Herbs & Botanicals · Herbs · Daisy-family leaf, with low-certainty evidence for preventing migraine and clear cautions for pregnancy, allergy and bleeding

Feverfew

Q: Does feverfew prevent migraine?

Possibly a little, but the evidence is low quality. The 2015 Cochrane review found that in the largest trial feverfew cut attacks by 1.9 a month and placebo by 1.3. Earlier trials were mixed, and a 2025 meta-analysis found fewer attacks but no clear effect on pain severity, nausea or vomiting. The 2012 US guideline rated one extract, MIG-99, as probably effective.

Q: What is MIG-99 and is it better than ordinary feverfew?

MIG-99 is a standardised CO2 extract of feverfew used in two trials. The first (147 people) found no overall benefit, with benefit only in a small subgroup with four or more attacks a month. The second (170 people) found a small gain over placebo. There has been no head-to-head test against ordinary leaf, so it is not known to be better.

Q: Can feverfew treat a migraine that has already started?

Only a pilot trial of an under-the-tongue feverfew and ginger product suggests it might: 32% were pain-free at two hours versus 16% on placebo, in 60 people. That is a combination product tested on very few people, and mouth numbness and nausea were reported.

Q: What is post-feverfew syndrome and can I stop suddenly?

It is the name for rebound symptoms after stopping feverfew following long use: headaches, poor sleep, nervousness, tension, tiredness and joint and muscle stiffness. In a 1985 trial of 17 long-term users, people switched to placebo had more headache, nausea and vomiting. How common it is and whether tapering helps has not been studied. Ask your doctor or pharmacist before stopping if you have used feverfew for a long time.

Q: Does feverfew cause mouth ulcers?

It can. Mouth ulcers and stomach upset were the most common side effects in trials according to Cochrane. A review reports mouth ulceration in 11% of a larger series of users, with swollen lips and tongue and loss of taste in some. NCCIH says chewing fresh leaves can irritate the mouth.

Q: Is feverfew safe in pregnancy or breastfeeding?

No. The EU herbal committee says safety has not been established, animal studies show signs of reproductive toxicity, and it does not recommend use in pregnancy or breastfeeding. NCCIH says not to take it in pregnancy because it may affect contractions of the womb. In rats, a high dose produced smaller fetuses and was toxic to cultured embryos. There are no human pregnancy studies.

Q: Can I take feverfew with blood thinners or before surgery?

Ask first. In test-tube studies feverfew extract and parthenolide reduce platelet clumping, and one woman had months of vaginal bleeding and abnormal clotting tests on feverfew capsules. No study of feverfew with warfarin or aspirin in people was found, and the EU monograph lists no interactions, so sources disagree. NCCIH advises stopping at least 2 weeks before scheduled surgery.

Q: Who should not use feverfew?

Anyone allergic to feverfew or other daisy-family plants (such as chamomile, ragweed, chrysanthemum or tansy), as the EU monograph states. Also not recommended in pregnancy, breastfeeding and under 18. People with bleeding problems, those on blood thinners and those about to have surgery should ask a doctor first.

Q: Is feverfew safe for children?

The EU herbal committee does not recommend it under 18 because of a lack of adequate data. No trial of feverfew alone in children was found; a review of supplements for children's migraine mentions only a mixed product containing feverfew.

Q: Does feverfew help arthritis?

Not in the one trial done. In 41 women with rheumatoid arthritis, six weeks of dried feverfew leaf did no better than placebo on pain, stiffness, grip or inflammation blood tests. Cell studies show anti-inflammatory activity, but that has not been confirmed in patients.

Tanacetum parthenium (L.) Sch.Bip. · also called Feverfew, featherfew, bachelor's buttons, altamisa and matricaria (Spanish), grande camomille (French), Mutterkraut (German), matricale (Italian), formerly Chrysanthemum parthenium

Feverfew is a small, strongly scented plant of the daisy family. Its leaf has been used for centuries for fevers and headaches, and it is the subject of trials for preventing migraine. Researchers have studied dried leaf, leaf extracts and a standardised CO2 extract, mostly in small trials.

