Suggested Dosing
Osteoarthritis/Low Back Pain
Crude Extract: 2-9 g/d PO
Standardized Tablets: 600-1200 mg (=50-100 mg harpagoside) PO TID
Other Information
Anorexia: 1.5 g/day decoction
Elixir (1:1): 0.1-0.25 mL PO TID
Suggested Uses
Osteoarthritis, lower back pain, appetite loss, cancer pain
Efficacy
Increasing evidence of short-term benefit in osteoarthritis; some evidence of benefit in lower back pain; unclear with regards to other uses
Extensively used in Europe for mild joint pain
German Commission E approves the use of Devil's claw root for:
- Appetite loss, dyspepsia, supportive therapy for arthritis
ESCOP approves the use of Devil's claw root for:
- Painful arthrosis, tendinitis, appetite loss, dyspepsia
Interactions
Interaction Checker
No Results

Contraindicated
Serious - Use Alternative
Significant - Monitor Closely
Minor

Contraindicated (0)
Serious - Use Alternative (0)
Monitor Closely (15)
- alteplase
alteplase and devil's claw both increase anticoagulation. Use Caution/Monitor. Devil's claw may have additive anticoagulant activity.
- antithrombin alfa
antithrombin alfa and devil's claw both increase anticoagulation. Use Caution/Monitor.
- antithrombin III
antithrombin III and devil's claw both increase anticoagulation. Use Caution/Monitor.
- argatroban
argatroban and devil's claw both increase anticoagulation. Use Caution/Monitor.
- bemiparin
bemiparin and devil's claw both increase anticoagulation. Use Caution/Monitor.
- bivalirudin
bivalirudin and devil's claw both increase anticoagulation. Use Caution/Monitor.
- dabigatran
dabigatran and devil's claw both increase anticoagulation. Use Caution/Monitor.
- dalteparin
dalteparin and devil's claw both increase anticoagulation. Use Caution/Monitor.
- enoxaparin
enoxaparin and devil's claw both increase anticoagulation. Use Caution/Monitor.
- fondaparinux
fondaparinux and devil's claw both increase anticoagulation. Use Caution/Monitor.
- heparin
heparin and devil's claw both increase anticoagulation. Use Caution/Monitor.
- phenindione
phenindione and devil's claw both increase anticoagulation. Use Caution/Monitor.
- protamine
protamine and devil's claw both increase anticoagulation. Use Caution/Monitor.
- reteplase
reteplase and devil's claw both increase anticoagulation. Use Caution/Monitor.
- tenecteplase
tenecteplase and devil's claw both increase anticoagulation. Use Caution/Monitor.
Minor (102)
- abciximab
devil's claw, abciximab. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Conflicting evidence. Use with caution.
- acarbose
devil's claw increases effects of acarbose by pharmacodynamic synergism. Minor/Significance Unknown.
- aceclofenac
aceclofenac and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- acemetacin
acemetacin and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- agrimony
agrimony and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- alfalfa
alfalfa and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- aluminum hydroxide
devil's claw decreases effects of aluminum hydroxide by pharmacodynamic antagonism. Minor/Significance Unknown.
- American ginseng
American ginseng and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- anagrelide
devil's claw, anagrelide. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Conflicting evidence. Use with caution.
- anamu
anamu and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- aspirin
aspirin and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- aspirin rectal
aspirin rectal and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- aspirin/citric acid/sodium bicarbonate
aspirin/citric acid/sodium bicarbonate and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- calcium carbonate
devil's claw decreases effects of calcium carbonate by pharmacodynamic antagonism. Minor/Significance Unknown.
- celecoxib
celecoxib and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- chlorpropamide
devil's claw increases effects of chlorpropamide by pharmacodynamic synergism. Minor/Significance Unknown.
- choline magnesium trisalicylate
choline magnesium trisalicylate and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- cilostazol
devil's claw, cilostazol. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Conflicting evidence.ÿ Use with caution.
- cimetidine
devil's claw decreases effects of cimetidine by pharmacodynamic antagonism. Minor/Significance Unknown.
- cinnamon
cinnamon and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- clopidogrel
devil's claw, clopidogrel. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Conflicting evidence.ÿ Use with caution.
- cordyceps
cordyceps and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- danshen
danshen and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- dexlansoprazole
devil's claw decreases effects of dexlansoprazole by pharmacodynamic antagonism. Minor/Significance Unknown.
