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Devil's claw


What is it?

Devil’s claw is an herb. The botanical name, Harpagophytum, means “hook plant” in Greek. This plant, which is native to Africa, gets its name from the appearance of its fruit, which is covered with hooks meant to attach onto animals in order to spread the seeds. The roots and tubers of the plant are used to make medicine.

Devil’s claw is used for “hardening of the arteries" (atherosclerosis), arthritis, gout, muscle pain (myalgia), back pain, tendonitis, chest pain, gastrointestinal (GI) upset or heart burn, fever, and migraine headache. It is also used for difficulties in childbirth, menstrual problems, allergic reactions, loss of appetite, and kidney and bladder disease.

Some people apply devil’s claw to the skin for injuries and other skin conditions.

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 DEVIL'S CLAW are as follows:

Possibly effective for...

  • Decreasing pain from a kind of arthritis called osteoarthritis. Taking devil’s claw alone or along with nonsteroidal anti-inflammatory drugs (NSAIDs) seems to help decrease osteoarthritis-related pain. Some evidence suggests that devil’s claw works about as well as diacerhein (a slow-acting drug for osteoarthritis that is not available in the U.S.) for improving osteoarthritis pain in the hip and knee after 16 weeks of treatment. Some people taking devil’s claw seem to be able to lower the dose of NSAIDs they need for pain relief. This evidence comes from a study that used a specific powdered devil’s claw root product (Harpadol, Arkopharma) containing 2% of the devil’s claw ingredient harpagoside (9.5 mg/capsule) and 3% total iridoid glycosides (14.5 mg per capsule). Another specific devil’s claw extract (Doloteffin, Ardeypharm) 2400 mg/day providing 60 mg/day of the harpagoside ingredient has also been used.
  • Back pain. Taking devil’s claw orally seems to lessen low-back pain.

Insufficient evidence to rate effectiveness for...

  • Rheumatoid arthritis (RA). Early research suggests that taking devil’s claw extract by mouth might not improve RA.
  • Upset stomach.
  • Loss of appetite.
  • High cholesterol.
  • Gout.
  • Muscle pain.
  • Migraine headache.
  • Skin injuries and conditions.
  • Other conditions.
More evidence is needed to rate devil’s claw for these uses.

How does it work?

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Devil’s claw contains chemicals that might decrease inflammation and swelling and resulting pain.

Are there safety concerns?

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Devil’s claw is POSSIBLY SAFE for most adults when taken by mouth in appropriate doses for up to a year. The most common side effect is diarrhea. About 8% of the people participating in one research study developed diarrhea. Other possible side effects include nausea, vomiting, abdominal pain, headaches, ringing in the ears, loss of appetite, and loss of taste. It can also cause allergic skin reactions, menstrual problems, and changes in blood pressure.

However, not enough is known about the safety of using devil’s claw long-term or applying it to the skin.

Special precautions & warnings:

Pregnancy and breast-feeding: Devil’s claw is POSSIBLY UNSAFE. It might harm the developing fetus. Avoid use in pregnancy. It’s also best to avoid using devil’s claw while breast-feeding. Not enough is known yet about its safety during breast-feeding.

Heart problems, high blood pressure, low blood pressure: Since devil’s claw can affect heart rate, heartbeat, and blood pressure, it might harm people with disorders of the heart and circulatory system. If you have one of these conditions, talk with your healthcare provider before starting devil’s claw.

Diabetes: Devil’s claw might lower blood sugar levels. Using it along with medications that lower blood sugar might cause blood sugar to drop too low. Monitor blood glucose levels closely. Your healthcare provider might need to adjust your dose of diabetes medications.

Gallstones: Devil’s claw might increase bile production. This could be a problem for people with gallstones. Avoid using devil’s claw.

Peptic ulcer disease (PUD): Since devil’s claw might increase the production of stomach acids, it might harm people with stomach ulcers. Avoid using devil’s claw.

Are there interactions with medications?

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Moderate

Be cautious with this combination.

