Black Haw

Scientific Name(s): Viburnum prunifolium L. Caprifoliaceae (honeysuckle family)

Common Name(s): Black haw , sweet-haw , stagbush

Uses

Black haw is used to treat dysmenorrhea.

Dosing

There is no recent clinical evidence to guide dosage of black haw. The root or stem bark has been traditionally used at a typical dose of 4 g.

Contraindications

Contraindications have not yet been identified.

Pregnancy/Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking.

Interactions

None well documented.

Adverse Reactions

Use in pregnancy and lactation should be discouraged because of insufficient safety data.

Toxicology

Authentic black haw extracts were lethal to dogs at a 10 g/kg equivalent dose.

Botany

Black haw is a large shrub or small tree with white flowers and shiny, juicy, blue-black berries that is native to the eastern and central United States. An extensive study of Viburnum botany and pharmacognosy was published in 1932. 1 The southeastern US species V. alnifolium Marsh. has been used to adulterate V. prunifolium , 2 as has mountain maple ( Acer spicatum ), 3 and confusion as to the identity of commercial samples muddled early research on black haw. The root bark is preferred to the trunk bark as the usual drug product.

History

Black haw was used by Cherokee and Delaware American Indian tribes as an antispasmodic for female reproductive complaints. It reputedly was used by slaveowners to forestall abortions in female slaves attempting to abort using cotton root bark. 3 Its use was sufficiently common that it was official in the U.S. Pharmacopeia from 1882 to 1926 and then in the National Formulary . It was popularized by the Eclectic movement as a mild sedative and uterine antispasmodic.

V. prunifolium also has been used for menstrual cramps and threatened miscarriage and as a “partus preparation.”

Chemistry

The bioflavonoid amentoflavone 4 and the coumarin scopoletin 5 have been isolated from black haw root bark. Much of the earlier chemistry was not definitive because the source material was widely adulterated, and reports of salicin from black haw have since been disproven. 6 The compounds isovaleric acid 7 and 1-methyl-2,3-dibutyl hemimellitate 8 also have been reported. Iridoid glycosides have been reported from stem bark of black haw. 9 Further investigation using modern phytochemical methods is warranted.

Uses and Pharmacology

Dysmenorrhea
Animal/Clinical data

Early pharmacologic studies on black haw failed to find an effect on isolated uterine tissues from guinea pig, 10 , 11 , 12 human, 13 and rabbit. 14 This may have been caused by the aforementioned adulteration with other species. Using well-defined plant material, a definite relaxant activity in isolated uterine tissue was detected in guinea pigs, 15 rats, 16 , 17 and humans. 16 However, the potency of commercial preparations was noted to vary widely, 18 and an active principle proved elusive. Then scopoletin and amentoflavone were isolated and shown to contribute to the uterine relaxant activity. 4 , 5 , 19 No controlled clinical trials have been reported on black haw in dysmenorrhea or other conditions.

Dosage

There is no recent clinical evidence to guide dosage of black haw. The root or stem bark has been traditionally used at a typical dose of 4 g.

Pregnancy/Lactation

Information regarding safety and efficacy in pregnancy and lactation is lacking.

Interactions

None well documented.

Adverse Reactions

Black haw appears to be safe, although use in pregnancy and lactation should be discouraged because of insufficient safety data.

Toxicology

Extracts of the substituted species V. alnifolium were reported to be 10-fold more toxic to dogs than V. prunifolium and, therefore, unsuitable as a substitute. 2 Authentic black haw extracts were lethal to dogs at a 10 g/kg equivalent dose.

Bibliography

1. Youngken HW. The pharmacognosy, chemistry and pharmacology of Viburnum . III. Histology, botany and pharmacognosy of Viburnum opulus L. Var. americanum. (Miller) Aiton. J Am Pharm Assoc . 1932;21:444-468.
2. Youngken HW, Munch JC. Viburnum . IX. The pharmacognosy and pharmacology of Viburnum alnifolium . J Am Pharm Assoc . 1940;29:439.
3. Brinker F. A comparative review of Eclectic female regulators. J Naturopathic Med . 1998;7:11-26.
4. Hörhammer L, Wagner H, Reinhardt H. Chemistry, pharmacology, and pharmaceutics of the components of Viburnum prunifolium and V. opulus . Botan Mag (Tokyo). 1966;79:510-525.
5. Jarboe CH, Zirvi KA, Nicholson JA, Schmidt CM. Scopoletin, an antispasmodic component of Viburnum opulus and V. prunifolium . J Med Chem . 1967;10:488-489.
6. Heyl FW, Barkenbus C. Some constituents of Viburnum prunifolium . J Am Chem Soc . 1920;42:1744-1755.
7. Holbert JM. The identification of an acid in the root bark of Viburnum prunifolium . J Am Pharm Assoc . 1946;35:315-316.
8. Jarboe CH, Zirvi KA, Schmidt CM. 1-Methyl 2,3-dibutyl hemimellitate. A novel component of Viburnum prunifolium . J Org Chem . 1969;34:4202-4203.
9. Tomassini L, Copmeta MF. Iridoid glucosides from Viburnum prunifolium . Planta Med . 1999;65:195.
10. Lieb CC. Pharmacologic action of ecobolic drugs. Am J Obstet . 1914;69:1-32.
11. Pilcher JD. The action of certain drugs on the excised uterus of the guinea pig. J Pharmacol Exp Ther . 1916;8:110.
12. Pilcher D, Delzell WR, Burman GE. The action of various “female” remedies on the excised uterus of the guinea-pig. JAMA . 1916;47:490-492.
13. Pilcher JD. The action of the several female remedies on strips of the excised human uterus. Arch Intern Med . 1917;19:53-55.
14. Hager BH, Becht FC. The action of Viburnum prunifolium . J Pharmacol Exp Ther . 1919;13:61.
15. Munch JC, Pratt HJ. Studies on Viburnum XI. bioassay methods. Pharm Arch . 1941;12:88-91.
16. Evans WE, Harne WG, Krantz JC. A uterine principle from Viburnum prunifolium . J Pharmacol . 1942;75:174-177.
17. Grote IW, Woods M. Studies on Viburnum III. The uterine sedative action of various fractions. J Am Pharm Assoc . 1947;36:191-192.
18. Sloane AB, Latven AR, Munch JC. Viburnum studies. XIV. A note on the variability of potency of commercial Viburnum preparations. J Am Pharm Assoc . 1948;37:132.
19. Jarboe CH, Schmidt CM, Nicholson JA, Zirvi KA. Uterine relaxant properties of Viburnum . Nature . 1966;212:837.

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