- What other names is Peony known by?
- What is Peony?
- How does Peony work?
- Are there safety concerns?
- Are there any interactions with medications?
- Dosing considerations for Peony.
Bai Shao, Chi Shao, Chinese Peony, Common Peony, Coral Peony, Cortex Moutan, European Peony, Jiu Chao Bai Shao, Moutan, Mu Dan Pi, Paeonia, Paeonia alba, Paeonia albiflora, Paeonia anomala, Paeonia arborea, Paeonia arietina, Paeonia beresowskii, Paeonia caucasica, Paeonia corallina, Paeonia coriacea, Paeonia daurica, Paeonia japonica, Paeonia kavachensis, Paeonia lactiflora, Paeonia mascula, Paeonia microcarpa, Paeonia moutan, Paeonia obovata, Paeonia officinalis, Paeonia paradoxa, Paeonia suffruticosa, Paeonia triternata, Paeonia veitchii, Paeonia willmottiae, Paeonia woodwardii, Paeoniae Flos, Paeoniae Radix, Peonía, Peony Flower, Peony Root, Piney, Pivoine, Pivoine Arbustive, Pivoine Blanche, Pivoine Commune, Pivoine de Chine, Pivoine des Jardins, Pivoine en Arbre, Pivoine Moutan, Pivoine Officinale, Pivoine Rouge, Racine de Pivoine, Radix Paeoniae, Radix Paeoniae Alba, Radix Paeoniae Rubra, Radix Peony, Red Peony, Shakuyaku, Shao Yao, Tree Peony, Ud Saleeb, Udsalam, Udsalap, White Peony.
Peony is a plant. The root and, less commonly, the flower and seed are used to make medicine. Peony is sometimes called red peony and white peony. This does not refer to the color of the flowers, which are pink, red, purple, or white, but to the color of the processed root.
Peony is used for gout, osteoarthritis, fever, respiratory tract illnesses, and cough. Women use peony for menstrual cramps, polycystic ovary syndrome, premenstrual syndrome (PMS), and for starting menstruation or causing an abortion. It is also used for viral hepatitis, liver cirrhosis, upset stomach, muscle cramps, “hardening of the arteries” (atherosclerosis), and to cause vomiting. Peony is also used for spasms, whooping cough (pertussis), epilepsy, nerve pain (neuralgia), migraine headache, and chronic fatigue syndrome (CFS).
People apply peony to the skin for healing cracked skin, especially cracks around the anus (anal fissures) that sometimes occur with hemorrhoids.
Insufficient Evidence to Rate Effectiveness for...
- Skin wrinkles. Peony contains a chemical called paeoniflorin. Early research suggests that applying a specific cosmetic product containing 0.5% paeoniflorin for 8 weeks might reduce facial wrinkles.
- Muscle cramps.Early research suggests that taking a specific combination of peony and licorice (Shakuyaku-kanzoh-to) might ease muscle cramps in people with liver cirrhosis and in people undergoing hemodialysis.
- Rheumatoid arthritis (RA). Early research suggests that taking a product containing peony along with the drug methotrexate for 3 months might reduce test markers of swelling in people with RA better than taking methotrexate alone. However, taking this peony product with methotrexate does not appear to improve symptoms of RA better than methotrexate alone.
- Breathing problems.
- Skin diseases.
- Heart trouble.
- Stomach upset.
- Nerve problems.
- Migraine headache.
- Chronic fatigue syndrome (CFS).
- Other conditions.
Peony might block chemicals produced by the body that can cause muscle cramps. It may also prevent blood clotting and act as an antioxidant.
Peony is POSSIBLY SAFE when used by mouth, short-term. Peony has been used safely for up to 4 weeks. It can cause stomach upset. It can cause rash when it comes in contact with the skin of sensitive people.
Special Precautions & Warnings:Pregnancy and breast-feeding: Peony is POSSIBLY UNSAFE when taken by mouth during pregnancy. Some developing research suggests that peony can cause uterine contractions. However, other research suggests a combination of peony and angelica might be safe. Until more is known, don't use peony if you are pregnant. Also avoid peony if you are breast-feeding. Not enough is known about the safety of using peony if you are nursing.
Bleeding disorders: Because peony might slow blood clotting, there is a concern that it might increase the risk of bleeding in people with bleeding disorders. Don't use it if you have a bleeding disorder.
Surgery: Peony might slow blood clotting, so there is a concern that it could increase the chance of bleeding during and after surgery. Stop using peony at least 2 weeks before a scheduled surgery.
