Coltsfoot
Scientific Name(s): Tussilago farfara L.
Common Name(s): Coltsfoot, Filius ante patrem, Folia farfarae, Kuan Don Hua, Kuandong Hua
Medically reviewed by Drugs.com. Last updated on Jan 15, 2024.
Clinical Overview
Use
Information supporting antioxidant, antitussive, antimicrobial, or pressor effects of coltsfoot is limited to in vitro and animal studies. Nonclinical research also suggests potential applications in cancer and inflammatory processes. However, clinical data are lacking to recommend coltsfoot for any indication.
Dosing
Clinical trials are lacking to provide dosage recommendations for coltsfoot.
Contraindications
Information is lacking. Avoid in pregnancy and in patients with hepatic disease.
Pregnancy/Lactation
Avoid use. Preparations may contain hepatotoxic pyrrolizidine alkaloids with carcinogenic and mutagenic potential.
Interactions
None well documented. Caution is warranted if coltsfoot is used concurrently with anticoagulants (eg, warfarin) or antiplatelet agents (eg, aspirin, clopidogrel, prasugrel).
Adverse Reactions
Clinical trials are lacking. Allergic and hypertensive effects are possible.
Toxicology
No data.
Scientific Family
- Asteraceae (daisy)
Botany
Coltsfoot is an invasive, perennial plant growing up to 30 cm tall. Golden flowers similar to dandelions appear and die before leaves are produced, hence the name Filius ante patrem (meaning "the son before the father"). The seeds of the plant are soft, hair-like tufts often used by birds to build nests, and the leaves are broad and hoof-shaped, with hairs on the upper and lower surfaces. The leaves and flowering buds are of primary medicinal interest. Although coltsfoot is botanically similar to Petasites (butterbur), activities of the two differ.Duke 2002, Shikov 2014, USDA 2019 Although sometimes considered synonymous with Petasites Mill., butterbur and coltsfoot are monographed separately (see Butterbur monograph).
History
Coltsfoot has been widely used in traditional medicine for multiple indications, including the treatment of bronchitis, lung cancer, emphysema, inflammation, rheumatism, swelling and water retention, and tuberculosis. It is listed in the Chinese Pharmacopoeia (as "Kuandonghua") and Russian Pharmacopoeia as a product used for centuries in the treatment of cough.Duke 2002, Kim 2013, Li 2018, Shikov 2014
Chemistry
Pyrrolizidine alkaloids, especially senkirkine, are present in coltsfoot; however, the total alkaloid content is lower than that in butterbur.Duke 2002, Shikov 2014
Sesquiterpenes, including tussilagone, bisabolene, triterpenes, flavonoids, and pyrrolizidine alkaloids, are well described.Li 2012, Li 2012, Liu 2008, Liu 2011, Park 2008, Qin 2014 Phenolic compounds have been identified using high-performance liquid chromatography techniques.Uysal 2018 Reviews of the chemical constituents in the flowers, leaves, whole plant, and essential oil are available.Boucher 2018, Duke 2002, NAL 2019
Uses and Pharmacology
Anti-inflammatory effects
Animal and in vitro data
In vitro and rodent studies (eg, mice with induced colitis or cerebral ischemia) report anti-inflammatory effects of extracts of T. farfara (sesquiterpenoids, tussilagone), including moderation of nitric oxide production and inhibition of nuclear factor kappa B cells, which leads to suppression of cyclooxygenase, inflammatory cytokine, and tumor necrosis factor alpha levels.Cheon 2018, Hwang 2018, Jang 2016, Kim 2017, Lim 2015, Qin 2014
Antimicrobial effects
In vitro data
Antimicrobial effects against Bacillus cereus, Mycobacterium tuberculosis, and Staphylococcus aureus have been observed in vitro.Boucher 2018, Kokoska 2002, Zhao 2014
Antioxidant effects
Animal and in vitro data
Several animal and in vitro studies have demonstrated antioxidant effects for coltsfoot, possibly related to its anti-inflammatory and chemo- and neuroprotective effects.Cho 2005, Kang 2016, Kim 2006, Lee 2017, Lee 2018, Li 2012, Li 2012, Lim 2008
Cancer
Animal and in vitro data
