dong quai

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

ROUTEONSETPEAKDURATION
POunknownunknownunknown

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

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.

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Anesthesia Central is an all-in-one web and mobile solution for treating patients before, during, and after surgery. This collection of drug, procedures and test information is derived from Davis’s Drug, MGH Clinical Anesthesia Procedures, Pocket Guide to Diagnostic Tests, and MEDLINE Journals. .