Medications that slow blood clotting (Anticoagulant / Antiplatelet drugs)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Peony might slow blood clotting. Taking peony along with medications that also slow clotting might increase the chances of bruising and bleeding.
Some medications that slow blood clotting include aspirin, clopidogrel (Plavix), diclofenac (Voltaren, Cataflam, others), ibuprofen (Advil, Motrin, others), naproxen (Anaprox, Naprosyn, others), dalteparin (Fragmin), enoxaparin (Lovenox), heparin, warfarin (Coumadin), and others.
Phenytoin (Dilantin)Interaction Rating: Moderate Be cautious with this combination.Talk with your health provider.
Peony root might decrease the amount of phenytoin in the body. Taking peony root along with phenytoin (Dilantin) might decrease the effectiveness of phenytoin (Dilantin) and increase the risk of seizures.
The appropriate dose of peony depends on several factors such as the user's age, health, and several other conditions. At this time there is not enough scientific information to determine an appropriate range of doses for peony. Keep in mind that natural products are not always necessarily safe and dosages can be important. Be sure to follow relevant directions on product labels and consult your pharmacist or physician or other healthcare professional before using.
Natural Medicines Comprehensive Database rates effectiveness based on scientific evidence according to the following scale: Effective, Likely Effective, Possibly Effective, Possibly Ineffective, Likely Ineffective, and Insufficient Evidence to Rate (detailed description of each of the ratings).
Health Solutions From Our Sponsors
Au, T. K., Lam, T. L., Ng, T. B., Fong, W. P., and Wan, D. C. A comparison of HIV-1 integrase inhibition by aqueous and methanol extracts of Chinese medicinal herbs. Life Sci 2-23-2001;68(14):1687-1694. View abstract.
Betts, T. and Betts, H. John Hall and his epileptic patients--epilepsy management in early 17th century England. Seizure. 1998;7(5):411-414. View abstract.
Bian, X., Xu, Y., Zhu, L., Gao, P., Liu, X., Liu, S., Qian, M., Gai, M., Yang, J., and Wu, Y. Prevention of maternal-fetal blood group incompatibility with traditional Chinese herbal medicine. Chin Med J (Engl.) 1998;111(7):585-587. View abstract.
Deng, Y. Y., Chen, Y. P., Wang, L., Hu, Z., Jin, Y., Shen, L., Zhu, R., and Zhong, Y. [Clinical study on treatment of mid-advanced crescentic nephritis by qingre huoxue recipe]. Zhongguo Zhong.Xi.Yi.Jie.He.Za Zhi. 2004;24(12):1084-1086. View abstract.
Du, J. H. and Dong, B. D. [Comparative study on clinical efficacy of using methotrexate singly or combined with total glucosides of Paeony in treating rheumatoid arthritis]. Zhongguo Zhong.Xi.Yi.Jie.He.Za Zhi. 2005;25(6):540-542. View abstract.
Fang, J. Y. [Effect of fu-zheng qu-xie on gastric disease infected with Campylobacter pyloridis]. Zhong Xi Yi Jie He Za Zhi 1991;11(3):150-2, 133. View abstract.
Grebeniuk, V. N., Mannanov, A. M., Korsun, V. F., and Vinogradova, A. I. [Peony tincture in the complex treatment of allergic dermatoses]. Vestn.Dermatol.Venerol. 1987;(10):46-48. View abstract.
Guo, D., Ye, G., and Guo, H. A new phenolic glycoside from Paeonia lactiflora. Fitoterapia 2006;77(7-8):613-614. View abstract.
Guo, T. L. and Zhou, X. W. [Clinical observations on the treatment of the gestational hypertension syndrome with Angelica and Paeonia powder]. Zhong.Xi.Yi.Jie.He.Za Zhi. 1986;6(12):714-6, 707. View abstract.
Hsiang, C. Y., Hsieh, C. L., Wu, S. L., Lai, I. L., and Ho, T. Y. Inhibitory effect of anti-pyretic and anti-inflammatory herbs on herpes simplex virus replication. Am J Chin Med 2001;29(3-4):459-467. View abstract.
Hsiu, S. L., Lin, Y. T., Wen, K. C., Hou, Y. C., and Chao, P. D. A deglucosylated metabolite of paeoniflorin of the root of Paeonia lactiflora and its pharmacokinetics in rats. Planta Med 2003;69(12):1113-1118. View abstract.
Huang, X., Ren, P., and Chen, K. J. [Effect of combination of Chinese herbal drugs on clinical bioavailability of ferulic acid in serum]. Zhongguo Zhong.Xi.Yi.Jie.He.Za Zhi. 2001;21(1):7-9. View abstract.
