feverfew herb: clinical use

Prescribing considerations

• Confirm that migraine was previously medically diagnosed and assess any change in headache pattern.
• Explain that Traditional Herbal Registration supports quality and traditional use, not demonstrated clinical effectiveness.
• Review prescribed, over-the-counter and complementary products for additive bleeding risk.
• Advise long-term users before discontinuation; abrupt withdrawal has been associated with rebound headache, anxiety, insomnia, muscle stiffness and joint pain.

Contraindications and cautions

• Hypersensitivity to feverfew, any excipient or another Asteraceae/Compositae plant such as daisies, chrysanthemums or ragweed.
• The selected formulation should not be used in glucose-galactose malabsorption.
• Pregnancy and breastfeeding are not recommended because safety data are insufficient.
• Not recommended under 18 years because adequate data are lacking.

Monitoring

• No routine laboratory-monitoring schedule is specified.
• Monitor for altered migraine features, gastrointestinal or oral adverse effects, allergy and bleeding.
• After overdose, provide supportive management and monitor closely for bleeding.

Clinical pharmacology

The therapeutic mechanism and pharmacokinetics are not established. Limited in-vitro findings suggest inhibition of platelet function, but human relevance is uncertain.

Formulation and product differences

• Selected products are round, olive, film-coated tablets containing dried feverfew herb.
• The tablet coating contains dextrose and is unsuitable for glucose-galactose malabsorption.
• Fresh leaves and other supplements should not be assumed equivalent to the registered tablet; formulations and ingredient amounts can differ.