General information, not medical advice. Last substantive update October 25, 2026 · Not medically reviewed. A named clinician has not signed off on this page. How this page is made

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About Feverfew

Feverfew (Tanacetum parthenium) is a daisy-family herb used for centuries for fevers and headaches. Its main studied use is preventing migraine, where reviews call the evidence low quality and the benefit small; a standardised extract (MIG-99) is rated low and plain leaf is mixed. The one arthritis trial found no benefit. The main safety points are rebound symptoms after stopping long use, mouth ulcers, allergy in people sensitive to the daisy family, not recommended in pregnancy, breastfeeding or under 18, and caution with blood thinners and before surgery. Ask a doctor or pharmacist about amounts.

What it is

Feverfew (Tanacetum parthenium) is a small, bushy, strongly scented perennial of the daisy family (Asteraceae), with yellow-green leaves and small daisy-like flowers. A review says it comes from the Balkan Peninsula and now grows in Europe, Asia, North America, Australia and North Africa. Older books and trials call it Chrysanthemum parthenium.

The name comes from the Latin for fever reducer. Medicines are made from the leaf and other above-ground parts, as dried powder, extracts, and in some products with other ingredients. Chamomile and tansy are relatives, and people allergic to daisy-family plants can react to feverfew.

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Traditional and current uses

A review says feverfew has been used by Greek and early European herbalists for fevers, migraine, arthritis, stomach aches, toothaches, insect bites and menstrual and labour problems. In 1980s Britain many people ate fresh leaves daily to prevent migraine, which led to the first controlled trials.

The EU herbal committee lists powdered feverfew herb as a traditional medicine for preventing migraine, to be used only after a doctor has ruled out serious causes. That listing rests on long use, not on proof from trials. NCCIH says there is little or no evidence for any use other than migraine.

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What is in it and how it works

The best-known compound is parthenolide, one of more than 30 sesquiterpene lactones in the plant. It is highest in leaves, flowering tops and seeds. Amounts vary a great deal between products, from none detected to over 1% of dry weight, and it breaks down during storage and with heat.

In the lab, parthenolide and feverfew extracts block inflammation signals, reduce the release of serotonin and clumping of blood platelets, and block some serotonin receptors in rat tissue. Parthenolide is also the main skin allergen. None of this has been shown to explain a benefit in people, and one trial could not find parthenolide in blood after oral tablets.

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What the research shows

Migraine prevention is the main studied use. The 2015 Cochrane review (six trials, 561 people) calls the evidence low quality. The newest large trial found a 0.6-attack-a-month gain over placebo; earlier results were mixed. A 2025 meta-analysis of nine trials reports a modest benefit for how many attacks, but not for pain severity, nausea or vomiting. Reviews written before 2005 were more positive.

For rheumatoid arthritis, the only controlled trial found no benefit. Skin, pain and cancer uses rest on lab or animal work, a developer-funded skin study and one early cancer safety trial. Many trials tested blends or a single branded extract, so results cannot be assumed for other feverfew products.

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At a glance

Traditional uses history, not proof

European folk medicine: a review says Greek and early European herbalists used it for fevers, migraine, arthritis, stomach aches, toothaches, insect bites and menstrual and labour problems.
1980s Britain: many people ate fresh leaves daily to prevent migraine, which prompted the first controlled trials.
European herbal medicine: the EU herbal committee lists powdered feverfew herb as a traditional medicine for preventing migraine after a doctor has excluded serious causes, based on long use only.

Studied for research

Preventing migraine attacks (leaf, and the extract MIG-99): low certainty; plain leaf alone: mixed
Feverfew inside multi-ingredient migraine supplements, early treatment of an attack, quality of life: very low
Migraine in children: insufficient evidence
Rheumatoid arthritis: evidence against a benefit (one small trial)
Skin redness (cosmetic extract): very low; pain and cancer (lab work only) and traditional uses: insufficient

Main compounds

Parthenolide: the best-known active compound, a strong skin allergen, varying from none to over 1% of dry weight between products
Other sesquiterpene lactones, such as costunolide and santamarine, listed in reviews
Camphor and other oil compounds, and flavonoids such as apigenin and luteolin

Common forms

Dried powdered leaf and capsules
Fresh leaves (eaten or chewed)
Alcoholic leaf extract
CO2 extract (MIG-99)
Under-the-tongue feverfew and ginger products
Creams with parthenolide-depleted extract

