Coltsfoot Uses, Benefits & Dosage - Drugs.com Herbal Database

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# Coltsfoot

Scientific Name(s): Tussilago farfara L.
Common Name(s): Coltsfoot, Filius ante patrem, Folia farfarae, Kuan Don Hua, Kuandong Hua

Medically reviewed by Drugs.com. Last updated on Jan 25, 2021.

## Clinical Overview

### Use

Information supporting antioxidant, antitussive, antimicrobial, or pressor effects of coltsfoot is limited to in vitro and animal studies. Nonclinical research also suggests potential applications in cancer and inflammatory processes. However, clinical data are lacking to recommend coltsfoot for any indication.

### Dosing

Clinical trials are lacking to provide dosage recommendations for coltsfoot.

### Contraindications

Information is lacking. Avoid in pregnancy and in patients with hepatic disease.

### Pregnancy/Lactation

Avoid use. Preparations may contain hepatotoxic pyrrolizidine alkaloids with carcinogenic and mutagenic potential.

### Interactions

None well documented. Caution is warranted if coltsfoot is used concurrently with anticoagulants (eg, warfarin) or antiplatelet agents (eg, aspirin, clopidogrel, prasugrel).

### Adverse Reactions

Clinical trials are lacking. Allergic and hypertensive effects are possible.

### Toxicology

No data.

## Scientific Family

- Asteraceae (daisy)

## Botany

Coltsfoot is an invasive, perennial plant growing up to 30 cm tall. Golden flowers similar to dandelions appear and die before leaves are produced, hence the name Filius ante patrem (meaning "the son before the father"). The seeds of the plant are soft, hair-like tufts often used by birds to build nests, and the leaves are broad and hoof-shaped, with hairs on the upper and lower surfaces. The leaves and flowering buds are of primary medicinal interest. Although coltsfoot is botanically similar to Petasites (butterbur), activities of the two differ.Duke 2002, Shikov 2014, USDA 2019 Although sometimes considered synonymous with Petasites Mill., butterbur and coltsfoot are monographed separately (see Butterbur monograph).

## History

Coltsfoot has been widely used in traditional medicine for multiple indications, including the treatment of bronchitis, lung cancer, emphysema, inflammation, rheumatism, swelling and water retention, and tuberculosis. It is listed in the Chinese Pharmacopoeia (as "Kuandonghua") and Russian Pharmacopoeia as a product used for centuries in the treatment of cough.Duke 2002, Kim 2013, Li 2018, Shikov 2014

## Chemistry

Pyrrolizidine alkaloids, especially senkirkine, are present in coltsfoot; however, the total alkaloid content is lower than that in butterbur.Duke 2002, Shikov 2014

Sesquiterpenes, including tussilagone, bisabolene, triterpenes, flavonoids, and pyrrolizidine alkaloids, are well described.Li 2012, Li 2012, Liu 2008, Liu 2011, Park 2008, Qin 2014 Phenolic compounds have been identified using high-performance liquid chromatography techniques.Uysal 2018 Reviews of the chemical constituents in the flowers, leaves, whole plant, and essential oil are available.Boucher 2018, Duke 2002, NAL 2019

## Uses and Pharmacology

### Anti-inflammatory effects

#### Animal and in vitro data

In vitro and rodent studies (eg, mice with induced colitis or cerebral ischemia) report anti-inflammatory effects of extracts of T. farfara (sesquiterpenoids, tussilagone), including moderation of nitric oxide production and inhibition of nuclear factor kappa B cells, which leads to suppression of cyclooxygenase, inflammatory cytokine, and tumor necrosis factor alpha levels.Cheon 2018, Hwang 2018, Jang 2016, Kim 2017, Lim 2015, Qin 2014

### Antimicrobial effects

#### In vitro data

Antimicrobial effects against Bacillus cereus, Mycobacterium tuberculosis, and Staphylococcus aureus have been observed in vitro.Boucher 2018, Kokoska 2002, Zhao 2014

### Antioxidant effects

#### Animal and in vitro data

Several animal and in vitro studies have demonstrated antioxidant effects for coltsfoot, possibly related to its anti-inflammatory and chemo- and neuroprotective effects.Cho 2005, Kang 2016, Kim 2006, Lee 2017, Lee 2018, Li 2012, Li 2012, Lim 2008

### Cancer

#### Animal and in vitro data

In vitro and rodent studies suggest that extracts of coltsfoot may possess activity of relevance in cancer, such as induction of apoptosis in human cancer cell lines.Lee 2014, Li 2014, Qu 2018, Safonova 2018, Safonova 2018

Protective effects of the polysaccharide extract on chemotherapy-induced toxicities have been demonstrated.Safonova 2016, Safonova 2018, Safonova 2018

### Cardiovascular effects

#### Animal data

In dogs, cats, and rats, an alcoholic extract of T. farfara produced a pressor effect similar to that of dopamine; however, no tachyphylaxis was observed. This blood pressure response was associated with increased heart rate.Li 1988, Shikov 2014

### Diabetes

#### In vitro data

In vitro studies suggest extracts of coltsfoot may have applications in diabetes, possibly related to inhibitory activity against diacylglycerol acyltransferase and aldose reductase.Kuroda 2016, Park 2008

### Respiratory effects

#### Animal and in vitro data

Antitussive and expectorant effects of coltsfoot flowers have been investigated in mice.Li 2012, Li 2012, Li 2013, Li 2018 Caffeic acid constituents, as well as other compounds such as tussilagone and sitosterol, are considered active antitussives and expectorants and exhibit additional anti-inflammatory properties.Li 2018, Wu 2016 Tussilagone has been investigated in vitro for mucin regulatory activity, which is important in the production of mucus.Choi 2018

## Dosing

Clinical trials are lacking to provide dosage recommendations for coltsfoot.

