Indication-specific dosing for aubepine, Chinese hawthorn, crataegus laevigata hawthorn in combination, frequency-based adverse effects, comprehensive interactions, contraindications, pregnancy & lactation schedules, and cost information.

Sections

Sections Hawthorn
Suggested Dosing
Suggested Uses
Interactions
Adverse Effects
Warnings
Pregnancy
Pharmacology

Suggested Dosing

Brewed tea

TID after meals; 1 tsp of leaves and flowers/ 8 oz boiling water

Fruit

Dried powder: 300-1000 mg PO TID

Liquid extract: 0.5-1 ml PO TID

Tincture: 1-2 ml PO TID

Solid extract: 1/4-1/2 tsp PO qD

Syrup: 1 tsp PO BID-TID

Leaf/flower

Extract: 160-900 mg/d PO div BID-TID

Powder: 200-500 mg PO TID

Tincture: 20 gtts PO BID-TID

Other Information

Extract standardized to 1.8% vitexin-4-rhamnoside or 20% procyanidins

Up to 2 weeks of treatment necessary to produce observable effects

Suggested Uses

Arrhythmias, atherosclerosis, Buerger's disease, circulatory disorders, CHF, hyperlipidemia, hypertension, hypotension, indigestion, tapeworm infections

Efficacy

Contradictory evidence about the effects of hawthorn extract in heart failure patients.

Increase coronary circulation confirmed by double-blind studies; comparable to captopril

Decrease serum lipids in animal studies

Interaction Checker

Enter a drug name and Hawthorn

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Contraindicated

Serious - Use Alternative

Significant - Monitor Closely

Minor

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Contraindicated (0)

Serious - Use Alternative (1)

vandetanib
hawthorn, vandetanib. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a drug known to prolong QT interval must be used, more frequent ECG monitoring is recommended.

Monitor Closely (48)

acebutolol
hawthorn increases effects of acebutolol by pharmacodynamic synergism. Use Caution/Monitor.
adenosine
hawthorn increases effects of adenosine by pharmacodynamic synergism. Use Caution/Monitor.
amiodarone
hawthorn increases effects of amiodarone by pharmacodynamic synergism. Use Caution/Monitor.
amobarbital
hawthorn increases effects of amobarbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
azelastine
hawthorn increases effects of azelastine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
brompheniramine
hawthorn increases effects of brompheniramine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
butabarbital
hawthorn increases effects of butabarbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
butalbital
hawthorn increases effects of butalbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
carbinoxamine
hawthorn increases effects of carbinoxamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
chloral hydrate
hawthorn increases effects of chloral hydrate by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
chlorpheniramine
hawthorn increases effects of chlorpheniramine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
cinnarizine
hawthorn increases effects of cinnarizine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
clemastine
hawthorn increases effects of clemastine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
crizotinib
crizotinib and hawthorn both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
cyclizine
hawthorn increases effects of cyclizine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
cyproheptadine
hawthorn increases effects of cyproheptadine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
dexchlorpheniramine
hawthorn increases effects of dexchlorpheniramine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
dexmedetomidine
hawthorn increases effects of dexmedetomidine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
digoxin
hawthorn increases effects of digoxin by pharmacodynamic synergism. Use Caution/Monitor.
diltiazem
hawthorn increases effects of diltiazem by pharmacodynamic synergism. Use Caution/Monitor.
dimenhydrinate
hawthorn increases effects of dimenhydrinate by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
diphenhydramine
hawthorn increases effects of diphenhydramine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
disopyramide
hawthorn increases effects of disopyramide by pharmacodynamic synergism. Use Caution/Monitor.
doxylamine
hawthorn increases effects of doxylamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
encainide
hawthorn increases effects of encainide by pharmacodynamic synergism. Use Caution/Monitor.
esmolol
hawthorn increases effects of esmolol by pharmacodynamic synergism. Use Caution/Monitor.
flecainide
hawthorn increases effects of flecainide by pharmacodynamic synergism. Use Caution/Monitor.
hydroxyzine
hawthorn increases effects of hydroxyzine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
ibutilide
hawthorn increases effects of ibutilide by pharmacodynamic synergism. Use Caution/Monitor.
indacaterol, inhaled
indacaterol, inhaled, hawthorn. QTc interval. Use Caution/Monitor. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.
lidocaine
hawthorn increases effects of lidocaine by pharmacodynamic synergism. Use Caution/Monitor.
mexiletine
hawthorn increases effects of mexiletine by pharmacodynamic synergism. Use Caution/Monitor.
olodaterol inhaled
hawthorn and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias
pentobarbital
hawthorn increases effects of pentobarbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
phenobarbital
hawthorn increases effects of phenobarbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
phenytoin
hawthorn increases effects of phenytoin by pharmacodynamic synergism. Use Caution/Monitor.
primidone
hawthorn increases effects of primidone by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
procainamide
hawthorn increases effects of procainamide by pharmacodynamic synergism. Use Caution/Monitor.
promethazine
hawthorn increases effects of promethazine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
propafenone
hawthorn increases effects of propafenone by pharmacodynamic synergism. Use Caution/Monitor.
propranolol
hawthorn increases effects of propranolol by pharmacodynamic synergism. Use Caution/Monitor.
quetiapine
quetiapine, hawthorn. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT.
quinidine
hawthorn increases effects of quinidine by pharmacodynamic synergism. Use Caution/Monitor.
secobarbital
hawthorn increases effects of secobarbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
sotalol
hawthorn increases effects of sotalol by pharmacodynamic synergism. Use Caution/Monitor.
triclofos
hawthorn increases effects of triclofos by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
triprolidine
hawthorn increases effects of triprolidine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
verapamil
hawthorn increases effects of verapamil by pharmacodynamic synergism. Use Caution/Monitor.

