Alteration of Coagulation Test Results and Vaginal Bleeding Associated With the Use of Feverfew (<em>Tanacetum parthenium</em>)

^{Ministry of Health, Regional Drug Information and Pharmacovigilance Center, Tabuk, Saudi Arabia}

^{Ministry of Health, Prince Sultan Cardiac Center, Al-Qassim, Saudi Arabia}

^{Corresponding Author: Khalidah A. Alenzi, Regional Drug Information and Pharmacovigilance Center, General Directorate of Health Affairs in Tabuk Region, P.O. Box 876 King Fahad Hospital, Tabuk, Saudi Arabia. Email:}moc.liamtoh@hk_hp

Received 2020 Oct 6; Accepted 2020 Oct 17.

This article is distributed under the terms of the Creative Commons Attribution Non-Commercial 4.0 International License, which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Tanacetum parthenium (feverfew) is a member of the daisy family; it is used to prevent and treat migraine and rheumatoid arthritis. It has a long history of use as a traditional and folk medicine in Chinese, Greek, Indian and Arabic medicine, having been used for hundreds of years. The term feverfew comes from the Latin word febrifugia and means fever reducer. However, Short term use of feverfew (up to 4 months) is considered safe in adults. According to a few clinical trials, Tanacetum parthenium was not associated with serious adverse events but rather with mild and reversible events. Adverse events leading to withdrawals were mainly of a gastrointestinal nature. There is no major safety issue. Nevertheless, we report one case of a 36-year-old woman with known migraine who visited the obstetrics and gynecology clinic upon developing vaginal bleeding, prolonged duration of the menstrual cycle, and reddish skin without bruising. The patient suffered from these symptoms over a period of 3 months prior to the clinic visit. Based on history, the patient began taking 800 mg capsules of feverfew three times per day 9 months ago. We applied the Naranjo scale in our case, and it indicated that a probable relationship exists between feverfew and vaginal bleeding. Feverfew should be used cautiously by patients planning elective surgery, having coagulant disorders or taking antithrombotic drugs.

Keywords: Tanacetum parthenium, Feverfew, Vaginal bleeding, Migraine, Naranjo adverse drug reaction probability scale

Abstract

Acknowledgments

The authors would like to thank Dr. Tariq Abdulkareem Al-Rashdan, the obstetrics/gynecology consultant at King Khalid Hospital, Tabuk, Saudi Arabia.

Acknowledgments

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