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

PO: Premenstrual syndrome
Topical Premature ejaculation

Action ⬆ ⬇

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

Therapeutic effects:

Improved ejaculatory latency.
Reduction in symptoms of premenstrual syndrome.

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;
Lactation: 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

Interactions ⬆ ⬇

Natural-Drug Products:

Alcohol-containing preparations may interact with disulfiram and metronidazole.
Anticoagulants, antiplatelets, thrombolytics, NSAIDs, some cephalosporins, and valproates may ↑ risk of bleeding.

Natural-Natural Products:

Angelica, clove, danshen, garlic, ginger, ginkgo, Panax ginseng, and willow may ↑ risk of bleeding.

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.
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 regular over-the-counter use of products such as aspirin- and ibuprofen-based products to treat menstrual pain.

Implementation ⬆ ⬇

PO: Take with food.

Patient/Family Teaching ⬆ ⬇

Explain purpose and side effects of medication.
Advise patient to notify health care professional of all Rx or OTC medications, vitamins, or herbal products being taken and to consult health care professional before taking other medications, especially concurrent use with aspirin or NSAIDs.
Notify patient that there are no studies supporting the use of this herbal supplement for treatment of menopausal symptoms.
Discontinue the herbal supplement if diarrhea or excessive bleeding occurs and notify health care professional if symptoms persist.
Inform patient that photosensitivity may occur and to wear sunscreen and protective clothing if sun exposure is anticipated.
Rep: Advise women of reproductive potential to notify health care professional if pregnancy is planned or suspected, or if breastfeeding.

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