PDR for Herbal Medicines

HERBAL MONOGRAPHS ENGLISH HAWTHORN/273

rate product (PRP) under standardized loading on a bicycle

ergometer, and the score of a subjective questionnaire on

improvement of complaints. Secondary target parameters

included exercise tolerance and the change in heart rate and

arterial blood pressure. A statistically significant improve-

ment in both primary and secondary parameters were noted

in the WS 1442 group over that of the placebo group

(Leuchtgens, 1993).

CONTRAINDICATIONS

Hawthorn is contraindicated in children under 12 years of

age. Use of Hawthorn during the first trimester of pregnancy

is contraindicated.

PRECAUTIONS AND ADVERSE REACTIONS

General: It is recommended that Hawthorn supplements be

prescribed and monitored by a physician. During treatment

with Hawthorn, the clinician should monitor heart rate and

blood pressure on a regular basis.

Higher doses can produce hypotension, cardiac arrhythmia,

and sedation. Less serious adverse effects include dizziness

and tremor.

Accidental corneal scratches caused by thorns of hawthorn

bushes have resulted in blindness in 88 out of 132 reported

cases in Ireland (Duke, 1985).

Drug Interactions Hawthorn may potentiate the effects of

cardiac glycosides. If Hawthorn therapy is initiated in

patients taking digoxin, digitoxin or g-strophanthin, the

dosage of standard cardiac glycosides should be adjusted

downward.

Hawthorn may cause a hypertensive effect when used in

combination with beta-blockers (Murray & Pizzorno, 1996).

Because Hawthorn has an action similar to Class III

antiarrhythmics, use with other antiarrhythmics should be

discouraged.

Hawthorn has been found to inhibit the inward flow of

potassium channels resulting in an increased action potential

in cardiac ventricular cells. Drugs that act in a similar

manner such as cisapride are likely to interact with Hawthorn

and should therefore not be taken in conjunction with

Hawthorn.

Pregnancy: Hawthorn is contraindicated during the first

trimester of pregnancy.

Nursing Mothers: There are no warnings in the literature

regarding use of Hawthorn in nursing mothers.

Pediatrics: Hawthorn is not recommended for children under
the age of 12 years.

OVERDOSAGE

The LD50 via intraperitoneal injection in the mouse model

has been reported at a single dose of 1,170 mg/kg and 750

mg/kg in the rat. In both species, signs of overdose included

sedation, dyspnea, tremor and piloerection (Schlegelilch &

Hey wood, 1994). The same authors reported that an oral

dose if 3,000 mg/kg in mice and rats was well tolerated with

no negative clinical signs or death reported in the animal

models.

DOSAGE

Mode of Administration: The dried and comminuted drug for

decoctions as well as liquid or dry extracts for oral intake.

How Supplied:

Capsules — 80 mg, 100 mg, 300 mg, 450 mg, 455 mg, 480

mg, 500 mg, 510 mg, 565 mg

Liquid — 250 mg/ml

Tablets — 80 mg

Daily Dosage: The average daily dose is 5 gm of drug or 160

to 900 mg extract administered in divided doses, 3 times

daily, (ethanol 45% V/V or methanol 70% V/V) standardized

on procyanidin or flavonoids; single dose: 1 gm of drug

several times daily. The duration of treatment is minimum 6

weeks.

Homeopathic Dosage: 5 to 10 drops, 1 tablet or 5 to 10

globules 1 to 3 times a day or 1 ml injection solution sc twice

a week; ointment 1 to 2 times a day (HAB1)

Storage: Hawthorn should be protected from light and

moisture in well-sealed containers at temperatures below

25° C.

LITERATURE

Ammon HPT, Handel M, (1981) Crataegus, Toxikologie und

Pharmakologie. Teil 1, Toxizitat. Planta Med 43:105-120.

Ammon HPT, Handel M, (1981) Planta Med 43:105, 209 et

313.

Anonym, 5. KongreJJ fur Phytotherapie: Phytoforschung

intensiviert. In: DAZ 133(48):4593. 1993.

Anonym, Behandlung der leichten Herzinsuffiziens:

Weijklornextrakt und ACE-Hemmer im Vergleich. In: DAZ

134(39):3749. 1994.

Anonym, Phytopharmaka fur altere Menschen: Ginkgo, Kava,

Hypericum und Crataegus. In: DAZ 135(5):400-402. 1995.

Anonym, Weipdorn bei Herzinsuffiziens und Angina pectoris.

In: Symbiose 4(3): 16. 1992.

Bahorun T, Gressier B, Trotin F, Brunet C, Dine Th, Luyckx

M, Vasseur J, Cazin M, Cazin JC, Pinkas M, Oxygen species

scavenging activity of phenolic activities, fresh plant organs and

pharmaceutical preparations. In: Arzneim Forsch 46(11): 1086-

1089. 19%.