Dong quai

Dong quai Fenugreek Feverfew Garlic Ginger Ginkgo Horse chestnut ... 

A number of non-hormonal therapies have been studied for symptomatic management of vasomotor symptoms, including antidepressants [e.g., selective serotonin reuptake inhibitors (SSRIs) and venlafaxine], herbal products (e.g., soy, black cohosh, and dong quai), and a group of miscellaneous agents (e.g., gabapentin, clonidine, and megestrol). The choice of therapy depends on the patient s concomitant disease states, such as depression and hypertension, and the risk for potential adverse effects. 

Dong quai and several other herbal products, including evening primrose oil, passion flowers, sage, valerian root, flaxseed, and wild yam, have not demonstrated efficacy with regard to the relief of vasomotor symptoms, and the safety of these products is also questionable.4,33,35 Therefore, these products should not be recommended for the relief of vasomotor symptoms in postmenopausal women. 

Dong quai No demonstrated efficacy Not recommended Structurally similar to coumarins—avoid with warfarin because INR can increase... 

Dose Initial 0.25 mg PO tid, wkly 10.25 mg/dose, to 3 mg max max 4 mg for RLS Caution [C, /-] Sev e CV, renal, or hepatic impair Contra Component allergy Disp Tabs SE Syncope, postural X BP, NA, HA, somnolence, dosed-related hallucinations, dyskinesias, dizziness Interactions t Risk of bleeding W/ ASA, NSAIDs, fevCTfew, garlic, ginger, horse chestnut, red clover, EtOH, tobacco t effects OF amitriptyline, Li, MTX, theophylline, warfarin t risk of photosensitivity W/ dong quai— use sunscreen, St. John s wort X effects W/ antacids, rifampin X effects OF ACEIs, diuretics EMS t Bleeding risk w/ concurrent EtOH, tobacco, ASA, and NSAID use t effects of warfarin OD May cause N/V, drowsiness, hypotension, and CP symptomatic and supportive... 

Page RL II, Lawerence JD. Potentiation of warfarin by dong quai. Pharmacotherapy 1999 19 870-878. 

Dong quai Coumarin constituents inhibition of platelet aggregation possible inhibition of CYP isoenzymes Increased INR and PT no bleeding episode in one case widespread bruising in another report ... 

CHINESE BOTANICAL PRODUCTS AND WARFARIN Angelica sinensis (Chinese Angelica, Dong Quai)... 

Dong quai (dang gui, tang kuei) is the extract from the dried root of Radix Angelicae sinensis (Fig. 1), which belongs to the family Umbelliferae. It has been used for many years as a Chinese botanical remedy for management of menstrual cramps, irregular menses, and menopausal symptoms, and the... 

In addition to the presence of natural coumarin derivatives, phytochemical analysis found that dong quai also contains ferulic acid and osthole as ingredients. Ferulic acid was reported to have antithrombotic activity (38). Similarly, study using the closely related Angelica pubescens also found osthole to be antithrombotic (39). These two chemical constituents exert their antithrombotic effects by interfering with different pathways responsible... 

Yin ZZ. The effect of dong quai (Angelica sinensis) and its ingredient ferulic acid on rat platelet aggregation and release of 5-HT. Acta Pharmaceut Sinica 1980 15 321-330. 

Do not take or discontinue any other medication, including salicylates (e.g., aspirin and topical analgesics), other over-the-counter medications, and botanical (herbal) products (e.g., bromelains, coenzyme Qio, danshen, dong quai, garlic. Ginkgo biloba, ginseng, and St. John s wort ) except on advice of... 

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