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Scientific Name(s): Filipendula ulmaria (L.) Maxim.
Common Name(s): Bridewort, Dropwort, Lady of the meadow, Meadowsweet, Queen of the meadow
Medically reviewed by Holevn.org. Last updated on Jun 27, 2019.
Clinical Overview
Use
Meadowsweet has been used for colds, respiratory problems, acid indigestion, peptic ulcers, arthritis and rheumatism, skin diseases, and diarrhea.
Dosing
Doses of 2.5 to 3.5 g/day of flower and 4 to 5 g of herb are considered conventional; however, no clinical trials support the safety or efficacy of these dosages. A tea may be prepared from 4 to 6 g of the dried herb and taken 3 times daily.
Contraindications
Patients with salicylate or sulfite sensitivity. Use with caution in patients with asthma.
Pregnancy/Lactation
Documented adverse effects. Uteroactivity from meadowsweet has been observed in vitro; avoid administration during pregnancy and lactation.
Interactions
Because meadowsweet contains salicylates, it may increase the risk of bleeding when given concomitantly with antiplatelet or anticoagulant drugs, with nonsteroidal anti-inflammatory drugs (NSAIDs), or with any alternative medicines with antiplatelet properties.
Adverse Reactions
Meadowsweet may cause GI bleeding.
Toxicology
Few toxic events have been reported.
Scientific Family
- Rosaceae
Botany
Meadowsweet is an herbaceous, perennial shrub growing up to 2 m tall. The plant is native to Europe, but also grows in North America, preferring damp, moist soil. The erect stem is red-marbled and hollow and the plant has 3 to 9 pairs of dark-green, toothed, dentate leaves. Meadowsweet’s aromatic, ornamental flowers are creamy and yellow-white with 5 petals. The flowers are 5 mm in length and have an aroma reminiscent of wintergreen oil. The medicinal product consists of flower petals and some unopened buds.1, 2, 3, 4, 5, 6, 7, 8
History
In 1597, botanist John Gerard noted that the smell of meadowsweet “delighteth the senses.” In 1652, English physician Nicholas Culpeper wrote about the plant’s therapeutic effects on the stomach.5 In 1682, meadowsweet was mentioned as a Dutch herbal. In Holland, the plant was called filipendula, while in the rest of Europe, it was known as spiraea. Queen Elizabeth I adorned her apartments with meadowsweet. The flowers were used to flavor alcoholic beverages in England and Scandinavian countries.8 In the Middle Ages, meadowsweet was known as “meadwort” because it was used to flavor mead, an alcoholic drink made by fermenting honey and fruit juices.5
In 1838, salicylic acid was isolated from the plant, and in the 1890s, it was first synthesized to make aspirin.5 The word “aspirin” is derived from spirin, based on meadowsweet’s former scientific name Spiraea.8
The plant was used in folk medicine for cancer, tumors, and rheumatism, and as a diuretic.7, 9 Today, it is used as a digestive remedy, as supportive therapy for colds, for analgesia, and for other indications.
Chemistry
Flavonoids in meadowsweet include the flavonol glycosides rutin, hyperin, and spiraeoside.4 Spiraeoside has been evaluated in the plant’s flowers.10 Glycoside spiraein (quercitin glycoside and salicylaldehyde primveroside) is present, as are phenolic glycosides including gaultherin.3, 8 A phenolic glycoside from meadowsweet flowers has been reported.11 Quercetin and kaempferol derivatives have also been found in the plant, and hyperoside is present primarily in the leaves and stalks.4 A report is available on 7 flavonoids isolated from meadowsweet flowers, fruits, leaves, and stalks.12
Constituents in meadowsweet include 10% to 20% of hexahydroxydiphenic acid esters of glucose and tannins.4, 5, 7, 8 One report found tannin content to be high compared with that of other Rosaceae species.13
The essential oil contains primarily salicylaldehyde (75%), as well as phenylethyl alcohol, benzyl alcohol, anisaldehyde, methyl salicylate, salicin, gaultherin, spiraein, spiraeoside, heliotropin, phenyl acetate, and vanillin.2, 4, 9
Salicylates in the plant include salicylic aldehyde, salicylic acid, salicin, methyl salicylate, and others.2, 4, 7, 9 High-performance liquid chromatography and thin-layer chromatography assays for meadowsweet salicylates have been developed.14
Meadowsweet flowers contain heparin, which binds to the plant’s proteins, forming a complex.15 Heparin isolated from meadowsweet shows some similarity to heparin of animal origin.16
Other constituents in meadowsweet include mucilage, carbohydrates, ascorbic acid, sugars, and minerals.2, 8
A phytochemical study of meadowsweet is available.17
Uses and Pharmacology
Colds
Meadowsweet is used for supportive therapy in colds, probably because of its proposed analgesic, anti-inflammatory, and antipyretic actions.3, 4, 6, 8 The roots have been used to treat respiratory symptoms such as hoarseness, cough, and wheezing.9
Animal data
There are no animal data regarding the use of meadowsweet for the treatment of colds.
