Related Terms

• European peony, mudanpi (Chinese), Paeonia, Paeonia emodi Wall, Paeonia L., Paeonia lactiflora, Paeonia lactiflora Pallas, Paeonia mascula, Paeonia officinalis, Paeonia radix, Paeonia rubra, Paeonia suffruticosa Andrews, Paeonia veitchii, Paeoniaceae (family), paeoniae flos, paeoniflorgenin (PG), paeoniflorin, paeony, partially purified paeoniflorin (PF), peony flower, peony root, PG, PGG, phenolic glycoside, piney, Quilinggao, Ranunculaceae (family), red peony root, resveratrol, Shakuyaku, stilbenes, total glucosides of Peony (TGP), Unkei-to.

• Note: Peony root is not to be confused with peony flower.

Background

• Peony root has been used in traditional Chinese medicine (TCM) for centuries. Peony flowers are also used medicinally, for example, in cough syrups and in herbal teas. In combination with other herbs, peony has been used to treat a wide variety of health conditions, including menstrual problems, kidney problems, pulmonary heart disease, uterine fibroids, and pneumonia. Peony has been applied to the skin to prevent wrinkles and has been taken by mouth to treat pulmonary heart disease and liver problems caused by chronic hepatitis.

• There is good scientific evidence of an effect of peony in the treatment of pulmonary heart disease. There is also a growing body of research on TCM formulas containing peony for women's health conditions including menstrual problems, uterine fibroids, hormone regulation, and heart disease prevention. Higher quality studies are needed before a firm recommendation can be made.

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.

• Abortion inducing, anal fissures, anemia, anti-inflammatory, antimutagenic (inhibits mutations), anti-spasm, antiviral, blood clots, blood vessel dilation (relaxation), bowel disorders, cancer, chronic fatigue syndrome, circulation problems, common cold, cough, digestive system disorders, emetic (induces vomiting), epilepsy, gastritis (chronic), gout, gynecological disorders, heart disease, hepatitis B (hemolytic disease), herpes simplex virus, high blood sugar, HIV, immune function, inflammation, leukemia, liver cancer, liver disease, menopausal disorders, menstruation pain, migraine headaches, nasal inflammation, nerve pain, nervous excitability, premenstrual syndrome (PMS), skin problems, stomach pain, sterility, tonic, upper respiratory infections, whooping cough.

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)

• Various doses have been studied and there is no proven effective dose for peony. Typically, peony is consumed by mouth as a tea that is made by steeping 1 gram peony flowers in 150 milliliters boiling water for 5 to 10 minutes.

• A preparation containing peony has been applied to the skin for eight weeks for wrinkle prevention.

Children (under 18 years old)

• There is no proven safe or effective dose for peony 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 sensitivity to peony.

Side Effects and Warnings

• Reported side effects of peony have included nausea, vomiting, hives, skin rash, breathing problems, and chest pain.

• Peony 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.

• Peony may have hormonal activity. Use with caution in women with estrogen-sensitive cancers or in patients taking hormonal agents, such as birth control pills and hormone replacement therapy.

Pregnancy and Breastfeeding

• Peony is not recommended in pregnant or breastfeeding women due to a lack of available scientific evidence. Peony may have hormonal activity and has traditionally been used to induce menstruation or abortion.

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

• Peony 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®).

• Peony may interact with tamoxifen, drugs that decrease blood vessel growth, drugs that dilate or relax blood vessels, drugs used in the treatment of HIV, drugs with hormonal activity, drugs that affect the immune system, and drugs used to treat cancer, inflammation, viruses, high blood pressure, and high cholesterol.

• Peony may delay absorption of the anti-seizure drug phenytoin (Dilantin®). Peony may decrease the need for steroid drugs in some patients.

Interactions with Herbs and Dietary Supplements

• Peony 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 have been reported with the use of garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

• Peony may interact with antioxidants, ferulic acid, herbs and supplements with hormonal activity, herbs and supplements that decrease the growth of blood vessels, and herbs and supplements used to lower cholesterol, treat viruses, dilate or relax blood vessels, lower blood pressure, stimulate the immune system, and decrease inflammation.

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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