Traditional dosages include 2 to 4 mL of liquid leaf extract or 0.6 to 2 mL of liquid flower extract.Duke 2002

## Pregnancy / Lactation

Avoid use. Preparations may contain hepatotoxic pyrrolizidine alkaloids with carcinogenic and mutagenic potential.Blumenthal 2000, Duke 2002, Ernst 2002

## Interactions

None well documented.Chen 2012, Ulbricht 2008 High doses of coltsfoot may interact with cardiovascular medicines.Duke 2002 The constituent tussilagone demonstrates weak antiplatelet and calcium channel blocking activity.Hwang 1987, Liu 2008 Caution is warranted if coltsfoot is used concurrently with anticoagulants (eg, warfarin) or antiplatelet agents (eg, aspirin, clopidogrel, prasugrel).

## Adverse Reactions

Animal studies have demonstrated allergenic potential.(Duke 2002) A warning label regarding the presence of potentially hepatotoxic pyrrolizidine alkaloids has been recommended for all coltsfoot preparations.(Dangerous Supplements 2010, Kim 2013) A systematic review of case studies published through November 2017 identified 3 cases of adverse reactions related to coltsfoot when combining keyword search terms for pyrrolizidine alkaloid (PA)-related harm and coltsfoot, T. farfara. Of the 2 cases considered to be assessable, 1 documented fatal exposure to unsaturated PAs in utero from a multi-herbal tea consumed daily for the duration of pregnancy; the 2nd case was hepatoveno-occlusive disease in an adult female. In contrast to the WHO Uppsala Monitoring Center system that rated these cases as "likely" and "possible," the causality assessment by a toxicologist concluded the harm as very "unlikely" related to coltsfoot considering the presence of other herbs, which also contained pyrrolizidine alkaloids.(Avila 2020)

## Toxicology

Pyrrolizidine alkaloids are liver toxins with carcinogenic and mutagenic potential.Blumenthal 2000, Seremet 2016, Shikov 2014 Coltsfoot has been reported to be phototoxic in guinea pig skin.Duke 2002 Development of hepatic tumors has been reported in rats fed coltsfoot in their diet.Duke 2002, Hirono 1976 Case reports exist of both fatal (in a newborn) and reversible (in an 18-month-old child) hepatic vaso-occlusive disease; causality was suspected but not established.Shikov 2014, Sperl 1995 Coltsfoot was implicated in another case report of deep vein thrombosis and pulmonary embolism in an adult consuming a combination of herbal preparations.Freshour 2012

## Index Terms

- Petasites

## References

## Disclaimer

This information relates to an herbal, vitamin, mineral or other dietary supplement. This product has not been reviewed by the FDA to determine whether it is safe or effective and is not subject to the quality standards and safety information collection standards that are applicable to most prescription drugs. This information should not be used to decide whether or not to take this product. This information does not endorse this product as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this product. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this product. This information is not specific medical advice and does not replace information you receive from your health care provider. You should talk with your health care provider for complete information about the risks and benefits of using this product.

This product may adversely interact with certain health and medical conditions, other prescription and over-the-counter drugs, foods, or other dietary supplements. This product may be unsafe when used before surgery or other medical procedures. It is important to fully inform your doctor about the herbal, vitamins, mineral or any other supplements you are taking before any kind of surgery or medical procedure. With the exception of certain products that are generally recognized as safe in normal quantities, including use of folic acid and prenatal vitamins during pregnancy, this product has not been sufficiently studied to determine whether it is safe to use during pregnancy or nursing or by persons younger than 2 years of age.

## More about coltsfoot

### Related treatment guides

- Herbal Supplementation

Avila C, Breakspear I, Hawrelak J, Salmond S, Evans S. A systematic review and quality assessment of case reports of adverse events for borage (Borago officinalis), coltsfoot (Tussilago farfara) and comfrey (Symphytum officinale). Fitoterapia. 2020;142:104519.32105669
Blumenthal M, Goldberg A, Brinckmann J, eds. Herbal Medicine: Expanded Commission E Monographs. Newton, MA: Integrative Medicine Communications; 2000.
Boucher MA, Côté H, Pichette A, Ripoll L, Legault J. Chemical composition and antibacterial activity of Tussilago farfara (L.) essential oil from Quebec, Canada. Nat Prod Res. 2018:1-4.30257572
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Choi BS, Kim YJ, Yoon YP, Lee HJ, Lee CJ. Tussilagone suppressed the production and gene expression of MUC5AC mucin via regulating nuclear factor-kappa B signaling pathway in airway epithelial cells. Korean J Physiol Pharmacol. 2018;22(6):671-677.30402027
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