Hawthorn

Hawthorn/Drug Interactions:

  • Alpha-agonistsAlpha-agonists: In animal research, which have demonstrated in vitro inhibition of phenylephrine-induced vasoconstriction (59), hawthorn may reduce the vasoconstrictive effects of phenylephrine (Neo-Synephrine?) or other alpha receptor agonists such as ephedrine or norepinephrine.
  • AntiarthriticsAntiarthritics: In human research, Curtobacterium flaccumfaciens-induced septic arthritis was observed (54) and childhood septic arthritis was seen following hawthorn puncture and resultant infection by Serratia fonticola (55). In clinical trials, arthritis (15), back pain (15), weakness (30), and other non-specific musculoskeletal effects (14) have also been reported following the use of various hawthorn preparations (e.g. WS 1442, CKBM-A01).
  • Anticoagulants and antiplateletsAnticoagulants and antiplatelets: In vitro, several constituents of hawthorn inhibited thromboxane A2 biosynthesis (24), although human research is contradictory (25).
  • AntihypertensivesAntihypertensives: In human research, hawthorn extract LI 132 (Faros? 600) reduced diastolic blood pressure vs. placebo (26) and the coadministration of Crataegus berry extract and D-camphor (Korodin?) increased short-term blood pressure (27). In on animal and clinical research, hawthorn may have additive activity with medications that possess hypotensive action (19).
  • Antilipemic agentsAntilipemic agents: In laboratory, animal, and clinical research, hawthorn demonstrated hypolipidemic effects suggestive of plausible additive effects with medications that reduce cholesterol (60; 34; 52; 18), although some human research has found a lack of effect on total cholesterol level (39). In a non-systematic review, coadministration of hawthorn fruit and kiwifruit demonstrated hypolipidemic effects in both mice and hamsters (52).
  • Antineoplastic agentsAntineoplastic agents: Hawthorn may exhibit antineoplastic activity and collagen stabilizing actions. Triterpenes-enriched fractions of hawthorn extract have demonstrated almost complete inhibition of cultured larynx cancer cell growth (61).
  • AntipsychoticsAntipsychotics: In human research, agitation was reported (28).
  • Beta blockersBeta blockers: In animal research, hawthorn may cause additive vasodilation and hypotensive effects when used with beta blockers (19).
  • BronchodilatorsBronchodilators: Dyspnea was reported in one patient receiving a hawthorn/passion flower extract (34) and incidences of bronchitis have also been reported following the use of hawthorn extract WS 1442 (15).
  • Calcium channel blockersCalcium channel blockers: In animal research, hawthorn may cause vasodilation when used with calcium channel blockers (19).
  • Cardiac glycosides (digoxin, digitoxin)Cardiac glycosides (digoxin, digitoxin): Hawthorn has been noted to potentiate inotropic effects of cardiac glycoside drugs lacking toxicity in a study of isolated guinea pig hearts (23). Hawthorn has been suggested and used concomitantly with cardiac glycosides, to decrease glycoside dosage and potential toxicity (20; 21; 22). A 10-day, randomized, crossover pharmacokinetic trial in eight healthy volunteers lacked statistically significant effects of hawthorn on digoxin, suggesting possible safe coadministration, although close monitoring during dose titration is warranted (62).
  • Cardioactive agentsCardioactive agents: In human research, hawthorn alone and in combination with beetroot (Neo40? daily) has demonstrated direct effects on the cardiovascular system (9; 10; 11; 12; 13; 14; 15; 16; 17; 18). In clinical trials, various cardiovascular adverse effects have been reported following the use of hawthorn preparations (e.g. WS 1442, Korodin?), including chest pain (15), tachycardia (29), palpitations (32), short-term increases in blood pressure (27), and other non-specific heart problems (33). In animal and human research, additive vasodilation and hypotensive effects are plausible when hawthorn is used with medications formulated for cardiovascular conditions (19).
