Meadowsweet (Filipendula ulmaria)
Natural Standard Bottom Line Monograph, Copyright © 2013 (www.naturalstandard.com). Commercial distribution prohibited. This monograph is intended for informational purposes only, and should not be interpreted as specific medical advice. You should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.
While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.
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.
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.
No available studies qualify for inclusion in the evidence table.
*Key to grades:A: Strong scientific evidence for this use; B: Good scientific evidence for this use; C: Unclear scientific evidence for this use; D: Fair scientific evidence against this use (it may not work); F: Strong scientific evidence against this use (it likely does not work).
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.
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.
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 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.
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.
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.
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
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.
Meadowsweet may induce muscle relaxation and potentiate narcotic effects. Caution is advised when taking with narcotics or other drugs with muscle relaxing effects.
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 edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).
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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Copyright © 2013 Natural Standard (www.naturalstandard.com)
The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.
March 22, 2017