Dong Quai

Drug Levels and Effects:




Summary of Use during Lactation:


Dong quai (</span>Angelicasinensis) root contains a number of chemicals, including ligustilide, ferulic acid, angelicide. Dong quai has no generally recognized lactation-related uses, although some midwives in the United States reportedly have used it for postpartum blues or depression.[1] It is often used as part of a postpartum herbal mixture in Asia[2][3] and is used as a "women's herb" in Chinese medicine for symptoms associated with menstruation and menopause. No data exist on the excretion of any components of dong quai into breastmilk or on the safety and efficacy of dong quai in nursing mothers or infants. Although it is usually well tolerated in general use, it may increase the risk of bleeding in patients taking warfarin and antiplatelet drugs and cause photosensitivity reactions. Dong quai is best avoided during breast feeding.[4]

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Drug Levels:


Maternal Levels.

Relevant published information was not found as of the revision date.

Infant Levels.

Relevant published information was not found as of the revision date.


Effects in Breastfed Infants:


Relevant published information was not found as of the revision date.


Possible Effects on Lactation:


A study in Japan compared the use of a mixture of 13 herbs, including dong quai, to ergonovine for their effects on lactation and serum prolactin in postpartum women. The herbal mixture, called Xiong-gui-tiao-xue-yin, was given in a randomized fashion to 41 women in a dose of 2 grams of a dried aqueous extract 3 times daily. A comparable group of 41 women were randomized to receive methylergonovine 0.375 mg daily. Therapy was started on the day of delivery, but the duration of therapy was not specified. Plasma oxytocin and prolactin were measured on days 1 and 6; milk volumes were measured daily, although the method of measuring milk volume was not specified. Serum prolactin was higher on days 1 and 6 in the women who received the herbals; plasma oxytocin was lower on day 1 in the women who received the herbal, but not different on day 6. Milk volumes were greater on days 4, 5, and 6 in women who received the herbal mixture.[5] This study has serious flaws that make its interpretation impossible. First, milk volume measurement is subject to considerable variability depending on the measurement method used, but the method was not specified. Second, methylergonovine has caused decreases in serum prolactin and milk production in some studies.[6][7] Because of the lack of a placebo group, the differences found could be a negative effect of methylergonovine rather than a positive effect of the herbal preparation. Because this study used a multi-ingredient combination products in which dong quai was only one component, the results might be different from studies in which dong quai was used alone.


References:


1. Allaire AD, Moos MK, Wells SR. Complementary and alternative medicine in pregnancy: a survey of North Carolina certified nurse-midwives. Obstet Gynecol. 2000;95:19-23. PMID:10636495
2. Chuang CH, Chang PJ, Hsieh WS et al. Chinese herbal medicine use in Taiwan during pregnancy and the postpartum period: a population-based cohort study. Int J Nurs Stud. 2009;46:787-95. PMID:19193377
3. Wong HB. Effects of herbs and drugs during pregnancy and lactation. J Singapore Paediatr Soc. 1979;21:169-78. PMID:262485
4. Amir LH, Pirotta MV, Raval M. Breastfeeding - Evidence based guidelines for the use of medicines. Aust Fam Physician. 2011;40:684-90. PMID:21894275
5. Ushiroyama T, Sakuma K, Souen H et al. Xiong-gui-tiao-xue-yin (Kyuki-chouketsu-in), a traditional herbal medicine, stimulates lactation with increase in secretion of prolactin but not oxytocin in the postpartum period. Am J Chin Med. 2007;35:195-202. PMID:17436360
6. Peters F, Lummerich M, Breckwoldt M. Inhibition of prolactin and lactation by methylergometrine hydrogenmaleate. Acta Endocrinol (Copenh). 1979;91:213-6. PMID:463447
7. Arabin B, Ruttgers H, Kubli F. [Effects of routine administration of methylergometrine during puerperium on involution, maternal morbidity and lactation]. Geburtshilfe Frauenheilkd. 1986;46:215-20. PMID:3519353



Substance Identification:




Substance Name:

Dong Quai

Scientific Name:

Angelicasinensis

CAS Registry Number:

299184-76-2

Drug Class:


  • Complementary Therapies

  • Phytotherapy

  • Plants, Medicinal


  • Administrative Information:




    LactMed Record Number:


    921


    Last Revision Date:


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