  • Cardiovascular agentsCardiovascular agents: In human research, hawthorn alone and in combination with beetroot (Neo40? daily) has demonstrated direct effects on the cardiovascular system (9; 10; 11; 12; 13; 14; 15; 16; 17; 18). In clinical trials, various cardiovascular adverse effects have been reported following the use of hawthorn preparations (e.g. WS 1442, Korodin?), including chest pain (15), tachycardia (29), palpitations (32), short-term increases in blood pressure (27), and other non-specific heart problems (33). In animal and human research, additive vasodilation and hypotensive effects are plausible when hawthorn is used with medications formulated for cardiovascular conditions (19).
  • ChronotropicsChronotropics: According to secondary sources, hawthorn may interact with chronotropic agents.
  • Dermatologic agentsDermatologic agents: In human research, mild macular skin eruption (34) and erythematous rash (8) have been reported. Non-specific rashes and itching (14; 30) as well as toxiderma from the fruits of hawthorn (53) have also been reported.
  • DigoxinDigoxin: A 10-day, randomized, crossover pharmacokinetic trial in eight healthy volunteers lacked statistically significant effects of hawthorn on digoxin, suggesting possible safe coadministration, although close monitoring during dose titration is warranted (62).
  • DisulfiramDisulfiram: According to secondary sources, many tinctures, including those made with hawthorn, contain high levels of alcohol and may cause nausea or vomiting when taken with disulfiram (Antabuse?).
  • Gastrointestinal agentsGastrointestinal agents: In human research, abdominal discomfort (8; 28; 29), digestive intolerance (17), diarrhea (30), flatulence (15), gastroenteritis (15), gastrointestinal hemorrhage (8), increased bowel movements (30), obstipation (15), mild and rare nausea (8; 31; 32), nutritional and metabolic problems (33), and other non-specific gastrointestinal effects (14) and have been reported following the use of hawthorn.
  • ImmunosuppressantsImmunosuppressants: In human research, there are reports of opportunistic infections by various microorganisms following puncture wounds by hawthorn plants and the subsequent retention of foreign body plant fragments (35), as well as other non-specific reports of infection (14; 33).
  • MetronidazoleMetronidazole: In human research, many tinctures, including those made with hawthorn, contain high levels of alcohol and may cause nausea or vomiting when taken with metronidazole (Flagyl?).
  • Neurologic agentsNeurologic agents: In human research and reviews, headache and dizziness/vertigo have been reported (28; 8; 14; 15; 32). Incidences of fainting (14), fever (33), and infrequent, mild and transient sleepiness have also been reported (28; 56).
  • NitratesNitrates: In animal research, hawthorn may cause additive vasodilation when used with nitrates (19).
  • Phosphodiesterase inhibitorsPhosphodiesterase inhibitors: In animal research, hawthorn may cause additive vasodilation and hypotensive effects when used with phosphodiesterase inhibitors (19).
  • Radioprotective agentsRadioprotective agents: In vitro, powdered Crataegus microphylla fruit extract decreased the frequency of micronuclei-containing binucleated cells compared to baseline (up to a maximum of 44%) in cultured human blood lymphocytes exposed to cobalt-60-induced gamma irradiation (7).
  • Renal agentsRenal agents: A case of multiorgan hypersensitivity reaction and acute renal failure following the consumption of C. orientalis has been reported (37).
  • Sleep inducersSleep inducers: In human research, infrequent, mild and transient sleepiness has been reported (28; 56).
  • VasodilatorsVasodilators: In animal research, hawthorn may have additive activity with medications that possess coronary vasodilatory action (19).