Medications changed by the liver (Cytochrome P450 2C19 (CYP2C19) substrates)
Some medications are changed and broken down by the liver. Devil's claw might decrease how quickly the liver breaks down some medications. Taking devil's claw along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking devil's claw talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications that are changed by the liver include omeprazole (Prilosec), lansoprazole (Prevacid), and pantoprazole (Protonix); diazepam (Valium); carisoprodol (Soma); nelfinavir (Viracept); and others.

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

Some medications that are changed by the liver include diclofenac (Cataflam, Voltaren), ibuprofen (Motrin), meloxicam (Mobic), and piroxicam (Feldene); celecoxib (Celebrex); amitriptyline (Elavil); warfarin (Coumadin); glipizide (Glucotrol); losartan (Cozaar); and others.

Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)
Some medications are changed and broken down by the liver. Devil's claw might decrease how quickly the liver breaks down some medications. Taking devil's claw along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking devil's claw, talk to your healthcare provider if you are taking any medications that are changed by the liver.

Some medications changed by the liver include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and many others.

Warfarin (Coumadin)
Warfarin (Coumadin) is used to slow blood clotting. Devil's claw might increase the effects of warfarin (Coumadin) and increase the chances of bruising and bleeding. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.

Minor

Be watchful with this combination.

Medications moved by pumps in cells (P-glycoprotein Substrates)
Some medications are moved by pumps into cells. Devil's claw might make these pumps less active and increase how much of some medications get absorbed by the body. This might increase the side effects of some medications.

Some medications that are moved by these pumps include etoposide, paclitaxel, vinblastine, vincristine, vindesine, ketoconazole, itraconazole, amprenavir, indinavir, nelfinavir, saquinavir, cimetidine, ranitidine, diltiazem, verapamil, corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, and others.

Medications that decrease stomach acid (H2-blockers)
Devil's claw might increase stomach acid. By increasing stomach acid, devil's claw might decrease the effectiveness of some medications that decrease stomach acid, called H2-blockers.

Some medications that decrease stomach acid include cimetidine (Tagamet), ranitidine (Zantac), nizatidine (Axid), and famotidine (Pepcid).

Medications that decrease stomach acid (Proton pump inhibitors)
Devil's claw might increase stomach acid. By increasing stomach acid, devil's claw might decrease the effectiveness of medications that are used to decrease stomach acid, called proton pump inhibitors.

Some medications that decrease stomach acid include omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix), and esomeprazole (Nexium).

Are there interactions with herbs and supplements?

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There are no known interactions with herbs and supplements.

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 osteoarthritis: A specific powdered devil’s claw root product (Harpadol, Arkopharm) dosed at 2.6 grams/day. This dose provides a total of 57 mg of harpagoside, one of the active ingredients, and 87 mg of total iridoid glycosides, another active ingredient. Another specific devil’s claw extract (Doloteffin, Ardeypharm) dosed at 2400 mg/day has also been used.
  • For back pain: A specific devil’s claw extract (Doloteffin, Ardeypharm) that provides 50-100 mg of the active ingredient harpagoside daily.

Other names

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Devils Claw, Devil's Claw Root, Garra del Diablo, Grapple Plant, Griffe du Diable, Harpagophyti Radix, Harpagophytum, Harpagophytum procumbens, Harpagophytum zeyheri, Racine de Griffe du Diable, Racine de Windhoek, Teufelskrallenwurzel, Uncaria procumbens, Wood Spider.

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 Devil's claw page, please go to http://www.nlm.nih.gov/medlineplus/druginfo/natural/984.html.