Jia, Y. B. and Tang, T. Q. [Paeonia Lactiflora injection in treating chronic cor pulmonale with pulmonary hypertension]. Zhong.Xi.Yi.Jie.He.Za Zhi. 1991;11(4):199-202, 195. View abstract.
Kang, D. G., Moon, M. K., Choi, D. H., Lee, J. K., Kwon, T. O., and Lee, H. S. Vasodilatory and anti-inflammatory effects of the 1,2,3,4,6-penta-O-galloyl-beta-D-glucose (PGG) via a nitric oxide-cGMP pathway. Eur J Pharmacol 11-7-2005;524(1-3):111-119. View abstract.
Kang, J. H., Park, Y. H., Choi, S. W., Yang, E. K., and Lee, W. J. Resveratrol derivatives potently induce apoptosis in human promyelocytic leukemia cells. Exp.Mol.Med 12-31-2003;35(6):467-474. View abstract.
Kim, H. J., Chang, E. J., Bae, S. J., Shim, S. M., Park, H. D., Rhee, C. H., Park, J. H., and Choi, S. W. Cytotoxic and antimutagenic stilbenes from seeds of Paeonia lactiflora. Arch Pharm Res 2002;25(3):293-299. View abstract.
Kim, H. J., Chang, E. J., Cho, S. H., Chung, S. K., Park, H. D., and Choi, S. W. Antioxidative activity of resveratrol and its derivatives isolated from seeds of Paeonia lactiflora. Biosci.Biotechnol.Biochem. 2002;66(9):1990-1993. View abstract.
Lee, S. J., Lee, H. M., Ji, S. T., Lee, S. R., Mar, W., and Gho, Y. S. 1,2,3,4,6-Penta-O-galloyl-beta-D-glucose blocks endothelial cell growth and tube formation through inhibition of VEGF binding to VEGF receptor. Cancer Lett. 5-10-2004;208(1):89-94. View abstract.
Lee, S. J., Lee, I. S., and Mar, W. Inhibition of inducible nitric oxide synthase and cyclooxygenase-2 activity by 1,2,3,4,6-penta-O-galloyl-beta-D-glucose in murine macrophage cells. Arch Pharm Res 2003;26(10):832-839. View abstract.
Lee, S. M., Li, M. L., Tse, Y. C., Leung, S. C., Lee, M. M., Tsui, S. K., Fung, K. P., Lee, C. Y., and Waye, M. M. Paeoniae Radix, a Chinese herbal extract, inhibit hepatoma cells growth by inducing apoptosis in a p53 independent pathway. Life Sci 9-27-2002;71(19):2267-2277. View abstract.
Lee, S., Lim, J. M., Jin, M. H., Park, H. K., Lee, E. J., Kang, S., Kim, Y. S., and Cho, W. G. Partially purified paeoniflorin exerts protective effects on UV-induced DNA damage and reduces facial wrinkles in human skin. J Cosmet.Sci 2006;57(1):57-64. View abstract.
Leem, K., Kim, H., Boo, Y., Lee, H. S., Kim, J. S., Yoo, Y. C., Ahn, H. J., Park, H. J., Seo, J. C., Kim, H. K., Jin, S. Y., Park, H. K., Chung, J. H., and Cho, J. J. Effects of Paeonia lactiflora root extracts on the secretions of monocyte chemotactic protein-1 and -3 in human nasal fibroblasts. Phytother.Res 2004;18(3):241-243. View abstract.
Lev, E. [Some evidence for the use of doctrine of signatures in the land of Israel and its environs during the Middle Ages]. Harefuah 2002;141(7):651-5, 664. View abstract.
Liang, R., Chen, M. R., and Xu, X. [Effect of dandi tablet on blood lipids and sex hormones in women of postmenopausal stage]. Zhongguo Zhong.Xi.Yi.Jie.He.Za Zhi. 2003;23(8):593-595. View abstract.
Liu, Z. Q., Zhou, H., Liu, L., Jiang, Z. H., Wong, Y. F., Xie, Y., Cai, X., Xu, H. X., and Chan, K. Influence of co-administrated sinomenine on pharmacokinetic fate of paeoniflorin in unrestrained conscious rats. J Ethnopharmacol. 5-13-2005;99(1):61-67. View abstract.
Ma, X. F. [Experimental and clinical studies on the treatment of pulmonary heart disease and pulmonary hypertension with Paeonia lactiflora]. Zhong.Xi.Yi.Jie.He.Za Zhi. 1988;8(11):660-2, 645. View abstract.
