dong quai

Complementary/Alternative Medicine: This monograph describes a natural or herbal product that is not subject to FDA guidelines for medicines. Patients and clinicians are advised to read package labels carefully to ensure safe and efficacious use.

REMS

Premenstrual syndrome
Various uses as a blood purifier
Topically in combination with other ingredients for premature ejaculation

Action ⬆ ⬇

May have vasodilating and antispasmodic properties.
Binds to estrogen receptors.

Therapeutic effects:

Improved ejaculatory latency.

Pharmacokinetics ⬆ ⬇

Absorption: Unknown.

Distribution: Unknown.

Metabolism/Excretion: Unknown.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
PO	unknown	unknown	unknown

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Allergy to carrot, celery, mugwort, or other members of the Apiaceae family;
OB: Pregnancy and lactation.

Use Cautiously in:

Hormone-sensitive cancers and conditions (may exacerbate effects or stimulate growth of cancer cells);
Protein S deficiency (↑ risk for thrombosis);
Surgery (discontinue 2 wk prior to procedure).

Adv. Reactions/Side Effects ⬆ ⬇

Derm: photosensitivity

GI: diarrhea

Misc: Some constituents are carcinogenic and mutagenic

Interactions ⬆ ⬇

Natural-Drug Products:

Alcohol-containing preparations may interact with disulfiram and metronidazole.
Use of dong quai with anticoagulant and antiplatelet drugs, thrombolytics, NSAIDs, some cephalosporins, and valproates may increase risk of bleeding.

Natural-Natural Products:

Herbs with antiplatelet or anticoagulant properties may increase bleeding risk when combined with dong quai including: angelica, clove, danshen, garlic, ginger, ginkgo, Panax ginseng, and willow.

Route/Dosage ⬆ ⬇

PO (Adults ): Bulk herb: 3–4.5 g per day in divided doses with meals; Extract: 1 mL (20–40 drops) three times daily.

Availability ⬆ ⬇

Bulk herb: OTC
Extract: OTC

Assessment ⬆ ⬇

Assess pain and menstrual patterns prior to and following menstrual cycle to determine effectiveness of this herbal supplement.
Assess for pregnancy prior to recommending use of the herbal supplement.
Assess for history of hormone-sensitive cancers or conditions and warn against use.
Assess medication profile including prescription and over-the-counter use of products such as aspirin- and ibuprofen-based products to treat menstrual pain.

Implementation ⬆ ⬇

PO: Take with meals.

Patient/Family Teaching ⬆ ⬇

Caution patients to avoid use of aspirin or other NSAIDs concurrently because of the risk of bleeding.
Notify patients that there are no studies supporting the use of this herbal supplement for treatment of menopausal symptoms.
Advise patients to consult their health care professional if taking prescription medications before taking dong quai.
Discontinue the herbal supplement if diarrhea or excessive bleeding occurs and contact a health care provider if symptoms do not resolve.
Inform patients that photosensitivity may occur and to wear sunscreen and protective clothing if sun exposure is anticipated.
Advise females of reproductive potential to avoid use if pregnancy is planned or suspected.

Evaluation/Desired Outcomes ⬆ ⬇

Reduction in menstrual pain and cramping and regular periods with normal flow.

US Brand Names ⬆

Angelica sinensis, Chinese Angelica, Dang Gui, Danggui, Don Quai, Ligustilides, Phytoestrogen, Radix angelicae gigantis, Tang Kuei, Tan Kue Bai Zhi

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