Devil's Claw - What is it & How to use
Effectiveness
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, Ineffective, and Insufficient Evidence to Rate.
The effectiveness ratings for DEVIL’S CLAW are as follows:
Possibly effective for…
- Back pain. Taking devil’s claw by mouth seems to reduce low-back pain. Devil’s claw seems to work about as well as some non-steroidal anti-inflammatory drugs (NSAIDs).
- Osteoarthritis. Taking devil’s claw alone or along with nonsteroidal anti-inflammatory drugs (NSAIDs) seems to help decrease osteoarthritis-related pain. Some evidence suggests that devil’s claw works about as well as diacerhein (a slow-acting drug for osteoarthritis that is not available in the U.S.) for improving osteoarthritis pain in the hip and knee after 16 weeks of treatment. Some people taking devil’s claw seem to be able to lower the dose of NSAIDs they need for pain relief.
Insufficient evidence to rate effectiveness for…
- Rheumatoid arthritis (RA). Early research suggests that taking devil’s claw extract by mouth might not improve RA.
- Gout.
- High cholesterol.
- Loss of appetite.
- Muscle pain.
- Migraine headache.
- Skin injuries and conditions.
- Upset stomach.
- Other conditions.
More evidence is needed to rate devil’s claw for these uses.
Dose
BY MOUTH:
- For osteoarthritis: 2-2.6 grams of devil’s claw extract have been taken in up to three divided doses daily for up to 4 months. A specific combination product providing 600 mg of devil’s claw, 400 mg of turmeric, and 300 mg of bromelain has been taken 2-3 three times daily for up to 2 months.
- For back pain: 0.6-2.4 grams of devil’s claw extract has been taken daily, usually in divided doses, for up to 1 year.
Safety Concerns
Not enough is known about the safety of using devil’s claw long-term or applying it to the skin.
Special precautions & warnings:
Pregnancy and breast-feeding: Devil’s claw is POSSIBLY UNSAFE. It might harm the developing fetus. Avoid use in pregnancy. It is also best to avoid using devil’s claw while breast-feeding. Not enough is known yet about its safety during breast-feeding.
Heart problems, high blood pressure, low blood pressure: Since devil’s claw can affect heart rate, heartbeat, and blood pressure, it might harm people with disorders of the heart and circulatory system. If you have one of these conditions, talk with your healthcare provider before starting devil’s claw.
Diabetes: Devil’s claw might lower blood sugar levels. Using it along with medications that lower blood sugar might cause blood sugar to drop too low. Monitor blood glucose levels closely. Your healthcare provider might need to adjust your dose of diabetes medications.
Gallstones: Devil’s claw might increase bile production. This could be a problem for people with gallstones. Avoid using devil’s claw.
Peptic ulcer disease (PUD): Since devil’s claw might increase the production of stomach acids This might harm people with stomach ulcers. Avoid using devil’s claw.
Interaction with medication
- Medications changed by the liver (Cytochrome P450 2C19 (CYP2C19) substrates)
- Some medications are changed and broken down by the liver. Devil’s claw might decrease how quickly the liver breaks down some medications. Taking devil’s claw along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking devil’s claw talk to your healthcare provider if you take any medications that are changed by the liver.
Some medications that are changed by the liver include omeprazole (Prilosec), lansoprazole (Prevacid), and pantoprazole (Protonix); diazepam (Valium); carisoprodol (Soma); nelfinavir (Viracept); and others.
- Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates)
- Some medications are changed and broken down by the liver. Devil’s claw might decrease how quickly the liver breaks down some medications. Taking devil’s claw along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking devil’s claw talk to your healthcare provider if you take any medications that are changed by the liver.
Some medications that are changed by the liver include diclofenac (Cataflam, Voltaren), ibuprofen (Motrin), meloxicam (Mobic), and piroxicam (Feldene); celecoxib (Celebrex); amitriptyline (Elavil); warfarin (Coumadin); glipizide (Glucotrol); losartan (Cozaar); and others.
- Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)
- Some medications are changed and broken down by the liver. Devil’s claw might decrease how quickly the liver breaks down some medications. Taking devil’s claw along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking devil’s claw, talk to your healthcare provider if you are taking any medications that are changed by the liver.
Some medications changed by the liver include lovastatin (Mevacor), ketoconazole (Nizoral), itraconazole (Sporanox), fexofenadine (Allegra), triazolam (Halcion), and many others.
- Warfarin (Coumadin)
- Warfarin (Coumadin) is used to slow blood clotting. Devil’s claw might increase the effects of warfarin (Coumadin) and increase the chances of bruising and bleeding. Be sure to have your blood checked regularly. The dose of your warfarin (Coumadin) might need to be changed.
- Medications moved by pumps in cells (P-glycoprotein Substrates)
- Some medications are moved by pumps into cells. Devil’s claw might make these pumps less active and increase how much of some medications get absorbed by the body. This might increase the side effects of some medications.
Some medications that are moved by these pumps include etoposide, paclitaxel, vinblastine, vincristine, vindesine, ketoconazole, itraconazole, amprenavir, indinavir, nelfinavir, saquinavir, cimetidine, ranitidine, diltiazem, verapamil, corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, and others.
- Medications that decrease stomach acid (H2-blockers)
- Devil’s claw might increase stomach acid. By increasing stomach acid, devil’s claw might decrease the effectiveness of some medications that decrease stomach acid, called H2-blockers.
Some medications that decrease stomach acid include cimetidine (Tagamet), ranitidine (Zantac), nizatidine (Axid), and famotidine (Pepcid).
- Medications that decrease stomach acid (Proton pump inhibitors)
- Devil’s claw might increase stomach acid. By increasing stomach acid, devil’s claw might decrease the effectiveness of medications that are used to decrease stomach acid, called proton pump inhibitors.
Some medications that decrease stomach acid include omeprazole (Prilosec), lansoprazole (Prevacid), rabeprazole (Aciphex), pantoprazole (Protonix), and esomeprazole (Nexium).