweet with other herbs containing salicylate constituents could potentiate both therapeutic and adverse effects. Some of these herbs include black cohosh, poplar, sweet birch, white willow, and wintergreen. The adverse effects of high salicylate levels could include impairing the effects of herbs and supplements similar to beta-adrenergic blockers, ACE inhibitors, loop diuretics, thiazide diuretics, probenecid, and sulfinpyrazone.
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): Jason Barker, ND (Oregon Health & Science University); Jessica Clubb, PharmD (Northeastern University); Nicole Giese, MS (Natural Standard Research Collaboration); Toni M. Schaeffer, PhD, PharmD (Albany College of Pharmacy); Shaina Tanguay-Colucci, BS (Natural Standard Research Collaboration); Wendy Weissner, BA (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.
Abebe W. Herbal medication: potential for adverse interactions with analgesic drugs. J Clin Pharm Ther. 2002;27(6):391-401.
Calliste CA, Trouillas P, Allais DP, et al. Free radical scavenging activities measured by electron spin resonance spectroscopy and B16 cell antiproliferative behaviors of seven plants. J Agric.Food Chem 2001;49(7):3321-3327.
Candy JM, Morrison C, Paton RD, et al. Salicylate toxicity masquerading as malignant hyperthermia. Paediatr.Anaesth. 1998;8(5):421-423.
Downs C, Phillips J, Ranger A, et al. A hemlock water dropwort curry: a case of multiple poisoning. Emerg.Med.J. 2002;19(5):472-473.
Fritioff A, Greger M. Aquatic and terrestrial plant species with potential to remove heavy metals from storm-water. Int J Phytoremediation. 2003;5(3):211-224.
Hamad AM, Sutcliffe AM, Knox AJ. Aspirin-induced asthma: clinical aspects, pathogenesis and management. Drugs 2004;64(21):2417-2432.
Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health Syst.Pharm 7-1-2000;57(13):1221-1227.
Kahkonen MP, Hopia AI, Vuorela HJ, et al. Antioxidant activity of plant extracts containing phenolic compounds. J Agric.Food Chem 1999;47(10):3954-3962.
Liapina LA, Koval'chuk GA. [A comparative study of the action on the hemostatic system of extracts from the flowers and seeds of the meadowsweet (Filipendula ulmaria (L.) Maxim.)]. Izv.Akad.Nauk Ser Biol. 1993;(4):625-628.
Rauha JP, Remes S, Heinonen M, et al. Antimicrobial effects of Finnish plant extracts containing flavonoids and other phenolic compounds. Int J Food Microbiol. 5-25-2000;56(1):3-12.
Rohner Machler M, Glaus TM, Reusch CE. [Life threatening intestinal bleeding in a Bearded Collie associated with a food supplement for horses]. Schweiz.Arch Tierheilkd. 2004;146(10):479-482.
Ryzhikov MA, Ryzhikova VO. [Application of chemiluminescent methods for analysis of the antioxidant activity of herbal extracts]. Vopr.Pitan. 2006;75(2):22-26.
Spiridonov NA, Konovalov DA, Arkhipov VV. Cytotoxicity of some Russian ethnomedicinal plants and plant compounds. Phytother Res 2005;19(5):428-432.
Sroka Z, Cisowski W, Seredynska M, et al. Phenolic extracts from meadowsweet and hawthorn flowers have antioxidative properties. Z.Naturforsch.[C.] 2001;56(9-10):739-744.
Stenberg JA, Witzell J, Ericson L. Tall herb herbivory resistance reflects historic exposure to leaf beetles in a boreal archipelago age-gradient. Oecologia. 2006;148(3):414-25.
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.