Tanacetum parthenium

FRESH LEAVES (traditional long-term prophylaxis): 1–2 fresh feverfew leaves daily, consumed with bread, cottage cheese, or in a sandwich — do NOT chew plain, as fresh leaves contain high parthenolide that can irritate oral mucosa (mouth ulcers, swelling). Traditional use for migraine prophylaxis, well established in British folk medicine since the 18th century, recorded in the British Herbal Pharmacopoeia. Take daily for at least 4–6 weeks before assessing effect; clinical data show moderate benefit (Cochrane 2004: modest evidence for migraine prevention). After prolonged use, do NOT stop abruptly — taper gradually (see warnings: 'post-feverfew syndrome').

Dry amount

1–2 g

Doses per day

1×

Max duration

16 weeks

⚠ Age restriction: ≥ 18 years — Adults only — insufficient data for children.

TINCTURE (pharmacopoeia quality, DER 1:5 in 25–45 % ethanol): 1–2 ml (~20–40 drops) 3× daily, diluted in water, preferably with meals. Parthenolide content: minimum 0.2 % relative to dried leaf. Tincture formulations avoid direct chewing of raw leaves and markedly reduce oral mucosa irritation risk. Long-term use (migraine prophylaxis) — effect not assessable before 4–6 weeks of regular intake. EMA Traditional Use Monograph (2016) covers this form. Do not stop abruptly after more than 8 weeks of use.

Liquid amount

1–2 ml

Doses per day

3×

Max duration

16 weeks

⚠ Age restriction: ≥ 18 years — Adults only. Due to ethanol content, not suitable for alcohol dependence, liver disease, or epilepsy.

INFUSION: 1–2 tsp (~1–2 g) dried feverfew herb (flowering aerial parts, pharmacopoeia grade) with 250 ml just-boiled water, covered, steep 10 min, strain. Up to 2 cups daily, preferably with meals (noticeably bitter — honey or peppermint may be added). Folk use for fever, headache, and promoting menstruation (emmenagogue effect — CONTRAINDICATED in pregnancy). The common name 'feverfew' reflects centuries of traditional use as a febrifuge, pre-dating the aspirin era. No clinical evidence for these specific indications beyond migraine prophylaxis.

Dry amount

1–2 g

Doses per day

2×

Max duration

4 weeks

TINCTURE for rheumatism/arthritis (folk use): 1–3 ml tincture (DER 1:5 in 40–50 % ethanol) 3× daily, diluted in water. Traditional use in British herbal medicine as an anti-inflammatory for rheumatic complaints and arthritis, mentioned in Culpeper's 'Complete Herbal' (1653) and the British Herbal Pharmacopoeia. No clinical evidence for this indication; parthenolide inhibits NF-κB pathway and prostaglandin synthesis in vitro but no controlled human trials exist for arthritis. Adjunctive measure only, not a substitute for medical treatment of inflammatory joint disease.

Liquid amount

1–3 ml

Doses per day

3×

Max duration

6 weeks

FLOWER INFUSION (emmenagogue, digestive): 1–1.5 tsp dried feverfew flowers with 200 ml hot water (~90 °C), covered, steep 8 min, strain. 2× daily. Folk use as a bitter tonic for digestion (sesquiterpene lactones, especially parthenolide, stimulate bile secretion) and to support absent or scanty menstruation. CONTRAINDICATED in pregnancy — abortifacient effect documented. Do not use for more than 2 weeks without a break.

Dry amount

1–1.5 g

Doses per day

2×

Max duration

2 weeks

COMPRESS (external, folk use): Bruise or roughly chop a handful of fresh feverfew leaves, place on a clean linen or cotton cloth, and apply to the affected area (forehead for headache, aching joints) for 15–20 minutes. Caution: raw leaves can cause contact dermatitis — patch test recommended, especially with known Asteraceae allergy. Remove immediately if redness or burning occurs. Not clinically verified — purely folk tradition.

STANDARDISED EXTRACT / CAPSULES (Kommission E / EMA Traditional Use): Daily dose equivalent to 0.2–0.6 mg parthenolide from standardised dry extract or tincture. Commercial formulations typically 50–250 mg dried leaf extract per capsule/tablet, standardised to ≥ 0.2 % parthenolide. Take morning and evening with ample fluid and meals. For prophylaxis ONLY — not for acute migraine attack treatment. Effect not assessable before 4–6 weeks of regular intake. The positive Kommission E monograph (1988) and EMA Traditional Use assessment (2016) both target migraine prophylaxis. Cochrane review (2004, Diener et al.) describes modestly significant benefit over placebo — not gold-standard evidence.

Liquid amount

0.5–2 ml

Doses per day

2×

Max duration

16 weeks

⚠ Age restriction: ≥ 18 years — Per EMA, adults only — no data for children/adolescents.