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Evening primrose oil


What is it?

Evening primrose oil is the oil from the seed of the evening primrose plant. Evening primrose oil is used for skin disorders such as eczema, psoriasis, and acne. It is also used for rheumatoid arthritis, weak bones (osteoporosis), Raynaud’s syndrome, multiple sclerosis (MS), Sjogren’s syndrome, cancer, high cholesterol, heart disease, a movement disorder in children called dyspraxia, leg pain due to blocked blood vessels (intermittent claudication), alcoholism, Alzheimer’s disease, and schizophrenia.

Some people use evening primrose oil for chronic fatigue syndrome (CFS); asthma; nerve damage related to diabetes; an itching disorder called neurodermatitis; hyperactivity in children and attention deficit-hyperactivity disorder (ADHD); obesity and weight loss; whooping cough; and gastrointestinal disorders including ulcerative colitis, irritable bowel syndrome, and peptic ulcer disease.

Women use evening primrose oil in pregnancy for preventing high blood pressure (pre-eclampsia), shortening labor, starting labor, and preventing late deliveries. Women also use evening primrose oil for premenstrual syndrome (PMS), breast pain, endometriosis, and symptoms of menopause such as hot flashes.

In foods, evening primrose oil is used as a dietary source of essential fatty acids.

In manufacturing, evening primrose oil is used in soaps and cosmetics.

In Britain, evening primrose oil used to be approved for treating eczema and breast pain. However, the Medicines Control Agency (MCA), the British equivalent of the US Food and Drug Administration (FDA), withdrew the licenses for evening primrose oil products marketed as prescription drug products for these uses. The licenses were withdrawn because the agency concluded that there is not enough evidence that they are effective. The manufacturer disagrees, but it hasn’t published studies yet to prove the effectiveness of evening primrose for these uses.

How effective is it?

Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.

The effectiveness ratings for EVENING PRIMROSE OIL are as follows:

Possibly effective for...

  • Nerve damage caused by diabetes. Research shows that taking evening primrose oil daily for 6-12 months improves symptoms of nerve damage caused by diabetes.
  • Osteoporosis. Taking evening primrose oil with fish oil and calcium seems to decrease bone loss and increase bone density in elderly people with osteoporosis.

Possibly ineffective for...

  • Asthma. Some research shows that taking 500 mg of a specific evening primrose oil product (Epogam, Efamol) daily for up to 16 weeks does not improve asthma symptoms.
  • Itchy and inflamed skin condition (eczema). Some research shows that taking 0.5 grams or more of evening primrose oil for 16 to 24 weeks does not reduce itchy and inflamed skin symptoms in adults or children. Most research used a specific evening primrose oil product (Epogam, Scotia Pharmaceuticals). Some previous research showed beneficial effects.
  • Attention deficit-hyperactivity disorder (ADHD). Taking evening primrose oil by mouth does not improve ADHD symptoms in children. However, taking a specific supplement containing fish oil and evening primrose oil ( Eye q, Novasel) daily does seem to improve symptoms in children 7-12 years-old. The fish oil might be the beneficial part of the supplement.
  • Hepatitis B. Research shows that taking 2 grams of a specific evening primrose oil product (Efamol) daily for 12 months does not improve hepatitis B symptoms.
  • High cholesterol. Research shows that taking evening primrose oil daily for up to four months does not affect cholesterol levels.
  • Liver cancer. Early research shows that taking evening primrose oil (Efamol) daily does not affect liver size or survival in people with liver cancer.
  • Breast pain (mastalgia). Evidence on the effects of evening primrose oil on breast pain is unclear. Some research shows that taking evening primrose oil by mouth alone and with a drug called bromocriptine can reduce breast pain. However, other research shows that taking evening primrose oil for 3-6 months does not reduce breast pain.
  • Hot flashes and night sweats due to menopause. Research shows that taking evening primrose oil by mouth daily for 3-6 months alone or with other supplements does not reduce hot flashes or night sweats caused by menopause. However, one study found that a specific product containing evening primrose oil, damiana, ginseng, and royal jelly (Lady 4) did reduce menopausal symptoms. However, overall, most evidence suggests that evening primrose oil does not reduce menopausal symptoms.
  • Obesity. Taking evening primrose oil capsules four times daily for 12 weeks did result in weight loss in obese women.
  • Low bone mineral density (osteopenia). Research shows that taking a specific product containing evening primrose oil, calcium and fish oil (Efacal) does not affect bone mineral density compared to just calcium alone in women.
  • Premenstrual syndrome (PMS). Most research shows that taking evening primrose oil by mouth does not relieve PMS symptoms. Most studies have used a specific product (Epogam, Scotia Pharmaceuticals).
  • Red and scaly skin (psoriasis). Research shows that taking a specific product containing evening primrose oil and fish oil (Efamol Marine) does not improve red, scaly skin.
  • Joint pain associated with psoriasis (psoriatic arthritis). Research shows that taking a specific product containing evening primrose oil and fish oil (Efamol Marine) daily for 12 months does not reduce symptoms of joint pain associated with psoriasis.

