Related Terms

• 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.

Background

• 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®).

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.

• Allergies, antiarrhythmic, anticoagulant, anti-inflammatory, antioxidant, arteriosclerosis (clogged arteries), arthritis, bitter tonic, blood diseases, boils (topical), choleretic, constipation, coronary artery disease, diabetes, diuretic, dysmenorrhea, edema, fever, fibromyalgia, flatulence, gall bladder tonic, gastrointestinal disorders, gout, headache, heartburn, high blood sugar, high cholesterol, hip pain, kidney disorders, knee pain, labor aid, liver tonic, malaria, menopausal hot flashes, menstrual pain, migraine, myalgia, nerve pain, nicotine poisoning, pain reliever, rheumatoid arthritis, sedative, skin cancer (topical), skin ulcers (topical), sores (topical), spasmolytic, tendonitis, urinary tract infection, vulnerary for skin injuries (topical), wound healing.

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)

• 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.

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

• 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

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

• 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.

• In theory, devil's claw may have an additive effect if taken with drugs used for pain, inflammation, high cholesterol, and gout. Drugs used for malaria may also interact.

• 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.

• Devil's claw may reduce cholesterol concentrations and may add to the lipid-lowering effects of fish oil or garlic.

• 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.

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.

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2. 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.

3. Chrubasik S, Sporer F, Wink M. [Harpagoside content of different powdered dry extracts from Harpagophytum procumbens]. Forsch Komplmentarmed 1996;3:6-11.

4. Chrubasik S, Sporer F, Wink M, et al. Zum wirkstoffgehalt in arzneimitteln aus harpagophytum procumbens. Forsch Komplementärmed 1996;3:57-63.

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7. 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. View Abstract

8. 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. View Abstract

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11. 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. View Abstract

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13. 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. View Abstract

14. 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. View Abstract

15. 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. View Abstract