Devil's Claw

Are there any interactions with medications?

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Medications changed by the liver (Cytochrome P450 2C19 (CYP2C19) substrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

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.

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Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

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.

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Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

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.

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Warfarin (Coumadin)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

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.

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Medications moved by pumps in cells (P-glycoprotein Substrates)
Interaction Rating: Minor Be cautious with this combination.
Talk with your health provider.

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.

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Medications that decrease stomach acid (H2-blockers)
Interaction Rating: Minor Be cautious with this combination.
Talk with your health provider.

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).

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Medications that decrease stomach acid (Proton pump inhibitors)
Interaction Rating: Minor Be cautious with this combination.
Talk with your health provider.

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).

Dosing considerations for Devil's Claw.

The following doses have been studied in scientific research:

BY MOUTH:

• For osteoarthritis: A specific powdered devil's claw root product (Harpadol, Arkopharm) dosed at 2.6 grams/day. This dose provides a total of 57 mg of harpagoside, one of the active ingredients, and 87 mg of total iridoid glycosides, another active ingredient. Another specific devil's claw extract (Doloteffin, Ardeypharm) dosed at 2400 mg/day has also been used.
• For back pain: A specific devil's claw extract (Doloteffin, Ardeypharm) that provides 50-100 mg of the active ingredient harpagoside daily.