    • Hawthorn/Herb/Supplement Interactions:

  • AntiarthriticsAntiarthritics: In human research, Curtobacterium flaccumfaciens-induced septic arthritis was observed (54) and childhood septic arthritis was seen following hawthorn puncture and resultant infection by Serratia fonticola (55). In clinical trials, arthritis (15), back pain (15), weakness (30), and other non-specific musculoskeletal effects (14) have also been reported following the use of various hawthorn preparations (e.g. WS 1442, CKBM-A01).
  • Anticoagulants and antiplateletsAnticoagulants and antiplatelets: In vitro, several constituents of hawthorn were found to inhibit thromboxane A2 biosynthesis (24), although human research is contradictory (25). Concomitant use of hawthorn with anticoagulant/antiplatelet agents may increase the risk of bleeding through inhibition of platelet aggregation.
  • Antilipemic agentsAntilipemic agents: In laboratory, animal, and clinical research, hawthorn has demonstrated hypolipidemic effects suggestive of plausible additive effects with herbs/supplements that reduce cholesterol (60; 34; 52; 18), although some human research has found a lack of effect on total cholesterol level (39). Examples include niacin, guggul, garlic, and fish oil.
  • Antineoplastic agentsAntineoplastic agents: Hawthorn may exhibit antineoplastic activity and collagen stabilizing actions. Triterpenes-enriched fractions of hawthorn extract have demonstrated almost complete inhibition of cultured larynx cancer cell growth (61).
  • AntioxidantsAntioxidants: Free radical properties have been demonstrated in vivo (63; 64) and may depend on the phenol (65) or flavonoid content of the extract.
  • AntipsychoticsAntipsychotics: In human research, agitation was reported (28).
  • BronchodilatorsBronchodilators: Dyspnea was reported in one patient receiving a hawthorn/passion flower extract (34) and incidences of bronchitis have also been reported following the use of hawthorn extract WS 1442 (15).
  • Cardiac glycosidesCardiac glycosides: Hawthorn has been noted to potentiate inotropic effects of cardiac glycoside drugs without toxicity in a study of isolated guinea pig hearts (23). Hawthorn has been used concomitantly with cardiac glycoside drugs, to decrease glycoside dosage and toxicity (20; 21; 22). These data suggest potential synergistic/additive and/or potential toxic effects when taken concomitantly with cardiac glycoside herbs/supplements.
  • Cardioactive agentsCardioactive agents: In human research, hawthorn alone and in combination with beetroot (Neo40? daily) has demonstrated direct effects on the cardiovascular system (9; 10; 11; 12; 13; 14; 15; 16; 17; 18). In clinical trials, various cardiovascular adverse effects have been reported following the use of hawthorn preparations (e.g. WS 1442, Korodin?), including chest pain (15), tachycardia (29), palpitations (32), short-term increases in blood pressure (27), and other non-specific heart problems (33). In animal and human research, additive vasodilation and hypotensive effects are plausible when hawthorn is used with herbs/supplements for cardiovascular conditions (19).
  • Cardiovascular agentsCardiovascular agents: In human research, hawthorn alone and in combination with beetroot (Neo40? daily) has demonstrated direct effects on the cardiovascular system (9; 10; 11; 12; 13; 14; 15; 16; 17; 18). In clinical trials, various cardiovascular adverse effects have been reported following the use of hawthorn preparations (e.g. WS 1442, Korodin?), including chest pain (15), tachycardia (29), palpitations (32), short-term increases in blood pressure (27), and other non-specific heart problems (33). In animal and human research, hawthorn may cause additive vasodilation and hypotensive effects when used with other herbs/supplements formulated for cardiovascular conditions (19).
  • D-camphorD-camphor: In human research, the coadministration of D-camphor and Crataegus berry extract (Korodin?) improved cognitive function, as assessed via tests of processing capacity and visuomotor speed (27). According to investigators, purported mechanisms of action included hemodynamic alteration, sympathetic stimulation, or improved cerebral metabolism.
  • Gastrointestinal agentsGastrointestinal agents: In human research, abdominal discomfort (8; 28; 29), digestive intolerance (17), diarrhea (30), flatulence (15), gastroenteritis (15), gastrointestinal hemorrhage (8), increased bowel movements (30), obstipation (15), mild and rare nausea (8; 31; 32), nutritional and metabolic problems (33), and other non-specific gastrointestinal effects (14) and have been reported following the use of hawthorn.
  • HypotensivesHypotensives: In animal and clinical research, hawthorn may have additive activity with herbs/supplements that possess hypotensive or coronary vasodilatory action (19) and hawthorn may interfere with the activity of herbs/supplements that increase blood pressure (19; 59).
  • ImmunosuppressantsImmunosuppressants: In human research, there are reports of opportunistic infections by various microorganisms following puncture wounds by hawthorn plants and the subsequent retention of foreign body plant fragments (35), as well as other non-specific reports of infection (14; 33).
  • Neurologic agentsNeurologic agents: In human research and reviews, headache and dizziness/vertigo have been reported (28; 8; 14; 15; 32). Incidences of fainting (14), fever (33), and infrequent, mild and transient sleepiness have also been reported (28; 56).
  • Radioprotective agentsRadioprotective agents: In vitro, powdered Crataegus microphylla fruit extract decreased the frequency of micronuclei-containing binucleated cells compared to baseline (up to a maximum of 44%) in cultured human blood lymphocytes exposed to cobalt-60-induced gamma irradiation (7).
  • Renal agentsRenal agents: A case of multiorgan hypersensitivity reaction and acute renal failure following the consumption of C. orientalis has been reported (37).
  • Sleep inducersSleep inducers: In human research, infrequent, mild and transient sleepiness has been reported (28; 56).
  • VasodilatorsVasodilators: In animal research, hawthorn may have additive activity with herbs/supplements that possess coronary vasodilatory action (19).

