|
Composition:
Each tablet contains:
480 mg of Harpagophytum dry extract, equivalent to 1440 mg dry devils claw
root.
Inactive ingredients: Lactose, cornstarch, microcrystalline cellulose,
silicon dioxide, magnesium stearate,
methylhydroxypropylcellulose, talcum, titan dioxide, polyethylene glycol.
The daily dose of Atrosan corresponds to 2880 mg of dry devils claw root.
Dosage:
Take 1 tablet 3 times daily, preferably with meals.
Historical overview:
Devils claw gets its name from the hooks that cover the fruits skin and that
hang on animals hoofs, thus allowing the species to spread. Traditional
African and European medicines use devils claw for its anti-inflammatory and
analgesic properties as well as its tonic activity on liver and stomach.
Traditionally, it is used for arthritis, gout, muscle pain of all types (myalgia),
lumbago, etc. as well as for loss of appetite, liver disorders and
dyspepsia. In African pharmacopoeia, devils claw is used for urinary and
menstrual problems.
Actions and pharmacology:
Devils claw active principles are iridoids in the form of glycosides (harpagoside,
harpagide, procumbine) or aglycone (harpagegine), as well as flavonoids (kaempferol,
apigenine). A recent study evaluating the production of eicosanoids
(inflammation mediators such as prostaglandins) found a very clear
anti-inflammatory effect. It has been demonstrated that devils claw extract
(particularly harpagosides) inhibits the synthesis of tromboxanes and
leukotrienes.(1)
It seems that devils claw extract also may have cardiac effects, which could
limit its use in patients on heart medications. This effect has only been
demonstrated in vitro and its actual relevance in humans has never been
demonstrated.(2) Some authors also mention a hypoglycemic effect but no
clinical data supports this affirmation.
The German Commission E acknowledges the following uses: loss of appetite,
dyspepsia, and supportive therapy of degenerative disorders of the locomotor
system.
The specific extract used in Atrosan demonstrated a potent anti-inflammatory
effect in an in vitro study. In addition, the partial inhibition of the COX
enzyme caused by this extract seems to have a beneficial effect on the
kidney, contrary to non-specific synthetic anti-inflammatory medications.(3)
Scientific studies:
Several well-designed clinical studies demonstrated the efficacy of devils
claw in inflammatory disorders. A French double-blind randomized study
compared a devils claw preparation and an anti-inflammatory agent (diacerhein)
in 122 patients with hip and knee osteoarthritis over a period of 4 months.
The devils claw extract proved as effective as the anti-inflammatory agent
but had a much better tolerance and was safer.(4) A German 4-week study
conducted on 197 patients with chronic back pain demonstrated that devils
claw extract relieves and reduces exacerbation. Only few minor and transient
gastro-intestinal side effects were reported.(5)
Many clinical trials have confirmed the efficacy of tablets of harpagophytum
dry extracts. For instance, researchers compared an extract of devils claw
to a new generation anti-inflammatory medication, Vioxx®, at 12,5 mg daily.
The extract was as effective as the medication to relieve low back pain.(6)
In another study, the same researchers evaluated the efficacy of the extract
not only for non-specific low back pain but also for osteo-arthritis of the
knee and hip. Of the 227 patients following the protocol 70% reported a
significant relief.(7)
Two more trials used a devils claw extract similar to Atrosan. At the same
dosage (480 mg twice daily) the harpagophytum extract proved effective for
muscle pain: on the perception of pain as well as on inflammation. In
addition no serious side effects were reported in either double blind
randomized clinical trials.(8,9)
Precautions, contraindications and interactions
Contraindication:
Known allergy to devils claw.
In case of gastric or duodenal ulcer consult a healthcare professional.
The only side effects reported, mainly gastric discomforts, are minor and
transient. In one study, a patient reported a headache with tinnitus.
Devils claw is contra-indicated during pregnancy because of a possible
oxytocic effect. It is not recommended during breastfeeding.
A theoretical interaction with heart drugs is possible.(2) A case of purpura
(small spontaneous bruises) has been reported during concomitant use with
Coumadin®.(10)
If symptoms persist consult a healthcare professional.
References:
1- Loew D, Mollerfeld J, Schrodter A et al. Investigations on the
pharmacokinetic properties of Harpagophytum extracts and their effects on
eicosanoid biosynthesis in vitro and ex vivo. Clin Pharmacol Ther 2001
May;69(5):356-64
2- Occhiuto F et al. A drug used in traditional medicine: Harpagophytum
procumbens DC. IV. Effects on some isolated muscle preparations. J
Ethnopharmacol 1985;13:201-8.
3- Kaszkin M, Degenring FH, Suter A et al. Anti-inflammatory Activity of The
Newly Developed Harpagophytum procumbens Extracts. Poster presentation 6th
ESCOP Symposium, Bonn 2001
4- Chantre P, Cappelaere A, Leblan D et al. Efficacy and tolerance of
Harpagophytum procumbens versus diacerhein in treatment of osteoarthritis.
Phytomedicine 1999 Jun;7(3):177-83
5- Chrubasik S, Junck H, Breitschwerdt H et al. Effectiveness of
Harpagophytum extract WS 1531 in the treatment of exacerbation of low back
pain: a randomized, placebo-controlled, double-blind study. Eur J
Anaesthesiol 1999 Feb;16(2):118-29
6- Chrubasik S, Model A, Black A, Pollak S. A randomized double-blind pilot
study comparing Doloteffin((R)) and Vioxx((R)) in the treatment of low back
pain. Rheumatology (Oxford) 2003 Jan;42(1):141-8
7- Chrubasik S, Thanner J, Kunzel O et al. Comparison of outcome measures
during treatment with the proprietary Harpagophytum extract doloteffin in
patients with pain in the lower back, knee or hip. Phytomedicine 1999
Apr;9(3):181-94
8. Gobel H, Heinze A, Ingwersen M et al. [Effects of Harpagophytum
procumbens LI 174 (devil's claw) on sensory, motor und vascular muscle
reagibility in the treatment of unspecific back pain] [Article in German]
Schmerz 2001 Feb;15(1):10-8
9- Laudahn D, Walper A. Efficacy and tolerance of Harpagophytum extract LI
174 in patients with chronic non-radicular back pain. Phytother Res 2001
Nov;15(7):621-4
10- Shaw D, et al. Traditional remedies and food supplements: a 5-year
toxicological study (1991-1995). Drug Safety 1997;17:342-56.
11- The Complete German Commission E Monographs, Therapeutic Guide to Herbal
Medicines. Blumenthal M et al. 1998. American Botanical Council, 6200 Manor
Rd, Austin, Texas, 78723
|
Ayurvedic & Herbal Health Medicine
