Devil's Claw
Scientific Name(s): Harpagophytum procumbens DeCandolle. Family: Pediliaceae
Common Name(s): Devils' claw , grapple plant
Clinical Overview
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Uses of Devil's Claw
Devil's claw is a folk remedy used for an extensive range of diseases, including arthritis and rheumatism. Research suggests it may be useful as a hypotensive, anti-arrhythmic, anti-inflammatory, and analgesic.
Devil's Claw Dosing
Devil's claw has been studied for low back pain, muscle pain, and osteoarthritis using daily doses of crude tuber up to 9 g daily, 1 to 3 g of extract, and 50 to 100 mg of harpagoside. Standardized preparations include LI 174 ( Rivoltan ), Doloteffin (more than 50 mg harpagoside), and WS 1531. A level of more than 1% harpagoside in root is considered acceptable. 1 , 2 , 3 , 4 , 5
Contraindications
Contraindications have not yet been identified.
Pregnancy/Lactation
Documented oxytoxic adverse effects. Avoid use. 6
Devil's Claw Interactions
None well documented.
Devil's Claw Adverse Reactions
Rare, generally consisting of headache, tinnitus, or anorexia.
Toxicology
Significant toxicity has not been observed in limited use.
Botany
Devil's claw grows naturally in the Kalahari desert and Namibian steppes of southwest Africa. The secondary roots are used in decoctions and teas.
History
Devil's claw has been used by native Africans as a folk remedy for diseases ranging from liver and kidney disorders to allergies, headaches and, most commonly, rheumatisms. This drug, however, is more widely used in South Africa, especially by Bushmen, Hottentots and Bantu. 7 Devil's claw is marketed in Canada and Europe as a home remedy for the relief of arthritic disease. 8
Chemistry
The major chemical component, which has been thought to be responsible for the anti-inflammatory activity of devil's claw, is harpagoside, a monoterpene glucoside. Harpagide has also been shown to be one of the active principles of devil's claw. 9 Harpagoside is found primarily in the roots; secondary tubers contain twice as much glucoside as the primary roots. Flowers, stems and ripe fruits are essentially devoid of the compound while traces have been isolated from the leaves. 10 Harpagoside can be progressively hydrolyzed to harpagid and harpagogenin. 11 Commercial sources of devil's claw extract contain 1.4% to 2% harpagoside. 12
The plant also contains procombide, a diasteroisomer of antirrhinoside 13 , 14 and a variety of other glycosides whose pharmacologic significance is unknown. 15
Devil's Claw Uses and Pharmacology
Cardiac effectsAnimal data
Studies of the crude methanolic extract of the secondary roots of Harpagophytum procumbens indicate that its effect on smooth muscles is due to a complex interaction of the different active principles of the drug at cholinergic receptors. 9 The dried crude methanolic extract, harpagoside, causes significant dose-dependent reduction in blood pressure, decreased heart rate and anti-arrhythmic activity on isolated rabbit heart and on intact rats. 16 Studies of the extract have shown that harpagoside interferes with the mechanisms that regulate the influx of calcium in cells of smooth muscles. 9 The methanolic extract also causes a mild decrease in the heart rate with a concomitant and positive inotropic effect at higher doses. The coronary flow decreases at higher doses only.
The negative chronotropic and positive inotropic effects of harpagoside are comparatively higher than those of the extract, while harpagide has only a slight negative chronotropic effect and a considerable negative inotropic one. 17 In experiments on intact rats and on isolated rabbit heart, the H. procumbens extract has demonstrated a protective action against arrhythmias induced by aconitine, and particularly to those provoked by calcium chloride and epinephrine chloroform. 17
Clinical dataResearch reveals no clinical data regarding the use of devil's claw for cardiac effects.
Other usesAqueous extract of H. procumbens significantly reduced carrageenan-induced edema at 400 and 800 mg/kg 4 hours after carrageenan injection. Orally administered extracts are inefficient; this was attributed to the time in transition in the stomach, where the pH is acidic, causing a decrease in activity of the extract. 17
The results of a German clinical study indicate that devil's claw has anti-inflammatory activity comparable to that of phenylbutazone. Analgesia was observed, along with a reduction in abnormally high uric acid and cholesterol levels. 18
The suggestion that devil's claw possesses oxytocic or abortive properties has been largely disproved.