Insufficient evidence to rate effectiveness for...

  • Chronic fatigue syndrome (CFS). There is some early evidence that a specific combination of evening primrose oil and fish oils (Efamarine) might reduce the symptoms of CFS. However, study results have not been consistent.
  • Diaper rash. Early research shows that applying evening primrose oil to infants with diaper rash was similar to applying skin protection cream after 8 weeks.
  • Dry eyes. Research shows that taking a specific evening primrose oil product (Qarma) daily for six months improved dry eye symptoms in women wearing contacts.
  • Dyslexia. Early research shows that a specific evening primrose oil product (Efalex) improved mental performance in children with dyslexia.
  • Coordination and movement problems (dyspraxia). Early research shows that taking a specific product containing evening primrose oil, thyme oil and vitamin E (Efalex) improves movement disorders in children with coordination and movement problems.
  • Scaly, flaky skin (ichthyosis). Early research shows that evening primrose oil does not improve scaly and flaky skin.
  • Infant development. Research shows that infants fed a formula containing evening primrose oil and fish oil might have better development compared to those fed regular formula. However, infants who were breastfed showed better results than those fed evening primrose oil formula.
  • Complications of pregnancy. Taking evening primrose oil does not seem to shorten labor, prevent high blood pressure (pre-eclampsia), or prevent late deliveries in pregnant women. However, taking evening primrose oil might reduce the need to induce labor.
  • Reduced blood flow in response to temperature or stress (Raynaud’s phenomenon). Early research suggests that taking a specific evening primrose oil product (Efamol) daily for eight weeks reduces symptoms of Raynaud’s phenomenon, but does not affect hand temperature or blood flow.
  • Rheumatoid arthritis (RA). Some early research suggests that taking evening primrose oil might reduce pain in RA. But some other studies show no benefit.
  • Schizophrenia. Early research shows that taking evening primrose oil (Efamol) does not have mental or physical effects on people with schizophrenia. However, one study found that it might have some psychological and memory benefits.
  • Sjogren’s syndrome (an autoimmune disorder in which certain body cells attack and destroy the glands that produce tears and saliva). There is some early evidence that taking evening primrose oil does not improve symptoms.
  • Inflammatory bowel disease (ulcerative colitis). Early research shows that taking evening primrose oil with borage and olive oil can improve some but not all symptoms of inflammatory bowel disease.
  • Cancer.
  • Acne.
  • Multiple sclerosis (MS).
  • Heart disease.
  • Alzheimer’s disease.
  • Other conditions.
More evidence is needed to rate evening primrose oil for these uses.

How does it work?

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Evening primrose oil contains “fatty acids.” Some women with breast pain might not have high enough levels of certain ”fatty acids.” Fatty acids also seem to help decrease inflammation related to conditions such as arthritis and eczema.

Are there safety concerns?

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Evening primrose oil is LIKELY SAFE for most people when used for up to a year. It can sometimes cause mild side effects including upset stomach, nausea, diarrhea, and headache.

Special precautions & warnings:

Pregnancy and breast-feeding: Taking evening primrose oil is POSSIBLY UNSAFE during pregnancy. It might increase the chance of having complications. Don’t use it if you are pregnant.

It is POSSIBLY SAFE to take evening primrose oil during breast-feeding, but it’s best to check with your healthcare provider first.

