devil’s claw

Devil’s claw is the common name of Harpagophytum procumbens, a flowering plant native to southern Africa. The plant derives its name devil’s claw from the tiny hooks that cover the fruit. Devil’s claw has been historically used as an oral herbal remedy for pain, liver and kidney problems, malaria and fever, and topically applied as an ointment to heal boils, sores and other skin issues. Devil’s claw is currently used most commonly for osteoarthritis, back pain, appetite loss and other gastrointestinal conditions.

Studies suggest devil’s claw has anti-inflammatory, analgesic, antioxidant and anticancer properties. The therapeutic effects of devil’s claw are believed to be from the bioactive substances it contains including iridoid glucosides, phytosterols and flavonoids. In particular, devil’s claw contains a high concentration of harpagoside, a type of iridoid glucoside, which appears to have strong anti-inflammatory effects.

Animal studies show that harpagoside inhibits the production of inflammatory proteins (cytokines), and the induction of pro-inflammatory gene expression. Harpagoside may also prevent bone loss by promoting differentiation of osteoblasts, the bone cells that form new bone tissue, and suppress osteoclasts that break down bone. There is some evidence that devil’s claw may have short-term benefits in osteoarthritis and lower back pain, but there is inadequate evidence to support its other uses.

Devil’s claw supplements are available as capsules, tablets, liquid extracts and ointments prepared from fresh or dried roots of devil’s claw. Suggested uses of devil’s claw include:

• Osteoarthritis
• Lower back pain
• Loss of appetite (anorexia)
• Gastrointestinal disorders
• Inflammation of tendons and joints
• Pain
• Muscle pain
• Cancer pain

• Do not take devil’s claw if you are hypersensitive to any component of the formulation.
• Do not administer devil’s claw to children.
• Avoid taking devil’s claw if you have any of the following conditions:
  • Cardiovascular problems: Devil’s claw may affect heart rate and blood pressure.
  • Gallstones: Devil’s claw may increase bile production and worsen the condition.
  • Low blood sodium levels: Devil’s claw may further reduce sodium levels.
  • Peptic ulcer disease: Devil’s claw may increase production of stomach acids and worsen the condition.

Common side effects of devil’s claw include:

• Diarrhea
• Indigestion
• Taste loss
• Allergic skin reactions
• Headache
• Slow heart rate (bradycardia)

Call your doctor immediately if you experience any of the following symptoms or serious side effects while using this drug:

• Serious heart symptoms include fast or pounding heartbeats, fluttering in your chest, shortness of breath, and sudden dizziness;
• Severe headache, confusion, slurred speech, severe weakness, vomiting, loss of coordination, feeling unsteady;
• Severe nervous system reaction with very stiff muscles, high fever, sweating, confusion, fast or uneven heartbeats, tremors, and feeling like you might pass out; or
• Serious eye symptoms include blurred vision, tunnel vision, eye pain or swelling, or seeing halos around lights.

This is not a complete list of all side effects or adverse reactions that may occur from the use of this drug. Call your doctor for medical advice about serious side effects or adverse reactions. You may also report side effects or health problems to the FDA at 1-800-FDA-1088.

Osteoarthritis/Low Back Pain

• Crude Extract: 2-9 g/d orally
• Standardized Tablets: 600-1200 mg (=50-100 mg harpagoside) orally three times daily

Other Information

• Anorexia: 1.5 g/day decoction
• Elixir (1:1): 0.1-0.25 mL orally three times daily

Overdose

Devil’s claw appears to have low toxicity and overdose may cause gastrointestinal upset but is unlikely to cause any serious adverse effects. Symptoms should resolve with discontinuation of devil’s claw and supportive care.

Inform your doctor of all medications you are currently taking, who can advise you on any possible drug interactions. Never begin taking, suddenly discontinue, or change the dosage of any medication without your doctor’s recommendation.

• Devil's claw has no known severe or serious interactions with other drugs.
• Moderate interactions of devil's claw include:
  • alteplase
  • antithrombin alfa
  • antithrombin III
  • argatroban
  • bemiparin
  • bivalirudin
  • dabigatran
  • dalteparin
  • enoxaparin
  • fondaparinux
  • heparin
  • phenindione
  • protamine
  • reteplase
  • tenecteplase
• Devil's claw has mild interactions with at least 102 different drugs.

The drug interactions listed above are not all of the possible interactions or adverse effects. For more information on drug interactions, visit the RxList Drug Interaction Checker.

It is important to always tell your doctor, pharmacist, or health care provider of all prescription and over-the-counter medications you use, as well as the dosage for each, and keep a list of the information. Check with your doctor or health care provider if you have any questions about the medication.

• Devil’s claw may harm the fetus, do not take it if you are pregnant.
• There isn’t enough information on the safety of devil’s claw use in breastfeeding women. Avoid if you are a nursing mother.
• Never take any herbal supplement without first checking with your healthcare provider, if you are pregnant or breastfeeding.

• Devil’s claw is likely safe for most adults in recommended dose for up to 12 weeks.
• Use devil’s claw exactly as per label instructions. Natural products are not necessarily safe always and following suggested dosing is important.
• Check with your healthcare provider before taking any herbal supplement, including devil’s claw, particularly if you have any health conditions or if you are on any regular medication.
• Herbal products often contain many ingredients. Check labels for the components in the devil’s claw product you choose.
• Devil’s claw is marketed as an herbal supplement and is not regulated by the FDA. Products may differ in formulations and strengths, and labels may not always match contents; exercise caution in choosing your product.
• Store devil’s claw supplements safely out of reach of children.
• In case of overdose, seek medical help or contact Poison Control.