Miller-Martini, D. M., Chan, R. Y., Ip, N. Y., Sheu, S. J., and Wong, Y. H. A reporter gene assay for the detection of phytoestrogens in traditional Chinese medicine. Phytother Res 2001;15(6):487-492. View abstract.
Nishida, S., Kikuichi, S., Yoshioka, S., Tsubaki, M., Fujii, Y., Matsuda, H., Kubo, M., and Irimajiri, K. Induction of apoptosis in HL-60 cells treated with medicinal herbs. Am J Chin Med 2003;31(4):551-562. View abstract.
Oh, G. S., Pae, H. O., Choi, B. M., Jeong, S., Oh, H., Oh, C. S., Rho, Y. D., Kim, D. H., Shin, M. K., and Chung, H. T. Inhibitory effects of the root cortex of Paeonia suffruticosa on interleukin-8 and macrophage chemoattractant protein-1 secretions in U937 cells. J Ethnopharmacol. 2003;84(1):85-89. View abstract.
Oh, G. S., Pae, H. O., Choi, B. M., Lee, H. S., Kim, I. K., Yun, Y. G., Kim, J. D., and Chung, H. T. Penta-O-galloyl-beta-D-glucose inhibits phorbol myristate acetate-induced interleukin-8 [correction of intereukin-8] gene expression in human monocytic U937 cells through its inactivation of nuclear factor-kappaB. Int Immunopharmacol. 2004;4(3):377-386. View abstract.
Oh, G. S., Pae, H. O., Oh, H., Hong, S. G., Kim, I. K., Chai, K. Y., Yun, Y. G., Kwon, T. O., and Chung, H. T. In vitro anti-proliferative effect of 1,2,3,4,6-penta-O-galloyl-beta-D-glucose on human hepatocellular carcinoma cell line, SK-HEP-1 cells. Cancer Lett 12-10-2001;174(1):17-24. View abstract.
Sakamoto, S., Yoshino, H., Shirahata, Y., Shimodairo, K., and Okamoto, R. Pharmacotherapeutic effects of kuei-chih-fu-ling-wan (keishi-bukuryo-gan) on human uterine myomas. Am J Chin Med 1992;20(3-4):313-317. View abstract.
Shen, A. Y., Wang, T. S., Huang, M. H., Liao, C. H., Chen, S. J., and Lin, C. C. Antioxidant and antiplatelet effects of dang-gui-shao-yao-san on human blood cells. Am J Chin Med 2005;33(5):747-758. View abstract.
Sun, W. S., Imai, A., Tagami, K., Sugiyama, M., Furui, T., and Tamaya, T. In vitro stimulation of granulosa cells by a combination of different active ingredients of unkei-to. Am.J Chin Med 2004;32(4):569-578. View abstract.
Wong, A. L. and Chan, T. Y. Interaction between warfarin and the herbal product quilinggao. Ann Pharmacother 2003;37(6):836-838. View abstract.
Zong, P. P., Yan, T. Y., and Gong, M. M. [Clinical and experimental studies of effects of huayu decoction on scavenging free radicals]. Zhongguo Zhong.Xi.Yi.Jie.He.Za Zhi. 1993;13(10):591-3, 579. View abstract.
Anon. Monograph. Peony (Paeonia spp). Alt Med Rev 2001;6:495-9. View abstract.
Bruynzeel DP. Contact Dermatitis Due to Paeonia (Peony). Contact Dermatitis 1989; 20:152-3.. View abstract.
Chen LC, Chou MH, Lin MF, Yang LL. Effects of Paeoniae Radix, a traditional Chinese medicine, on the pharmacokinetics of phenytoin. J Clin Pharm Ther 2001;26:271-8.
Guo TL, Zhou XW. [Clinical observations on the treatment of the gestational hypertension syndrome with Angelica and Paeonia powder]. Zhong Xi Yi Jie He Za Zhi 1986;6:714-6, 707.
Harada M, Suzuki M, Ozaki Y. Effect of Japanese Angelica root and peony root on uterine contraction in the rabbit in situ. J Pharmacobiodyn 1984;7:304-11. View abstract.
He X, Xing D, Ding Y, et al. Effects of cerebral ischemia-reperfusion on pharmacokinetic fate of paeoniflorin after intravenous administration of Paeoniae Radix extract in rats. J Ethnopharmacol 2004;94:339-44. . View abstract.
Hinoshita F, Ogura Y, Suzuki Y, et al. Effect of orally administered shao-yao-gan-cao-tang (Shakuyaku-kanzo-to) on muscle cramps in maintenance hemodialysis patients: a preliminary study. Am J Chin Med 2003;31:445-53. . View abstract.