Research links: EU herbal monograph on feverfew herb, final Revision 1, 2020 (European Medicines Agency) · Original EU herbal monograph on feverfew herb, 2010 (European Medicines Agency) · Feverfew (NCCIH, US National Institutes of Health) · Feverfew for preventing migraine: Cochrane review 2015 (abstract) · Systematic review and meta-analysis of Tanacetum parthenium in migraine, 2025 (abstract) · Feverfew in rheumatoid arthritis: double-blind placebo-controlled trial (abstract) · Research Library · Genes & Biomarkers Library

The plant and its history

Accepted scientific name: Tanacetum parthenium (L.) Sch.Bip.
Naming authority: Sch.Bip. (Carl Heinrich Schultz Bipontinus) for the combination in Tanacetum; the species was first named by Linnaeus. GBIF: accepted species, name-match confidence 99 (usageKey 3118430). NCBI Taxonomy lists Tanacetum parthenium (L.) Sch.Bip., 1844 (taxid 127999). The EU monographs write the author as 'Schultz Bip.' or 'Schulz Bip.'; this is the same name.
Synonyms: Chrysanthemum parthenium (L.) Bernh.; Chamaemelum parthenium (L.) E.H.L.Krause; Leucanthemum parthenium (L.) Godr. & Gren.; Matricaria parthenium L.; Pyrethrum parthenium (L.) Sm.; Dendranthema parthenium (L.) Des Moul.; Matricaria eximia Voss; Matricaria odorata Lam.
Common names: Feverfew (English); Featherfew (English); Bachelor's buttons (English); Altamisa (Spanish); Matricaria (Spanish); Grande camomille (French); Matricaire (French); Mutterkraut (German); Matricale (Italian); Artemisia-dos-prados (Portuguese)
Botanical family: Asteraceae (the daisy, sunflower or aster family, also called Compositae; order Asterales, tribe Anthemideae). Relatives include chamomile, tansy, chrysanthemum, ragweed, sunflower, yarrow and echinacea. Allergy to one daisy-family plant can cross to others, which is why the EU lists hypersensitivity to Asteraceae as a contraindication.
Classification: Plantae > Tracheophyta > Magnoliopsida (dicots) > Asterales > Asteraceae > Tanacetum > Tanacetum parthenium
Native range: A review (Kashkooe 2024) says the species originates from the Balkan Peninsula and is now found in Asia, Europe, North America, Australia and North Africa. Not checked against a flora.
Habitat: A small, bushy, aromatic perennial 0.3 to 1 m tall (Kashkooe 2024). Habitat details beyond that were not retrieved.
What the plant looks like: Roots: Roots and rhizomes are mentioned in essential-oil studies but not described in the sources read.; Stems: Not described in detail in the sources read; the plant is bushy.; Leaves: Yellow-green, alternate, usually under 8 cm long, almost hairless and chrysanthemum-like (Kashkooe 2024).; Flowers: Yellow centres in compact flat-topped clusters about 2 cm across, blooming roughly July to October (Kashkooe 2024); the flowers smell strongly and bitterly and the plant resembles chamomile.; Fruit: Seeds are mentioned as high in parthenolide (Heptinstall 1992); fruit form not described in the sources read.
Cultivation: Not covered by the sources read, apart from plant-breeding work showing wide differences in parthenolide between seed sources (Cutlan 2000).
Harvest and processing: The EU monograph describes the herbal substance as powdered feverfew herb (aerial parts) that complies with the European Pharmacopoeia monograph 1516, given in solid oral forms. MIG-99 is a supercritical CO2 extract of feverfew (Pfaffenrath 2002). Parthenolide in powdered leaf falls during storage (Heptinstall 1992).
Look-alikes and adulterants: Name: Chamomile (Matricaria chamomilla); Note: Accepted species, Asteraceae (GBIF key 8370958). Flowers look similar and feverfew has been called wild chamomile (Kashkooe 2024). Different chemistry; both are daisy-family allergens.; Name: Common tansy (Tanacetum vulgare); Note: Accepted species, same genus (GBIF key 3118274). One patient allergic to feverfew also reacted to tansy on patch testing (Killoran 2007).; Name: Parthenium weed (Parthenium hysterophorus); Note: Accepted species, different genus (GBIF key 3086784), a weed that causes skin and airway allergy. Some reviews list it among feverfew's names in error; do not mix up the evidence.; Name: Oxeye daisy (Leucanthemum vulgare); Note: Accepted species (GBIF key 8848598). Feverfew was once placed in Leucanthemum (L. parthenium), so the names overlap in old texts. That the two look alike is general knowledge, not checked in the sources read.; Name: Scentless mayweed (Tripleurospermum inodorum) and pineapple weed (Matricaria discoidea); Note: Accepted species (GBIF keys 3104179 and 3103791), daisy-like weeds. That they can be confused with feverfew is general knowledge, not verified in the sources read.