    • Hawthorn/Food Interactions:

  • BeetrootBeetroot: In individuals at risk for cardiovascular disease, the coadministration of hawthorn berry and beetroot (Neo40? Daily) increased plasma nitrate and nitrite and reduced triglyceride levels vs. baseline (18).
  • KiwiKiwi: In a non-systematic review, the coadministration of hawthorn fruit and kiwifruit demonstrated hypolipidemic effects in both mice and hamsters (52).

    • Hawthorn/Lab Interactions:

  • Blood pressureBlood pressure: In animal and clinical research, hawthorn has demonstrated hypotensive or coronary vasodilatory action (19; 26).
  • CalciumCalcium: In human research, hawthorn extract (WS 1442) lacked effect on calcium in individuals with CHF (39)
  • ChlorideChloride: In human research, hawthorn extract (WS 1442) lacked effect on chloride in individuals with CHF (39).
  • GlucoseGlucose: In human research, hawthorn extract (WS 1442) lacked effect on glucose level in individuals with congestive heart failure (CHF) (39).
  • HemoglobinHemoglobin: In human research, hawthorn extract (WS 1442) lacked effect on levels of hematocrit, erythrocytes, erythrocyte sedimentation rate, hemoglobin, leucocytes, and platelets, in individuals with CHF (39).
  • Lipid profileLipid profile: In limited laboratory, animal, and clinical research, hawthorn has demonstrated hypolipidemic effects suggestive of plausible additive effects with agents that reduce cholesterol (60; 34; 52; 18), although some human research has found a lack of effect on total cholesterol level (39).
  • Liver panelLiver panel: In human research, hawthorn extract (WS 1442) lacked effect on levels of aspartate aminotransferase (AST), alanine aminotransferase (ALT), gamma-glutamyl transpeptidase (gamma-GT), total bilirubin, creatinine, urea, and uric acid, in individuals with CHF (39).
  • PotassiumPotassium: In human research, hawthorn extract (WS 1442) lacked effect on potassium in individuals with CHF (39).
  • SodiumSodium: In human research, hawthorn extract (WS 1442) lacked effect sodium in individuals with CHF (39).