Hyodo T, Taira T, Kumakura M, et al. The immediate effect of Shakuyaku-kanzo-to, traditional Japanese herbal medicine, for muscular cramps during maintenance hemodialysis. Nephron 2002;90:240. View abstract.
Kamei T, Kumano H, Iwata K, et al. The effect of a traditional Chinese prescription for a case of lung carcinoma. J Altern Complement Med 2000;6:557-9. View abstract.
Kumada T, et al. Effect of Shakuyaku-kanzo-to (Tsumura TJ-68) on muscle cramps accompanying cirrhosis in a placebo-controlled double-blind parallel study. J Clin Ther Med 1999;15:499-523.
Liang Xiao, Wang YZ, Jing Liu, et al. Effects of paeoniflorin on the cerebral infarction, behavioral and cognitive impairments at the chronic stage of transient middle cerebral artery occlusion in rats. Life Sci 2005;78:413-20 . View abstract.
Liapina LA, Ammosova IaM, Novikov VS, et al. [The nature of an anticoagulant isolated from peonies in the central zone of Russia]. Izv Akad Nauk Ser Biol 1997;2:235-7. . View abstract.
Liu C, Wang J, Yang J. [Study on activating blood and eliminating stasis of total paeony glycoside(TPG)]. Zhong Yao Cai 2000;23:557-60. . View abstract.
Liu J. [Effect of Paeonia obovata 801 on metabolism of thromboxane B2 and arachidonic acid and on platelet aggregation in patients with coronary heart disease and cerebral thrombosis]. Zhonghua Yi Xue Za Zhi 1983;63:477-81. View abstract.
Maeda T, Shinozuka K, Baba K, et al. Effect of shakuyaku-kanzoh-toh, a prescription composed of shakuyaku (Paeoniae Radix) and kanzoh (Glycyrrhizae Radix) on guinea pig ileum. J Pharmacobiodyn 1983;6:153-60. . View abstract.
Ohta H, Ni JW, Matsumoto K, et al. Peony and its major constituent, paeoniflorin, improve radial maze performance impaired by scopolamine in rats. Pharmacol Biochem Behav 1993;45:719-23. . View abstract.
Okubo T, Nagai F, Seto T, et al. The inhibition of phenylhydroquinone-induced oxidative DNA cleavage by constituents of Moutan Cortex and Paeoniae Radix. Biol Pharm Bull 2000;23:199-203.. View abstract.
Papandreou V, Magiatis P, Chinou I, et al. Volatiles with antimicrobial activity from the roots of Greek Paeonia taxa. J Ethnopharmacol 2002;81:101-4.. View abstract.
Prieto JM, Recio MC, Giner RM, et al. Influence of traditional Chinese anti-inflammatory medicinal plants on leukocyte and platelet functions. J Pharm Pharmacol 2003;55:1275-82. View abstract.
Qi XG. [Protective mechanism of Salvia miltiorrhiza and Paeonia lactiflora for experimental liver damage]. Zhong Xi Yi Jie He Za Zhi 1991;11:102-4, 69. View abstract.
Sakamoto S, Kudo H, Suzuki S, et al. Pharmacotherapeutic effects of toki-shakuyaku-san on leukorrhagia in young women. Am J Chin Med 1996;24:165-8. View abstract.
Tsuda T, Sugaya A, Ohguchi H, et al. Protective effects of peony root extract and its components on neuron damage in the hippocampus induced by the cobalt focus epilepsy model. Exp Neurol 1997;146:518-25. View abstract.
Wang H, Wei W, Wang NP, et al. Effects of total glucosides of peony on immunological hepatic fibrosis in rats. World J Gastroenterol 2005;11:2124-9. . View abstract.
Wang Y, Ma R. [Effect of an extract of Paeonia lactiflora on the blood coagulative and fibrinolytic enzymes]. Zhong Xi Yi Jie He Za Zhi 1990;10:101-2, 70. . View abstract.
Xie HJ, Yasar U, Sandberg M, Rane A. Paeoniae Radix, a traditional Chinese medicine, and CYP2C9 activity. J Clin Pharm Ther 2002;27:229-30. . View abstract.
Yang DG. [Comparison of pre- and post-treatmental hepatohistology with heavy dosage of Paeonia rubra on chronic active hepatitis caused liver fibrosis]. Zhongguo Zhong Xi Yi Jie He Za Zhi. 1994;14:207-9, 195. . View abstract.
Yang HO, Ko WK, Kim JY, Ro HS. Paeoniflorin: an antihyperlipidemic agent from Paeonia lactiflora. Fitoterapia 2004;75:45-9.. View abstract.