Scientific Name(s): Tussilago farfara L.
Common Name(s): Folia farfarae, Coltsfoot, Filius ante patrem, Kuan Don Hua, Kuandong Hua
Information to support traditional uses (eg, antioxidant, antitussive, antimicrobial, pressor effects) is limited to in vitro and animal studies.
Clinical trials are lacking to provide dosage recommendations.
Information is lacking. Avoid in pregnancy and in patients with hepatic disease.
Avoid use. Preparations may contain hepatotoxic pyrrolizidine alkaloids with carcinogenic and mutagenic potential.
None well documented. Caution is warranted if used concurrently with anticoagulants (eg, warfarin) or antiplatelet agents (eg, aspirin, clopidogrel, prasugrel).
Clinical trials are lacking. Allergic and hypertensive effects are possible.
Carcinogenicity, mutagenicity, and phototoxicity have been described for various chemical constituents.
Coltsfoot is an invasive, perennial plant growing up to 30 cm tall. Golden flowers that look similar to dandelions appear and die before leaves are produced, hence the name Filius ante patrem (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 upper and lower surfaces. The leaves and flowering buds are of primary medicinal interest. Although related to Petasites (butterbur), activities of coltsfoot should be regarded separately.USDA.2014, Duke.2002, Shikov 2014 Although sometimes considered synonymous with Petasites Mill., butterbur and coltsfoot are monographed separately (see Butterbur monograph).
Coltsfoot has been widely used 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 and Russian pharmacopoeias as having been used for centuries for coughs.Duke 2002, Kim 2013, Shikov 2014
Pyrrolizidine alkaloids, especially senkirkine, are present; however, the total alkaloid content is lower than in butterbur.Duke 2002, Shikov 2014
Sequiterpenes, including tussilagone, bisabolene, triterpenes, flavonoids, and pyrrolizidine alkaloids, are well described.Li 2012, Liu 2011, Liu 2008, Park 2008 An overview of the chemical constituents in the flowers, leaves, and whole plant is available.Duke 2014
Uses and Pharmacology
In dogs, cats, and rats, an alcoholic extract produced a pressor effect similar to that of dopamine, but without tachyphylaxis. Increased heart rate was observed.Shikov 2014, Li 1988
Research reveals no clinical data regarding the use of coltsfoot in cardiovascular conditions.
Antitussive and expectorant effects of coltsfoot flowers have been investigated in mice.Li 2012, Li 2013
Despite traditional use for coughs, research reveals no clinical data regarding the use of coltsfoot in respiratory conditions.
Antimicrobial effects have been shown against Bacillus cereus, Mycobacterium tuberculosis, and Staphylococcus aureus.Kokoska 2002, Zhao 2014
Several studies have demonstrated antioxidant effects for coltsfoot; clinical applications are lacking, but may relate to anti-inflammatory and chemo- and neuroprotective effects.Cho 2005, Kim 2006, Li 2012, Lim 2008
Further in vitro studies suggest extracts of coltsfoot may have applications in diabetes and cancer.Li 2014, Park 2008
Clinical trials are lacking to provide dosage recommendations.
Traditional dosage: 2 to 4 mL liquid leaf extract or 0.6 to 2 mL liquid flower extract.Duke 2002
No more than 4.5 to 6 g/day for no longer than 4 to 6 weeks per year in total, due to pyrrolizidine alkaloid content.Duke 2002, Blumenthal 2000
Pregnancy / Lactation
Avoid use. Preparations may contain hepatotoxic pyrrolizidine alkaloids with carcinogenic and mutagenic potential.Blumenthal 2000, Duke 2002, Ernst 2002
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).