Clinical data
There are no clinical data regarding the use of meadowsweet for the treatment of colds.
Ulcers
The plant is used as a digestive remedy for acid indigestion or peptic ulcers. It protects the inner lining of the stomach while providing the anti-inflammatory benefits of salicylates.5
Animal data
A reduction in ulcerogenic action has been documented in rats, promoting the healing of induced chronic ulcers and preventing acetylsalicylic acid–induced lesions in the stomach.18 However, meadowsweet has been reported to potentiate ulcerogenic properties in animals.2
Clinical data
There are no clinical data regarding the use of meadowsweet for the treatment of ulcers.
Arthritis/Rheumatism
Meadowsweet may be beneficial in treating joint pain.5 Meadowsweet may also improve the condition of connective joint tissue.8 In folk medicine, meadowsweet was used as a treatment for rheumatism and arthritis.4
Animal data
There are no animal data regarding the use of meadowsweet for the treatment of arthritis/rheumatism.
Clinical data
There are no clinical data regarding the use of meadowsweet for the treatment of arthritis/rheumatism.
Antioxidant
Aqueous and ethanolic extracts of the above-ground parts of meadowsweet were found to possess antioxidant activity.19
Animal data
In a murine model, 100 mg/kg of meadowsweet extract given intragastrically for 5 days was found to possess antioxidant properties as well as hepatoprotective effects. The extract in 70% ethanol had the most potent effects with the lowest toxicity.20
Clinical data
There are no clinical data regarding the use of meadowsweet for its antioxidant properties.
Bacteriostatic effects
Bacteriostatic activity from meadowsweet flower extracts includes actions against Staphylococcus aureus, Staphylococcus epidermidis, Escherichia coli, Proteus vulgaris, and Pseudomonas aeruginosa.2 The salicylic acid in the plant is a known disinfectant used to treat ailments such as skin diseases.9 Meadowsweet is also a urinary antiseptic.8 Another study found meadowsweet to inhibit the growth of Helicobacter pylori.21 Meadowsweet did not demonstrate antiadhesive activity against Campylobacter jejuni.22
Animal data
There are no animal data regarding the use of meadowsweet to treat bacterial infections.
Clinical data
There are no clinical data regarding the use of meadowsweet to treat bacterial infections.
