General

Complementary/Alternative Medicine: This monograph describes a natural or herbal product that is not subject to FDA guidelines for medicines. Patients and clinicians are advised to read package labels carefully to ensure safe and efficacious use.

Pronunciation:
don kwi

Trade Name(s)

• Angelica sinensis 
• Chinese Angelica
• Dang Gui
• Danggui
• Don Quai
• Ligustilides
• Phytoestrogen
• Radix angelicae gigantis 
• Tang Kuei
• Tan Kue Bai Zhi

Ther. Class.
none assigned

Common Uses

• Premenstrual syndrome
• Various uses as a blood purifier
• Topically in combination with other ingredients for premature ejaculation

Action

• May have vasodilating and antispasmodic properties.
• Binds to estrogen receptors.

Therapeutic Effect(s):

Improved ejaculatory latency.

Pharmacokinetics

Absorption: Unknown.

Distribution: Unknown.

Metabolism and Excretion: Unknown.

Half-life: Unknown.

TIME/ACTION PROFILE

Contraindication/Precautions

Contraindicated in:

• Allergy to carrot, celery, mugwort, or other members of the Apiaceae family;
• OB:  Pregnancy and lactation.

Use Cautiously in:

• Hormone sensitive cancers and conditions (may exacerbate effects or stimulate growth of cancer cells);
• Protein S deficiency (↑ risk for thrombosis);
• Surgery (discontinue 2 wk prior to procedure).

Adverse Reactions/Side Effects

Derm: photosensitivity

GI: diarrhea

Misc: Some constituents are carcinogenic and mutagenic

* CAPITALS indicate life-threatening.
Underline indicate most frequent.

Interactions

Natural Drug Interaction

•  Alcohol -containing preparations may interact with  disulfiram  and  metronidazole.
• Use of dong quai with  anticoagulant  and  antiplatelet  drugs,  thrombolytics,  NSAIDs, some  cephalosporins, and  valproates  may increase risk of bleeding.

Natural-Natural:

Herbs with antiplatelet or anticoagulant properties may increase bleeding risk when combined with dong quai including:  angelica,  clove,  danshen,  garlic,  ginger,  ginkgo,  Panax ginseng , and  willow .

Route/Dosage

PO (Adults): Bulk herb– 3–4.5 g per day in divided doses with meals;  Extract– 1 mL (20–40 drops) three times daily.

Availability

Bulk herb: ^OTC

Extract: ^OTC

Assessment

• Assess pain and menstrual patterns prior to and following menstrual cycle to determine effectiveness of this herbal supplement.
• Assess for pregnancy prior to recommending use of the herbal supplement.
• Assess for history of hormone sensitive cancers or conditions and warn against use.
• Assess medication profile including prescription and over-the-counter use of products such as aspirin- and ibuprofen-based products to treat menstrual pain.

Potential Diagnoses

• Acute pain (Indications) 
• Deficient knowledge, related to medication regimen (Patient/Family/Teaching) 

Implementation

• PO Take with meals.

Patient/Family Teaching

• Caution patients to avoid use of aspirin or other NSAIDs concurrently because of the risk of bleeding.
• Notify patients that there are no studies supporting the use of this herbal supplement for treatment of menopausal symptoms.
• Advise patients to consult their health care professional if taking prescription medications before taking dong quai.
• Discontinue the herbal supplement if diarrhea or excessive bleeding occurs and contact a health care provider if symptoms do not resolve.
• Inform patients that photosensitivity may occur and to wear sunscreen and protective clothing if sun exposure is anticipated.
• Advise females of reproductive potential to avoid use if pregnancy is planned or suspected.

Evaluation/Desired Outcomes

Reduction in menstrual pain and cramping and regular periods with normal flow.