  1. Romiti N, Tramonti G, Corti A, Chieli E. Effects of Devil's Claw (Harpagophytum procumbens) on the multidrug transporter ABCB1/P-glycoprotein. Phytomedicine 2009;16:1095-100.
  2. Chrubasik S, Kunzel O, Thanner J, et al. A 1-year follow-up after a pilot study with Doloteffin for low back pain. Phytomedicine 2005;12:1-9.
  3. 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;17:1165-72.
  4. Unger M, Frank A. Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom 2004;18:2273-81.
  5. Jang MH, Lim S, Han SM, et al. Harpagophytum procumbens suppresses lipopolysaccharide-stimulated expressions of cyclooxygenase-2 and inducible nitric oxide synthase in fibroblast cell line L929. J Pharmacol Sci 2003;93:367-71.
  6. Gagnier JJ, Chrubasik S, Manheimer E. Harpgophytum procumbens for osteoarthritis and low back pain: a systematic review. BMC Complement Altern Med 2004;4:13.
  7. Moussard C, Alber D, Toubin MM, et al. A drug used in traditional medicine, harpagophytum procumbens: no evidence for NSAID-like effect on whole blood eicosanoid production in human. Prostaglandins Leukot Essent Fatty Acids. 1992;46:283-6.
  8. Whitehouse LW, Znamirowska M, Paul CJ. Devil's Claw (Harpagophytum procumbens): no evidence for anti-inflammatory activity in the treatment of arthritic disease. Can Med Assoc J 1983;129:249-51.
  9. Fiebich BL, Heinrich M, Hiller KO, Kammerer N. Inhibition of TNF-alpha synthesis in LPS-stimulated primary human monocytes by Harpagophytum extract SteiHap 69. Phytomedicine 2001;8:28-30..
  10. Baghdikian B, Lanhers MC, Fleurentin J, et al. An analytical study, anti-inflammatory and analgesic effects of Harpagophytum procumbens and Harpagophytum zeyheri. Planta Med 1997;63:171-6.
  1. Lanhers MC, Fleurentin J, Mortier F, et al. Anti-inflammatory and analgesic effects of an aqueous extract of Harpagophytum procumbens. Planta Med 1992;58:117-23 .
  2. Grahame R, Robinson BV. Devils's claw (Harpagophytum procumbens): pharmacological and clinical studies. Ann Rheum Dis 1981;40:632.
  3. Chrubasik S, Sporer F, Dillmann-Marschner R, et al. Physicochemical properties of harpagoside and its in vitro release from Harpagophytum procumbens extract tablets. Phytomedicine 2000;6:469-73.
  4. Soulimani R, Younos C, Mortier F, Derrieu C. The role of stomachal digestion on the pharmacological activity of plant extracts, using as an example extracts of Harpagophytum procumbens. Can J Physiol Pharmacol 1994;72:1532-6.
  5. Costa De Pasquale R, Busa G, et al. A drug used in traditional medicine: Harpagophytum procumbens DC. III. Effects on hyperkinetic ventricular arrhythmias by reperfusion. J Ethnopharmacol 1985;13:193-9 .
  6. Circosta C, Occhiuto F, Ragusa S, et al. A drug used in traditional medicine: Harpagophytum procumbens DC. II. Cardiovascular activity. J Ethnopharmacol 1984;11:259-74.
  7. Chrubasik S, Thanner J, Kunzel O, et al. Comparison of outcome measures during treatment with the proprietary Harpagophytum extract doloteffin in patients with pain in the lower back, knee or hip. Phytomedicine 2002;9:181-94.
  8. Chantre P, Cappelaere A, Leblan D, et al. Efficacy and tolerance or Harpagophytum procumbens versus diacerhein in treatment of osteoarthritis. Phytomedicine 2000;7:177-83.
  9. Fetrow CW, Avila JR. Professional's Handbook of Complementary & Alternative Medicines. 1st ed. Springhouse, PA: Springhouse Corp., 1999.
  10. Shaw D, Leon C, Kolev S, Murray V. Traditional remedies and food supplements: a 5-year toxicological study (1991-1995). Drug Saf 1997;17:342-56.
  11. Brinker F. Herb Contraindications and Drug Interactions. 2nd ed. Sandy, OR: Eclectic Medical Publications, 1998.
  12. Wichtl MW. Herbal Drugs and Phytopharmaceuticals. Ed. N.M. Bisset. Stuttgart: Medpharm GmbH Scientific Publishers, 1994.
  13. Newall CA, Anderson LA, Philpson JD. Herbal Medicine: A Guide for Healthcare Professionals. London, UK: The Pharmaceutical Press, 1996.
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Last reviewed - 08/16/2011




Page last updated: 01 July 2014