- diclofenac
diclofenac and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- diflunisal
diflunisal and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- dipyridamole
devil's claw, dipyridamole. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Conflicting evidence.ÿ Use with caution.
- dong quai
devil's claw and dong quai both increase anticoagulation. Minor/Significance Unknown.
- epoprostenol
devil's claw and epoprostenol both increase anticoagulation. Minor/Significance Unknown.
- eptifibatide
devil's claw, eptifibatide. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Conflicting evidence.ÿ Use with caution.
- esomeprazole
devil's claw decreases effects of esomeprazole by pharmacodynamic antagonism. Minor/Significance Unknown.
- etodolac
etodolac and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- famotidine
devil's claw decreases effects of famotidine by pharmacodynamic antagonism. Minor/Significance Unknown.
- fennel
devil's claw and fennel both increase anticoagulation. Minor/Significance Unknown.
- fenoprofen
fenoprofen and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- feverfew
devil's claw and feverfew both increase anticoagulation. Minor/Significance Unknown.
- flurbiprofen
flurbiprofen and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- forskolin
devil's claw and forskolin both increase anticoagulation. Minor/Significance Unknown.
- garlic
devil's claw and garlic both increase anticoagulation. Minor/Significance Unknown.
- ginger
devil's claw and ginger both increase anticoagulation. Minor/Significance Unknown.
- ginkgo biloba
devil's claw and ginkgo biloba both increase anticoagulation. Minor/Significance Unknown.
- glimepiride
devil's claw increases effects of glimepiride by pharmacodynamic synergism. Minor/Significance Unknown.
- glipizide
devil's claw increases effects of glipizide by pharmacodynamic synergism. Minor/Significance Unknown.
- glyburide
devil's claw increases effects of glyburide by pharmacodynamic synergism. Minor/Significance Unknown.
- horse chestnut seed
devil's claw and horse chestnut seed both increase anticoagulation. Minor/Significance Unknown.
- ibuprofen
ibuprofen and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- ibuprofen IV
ibuprofen IV and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- ibuprofen/famotidine
devil's claw decreases effects of ibuprofen/famotidine by pharmacodynamic antagonism. Minor/Significance Unknown.
- indomethacin
indomethacin and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- insulin aspart
devil's claw increases effects of insulin aspart by pharmacodynamic synergism. Minor/Significance Unknown.
- insulin detemir
devil's claw increases effects of insulin detemir by pharmacodynamic synergism. Minor/Significance Unknown.
- insulin glargine
devil's claw increases effects of insulin glargine by pharmacodynamic synergism. Minor/Significance Unknown.
- insulin glulisine
devil's claw increases effects of insulin glulisine by pharmacodynamic synergism. Minor/Significance Unknown.
- insulin lispro
devil's claw increases effects of insulin lispro by pharmacodynamic synergism. Minor/Significance Unknown.
- insulin NPH
devil's claw increases effects of insulin NPH by pharmacodynamic synergism. Minor/Significance Unknown.
- insulin regular human
devil's claw increases effects of insulin regular human by pharmacodynamic synergism. Minor/Significance Unknown.
- ketoprofen
ketoprofen and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- ketorolac
ketorolac and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- ketorolac intranasal
ketorolac intranasal and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- lansoprazole
devil's claw decreases effects of lansoprazole by pharmacodynamic antagonism. Minor/Significance Unknown.
- lornoxicam
lornoxicam and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- meclofenamate
meclofenamate and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- mefenamic acid
mefenamic acid and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- meloxicam
meloxicam and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- metformin
devil's claw increases effects of metformin by pharmacodynamic synergism. Minor/Significance Unknown.
- miglitol
devil's claw increases effects of miglitol by pharmacodynamic synergism. Minor/Significance Unknown.
- mistletoe
devil's claw increases and mistletoe decreases anticoagulation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.
- nabumetone
nabumetone and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- naproxen
naproxen and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- nateglinide
devil's claw increases effects of nateglinide by pharmacodynamic synergism. Minor/Significance Unknown.
- nettle
devil's claw increases and nettle decreases anticoagulation. Effect of interaction is not clear, use caution. Minor/Significance Unknown.
- nizatidine
devil's claw decreases effects of nizatidine by pharmacodynamic antagonism. Minor/Significance Unknown.
