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

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.

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.