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Boneset

Scientific Name(s): Eupatorium perfoliatum L.
Common Name(s): Agueweed, Boneset, Crosswort, Eupatorium, Feverwort, Indian sage, Sweating plant, Thoroughstem, Thoroughwax, Thoroughwort, Vegetable antimony, Wild Isaac

Clinical Overview

Use

There is no recent clinical evidence to guide use of boneset. Limited experimental data suggest anti-inflammatory, antiviral, and cytotoxic activity.

Dosing

There is no recent clinical evidence to guide dosage of boneset. Traditional use was 2 g of leaves and flowers. Internal use should be tempered by the occurrence of hepatotoxic pyrrolizidine alkaloids in this plant.

Contraindications

Contraindications have not yet been identified.

Pregnancy/Lactation

Documented adverse effects, including cytotoxic constituents. Avoid use.

Interactions

None well documented.

Adverse Reactions

The FDA has classified boneset as an "Herb of Undefined Safety."

Toxicology

The ingestion of large amounts of teas or extracts may result in severe diarrhea. The identification of pyrrolizidine alkaloids in related Eupatorium species is cause for concern until detailed phytochemical investigations are carried out on boneset. This class of alkaloids is known to cause hepatic impairment after long-term ingestion. While direct evidence for a hepatotoxic effect from boneset does not exist, there is sufficient evidence to indicate that any plant containing unsaturated pyrrolizidine alkaloids should not be ingested.

Botany

Boneset is a ubiquitous plant found growing in swamps, marshes, and shores from Canada to Florida and west to Texas and Nebraska. The plant is easily recognized by its long, tapering leaves that join each other around a single stout stem giving the impression of one long leaf pierced at the center by the stem. Hence its name perfolia, meaning "through the leaves." The plant grows from July to October to a height of about 1 meter. It flowers in late summer with white blossoms that appear in small upright bunches. The entire plant is hairy and light green.Hensel 2011, USDA 2016

History

Boneset has been used as a charm and as a medicinal remedy for centuries by indigenous North Americans. As a charm, the root fibers were applied to hunting whistles with the belief that they would increase the whistle's ability to call deer. As an herbal remedy, American Indians used boneset as an antipyretic. The early settlers used the plant to treat rheumatism, dropsy, dengue fever, malaria, pneumonia, and influenza. The name boneset was derived from the plant's use in the treatment of breakbone fever, a term describing the high fever that often accompanies influenza. Boneset was official in the US Pharmacopeia from 1820 to 1900. Based on data from early medical compendia, boneset is believed to have diuretic and laxative properties in small doses, while large doses may result in emesis and catharsis. Boneset had been used by physicians to treat fever, but its use was replaced by safer and more effective antipyretics.Bolyard 1981, Erichsen-Brown 1989, Hensel 2011, Herz 1972

Chemistry

Boneset leaves and roots contain a variety of sesquiterpene lactonesBohlmann 1977, Herz 1977 as well as a number of sterols and triterpenes, including sitosterol and stigmasterol.DomInguez 1974 The flavonoids quercetin, kaempferol, and eupatorin and their glycosides also have been identified in the plant.Herz 1972, Wagner 1972 Boneset has not been shown to definitively contain alkaloids; however, 2 of 7 samples screened in 1 program tested positive.Raffauf 1996 A number of related species of Eupatorium have been shown to contain unsaturated pyrrolizidine alkaloids of the type that can cause serious liver damage.Locock 1966 Acidic polysaccharides containing principally xylose and glucuronic acid have been elucidatedVollmar 1986 as well as caffeic acid derivatives.Hensel 2011, Maas 2008

Uses and Pharmacology

Anti-inflammatory effects

Animal data

An ethanolic extract of the aboveground parts of the plant was found inactive in a carrageenan-induced rat paw model of inflammation.Benoit 1976, Khan 2009 In vitro anti-inflammatory properties of E. perfoliatum and its extracts have been demonstrated in vitro.Maas 2011

Clinical data

Research reveals no clinical data regarding the use of boneset as an anti-inflammatory agent.

The isolated polysaccharides and an extract of E. perfoliatum combined with other herbs have been shown to stimulate phagocytic activity in vitro by a carbon particle clearance technique.Wagner 1985, Wagner 1991

Other uses

The ethanol extract of boneset leaves was shown to have modest antibacterial and cytotoxic activity.Habtemariam 2009, Khan 2009

In vitro activity against the influenza virus via preventing attachment to the host cell has been reported.Derksen 2016 Reports of studies evaluating homeopathic E. perfoliatum preparations existHensel 2011; however, these have not been validated by any quality clinical studies.

Dosing

There is no recent clinical evidence to guide dosage of boneset. Traditional use was at a dose of 2 g of leaves and flowers. Internal use should be tempered by the occurrence of hepatotoxic pyrrolizidine alkaloids in this plant.

Pregnancy / Lactation

Avoid use. Documented adverse effects, including cytotoxic constituents.Duke 2002, Ernst 2002

Interactions

None well documented.