Animal studies reported allergenic potential.Duke 2002 A warning label regarding the presence of potentially hepatotoxic pyrrolizidine alkaloids has been recommended for all coltsfoot preparations.Kim 2013, Dangerous supplements 2010
Pyrrolizidine alkaloids are liver toxins with carcinogenic and mutagenic potential.Blumenthal 2000, Shikov 2014 Phototoxicity has been reported in guinea pig skin.Duke 2002 Development of hepatic tumors in rats has been reported.Duke 2002, Hirono 1976 Case reports exist of both fatal (in a newborn) and reversible (in an 18-month-old) 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
Blumenthal M, Goldberg A, Brinckmann J. Herbal medicine: Expanded Commission E Monographs
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Chen X, Sneed K, Pan S, et al. Herb-drug interactions and mechanistic and clinical considerations. Curr Drug Metab
Cho J, Kim HM, Ryu JH, Jeong YS, Lee YS, Jin C. Neuroprotective and antioxidant effects of the ethyl acetate fraction prepared from Tussilago farfara
L. Biol Pharm Bull
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Duke J, Bogenschutz-Godwin M, duCellier J, Duke P. Handbook of Medicinal Herbs
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Ernst E. Herbal medicinal products during pregnancy: Are they safe? BJOG
Freshour JE, Odle B, Rikhye S, Stewart DW. Coltsfoot as a potential cause of deep vein thrombosis and pulmonary embolism in a patient also consuming kava and blue vervain. J Diet Suppl
Hirono I, Mori H, Culvenor CC. Carcinogenic activity of coltsfoot, Tussilago farfara
Hwang SB, Chang MN, Garcia ML, et al. L-652,469 — a dual receptor antagonist of platelet activating factor and dihydropyridines from Tussilago farfara
L. Eur J Pharmacol
Kim EJ, Chen Y, Huang JQ, et al. Evidence-based toxicity evaluation and scheduling of Chinese herbal medicines. J Ethnopharmacol
Kim MR, Lee JY, Lee HH, et al. Antioxidative effects of quercetin-glycosides isolated from the flower buds of Tussilago farfara
L. Food Chem Toxicol
Kokoska L, Polesny Z, Rada V, Nepovim A, Vanek T. Screening of some Siberian medicinal plants for antimicrobial activity. J Ethnopharmacol
Li H, Lee HJ, Ahn YH, et al. Tussilagone suppresses colon cancer cell proliferation by promoting the degradation of beta-catenin. Biochem Biophys Res Commun
Li W, Huang X, Yang XW. New sesquiterpenoids from the dried flower buds of Tussilago farfara
and their inhibition on NO production in LPS-induced RAW264.7 cells. Fitoterapia
Li YP, Wang YM. Evaluation of tussilagone: a cardiovascular-respiratory stimulant isolated from Chinese herbal medicine. Gen Pharmacol
Li ZY, Zhi HJ, Xue SY, et al. Metabolomic profiling of the flower bud and rachis of Tussilago farfara
with antitussive and expectorant effects on mice. J Ethnopharmacol
Li ZY, Zhi HJ, Zhang FS, et al. Metabolomic profiling of the antitussive and expectorant plant Tussilago farfara
L. by nuclear magnetic resonance spectroscopy and multivariate data analysis. J Pharm Biomed Anal
Lim HJ, Lee HS, Ryu JH. Suppression of inducible nitric oxide synthase and cyclooxygenase-2 expression by tussilagone from Farfarae flos
in BV-2 microglial cells. Arch Pharm Res
Liu LL, Yang JL, Shi YP. Sesquiterpenoids and other constituents from the flower buds of Tussilago farfara
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Liu YF, Yang XW, Lu W, Xin XL. Determination and pharmacokinetic study of tussilagone in rat plasma by RP-HPLC method. Biomed Chromatogr
Park HR, Yoo MY, Seo JH, et al. Sesquiterpenoids isolated from the flower buds of Tussilago farfara
L. inhibit diacylglycerol acyltransferase. J Agric Food Chem
Shikov AN, Pozharitskaya ON, Makarov VG, Wagner H, Verpoorte R, Heinrich M. Medicinal plants of the Russian Pharmacopoeia; their history and applications. J Ethnopharmacol
Sperl W, Stuppner H, Gassner I, Judmaier W, Dietze O, Vogel W. Reversible hepatic veno-occlusive disease in an infant after consumption of pyrrolizidine-containing herbal tea. Eur J Pediatr
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