Boneset Drug Information - Precautions to be kept in mind while using Boneset

Taxonomic Class

Asteraceae

Common Trade Names

Multi-ingredient preparations: Catarrh Mixture, Nature's Answer Boneset Low Alcohol

Common Forms

Available as an extract, a tea, and a topical cream.

Source

The crude drug is obtained from the dried leaves and flowering tops of the perennial herb Eupatorium perfoliatum, which grows throughout much of the United States and parts of Canada.

Chemical Components

Boneset contains crystalline wax; flavonoids, such as astragalin, kaempferol, quercetin, and rutin; eupatorin, a bitter, crystalline glycoside; gallic acid; inulin; polysaccharides; resin; sterols; sugars; tannin; terpeno ids; triterpenes; and volatile oil.

Actions

Although boneset is an old herbal standby, especially as an antipyretic, comparatively little is known about its pharmacologically active constituents. Animal studies suggest that boneset exhibits immunostimulatory actions on granulocytes and macrophages of sesquiterpene lactones and polysaccharide fractions of E. perfoliatum .

Several studies attribute diaphoretic and emetic properties to boneset. Also, weak to moderate anti-inflammatory activity has been documented for some of the flavonoids and for an alcoholic extract of boneset. Although most members of the genus Eupatorium contain hepatotoxic pyrrolizidine alkaloids, they have not been found in boneset.

Reported Uses

Despite more than 200 years of anecdotal use as an antipyretic, no human clinical trial has been reported that establishes boneset's efficacy for this use. A study in Germany failed to find any difference between a homeopathic boneset remedy and aspirin for discomfort of the common cold . Other traditional uses are as a treatment for acute bronchitis, congestion of the respiratory mucosa, and influenza and as an expectorant and a sedative.

Dosage

• Extract: 10 to 40 gtt (2 to 4 g of plant material) mixed in a liquid P.O. daily.

• Tea: 2 to 6 tsp of crushed dried leaves and flowering tops steeped in 1 cup to 1 pt of boiling water.

Adverse Reactions

• GI: diarrhea, vomiting.

• Hepatic: hepatotoxicity.

• Other: allergic reactions.

Interactions

None reported.

Contraindications And Precautions

Boneset is contraindicated in pregnant or breast-feeding patients; effects are unknown.

Special Considerations

Monitor liver function test results periodically.

Inform the patient that insufficient data exist to recommend boneset as a treatment for any disease state and that many proven anti­inflammatory compounds with known risks and benefits exist.

Advise women to avoid using boneset during pregnancy or when breast-feeding.

Points of Interest

It has been suggested that boneset derived its name from an alleged ability to alleviate dengue fever, also known as breakbone fever.

Despite its inclusion in the USP for almost a century and the National Formulary for almost 25 years , boneset's use was never advocated by the traditional medical community. More recently, boneset has been included in homeopathic formulations and herbal mixtures marketed in Europe and to practicing herbalists.

Boneset was used by Native Americans to treat malaria.

Commentary

Medicinal use of boneset should be discouraged until more is known about its safety and efficacy. Because many substantiated allopathic therapies already exist for the range of boneset's claimed therapeutic applications, it is unlikely that additional research will be pursued.