Minor (0)

acebutolol
Monitor Closely (1)hawthorn increases effects of acebutolol by pharmacodynamic synergism. Use Caution/Monitor.
adenosine
Monitor Closely (1)hawthorn increases effects of adenosine by pharmacodynamic synergism. Use Caution/Monitor.
amiodarone
Monitor Closely (1)hawthorn increases effects of amiodarone by pharmacodynamic synergism. Use Caution/Monitor.
amobarbital
Monitor Closely (1)hawthorn increases effects of amobarbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
azelastine
Monitor Closely (1)hawthorn increases effects of azelastine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
brompheniramine
Monitor Closely (1)hawthorn increases effects of brompheniramine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
butabarbital
Monitor Closely (1)hawthorn increases effects of butabarbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
butalbital
Monitor Closely (1)hawthorn increases effects of butalbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
carbinoxamine
Monitor Closely (1)hawthorn increases effects of carbinoxamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
chloral hydrate
Monitor Closely (1)hawthorn increases effects of chloral hydrate by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
chlorpheniramine
Monitor Closely (1)hawthorn increases effects of chlorpheniramine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
cinnarizine
Monitor Closely (1)hawthorn increases effects of cinnarizine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
clemastine
Monitor Closely (1)hawthorn increases effects of clemastine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
crizotinib
Monitor Closely (1)crizotinib and hawthorn both increase QTc interval. Use Caution/Monitor. ECG monitoring is recommended, along with drugs that may prolong the QT interval.
cyclizine
Monitor Closely (1)hawthorn increases effects of cyclizine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
cyproheptadine
Monitor Closely (1)hawthorn increases effects of cyproheptadine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
dexchlorpheniramine
Monitor Closely (1)hawthorn increases effects of dexchlorpheniramine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
dexmedetomidine
Monitor Closely (1)hawthorn increases effects of dexmedetomidine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
digoxin
Monitor Closely (1)hawthorn increases effects of digoxin by pharmacodynamic synergism. Use Caution/Monitor.
diltiazem
Monitor Closely (1)hawthorn increases effects of diltiazem by pharmacodynamic synergism. Use Caution/Monitor.
dimenhydrinate
Monitor Closely (1)hawthorn increases effects of dimenhydrinate by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
diphenhydramine
Monitor Closely (1)hawthorn increases effects of diphenhydramine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
disopyramide
Monitor Closely (1)hawthorn increases effects of disopyramide by pharmacodynamic synergism. Use Caution/Monitor.
doxylamine
Monitor Closely (1)hawthorn increases effects of doxylamine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
encainide
Monitor Closely (1)hawthorn increases effects of encainide by pharmacodynamic synergism. Use Caution/Monitor.
esmolol
Monitor Closely (1)hawthorn increases effects of esmolol by pharmacodynamic synergism. Use Caution/Monitor.
flecainide
Monitor Closely (1)hawthorn increases effects of flecainide by pharmacodynamic synergism. Use Caution/Monitor.
hydroxyzine
Monitor Closely (1)hawthorn increases effects of hydroxyzine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
ibutilide
Monitor Closely (1)hawthorn increases effects of ibutilide by pharmacodynamic synergism. Use Caution/Monitor.
indacaterol, inhaled