Adverse Reactions

Diarrhea and nausea have been reported with large doses.Duke 2002, Khan 2009 E. perfoliatum is considered a toxic plant.Quattrocchi 2012

Toxicology

The ingestion of large amounts of teas or extracts may result in severe diarrhea. The identification of pyrrolizidine alkaloids in related Eupatorium species is cause for concern until detailed phytochemical investigations are carried out on boneset. This class of alkaloids is known to cause hepatic impairment after long-term ingestion. While direct evidence for a hepatotoxic effect from boneset does not exist, there is sufficient evidence to indicate that any plant containing unsaturated pyrrolizidine alkaloids should not be ingested. E. perfoliatum is considered a toxic plant.Duke 2002, Khan 2009, Quattrocchi 2012

References

Benoit PS, Fong HH, Svoboda GH, Farnsworth NR. Biological and phytochemical evaluation of plants. XIV. Antiinflammatory evaluation of 163 species of plants. Lloydia. 1976;39(2-3):160-171.986000
Bohlmann F, Mahanta PK, Suwita A, et al. Neue sesquiterpenelactone und andere inhaltstoffe aus vertretern der Eupatorium-gruppe. Phytochemistry. 1977;16:1973-1981.
Bolyard JL. Medicinal Plants and Home Remedies of Appalachia. Springfield, IL: Thomas; 1981:59-60.
Derksen A, Kühn J, Hafezi W, et al. Antiviral activity of hydroalcoholic extract from Eupatorium perfoliatum L. against the attachment of influenza A virus. J Ethnopharmacol. 2016;188:144-152.27178637
DomInguez XA, Gonzalez Quintanilla JA, Rojas P. Sterols and triterpenes from Eupatorium perfoliatum. Phytochemistry. 1974;13:673-674.
Duke J, Bogenschutz-Godwin M, duCellier J, Duke P. Handbook of Medicinal Herbs. 2nd ed. ed. Boca Raton, FL: CRC Press; 2002.
Eupatorium perfoliatum. USDA, NRCS. 2016. The PLANTS Database (http://plants.usda.gov, December 2016). National Plant Data Team, Greensboro, NC 27401-4901 USA.
Erichsen-Brown C. Medicinal and Other Uses of North American Plants: A Historical Survey with Special Reference to the Eastern Indian Tribes. NY: Dover Press; 1989:262-264.
Ernst E. Herbal medicinal products during pregnancy: Are they safe? BJOG. 2002;109(3):227-235.11950176
Habtemariam S, Macpherson AM. Cytotoxicity and antibacterial activity of ethanol extract from leaves of a herbal drug, boneset (Eupatorium perfoliatum). Phytother Res. 2000;14(7):575-577.11054857
Hensel A, Maas M, Sendker J, et al. Eupatorium perfoliatum L.: phytochemistry, traditional use and current applications. J Ethnopharmacol. 2011;138(3):641-651.22004891
Herz W, Gibaja S, Bhat SV, Srinivasan A. Dihydroflavonols and other flavonoids of Eupatorium species. Phytochemistry. 1972;11:2859-2863.
Herz W, Kalyanaraman PS, Ramakrishnan G. Sesquiterpene lactones of Eupatorium perfoliatum. J Org Chem. 1977;42(13):2264-2271.874606
Khan I, Abourashed E. Leung’s Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics. 3rd ed. Hoboken, NJ: Wiley; 2009.
Locock RA, Beal JL, Doskotch RW. Alkaloid constituents of Eupatorium serotinum. Lloydia. 1966;29:201-205.
Maas M, Deters AM, Hensel A. Anti-inflammatory activity of Eupatorium perfoliatum L. extracts, eupafolin, and dimeric guaianolide via iNOS inhibitory activity and modulation of inflammation-related cytokines and chemokines. J Ethnopharmacol. 2011;137(1):371-81.21669270
Maas M, Petereit F, Hensel A. Caffeic acid derivatives from Eupatorium perfoliatum L. Molecules. 2008;14(1):36-45.19104484
Quattrocchi U. CRC World Dictionary of Medicinal and Poisonous Plants. Boca Raton: CRC Press; 2012.
Raffauf RF. Plant Alkaloids: A Guide to Their Discovery and Distribution. NY: Food Products Press; 1996:49-57.
Vollmar A, Schafer W, Wagner H. Immunologically active polysaccharides of Eupatorium cannabinum and Eupatorium perfoliatum. Phytochemistry. 1986;25:377-381.
Wagner H, Iyengar MA, Hörhammer L. Flavonol-3-glucosides in eight Eupatorium species. Phytochemistry. 1972;11:1504-1505.
Wagner H, Jurcic K. Immunologic studies of plant combination preparations. In-vitro and in- vivo studies on the stimulation of phagocytosis [in German]. Arzneimittelforschung. 1991;41(10):1072-1076.1799388
Wagner H, Proksch A, Riess-Maurer I, et al. Immunostimulating action of polysaccharides (heteroglycans) from higher plants [in German]. Arzneimittelforschung. 1985;35(7):1069-1075.4052142

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This information relates to an herbal, vitamin, mineral or other dietary supplement. This product has not been reviewed by the FDA to determine whether it is safe or effective and is not subject to the quality standards and safety information collection standards that are applicable to most prescription drugs. This information should not be used to decide whether or not to take this product. This information does not endorse this product as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this product. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this product. This information is not specific medical advice and does not replace information you receive from your health care provider. You should talk with your health care provider for complete information about the risks and benefits of using this product.

This product may adversely interact with certain health and medical conditions, other prescription and over-the-counter drugs, foods, or other dietary supplements. This product may be unsafe when used before surgery or other medical procedures. It is important to fully inform your doctor about the herbal, vitamins, mineral or any other supplements you are taking before any kind of surgery or medical procedure. With the exception of certain products that are generally recognized as safe in normal quantities, including use of folic acid and prenatal vitamins during pregnancy, this product has not been sufficiently studied to determine whether it is safe to use during pregnancy or nursing or by persons younger than 2 years of age.

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