Cancer
Animal data
Local administration of a meadowsweet decoction resulted in a 39% decrease in the frequency of induced squamous cell carcinoma of the cervix and vagina in mice; 67% of mice had a positive response.23
Clinical data
Meadowsweet was found to exert cytotoxic effects on cultured human lymphoblastoid Raji cells.24
Miscellaneous
Meadowsweet had no effect on glycemic control when studied in mice for treatment of diabetes.25
A heparin-plant protein complex in meadowsweet was found to have anticoagulant and fibrinolytic properties.16 Meadowsweet flowers and seeds demonstrated an increased level of anticoagulant activity in vitro and in vivo in another report.26 In vitro complement inhibition from the plant’s flowers has been studied.27
The tannins in the plant possess astringent properties. Root preparations have been used in the treatment of diarrhea.2, 9
Meadowsweet has been used as a sedative and to soothe nerves.9 Reduction of motor activity and potentiation of narcotic action has been observed in animals given the herb.2
Dosing
Doses of 2.5 to 3.5 g/day of flower and 4 to 5 g of herb are considered conventional; however, no clinical trials support the safety or efficacy of these dosages.3
Pregnancy / Lactation
Documented adverse effects. Uteroactivity from meadowsweet has been observed in vitro; avoid administration during pregnancy and lactation.2
Interactions
Because meadowsweet contains salicylates, it may increase the risk of bleeding when given concomitantly with antiplatelet, or anticoagulant drugs, with NSAIDs, or with any herbals with antiplatelet properties.28, 29, 30
Adverse Reactions
Meadowsweet may possibly cause GI bleeding. A case report describes a 4-year-old boy admitted with hypovolemic shock caused by severe GI bleeding. Specifically, he experienced dark stools with episodes of hematemesis the day before admission. Findings from an esophagogastroduodenoscopy revealed hiatus hernia, erosions and ulceration of the lower esophagus, and a small duodenal erosion. Two days prior to admission, he received an herbal syrup containing meadowsweet along with several other herbals for a mild cold and began bleeding that evening. The child recovered after discontinuation of the product.31 Another case report described a dog that ingested a horse supplement containing meadowsweet and willow. Following its ingestion, the dog experienced acute weakness, hematemesis, melena, a painful abdomen, and pale mucosal membranes. The supplement was speculated to be the cause of the dog’s GI bleeding.32
Toxicology
The Complete German Commission E Monographs lists no known contraindications (except in people with salicylate sensitivity) for meadowsweet.3 The US Food and Drug Administration has classified the plant as an herb of undefined safety.9 Use caution because of the toxicity profile of salicylates. Methylsalicylate can be absorbed through the skin, resulting in fatalities, especially in children.2, 9 Bronchospasm has been documented with the use of the plant; therefore, use with caution in patients with asthma.
References
1. Van Wyk BE, Wink M. Medicinal Plants of the World. Portland, OR: Timber Press Inc; 2004.2. Newall C, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-Care Professionals. London, England: Pharmaceutical Press; 1996:191-192.3. Blumenthal M, Brinckmann J, Goldberg A, eds. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications; 2000: 253-256.4. Bisset NA, Wichtl M. Herbal Drugs and Phytopharmaceuticals. Boca Raton: CRC Press; 1994:480-482.5. Chevalier A. The Encyclopedia of Medicinal Plants. New York, NY: DK Publishing; 1996:96.6. Schulz V, Hansel R, Tyler VE. Rational Phytotherapy: A Physician’s Guide to Herbal Medicine. Berlin, Germany: Springer; 1998:143-144.7. Bruneton J. Pharmacognosy, Phytochemistry, Medicinal Plants. Paris, France: Lavoisier; 1995:221-222, 316-318.8. Zeylstra H. Filipendula ulmaria. Br J Phytother. 1998;5:8-12.9. Duke J. Handbook of Medicinal Herbs. Boca Raton, FL: CRC Press; 2001:196-197.10. Poukens-Renwart P, Tits M, Wauters JN, Angenot L. Densitometric evaluation of spiraeoside after derivatization in flowers of Filipendula ulmaria (L.) Maxim. J Pharm Biomed Anal. 1992;10(10-12):1085-1088.129836711. Thieme H. Isolation of a new phenolic glycoside from the blossoms of Filipendula ulmaria (L.) Maxim [in German]. Pharmazie. 