Monitor Closely (1)indacaterol, inhaled, hawthorn. QTc interval. Use Caution/Monitor. Drugs that are known to prolong the QTc interval may have an increased the risk of ventricular arrhythmias.
lidocaine
Monitor Closely (1)hawthorn increases effects of lidocaine by pharmacodynamic synergism. Use Caution/Monitor.
mexiletine
Monitor Closely (1)hawthorn increases effects of mexiletine by pharmacodynamic synergism. Use Caution/Monitor.
olodaterol inhaled
Monitor Closely (1)hawthorn and olodaterol inhaled both increase QTc interval. Use Caution/Monitor. Drugs that prolong the QTc interval and may potentiate the effects of beta2 agonists on the cardiovascular system; increased risk of ventricular arrhythmias
pentobarbital
Monitor Closely (1)hawthorn increases effects of pentobarbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
phenobarbital
Monitor Closely (1)hawthorn increases effects of phenobarbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
phenytoin
Monitor Closely (1)hawthorn increases effects of phenytoin by pharmacodynamic synergism. Use Caution/Monitor.
primidone
Monitor Closely (1)hawthorn increases effects of primidone by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
procainamide
Monitor Closely (1)hawthorn increases effects of procainamide by pharmacodynamic synergism. Use Caution/Monitor.
promethazine
Monitor Closely (1)hawthorn increases effects of promethazine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
propafenone
Monitor Closely (1)hawthorn increases effects of propafenone by pharmacodynamic synergism. Use Caution/Monitor.
propranolol
Monitor Closely (1)hawthorn increases effects of propranolol by pharmacodynamic synergism. Use Caution/Monitor.
quetiapine
Monitor Closely (1)quetiapine, hawthorn. Either increases toxicity of the other by QTc interval. Use Caution/Monitor. Avoid use with drugs that prolong QT and in patients with risk factors for prolonged QT interval. Postmarketing cases show QT prolongation with overdose in patients with concomitant illness or with drugs known to cause electrolyte imbalance or prolong QT.
quinidine
Monitor Closely (1)hawthorn increases effects of quinidine by pharmacodynamic synergism. Use Caution/Monitor.
secobarbital
Monitor Closely (1)hawthorn increases effects of secobarbital by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
sotalol
Monitor Closely (1)hawthorn increases effects of sotalol by pharmacodynamic synergism. Use Caution/Monitor.
triclofos
Monitor Closely (1)hawthorn increases effects of triclofos by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
triprolidine
Monitor Closely (1)hawthorn increases effects of triprolidine by pharmacodynamic synergism. Use Caution/Monitor. May enhance CNS depression.
vandetanib
Serious - Use Alternative (1)hawthorn, vandetanib. Either increases toxicity of the other by QTc interval. Avoid or Use Alternate Drug. Avoid coadministration with drugs known to prolong QT interval; if a drug known to prolong QT interval must be used, more frequent ECG monitoring is recommended.
verapamil
Monitor Closely (1)hawthorn increases effects of verapamil by pharmacodynamic synergism. Use Caution/Monitor.

Frequency Not Defined

Agitation

Circulatory disturbances

Dizziness

Fatigue

GI disturbances

Headache

Sleep disturbances

Nausea

Palpitations

Sweating

Contraindications

None reported

Cautions

Concurrent cardiovascular meds, vasodilatory agents, or CNS depressants

Pregnancy & Lactation

Pregnancy Category: unsafe

Lactation: avoid use

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

Proanthocyanidins: ACE inhibitor; vasodilator

Dehydrocatechins: CNS depressant

Medscape prescription drug monographs are based on FDA-approved labeling information, unless otherwise noted, combined with additional data derived from primary medical literature.

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