Bleeding disorders: There is a concern that evening primrose oil might increase the chance of bruising and bleeding. Don’t use it if you have a bleeding disorder.

Epilepsy or another seizure disorder: There is a concern that taking evening primrose oil might make seizures more likely in some people. If you have a history of seizure, avoid using it.

Schizophrenia: Seizures have been reported in people with schizophrenia treated with phenothiazine drugs, GLA (a chemical found in evening primrose oil), and vitamin E. Get your healthcare provider’s opinion before starting evening primrose oil.

Surgery: Evening primrose oil might increase the chance of bleeding during or after surgery. Stop using it at least 2 weeks before a scheduled surgery.

Are there interactions with medications?

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Major

Do not take this combination.

Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)
Evening primrose oil contains GLA (gamma-linolenic acid), which might slow blood clotting. Taking evening primrose oil along with medications that also slow clotting might increase the chances of bruising and bleeding.

Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), nonsteroidal anti-inflammatory drugs (NSAIDs) such as diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.

Moderate

Be cautious with this combination.

Medications used during surgery (Anesthesia)
Evening primrose oil might interact with medications used during surgery. One person who was taking evening primrose oil and other medications had a seizure during surgery. But there isn't enough information to know if evening primrose oil or the other medications caused the seizure. Be sure to tell your doctor what natural products you are taking before having surgery. To be on the safe side, you should stop taking evening primrose oil at least 2 weeks before surgery.

Phenothiazines
Taking evening primrose oil with phenothiazines might increase the risk of having a seizure in some people.

Some phenothiazines include chlorpromazine (Thorazine), fluphenazine (Prolixin), trifluoperazine (Stelazine), thioridazine (Mellaril), and others.

Minor

Be watchful with this combination.

Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates)
Some medications are changed and broken down by the liver. Evening primrose oil might decrease how quickly the liver breaks down some medications. Taking evening primrose oil along with some medications that are changed by the liver might increase the effects and side effects of some medications. Before taking evening primrose oil, talk to your healthcare provider if you take any medications that are changed by the liver.

Some of these medications that are changed by the liver include celecoxib (Celebrex), diclofenac (Voltaren), fluvastatin (Lescol), glipizide (Glucotrol), ibuprofen (Advil, Motrin), irbesartan (Avapro), losartan (Cozaar), phenytoin (Dilantin), piroxicam (Feldene), tamoxifen (Nolvadex), tolbutamide (Tolinase), torsemide (Demadex), and S-warfarin (Coumadin).

Are there interactions with herbs and supplements?

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Herbs and supplements that might slow blood clotting
Using evening primrose oil along with herbs that can slow blood clotting could increase the risk of bleeding in some people. These herbs include angelica, clove, danshen, garlic, ginger, ginkgo, red clover, turmeric, and others.

Are there interactions with foods?

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There are no known interactions with foods.

What dose is used?

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The following doses have been studied in scientific research:

BY MOUTH:
  • For breast pain: 3-4 grams daily.

Other names

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Aceite de Onagra, Acide Cis-linoléique, Cis-Linoleic Acid, EPO, Evening Primrose, Evening Primrose Seed Oil, Fever Plant, Herbe-aux-ânes, Huile de Graines d’Onagre, Huile D'Onagre, Huile de Primerose, Huile de Primevère Vespérale, Jambon de Jardinier, Jambon du Paysan, King's Cureall, Mâche Rouge, Night Willow-Herb, Oenothera biennis, Oenothera muricata, Oenothera purpurata, Oenothera rubricaulis, Oenothera suaveolens, Œnothère, Oil of Evening Primrose, Onagra biennis, Onagraire, Onagre Bisannuelle, Onagre Commune, Primevère du Soir, Primrose, Primrose Oil, Scabish, Sun Drop.

Methodology

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To learn more about how this article was written, please see the Natural Medicines Comprehensive Database methodology.methodology (http://www.nlm.nih.gov/medlineplus/druginfo/natural/methodology.html).

References

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To see all references for the Evening primrose oil page, please go to http://www.nlm.nih.gov/medlineplus/druginfo/natural/1006.html.

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Page last updated: 27 October 2014