The Longwood Herbal Task Force The Center for Holistic Pediatric Education and Research Devil’s Claw (Harpagophytum procumbens) Principal Proposed Use: Anti-inflammatory for degenerative or rheumatic joint disease and Other Proposed Uses: Analgesic for other pains (headache, menstrual pain), antipyretic,
antidiabetic, appetite stimulant and bitter tonic, liver and gall bladder tonic, vulnerary
The major clinical uses for Devil’s claw are for pain relief in joint diseases, back pain and
headache. The evidence from scientific studies in animals and humans has resulted in widespread
use of standardized Devil’s claw as a mild analgesic for joint pain in Europe. There are no
studies evaluating its effectiveness as an appetite stimulant or liver tonic, but it is widely used for
these purposes. The major potential risks and side effects include possible allergies and potential
inotropic, chronotropic, antiarrhythmic and hypotensive effects; it is traditionally contraindicated
for patients with gastric and duodenal ulcers, but side effects are rarely reported and tend to be
limited to mild gastrointestinal upset. Commercial products are occasionally contaminated with
inactive plants and other bitter African plants such as Elephantorrhiza and Acanthosicyos. There
are no studies evaluating its safety or effectiveness during pregnancy, lactation, or childhood. Historical and Popular Uses
Devil’s claw is a native of Southern Africa. It has long been used as a tea by indigenous
peoples to treat gastrointestinal disorders and rheumatic conditions. A German farmer who had
settled in the area exported the plant to Europe where it also became popular among British,
European and Canadian herbalists for the supportive treatment of degenerative or rheumatic joint
disease, tendonitis and other pains (headache, backache, menstrual pain)1,2,3,4,5. It is also used
as an antipyretic, appetite stimulant and bitter tonic, for conditions of the liver, gall bladder and
urinary tract, and to treat allergies. An ointment containing Devil’s claw root is used as a
vulnerary (to treat skin injuries and disorders). Botany Medicinal species:Harpagophytum procumbens DC and H. zeheri6
Common names: Devil’s claw, grapple plant, wood spider, Teufelskralle (German),
Trampelklette (German), griffe du diable (French). Plant description: The name derives from the fruits of the perennial plant, which appear to be
covered with small hooks. The fruits are 7-20 centimeters long and 6 cm in diameter;
they contain approximately 50 dark seeds. The flowers are large, pale-pink to red. The
part used medicinally is the dried tubular and secondary roots and the macerated thick
lateral tubers, which are cut into slices and dried. Where it’s grown: Devil’s claw is native to the red sand areas in the Transvaal of South Africa
and Namibia. It has spread throughout the Kalahari and Savannah desert regions.
American products are imported from Africa. Biochemistry Devils Claw: Potentially Active Chemical Constituents
• Iridoid glycosides (2.2% total weight)7:
Harpagosides (very bitter flavor): 0.5 –1.6% (minimum of 1.2% in European
• Phenols: acetoside (verbascoside), isoacetoside10• Other: harpagoquinones, amino acids, flavonoids, phytosterols, carbohydrates11
Harpagoside has a very bitter flavor which may make some products unpalatable. The
iridoid glycosides have dose-dependent anti-inflammatory and analgesic effects equivalent to
phenylbutazone; they are apparently inactivated by gastric acids12. Harpagoside is most effective
when given parenterally, and loses potency markedly when given by mouth; enteric coated
preparations might maintain efficacy despite exposure to gastric acids13. Harpagoside inhibits
arachidonic acid metabolism through both cyclo-oxygenase and lipoxygenase pathways. The
harpagoside content varies within the plant, and is highest in the secondary tubers, with lower
levels in the primary roots. The flowers, stems and leaves appear to be devoid of active
Experimental Studies Devil’s Claw: Potential Clinical Benefits
4. Gastrointestinal/hepatic: Appetite stimulant, digestive tonic, liver and gall bladder tonic
5. Neuro-psychiatric: Analgesic: see Immune modulation
8. Rheumatologic: Degenerative joint disease: see Immune modulation
14. Skin and mucus membranes: Vulnerary (wound healing)
1. Cardiovascular: Antiarrhythmic: This is not a traditional use of Devil’s claw.
i. In vitro data: In isolated rat hearts, Devil’s claw extracts had a dose-dependent protective
effect against arrhythmias induced by reperfusion14; similar protective effects were
found in isolated rabbit hearts subjected to arrhythmogenic chemicals14,15.
ii. Animal data: In low doses, Devil’s claw extracts had mildly negative chronotropic effects
and positive inotropic effects16,17; high doses caused a marked negative inotropic effect
and reduced coronary blood flow14. In normotensive rats, intraperitoneal injections of
Devil’s claw had mild hypotensive effects as well as antiarrhythmic effects15.
