Extract standardized to parthenolide, daily for prevention.
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Feverfew, known in Spanish as matricaria or partenio, is Tanacetum parthenium, a plant of the daisy family traditionally used in Europe for fever, headache, menstrual pain, and inflammatory disorders; it should not be confused with chamomile (also called Matricaria recutita in some texts); although both belong to the Asteraceae family, they are different plants with different pharmacological profiles and clinical applications that are not interchangeable.
The most studied active principle of feverfew is the sesquiterpene lactones, especially parthenolide, a compound with potent anti-inflammatory activity that inhibits the transcription factor NF-kB and the release of serotonin by platelets (a mechanism relevant to the pathogenesis of migraine); products standardized to 0.2-0.7 percent parthenolide are the ones that have shown reproducible clinical efficacy.
The indication with the best evidence is migraine prophylaxis: several randomized trials have shown modest but significant reductions in the monthly frequency of attacks (between 20 and 40 percent) with doses of 100-300 milligrams daily of standardized extract for 4-6 months; the effect is smaller than that of beta-blockers or topiramate (the first-line pharmacological options) but sufficient as a reasonable option for people who prefer nutritional interventions or who do not tolerate the pharmacological ones.
The Cochrane meta-analysis on feverfew in migraine concludes that the evidence is positive but modest, with a small effect size and methodological heterogeneity between studies; formulations combined with magnesium and riboflavin (other nutrients with evidence in migraine) appear to offer better results than feverfew alone, a multimodal strategy that many neurologists specializing in headache recommend.
In rheumatoid arthritis and inflammatory joint pain, the data are weaker, although some small studies have shown modest reductions in inflammatory markers; for menstrual pain, tradition uses it but modern clinical evidence is limited; in allergy and rhinitis, there are interesting preliminary data that are not yet consolidated.
The doses studied range from 50 to 300 milligrams daily of extract standardized to 0.2-0.7 percent parthenolide, divided into one or two doses with or without food; the preventive effect on migraine typically appears from the second month of continued use and requires at least 4-6 months to assess the full response.
Generally well tolerated; the most frequent adverse effects are: oral ulcers and canker sores (if fresh leaves are chewed, not with capsules), mild digestive discomfort, and occasionally allergic skin reactions in people sensitive to the Asteraceae family (chamomile, ragweed, chrysanthemum); people who take anticoagulants should use caution because of a theoretical antiplatelet effect (parthenolide modulates platelet aggregation); it is contraindicated in pregnancy (a uterotonic effect has been described) and breastfeeding, and caution is advised when stopping it abruptly after prolonged use because a withdrawal syndrome with headache, anxiety, and insomnia may appear.
Information, not medical advice. Scientific evidence reflects the quality of the studies.