Traditional use and history history, not clinical proof

Tradition or era	Documented use	Source
Greek and early European herbalists	Pareek and colleagues say feverfew has a long history of use in traditional and folk medicine, especially among Greek and early European herbalists, for fevers, migraine headaches, rheumatoid arthritis, stomach aches, toothaches, insect bites, infertility, and menstruation and labour problems.	p22096324
Origin of the name	Kashkooe and colleagues say the name feverfew comes from the Latin febrifugia, meaning fever reducer.	p39457613
Folk use for women's health	Pareek describes uses as an emmenagogue (to bring on periods), abortifacient and in difficult labour, and reports that the 'uterine stimulant effect' fits those folk uses; this is also why pregnant women are told to avoid it.	p22096324
1980s Britain: self-treatment with fresh leaves	A 1985 trial recruited 17 people who already ate fresh feverfew leaves daily to prevent migraine, which shows the herb was already a popular self-treatment by then.	p3929876
Standardised extract era (2002 to 2005)	Two trials tested MIG-99, a supercritical CO2 extract, because earlier products varied in parthenolide content.	p12230594
Cochrane reviews	Cochrane reviewed feverfew for migraine prevention; the 2004 version found the evidence insufficient and the 2015 update called it low-quality evidence with a small benefit in the largest trial.	p25892430
2012 US guideline	The American Academy of Neurology and American Headache Society guideline rated MIG-99 (feverfew extract) as probably effective for migraine prevention (Level B).	p22529203
Current regulatory status in the EU	The EU herbal committee lists powdered feverfew herb as a traditional herbal medicine for prevention of migraine after serious causes are excluded by a doctor; the monograph was first adopted in 2010 and revised in 2020. This is based on long-standing use, not on clinical proof.	s-ema-hmpc-feverfew-2020

Traditional use shows how a plant was used. It does not show that a supplement works or is safe today.

What is inside, and how it may work

What the plant contains and how those compounds act in cells and animals. Laboratory and animal mechanisms are not proven effects in people.

Main compounds

Compound	Family	Where it is concentrated	Activity studied	Level of evidence
Parthenolide PubChem 6473881	sesquiterpene lactone (germacranolide)	Leaves, flowering tops and seeds; low in stalks and roots 0.14% to 0.74% in US capsules (Nelson 2002); up to 1.68% of dry weight across 31 accessions (Cutlan 2000); 0.25 to 0.28% in the highest Mexican samples (Avula 2006); up to 85% of the plant's sesquiterpene lactones per a review.	The best-known active compound. A reactive molecule that binds proteins; blocks NF-kappa B inflammation signalling, reduces platelet secretion, and is a strong skin allergen. Falls during storage and with heat. ^{36 9 3 20 14 31 25}	Laboratory research
Costunolide PubChem 5281437	sesquiterpene lactone	Aerial parts Not quantified in the sources read.	Listed among feverfew's sesquiterpene lactones in a review. ²⁵	Laboratory research
Santamarine PubChem 188297	sesquiterpene lactone	Aerial parts Not quantified in the sources read.	Listed among feverfew's sesquiterpene lactones in a review. PubChem lists it as 'Santamarin'. ²⁵	Laboratory research
3beta-Hydroxyparthenolide PubChem 138911145	sesquiterpene lactone	Aerial parts Not quantified in the sources read.	Listed as a feverfew sesquiterpene lactone in a review. ²⁵	Laboratory research
Camphor PubChem 2537	monoterpene ketone (essential oil)	Aerial parts and roots (essential oil) 27% to 75% of the essential oil in studies summarised by a review; strongly variable.	Predominant component of feverfew oil. Monoterpenes released by the living plant have been tested for allergy; one woman's airborne dermatitis may have involved them. ^{25 40}	Laboratory research
Chrysanthenyl acetate PubChem 162747	monoterpene ester (essential oil)	Aerial parts and roots (essential oil) Not quantified in the sources read.	Another main oil component named in a review. ²⁵	Laboratory research
Apigenin PubChem 5280443	flavone (flavonoid)	Aerial parts Not quantified in the sources read.	Feverfew extracts containing apigenin had the highest affinity for the benzodiazepine site of GABA-A receptors in one in-vitro study cited by a review; not tested in people. ²⁵	Laboratory research
Luteolin PubChem 5280445	flavone (flavonoid)	Aerial parts Not quantified in the sources read.	Listed among flavonoids isolated from feverfew in a review. ²⁵	Laboratory research