In vitro and rodent studies suggest that extracts of coltsfoot may possess activity of relevance in cancer, such as induction of apoptosis in human cancer cell lines.Lee 2014, Li 2014, Qu 2018, Safonova 2018, Safonova 2018
Protective effects of the polysaccharide extract on chemotherapy-induced toxicities have been demonstrated.Safonova 2016, Safonova 2018, Safonova 2018
Cardiovascular effects
Animal data
In dogs, cats, and rats, an alcoholic extract of T. farfara produced a pressor effect similar to that of dopamine; however, no tachyphylaxis was observed. This blood pressure response was associated with increased heart rate.Li 1988, Shikov 2014
Diabetes
In vitro data
In vitro studies suggest extracts of coltsfoot may have applications in diabetes, possibly related to inhibitory activity against diacylglycerol acyltransferase and aldose reductase.Kuroda 2016, Park 2008
Respiratory effects
Animal and in vitro data
Antitussive and expectorant effects of coltsfoot flowers have been investigated in mice.Li 2012, Li 2012, Li 2013, Li 2018 Caffeic acid constituents, as well as other compounds such as tussilagone and sitosterol, are considered active antitussives and expectorants and exhibit additional anti-inflammatory properties.Li 2018, Wu 2016 Tussilagone has been investigated in vitro for mucin regulatory activity, which is important in the production of mucus.Choi 2018
Dosing
Clinical trials are lacking to provide dosage recommendations for coltsfoot.
Traditional dosages include 2 to 4 mL of liquid leaf extract or 0.6 to 2 mL of liquid flower extract.Duke 2002
Pregnancy / Lactation
Avoid use. Preparations may contain hepatotoxic pyrrolizidine alkaloids with carcinogenic and mutagenic potential.Blumenthal 2000, Duke 2002, Ernst 2002
Interactions
None well documented.Chen 2012, Ulbricht 2008 High doses of coltsfoot may interact with cardiovascular medicines.Duke 2002 The constituent tussilagone demonstrates weak antiplatelet and calcium channel blocking activity.Hwang 1987, Liu 2008 Caution is warranted if coltsfoot is used concurrently with anticoagulants (eg, warfarin) or antiplatelet agents (eg, aspirin, clopidogrel, prasugrel).
Adverse Reactions
Animal studies have demonstrated allergenic potential.(Duke 2002) A warning label regarding the presence of potentially hepatotoxic pyrrolizidine alkaloids has been recommended for all coltsfoot preparations.(Dangerous Supplements 2010, Kim 2013) A systematic review of case studies published through November 2017 identified 3 cases of adverse reactions related to coltsfoot when combining keyword search terms for pyrrolizidine alkaloid (PA)-related harm and coltsfoot, T. farfara. Of the 2 cases considered to be assessable, 1 documented fatal exposure to unsaturated PAs in utero from a multi-herbal tea consumed daily for the duration of pregnancy; the 2nd case was hepatoveno-occlusive disease in an adult female. In contrast to the WHO Uppsala Monitoring Center system that rated these cases as "likely" and "possible," the causality assessment by a toxicologist concluded the harm as very "unlikely" related to coltsfoot considering the presence of other herbs, which also contained pyrrolizidine alkaloids.(Avila 2020)
Toxicology
Pyrrolizidine alkaloids are liver toxins with carcinogenic and mutagenic potential.Blumenthal 2000, Seremet 2016, Shikov 2014 Coltsfoot has been reported to be phototoxic in guinea pig skin.Duke 2002 Development of hepatic tumors has been reported in rats fed coltsfoot in their diet.Duke 2002, Hirono 1976 Case reports exist of both fatal (in a newborn) and reversible (in an 18-month-old child) hepatic vaso-occlusive disease; causality was suspected but not established.Shikov 2014, Sperl 1995 Coltsfoot was implicated in another case report of deep vein thrombosis and pulmonary embolism in an adult consuming a combination of herbal preparations.Freshour 2012
Index Terms
- Petasites
References
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