2. Pulmonary: none
3. Renal and electrolyte balance: none
4. Gastrointestinal/hepatic: Appetite stimulant, digestive tonic, liver and gall bladder tonic
a. Appetite stimulant: No randomized trials have evaluated this use. In vitro data: In isolated guinea pig jejunum, Devil’s claw extracts decreased the
contractile response of smooth muscle to acetylcholine16; in guinea pig ileum,
harpagoside nonselectively inhibited contractions induced by various chemical
iii. Human data: In an adult case series, oral administration of Devil’s claw (1 tsp in 2
cups of water) resulted in improvements in constipation, diarrhea, appetite and
c. Liver and gall bladder tonic: No randomized trials have evaluated this use.
5. Neuro-psychiatric: Analgesic: See Immune modulation
6. Endocrine: Antidiabetic: Traditional use; no data.
7. Hematologic: none
8. Rheumatologic: Degenerative joint disease20: See Immune modulation
9. Reproductive: none
10. Immune modulation: Anti-inflammatory
i. In vitro data: Devil’s claw (100 mg/ ml) had no significant impact on prostaglandin
ii. Animal data: In several studies in rats, mice and guinea pigs, harpagoside reduced
experimentally-induced inflammation22,23,24,25,26. In one study, the effects of 20
mg/kg/day of Devil’s claw were comparable to 40 mg/kg/day of phenylbutazone25.
However, Devil’s claw extracts were not as effective as indomethacin, nor were they as
effective when given by mouth as when given by injection, apparently due to inactivation
iii. Human data: In normal volunteers, three weeks of daily treatment with 2 grams of
standardized Devil’s claw extract had no impact on levels of prostaglandin E2,
thromboxane B2, leukotriene B4, or 6-ketoprostaglandin F30. In 13 arthritic patients
treated for 13 weeks with Devil’s claw tablets (410 mg TID) there were no significant
improvements28. In an open trial in 630 adults with joint pain, six months of treatment
with Devil’s claw extract in daily dosages of 1 – 3 gms TID resulted in pain relief in 42%
- 85% (depending on site of pain); the only adverse effect was mild stomach upset even
In a double blind study of adults with joint pain, treatment with 770 mg TID of a
standardized Devil’s Claw extract resulted in significant improvement in pain and
flexibility over two months; no side effects were reported4,31. In two separate
randomized, double blind, placebo controlled trials of adults suffering from chronic low
back pain, Devil’s claw treatment provided significant improvement in pain scores within
11. Antimicrobial: none
12. Antineoplastic: none
13. Antioxidant: none
14. Skin and mucus membranes: Vulnerary (wound healing): Traditional use; no data.
15. Other/miscellaneous: none Toxicity and Contraindications All herbal products carry the potential for contamination with other herbal products, pesticides,herbicides, heavy metals, and pharmaceuticals.This is particularly concerning with imports from developing countries.Allergic reactions can occur to any natural product in sensitive persons.Allergic reactions have not been reported. Potentially toxic compounds in Devil’s claw: Unknown. Devil’s claw is occasionally adulterated
with harpagoside-poor primary roots or with other bitter African plants such as
Elephantorrhiza and Acanthosicyos.Acute toxicity: In a trial of Devil’s claw as a treatment for arthritis, one patient withdrew after
four days of therapy due to early morning headache, tinnitus, anorexia and loss of taste28.
Mild gastrointestinal upset has been reported in sensitive individuals, especially at higher
dosages. The LD 50 in mice is greater than 13.5 grams per kg of body weight21,23,34.