Mechanisms, receptors and pathways

Target or pathway	Gene or receptor	What was found	Level
NF-kappa B inflammation signalling	NF-kappa B; IKK-beta kinase	Parthenolide inhibits NF-kappa B signalling and can directly inhibit IKK-beta in cells. A parthenolide-depleted extract did not block NF-kappa B in the same assay, showing that the effect needs parthenolide. ^{31 49}	Laboratory research
STAT signalling	STAT family	Parthenolide suppresses STAT signalling and, in cancer cells, triggers cell death through reactive oxygen species. ³¹	Laboratory research
Covalent protein binding	Thiol groups on proteins	Parthenolide is a covalently reactive compound. In platelets, adding thiol compounds such as cysteine prevented the effect of feverfew, and feverfew and parthenolide lowered platelet sulphydryl groups. ^{14 19}	Laboratory research
Platelet secretion and clumping	Platelet serotonin release; collagen interaction	Feverfew extracts and parthenolide reduced serotonin release from human platelets, aggregation, and platelet sticking to collagen in a dish. Parthenolide alone raised platelet production in cultured megakaryocytes through NF-kappa B inhibition. ^{18 15 29 45}	Laboratory research
Serotonin receptors	5-HT2A and 5-HT2B receptors; neuronal 5-HT release	Feverfew extract blocked these receptors and neuronally released 5-HT in rat tissue; the effect fell when the extract's parthenolide was degraded. ³³	Animal research
Inflammatory chemicals (eicosanoids)	5-lipoxygenase; cyclo-oxygenase products	Extracts inhibited thromboxane B2 and leukotriene B4 production by rat and human white blood cells at 5 to 50 micrograms per mL, including lactone-free dried leaf, so non-lactone compounds contribute. ^{48 5}	Laboratory research
Joint-lining cell growth	Synovial fibroblasts	Parthenolide slowed proliferation of rheumatoid arthritis joint-lining cells in a dish. ³⁷	Laboratory research
Drug-metabolising enzymes	CYP1A2, 2C8, 2C9, 2C19, 2D6, 3A4	Feverfew herb was among extracts that inhibited these enzymes in a test-tube screen; strength for feverfew is not given in the abstract. ⁵⁰	Laboratory research
Microtubule modification	alpha-tubulin detyrosination	Parthenolide interferes with detyrosination of alpha-tubulin, a change in the cell skeleton. ¹⁴	Laboratory research
Pain and swelling in animals	Not identified	Oral feverfew extract and injected parthenolide reduced pain behaviour and paw swelling in mice and rats. Naloxone did not reverse it. ²²	Animal research
Smooth muscle	Receptor-linked contraction	Fresh-leaf extracts with parthenolide irreversibly blocked rabbit aorta contraction, while extracts of dried commercial leaf without parthenolide caused contraction. ⁴	Laboratory research
GABA-A receptor (benzodiazepine site)	GABA-A	An ethanol extract of feverfew and apigenin-containing extracts bound the benzodiazepine site in vitro, as summarised in a review (original studies not read). ²⁵	Laboratory research

Absorption, metabolism and elimination

Absorption: In a human gut-cell model (Caco-2), parthenolide crossed the cell layer by passive diffusion and was predicted to be well absorbed. In patients with cancer, however, tablets giving up to 4 mg of parthenolide a day produced no detectable parthenolide in blood (limit 0.5 ng/mL). The two results disagree; the blood result is the more relevant but small and in cancer patients only. Absorption of MIG-99 or other compounds in feverfew was not found.
Distribution: No data on tissue distribution in people were found. LactMed (summary only) says no data exist on passage into breast milk.
Metabolism: Not studied in people in the sources read. Parthenolide is reactive with thiols and may be quickly bound or changed, which would be one explanation for undetectable blood levels; this is a suggestion, not a finding.
Elimination: No data found.
Bioavailability: Parthenolide was not detectable in blood after oral feverfew tablets in the one human study found (Curry 2004), so its oral bioavailability is unknown. Parthenolide is stable at pH 5 to 7 and degrades below pH 3 or above 7 in solution (Jin 2007), which may matter in the stomach.