1966;21(2):123.598297812. Lamaison J, et al. Principal flavonoids of aerial parts of Filipendula ulmaria (L.) Maxim. subsp. ulmaria and subsp. denudata. Pharm Acta Helv. 1992;67:218-222.13. Lamaison JL, Carnat A, Petitjean-Freytet C. Tannin content and inhibiting activity of elastase in Rosaceae [in French]. Ann Pharm Fr. 1990;48(6):335-340.213176614. Meier B, et al. Salicylates in plant drugs: screening methods (HPLC, TLC) for their detection. Deutsche Apotheker Zeitung. 1987;127:2401-2407.15. Kudriashov BA, Liapina LA, Azieva LD. The content of a heparin-like anticoagulant in the flowers of the meadowsweet [in Russian]. Farmakol Toksikol. 1990;53(4):39-41.222675916. Kudriashov BA, Ammosova IM, Liapina LA, et al. Heparin from the meadowsweet ( Filipendula ulmaria ) and its properties [in Russian]. Izv Akad Nauk SSSR Biol. 1991;(6):939-943.180978517. Henih HIa, Ladna LIa. Phytochemical study of the dropworts, Filipendula ulmaria and F. hexapetala, from the flora of Lvov Province [in Ukrainian]. Farm Zh. 1980:(1):50-52.737181118. Barnaulov OD, Denisenko PP. Anti-ulcer action of a decoction of the flowers of the dropwort, Filipendula ulmaria (L.) Maxim [in Russian]. Farmakol Toksikol. 1980;43(6):700-705.745000819. Shilova IV, Krasnov EA, Korotkova EI, Nagaev MG, Lukina AN. Antioxidant properties of extracts from the above-ground parts of Filipendula ulmaria. Pharm Chem J. 2006;40:660-662.20. Shilova IV, Zhavoronok TV, Suslov NI, et al. Hepatoprotective and antioxidant activity of meadowsweet extract during experimental toxic hepatitis. Bull Exp Biol Med. 2006;142(2):216-218.1736994321. Cwikla C, Schmidt K, Matthias A, Bone KM, Lehmann R, Tiralongo E. Investigations into the antibacterial activities of phytotherapeutics against Helicobacter pylori and Campylobacter jejuni. Phytother Res. 2010;24(5):649-656.1965331322. Bensch K, Tiralongo J, Schmidt K, et al. Investigations into the antiadhesive activity of herbal extracts against Campylobacter jejuni. Phytother Res. 2011;25(8):1125-1132.2128011323. Peresun’ko AP, Bespalov VG, Limarenko AI, Aleksandrov VA. Clinico-experimental study of using plant preparations from the flowers of Filipendula ulmaria (L.) Maxim for the treatment of precancerous changes and prevention of uterine cervical cancer [in Russian]. Vopr Onkol. 1993;39(7-12):291-295.782530024. Spiridonov NA, Konovalov DA, Arkhipov VV. Cytotoxicity of some Russian ethnomedicinal plants and plant compounds. Phytother Res. 2005;19(5):428-432.1610638625. Swanson-Flatt SK, Day C, Bailey CJ, Flatt PR. Evaluation of traditional plant treatments for diabetes: studies in streptozotocin diabetic mice. Acta Diabetol Lat. 1989;26(1):51-55.275044526. Liapina LA, Koval’chuk GA. A comparative study of the action on the hemostatic system of extracts from the flowers and seeds of the meadowsweet ( Filipendula ulmaria [L.] Maxim.) [in Russian]. Izv Akad Nauk Ser Biol. 1993;(4):625-628.835827727. Halkes S, et al. Strong complement inhibitor from the flowers of Filipendula ulmaria (L.) Maxim. Pharm Pharmacol Lett. 1997;7:79-82.28. Abebe W. Herbal medication: potential for adverse interactions with analgesic drugs. J Clin Pharm Ther. 2002;27(6):391-401.1247297829. Heck AM, DeWitt BA, Lukes AL. Potential interactions between alternative therapies and warfarin. Am J Health-Syst Pharm. 2000;57(13):1221-1230.1090206530. Roumie CL, Griffin MR. Over-the-counter analgesics in older adults: a call for improved labeling and consumer education. Drugs Aging. 2004;21(8):485-498.1518221431. Moro PA, Flacco V, Cassetti F, et al. Hypovolemic shock due to severe gastrointestinal bleeding in a child taking an herbal syrup. Ann Ist Super Sanita. 2011;47(3):278-283.2195215332. Rohner Machler M, Glaus TM, Reusch CE. Life threatening intestinal bleeding in a Bearded Collie associated with a food supplement for horses [in German]. Schweiz Arch Tierheilkd. 2004;146(10):479-482.15526604
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