Harpagophytum procumbens

01 Identity and provenance

Accepted binomial: Harpagophytum procumbens
Common names: Devil's Claw
Family (APG IV): Pedaliaceae
Part used: Tuber
Verification tier: Tier 2 · Verified Clinical columns reviewed and a source is on record.
Reviewer note (2026 audit): Drugs.com NPP Devil’s Claw monograph | VERIFIED 2026 - synthetic analogue, application, interactions, side effects and references populated from retrieved primary/regulatory sources (see References). Interaction entries are labelled CLINICAL (case reports or trials in humans) vs THEORETICAL (in-vitro or animal only). Marketed-formulation column intentionally left blank. | HOST FACTOR

02 Constituent chemistry

Chemical class	Marker compound	Synthetic analogue in use
Iridoid glycosides	Harpagoside Tuber	NSAIDs - diclofenac, ibuprofen (FUNCTIONAL anti-inflammatory). No structural analogue.

The analogue column is what makes the interaction reasoning tractable: where a constituent has a marketed structural counterpart, the counterpart's interaction profile is the starting hypothesis for the plant.

Looking up structures and physicochemical properties from PubChem…

03 Stated application

Reported activity: Osteoarthritis (knee and hip) and low back pain; adjuvant in degenerative rheumatism and tendinitis per Commission E and ESCOP. Dose matters: little evidence below 30 mg/day harpagoside; >50 mg/day used in knee/hip OA.
Reported adverse effects: Gastrointestinal upset. CONTRAINDICATED in gastric or duodenal ulcer - the bitter principle increases gastric acid secretion. Caution in gallstones or bile-duct obstruction. Avoid in pregnancy (possible oxytocic effect).

04 Interaction matrix

Source column, verbatim: CLINICAL: purpura reported in a patient taking warfarin - caution with anticoagulants and antiplatelets. Drugs.com NPP advises against use with antiarrhythmic, chronotropic or inotropic medicines (negative chronotropic and inotropic properties reported). May reduce required NSAID dose.
Normalised onto 4 canonical drug classes below.

Curated from the reviewed source

Drug class	Severity	Mechanism type	Provenance	Expected effect
Antiarrhythmics Cardiovascular	4Contraindicated	PD-additive + electrolyte-mediated	curated A	Proarrhythmia, QT prolongation, torsade de pointes, ventricular arrhythmi…	why ▾
Class mechanism. Botanicals that shift potassium or magnesium, block sodium or potassium channels, or prolong repolarisation add to class I and class III antiarrhythmic effects on an already unstable myocardium. Expected Proarrhythmia, QT prolongation, torsade de pointes, ventricular arrhythmia. Management Avoid. If unavoidable, baseline and follow-up ECG with QTc measurement plus potassium and magnesium correction. Onset rapid Evidence A - human data with a cited source Matched on “antiarrhythmic” Find evidence for this pair Map this mechanism
Anticoagulants (vitamin-K antagonists, DOACs) Haemostasis	3Major	PD-additive + PK-CYP2C9	curated A	INR destabilisation in either direction; ecchymosis, epistaxis, gum bleed…	why ▾
Class mechanism. Coumarin-, salicylate- and coumestan-bearing botanicals add to vitamin-K-antagonist effect; several also compete for CYP2C9 and CYP3A4, raising S-warfarin exposure. Botanicals rich in vitamin K1 act in the opposite direction and blunt anticoagulation. Expected INR destabilisation in either direction; ecchymosis, epistaxis, gum bleeding, GI or intracranial haemorrhage. Management Do not start or stop the botanical without INR cover. Check INR at 3-5 days and again at 2 weeks. Document the product, batch and dose in the anticoagulation record. Onset rapid Evidence A - human data with a cited source Matched on “anticoagulants” Find evidence for this pair Map this mechanism
Antiplatelet agents Haemostasis	3Major	PD-additive	curated A	Prolonged bleeding time, surgical and post-procedural bleeding, bruising,…	why ▾
Class mechanism. Organosulfur compounds, gingerols, salicylates, ginkgolides and eugenol inhibit thromboxane A2 synthesis, platelet aggregation and PAF-mediated activation, duplicating the pharmacology of aspirin and P2Y12 blockers. Expected Prolonged bleeding time, surgical and post-procedural bleeding, bruising, haematuria. Management Stop the botanical 7-14 days before elective surgery or neuraxial anaesthesia. Record it on the pre-operative medicines list. Onset rapid Evidence A - human data with a cited source Matched on “antiplatelets” Find evidence for this pair Map this mechanism
NSAIDs Analgesia	3Major	PD-additive	curated A	Peptic ulceration, upper GI bleeding, acute kidney injury in volume-deple…	why ▾
Class mechanism. Salicylate-, coumarin- and eugenol-bearing botanicals add both antiplatelet activity and direct gastric mucosal irritation to cyclo-oxygenase inhibition; several also reduce renal prostaglandin-dependent perfusion. Expected Peptic ulceration, upper GI bleeding, acute kidney injury in volume-depleted patients. Management Avoid in ulcer history. Add gastroprotection where the combination is unavoidable, and monitor renal function in the elderly. Onset rapid Evidence A - human data with a cited source Matched on “nsaid” Find evidence for this pair Map this mechanism

05 Hazard register

contraindication - peptic ulcer (raises gastric acid); warfarin

06 Confusable material

No same-genus or shared-common-name entry in the corpus.

07 Mechanism map

Chemistry sorts to the left, pharmacology to the right. Dashed edges are predicted. Drag nodes, scroll to zoom, export at 3× for a figure.

species

chemical class

marker compound

drug class

expected effect

hazard

08 Open literature

Abstract-scoped query built from this binomial, its common names and its marker compounds, run live against Europe PMC, PubMed and OpenAlex, then ranked locally against an evidence hierarchy.

Checking openFDA spontaneous reports…

09 Isomechanistic neighbours

Species whose interaction profile overlaps this one, ranked by shared severity weight rather than by count — a shared contraindication counts for more than a shared minor signal. Practical use: these are the plants you should not stack with this one, because the mechanisms summate.

Species	Family	Shared classes	Jaccard
Camellia sinensis Green Tea	Theaceae	3	0.25
Trachyspermum ammi Ajwain	Apiaceae	3	0.60
Kaempferia galanga Chandramula	Zingiberaceae	3	0.60
Gaultheria fragrantissima Wintergreen	Ericaceae	3	0.75
Salix alba White Willow	Salicaceae	3	0.75
Filipendula ulmaria Meadowsweet	Rosaceae	3	0.75

10 References and notes

Source column: Brien S et al. J Altern Complement Med 2006;12:981-93. PubMed 17212570

Brien S et al. J Altern Complement Med 2006

Brien S et al. J Altern Complement Med 2006 manual

12:981-93. PubMed 17212570

manual

BibTeX for all 2 records

@article{BrienSeta2006,
  title = {Brien S et al. J Altern Complement Med 2006},
  author = {Brien S et al.},
  journal = {J Altern Complement Med},
  year = {2006},
}

@article{anon,
  title = {12:981-93. PubMed 17212570},
}

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