- omeprazole
devil's claw decreases effects of omeprazole by pharmacodynamic antagonism. Minor/Significance Unknown.
- oxaprozin
oxaprozin and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- panax ginseng
devil's claw and panax ginseng both increase anticoagulation. Minor/Significance Unknown.
- pantoprazole
devil's claw decreases effects of pantoprazole by pharmacodynamic antagonism. Minor/Significance Unknown.
- parecoxib
parecoxib and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- pau d'arco
devil's claw and pau d'arco both increase anticoagulation. Minor/Significance Unknown.
- phytoestrogens
devil's claw and phytoestrogens both increase anticoagulation. Minor/Significance Unknown.
- pioglitazone
devil's claw increases effects of pioglitazone by pharmacodynamic synergism. Minor/Significance Unknown.
- piroxicam
piroxicam and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- prasugrel
devil's claw, prasugrel. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Conflicting evidence. Use with caution.
- rabeprazole
devil's claw decreases effects of rabeprazole by pharmacodynamic antagonism. Minor/Significance Unknown.
- reishi
devil's claw and reishi both increase anticoagulation. Minor/Significance Unknown.
- repaglinide
devil's claw increases effects of repaglinide by pharmacodynamic synergism. Minor/Significance Unknown.
- rosiglitazone
devil's claw increases effects of rosiglitazone by pharmacodynamic synergism. Minor/Significance Unknown.
- salicylates (non-asa)
salicylates (non-asa) and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- salsalate
salsalate and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- saxagliptin
devil's claw increases effects of saxagliptin by pharmacodynamic synergism. Minor/Significance Unknown.
- Siberian ginseng
devil's claw and Siberian ginseng both increase anticoagulation. Minor/Significance Unknown.
- sitagliptin
devil's claw increases effects of sitagliptin by pharmacodynamic synergism. Minor/Significance Unknown.
- sodium bicarbonate
devil's claw decreases effects of sodium bicarbonate by pharmacodynamic antagonism. Minor/Significance Unknown.
- sodium citrate/citric acid
devil's claw decreases effects of sodium citrate/citric acid by pharmacodynamic antagonism. Minor/Significance Unknown.
- sulfasalazine
sulfasalazine and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- sulindac
sulindac and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- ticlopidine
devil's claw, ticlopidine. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Conflicting evidence. Use with caution.
- tirofiban
devil's claw, tirofiban. pharmacodynamic synergism. Minor/Significance Unknown. May prolong bleeding time. Conflicting evidence. Use with caution.
- tolazamide
devil's claw increases effects of tolazamide by pharmacodynamic synergism. Minor/Significance Unknown.
- tolbutamide
devil's claw increases effects of tolbutamide by pharmacodynamic synergism. Minor/Significance Unknown.
- tolfenamic acid
tolfenamic acid and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- tolmetin
tolmetin and devil's claw both increase anticoagulation. Minor/Significance Unknown.
- vildagliptin
devil's claw increases effects of vildagliptin by pharmacodynamic synergism. Minor/Significance Unknown.
Adverse Effects
Generally well-tolerated
Headache, GI upset, bradycardia, taste loss
Warnings
Cautions
Stomach or intestinal ulcer, diabetes, high or low blood pressure, arrhythmia
Safety/efficacy not established for children
Pregnancy & Lactation
Pregnancy Category: N/A
Lactation: N/A
Pregnancy Categories
A: Generally acceptable. Controlled studies in pregnant women show no evidence of fetal risk.
B: May be acceptable. Either animal studies show no risk but human studies not available or animal studies showed minor risks and human studies done and showed no risk. C: Use with caution if benefits outweigh risks. Animal studies show risk and human studies not available or neither animal nor human studies done. D: Use in LIFE-THREATENING emergencies when no safer drug available. Positive evidence of human fetal risk. X: Do not use in pregnancy. Risks involved outweigh potential benefits. Safer alternatives exist. NA: Information not available.Pharmacology
Metabolism: N/A
Excretion: N/A
Mechanism of Action
Unclear; one study found correlation between serum harpagoside levels & leukotriene biosynthesis inhibition; harpagoside may also have analgesic actions
May also have anti-oxidant effects
Constituents include iridoid glucosides (eg, harpagoside), phytosterols, & flavonoids