Related Terms

• Agueweed, Asteraceae (family), astragalin, common boneset, Compositae (family), crosswort, dendroidinic acid, eucannabinolide, eufoliatin, eufoliatorin, eupafolin, eupatorin, Eupatorium connatum Michx., Eupatorium perfoliatum, Eupatorium perfoliatum D2, euperfolide, euperfolitin, feverwort, flavonoids, gravelroot, hebenolide, helenalin, hyperoside, Indian sage, kaempferol, quercetin, rutin, sesquiterpene lactones, snakeroot, sterols, sweat plant, sweating plant, tearal, teasel, thoroughwax, thoroughwort, thorough-stem, vegetable antimony, wild Isaac, wild sage, wood boneset.

• 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).

Scientific Evidence

Tradition/Theory

The below uses are based on tradition or scientific theories. 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 health care professional.

• 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

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

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

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy. Consult a healthcare provider immediately if you experience side effects.

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

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

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.

Author Information

• This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

References

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.

1. 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. View Abstract

2. 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. View Abstract

3. Herz W, Kalyanaraman PS, Ramakrishnan G. Sesquiterpene lactones of Eupatorium perfoliatum. J Org Chem 6-24-1977;42(13):2264-2271. View Abstract

4. 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. View Abstract