© Andreas Trepte · CC BY-SA 2.5 · Commons
Tussilago
CautionHuflattich · (Tussilago farfara)
Daisy family (Asteraceae)
Description
Coltsfoot is an early herald of spring in the daisy family: its golden-yellow flower heads appear as early as March, long before the hoof-shaped leaves unfold. Flowers and leaves were traditionally used for irritating coughs because of their high mucilage content. The plant, however, contains 1,2-unsaturated pyrrolizidine alkaloids (chiefly senkirkine), which can damage the liver. Use of the wild plant is therefore discouraged; low-PA, controlled cultivated forms are available commercially.
CONTRAINDICATED during pregnancy
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CONTRAINDICATED during breastfeeding
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CONTRAINDICATED for children
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Critical drug interactions with:
Hepatotoxische Arzneimittel (Paracetamol-Hochdosis, Methotrexat, Isoniazid, Statine, Amiodaron, Valproat) · Andere PA-haltige Pflanzen (Beinwell/Symphytum, Borretsch/Borago, Kreuzkraut/Senecio, Wasserdost/Eupatorium)
Acute cough and bronchial catarrh
Preparation & dosage
Acute irritable cough, hoarseness (folk medicine)
Preparation & dosage
Mild inflammation of mouth and throat mucosa
Preparation & dosage
Poorly healing wounds, skin inflammation, eczema (folk medicine)
Preparation & dosage
PYRROLIZIDINE ALKALOIDS (PA) – severely hepatotoxic! Coltsfoot contains 1,2-unsaturated PA (especially senkirkine, senecionine and their N-oxides). These are metabolized in the liver to reactive pyrrole metabolites → veno-occlusive liver disease (VOD), cirrhosis, hepatocellular carcinoma (carcinogenic, mutagenic, demonstrated in animal studies). Infant death after maternal tea use during pregnancy documented. BfArM limit (Stufenplan): max. 1 µg 1,2-unsaturated PA (incl. N-oxides) per day orally, NOT longer than 4-6 weeks per year. EMA/HMPC recommendation even stricter: 0.35 µg/day, max. 14 days (for 50 kg person). In Germany, Austria, and Switzerland only PA-reduced or PA-free cultivar varieties (e.g. clone 'Wien') are licensed as pharmacy material. Wild-collected coltsfoot for prolonged use is NOT safe. There is NO positive EMA-HMPC Community Monograph for Tussilago farfara due to unresolved safety profile (EMA/HMPC/893108/2011 Rev. 1). Flowers and root/herb received NEGATIVE Commission E rating — only leaves received positive evaluation under strict PA limits (since superseded by Stufenplan ruling).
⏱ Max continuous use: 6 weeks
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Drug interactions
Hepatotoxische Arzneimittel (Paracetamol-Hochdosis, Methotrexat, Isoniazid, Statine, Amiodaron, Valproat)
Additive hepatotoxicity — PA metabolites combined with other hepatotoxic substances increase risk of liver damage, VOD, and liver failure.
Andere PA-haltige Pflanzen (Beinwell/Symphytum, Borretsch/Borago, Kreuzkraut/Senecio, Wasserdost/Eupatorium)
Summation of daily PA exposure — exceeding BfArM daily maximum (1 µg) is practically unavoidable when combining multiple PA-containing herbs.
CYP3A4-Induktoren (Rifampicin, Phenobarbital, Johanniskraut)
CYP3A4 induction increases metabolic activation of PA to reactive pyrrole intermediates → enhanced hepatotoxicity.
Alkohol (chronisch)
Chronic alcohol consumption causes pre-existing liver damage and CYP2E1 induction — PA toxicity is clinically potentiated.
Contraindications
- Pregnancy (PA crosses placenta; fatal infant liver damage after maternal coltsfoot tea documented)
- Lactation (PA pass into breast milk)
- Infants, toddlers and school children (under 12 years, ideally under 18 — liver particularly sensitive)
- Pre-existing liver disease (hepatitis, cirrhosis, fatty liver, liver failure)
- Long-term use beyond 4-6 weeks / year
- Concurrent use of other PA-containing herbs
Harvested part: flowers (spring) and leaves
- Pyrrolizidinalkaloide (Senkirkin, Senecionin, Tussilagin, Integerrimin, Seneciphyllin + N-Oxide)AlkaloidContent: 0,005-0,015 %
CRITICAL constituents! 1,2-unsaturated PA (senkirkine main in flowers; senecionine in leaves) are hepatotoxic, carcinogenic and mutagenic. Metabolic activation in liver to reactive pyrrole esters causes veno-occlusive disease (VOD). Tussilagin itself is the saturated (non-toxic) form. Concentration in flowers > leaves.
- Schleimstoffe (saure Polysaccharide: Arabinose, Galactose, Glucose, Uronsäuren, Xylose)MucilageContent: 6-10 %
Demulcent action on bronchial and pharyngeal mucosa — main active group for antitussive effect. Form protective film, soothe cough reflex.
- Inulin und PolysaccharidePolysaccharideContent: ca. 8 % gesamt (davon ~30 % Inulin)
Inulin as storage carbohydrate, immunomodulating and prebiotic properties. Contributes to overall soothing effect.
- Gerbstoffe (Tannine)TanninContent: ca. 5 %
Astringent action, mild anti-inflammatory effect on mucosa — supports use for pharyngeal inflammation.
- Flavonoide (Rutin, Quercetin, Hyperosid, Kaempferol)FlavonoidContent: Spuren bis 0,5 %
Antioxidant and anti-inflammatory action. Rutin contributes to capillary protection.
- Triterpene und Sterole (Sitosterol, Campesterol, Faradiol)OtherContent: Spuren
Sterols and triterpenes with mild anti-inflammatory, skin-soothing action — mainly relevant for external use.
- Ätherisches ÖlEssential oilContent: Spuren
Present only in traces, minor pharmacological relevance. Contributes to taste/aroma.
- [1]MonographEMA/HMPC Public Statement on the use of herbal medicinal products containing toxic, unsaturated pyrrolizidine alkaloids (EMA/HMPC/893108/2011 Rev. 1)(accessed: 2026-05-19)
- [2]MonographPlants For A Future — Tussilago farfara(accessed: 2026-05-19)
- [3]MonographHeilkräuter-Lexikon: Huflattich(accessed: 2026-05-19)
- [4]MonographKommission E Monographie — Farfarae folium (Huflattichblätter), Bundesanzeiger Nr. 138 vom 27.07.1990 / Bundesanzeiger Nr. 50 vom 13.03.1986 (Blüten/Kraut, negativ)(accessed: 2026-05-19)
- [5]MonographBfArM Stufenplanbescheid zu Pyrrolizidinalkaloid-haltigen Arzneimitteln (1992) und aktualisierte Stellungnahmen(accessed: 2026-05-19)
- [6]MonographCliniTox Giftpflanzen — Tussilago farfara L.: giftig + (Institut für Veterinärpharmakologie und -toxikologie, Universität Zürich)(accessed: 2026-08-10)