Dosage
Devil's claw has been studied for low back pain, muscle pain, and osteoarthritis using daily doses of crude tuber up to 9 g daily, 1 to 3 g of extract, and 50 to 100 mg of harpagoside. Standardized preparations include LI 174 ( Rivoltan ), Doloteffin (more than 50 mg harpagoside), and WS 1531. A level of more than 1% harpagoside in root is considered acceptable. 1 , 2 , 3 , 4 , 5
Pregnancy/Lactation
Documented oxytoxic adverse effects. Avoid use. 6
Interactions
None well documented.
Adverse Reactions
Adverse effects in human trials have been rare, generally consisting of headache, tinnitus, and anorexia.
Toxicology
Harpagoside has been found to be of low toxicity with an LD 50 of greater than 13.5 g/kg in mice. Although no chronic toxicity studies have been reported, rats given oral doses of 7.5 g/kg/day harpagoside showed no clinical, hematologic or gross pathologic changes. 19
Bibliography
1. Gobel H, Heinze A, Ingwersen M, Niederberger U, Gerber D. Effects of Harpagophytum procumbens LI 174 (devil's claw) on sensory, motor und vascular muscle reagibility in the treatment of unspecific back pain. Schmerz . 2001 Feb;15(1):10-18.2. Chrubasik S, Model A, Black A, Pollak S. A randomized double-blind pilot study comparing Doloteffin and Vioxx in the treatment of low back pain. Rheumatology (Oxford) . 2003 Jan;42(1):141-148.
3. Chantre P, Cappelaere A, Leblan D, et al. Efficacy and tolerance of Harpagophytum procumbens versus diacerhein in treatment of osteoarthritis. Phytomedicine . 2000 Jun;7(3):177-183.
4. Leblan D, Chantre P, Fournie B. Harpagophytum procumbens in the treatment of knee and hip osteoarthritis. Four-month results of a prospective, multicenter, double-blind trial versus diacerhein. Joint Bone Spine . 2000;67(5):462-467.
5. Chrubasik S, Junck H, Breitschwerdt H, et al. Effectiveness of Harpagophytum extract WS 1531 in the treatment of exacerbation of low back pain: a randomized, placebo-controlled, double-blind study. Eur J Anaesthesiol . 1999 Feb;16(2):118-129.
6. Newall CA, Anderson LA, Phillipson JD eds. Herbal Medicines: A Guide for Health-Care Professionals . London: Pharmaceutical Press; 1996.
7. Ragusa S, et al. A drug used in traditional medicine. Harpagophytum procumbens D.C. Part I. Scanning electron microscope observations. J Ethnopharmacol . 1984;11(3):245.
8. Moussard C, et al. A drug used in traditional medicine, harpagophytum procumbens: no evidence for NSAID-like effect on whole blood eicosanoid production in human. Prostaglandins Leuko Essent Fatty Acids . 2993;46(4):283.
9. Occhiuto F, et al. A drug used in traditional medicine: Harpagophytum procumbens D.C. Part IV. Effects on some isolated muscle preparations. J Ethnopharmacol . 1985;13(2):201.
10. Czygan FC, Krueger A. Planta Med . 1977;31:305.
11. Vahaelen M, et al. Biological activity of Harpagophytum procumbens D.C. Part I. Preparation and structure of harpagogenin. J Pharm Belg . 1981;36:38.
12. Caprasse M. [Description, identification and therapeutical uses of the 'Devil's claw:' Harpagophytum procumbens D.C.] [French] J Pharm Belg . 1980;35(2):143.
13. Biancho A, et al. Gazz Chim Ital . 1971;101:764.
14. Bendall M, et al. The structure of procumbide. Aust J Chem . 1979;32(9):2085.
15. Tunmann P, Bauersfeld HJ. [Further components from radix Harpagophytum procumbens D.C.] [German] Arch Pharm . 1975;308(8):655.
16. Circosta C, et al. Drug used in traditional medicine: Harpagophytum procumbens D.C. Part 2. Cardiovascular activity. J Ethnopharmacol . 1984;11:259.
17. Soulimani R, et al. 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.
18. Kampf R. Schweitz Apothek Zeitung . 1976;114:337.
19. Whitehouse LW, et al. Devil's Claw ( Harpagophytum procumbens ): no evidence for anti-inflammatory activity in the treatment of arthritic disease. Can Med Assoc J . 1983;129(3):249.
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