Because of the lack of effect on the biosynthesis of prostanoids, the adverse effects
usually expected with non-steroidal anti-inflammatories and glucocorticoid medications
are not expected with Devil’s claw30,35. Chronic toxicity: None in rat studies
Limitations during other illnesses or in patients with specific organ dysfunction: Devil’s claw is
traditionally contraindicated in patients with gastric or duodenal ulcers due to presumed
stimulation of gastric acid secretion; no studies have evaluated this possibility. Because
of its stimulant effects on the gall bladder, herbalists recommend that patients with
gallstones use Devil’s claw only in consultation with a physician. Traditionally, Devil’s
claw is contraindicated in diabetes, but no data support this assertion. In light of its
potential antiarrhythmic effects, potential interactions with antiarrhythmic drugs cannot
Interactionswith other herbs or pharmaceuticals: None reported
Safety during pregnancy, lactation and/or childhood: Devil’s claw is thought to be oxytocic and
therefore to be avoided in pregnancy25; however, there are no data to support this
recommendation, and no data on Devil’s claw’s safety or efficacy during pregnancy,
Typical Dosages Provision of dosage information does NOT constitute a recommendation or endorsement, butrather indicates the range of doses commonly used in herbal practice.Doses are given for single herb use and must be adjusted when using herbs in combinations.Doses may also vary according to the type and severity of the condition treated and individualFor pain relief: 3.0 - 4.5 grams of dried root mixed in boiling water, steeped eight
For appetite loss: 0.5 - 1.5 grams of dried root, mixed in boiling water, steeped
Tincture: (1:5 in 25% alcohol): 0.5 – 1.0 ml TID25
Liquid extract: (1:1 in 25% alcohol): 0.1 – 0.25 ml TID25
Availability of standardized preparations: A German analysis of several commercial products
showed variation of harpagoside content from 0.5 to 9.3 mg per tablet, resulting in daily
doses of 1.5 to 50 mg38,39. Standardized extracts are available; these should be used
whenever possible to ensure adequate dosing. Dosages used in herbal combinations: Variable
Proprietary names: Algophytum, Arthrosetten H, Arthrotabsm, Artigel, Defencid, Devil’s Claw
Secondary Root, Doloteffin, Fitokey Harpagophytum, Harpadol, Hariosen, Jucurba N,
Rheuma-Sern, Rheuma-Tee, HarpagoMega, Salus
Multi-ingredient preparations containing Devil’s claw root: Arktophytum, Arthritic Pain Herbal
Formula, Devil’s Claw Plus, Lifesystem Herbal Formula 1 Arthritic Aid, Lifesystem
Herbal Formula 12 Willowbark, Prost-1, Green Lipped Mussel (FM), Harpagophytum
Devil's Claw Clinician Information Summary:
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Belaiche P. Etude clinique de 630 cas d'artrose traites par le nebulisat aqueux d'Harpagophytumprocumbens (Radix). Phytotherapy 1982; 1:22-28.
Lecomte A, Costa J. Harpagophytum dans l'arthrose: Etude en double insu contre placebo. 37 2 Le
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Baghdikian B, Lanhers MC, Fleurentin J, et al. An analytical study, anti-inflammatory and analgesic effects
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procumbens DC. III. Effects on hyperkinetic ventricular arrhythmias by reperfusion. Journal of
Circosta C, Occhiuto F, Ragusa S, et al. A drug used in traditional medicine: Harpagophytum procumbens
DC. II. Cardiovascular activity. Journal of Ethnopharmacology 1984; 11:259-74.
Occhiuto F, Circosta C, Ragusa S, Ficarra P, Costa De Pasquale R. A drug used in traditional medicine:
Harpagophytum procumbens DC. IV. Effects on some isolated muscle preparations. Journal of
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Harpagophytum procumbens DC. in the dog. Pharmacological Research 1990; 22:72-3.
Fontaine J, Elchami AA, Vanhaelen M, Vanhaelen-Fastre R. Biological analysis of Harpagophytum
procumbens D.C. II. Pharmacological analysis of the effects of harpagoside, harpagide and harpagogenine
on the isolated guinea-pig ileum. Journal de Pharmacie de Belgique 1981; 36:321-4.
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Wenzel P, Wegener T. Harpagophtum procumbens -- A plant antirheumatic agent. Deutsche Apotheker
Whitehouse LW, Znamirowska M, Paul CJ. Devil's Claw (Harpagophytum procumbens): no evidence for
anti-inflammatory activity in the treatment of arthritic disease. Canadian Medical Association Journal 1983;
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root of Harpagophytum procumbens DC. Arzneimittel-Forschung 1970; 20:107-9.
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McLeod DW, Revell P, Robinson BV. Investigations of Harpagophytum procumbens (Devil's Claw) in the
treatment of experimental inflammation and arthritis in the rat [proceedings]. British Journal of
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Teufelskrallenwurzelextract bei Ruckenschmerzen: erste Ergebnisse einer Anwendungsbeobachtung.
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Mestdagh O, Torck M. Quality evaluation of Harpagophyton capsules. Annales Pharmaceutiques
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