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Isolated compounds versus whole extracts

Parthenolide is the best-known compound but not the only active one. In a white-blood-cell test, extract activity was about 1.7 times what parthenolide alone would explain (Brown 1997). Dried leaf without parthenolide still blocked thromboxane and leukotriene production (Sumner 1992). A parthenolide-depleted extract still reduced inflammation in mice and a skin model (Sur 2009) but could still cause patch-test reactions in feverfew-allergic people (Paulsen 2010). Fresh and dried leaf extracts had opposite effects on rabbit aorta (Barsby 1993). In migraine, the trial with an extract of about 0.5 mg parthenolide per capsule was negative (De Weerdt 1996) while the standardised CO2 extract MIG-99 was borderline positive, so 'whole' and 'standardised' products cannot be treated as interchangeable.

Nutritional composition

Feverfew is a medicinal and garden herb, not a nutritional food. No nutrient data were looked up. Some people ate fresh leaves daily in the trials of the 1980s (Johnson 1985), but fresh leaves are known to cause mouth sores.

12benefits and uses looked at

62studies and sources checked

Low certaintybest evidence rating found

12lab markers tracked in trials

1 mixed findings2 low certainty4 very low certainty4 not enough evidence1 evidence against

What was looked at

The 12 benefits and uses checked for Feverfew, each with how strong the evidence is. Tap one to open it.

Preventing migraine attacks: what the reviews concludeLow certainty
Dried or fresh feverfew leaf and leaf extract for migraine preventionMixed findings
MIG-99, a standardised CO2 feverfew extract, for migraine preventionLow certainty
Feverfew inside multi-ingredient supplements for migraine preventionVery low certainty
Treating a migraine attack early: under-the-tongue feverfew-ginger and feverfew-based aura productsVery low certainty
Quality of life and disability in women with chronic migraine (feverfew with acupuncture)Very low certainty
Migraine prevention in children and teenagersNot enough evidence
Rheumatoid arthritis: stiffness, pain and joint swellingEvidence against
Calming red, irritated skin (creams with parthenolide-free feverfew extract)Very low certainty
General pain and inflammation (animal and cell studies)Not enough evidence
Cancer (parthenolide in the lab and one early human safety trial)Not enough evidence
Other traditional uses with no human trials (fever, stomach ache, toothache, insect bites, menstrual problems)Not enough evidence

Lab markers tracked in the studies

Number of migraine attacks per monthPain intensity of attacksHow long attacks lastNausea and vomiting with attacksDays with migraine per monthResponders: at least 50% fewer attacksPain-free two hours after treating an attackMigraine disability and quality of lifeC-reactive protein (CRP) and sedimentation rate (ESR)Joint pain, stiffness, grip strength and joint indexSkin redness after a nicotinate challengeParthenolide in blood

What is Feverfew good for?

The main proposed uses and how strong the human evidence is for each. "Moderate" means good trials point the same way; "low" and "very low" mean small or inconsistent trials; "mixed" means results disagree; "insufficient" means too little to judge; "against" means the evidence points to no benefit.

Preventing migraine attacks: what the reviews sayLow certaintyThe 2015 Cochrane review rates the evidence low quality: in the largest trial feverfew cut attacks by 1.9 a month and placebo by 1.3, a gain of 0.6 attacks. A 2025 meta-analysis of nine trials reports a modest benefit for attack numbers but not for pain severity, nausea or vomiting, and its abstract leaves the units unclear. Older reviews were more positive. A 2012 US neurology guideline rated one extract (MIG-99) as probably effective. Plain leaf or leaf extract for migraine preventionMixed findingsTwo small old trials of dried leaf favoured feverfew, mostly in people already using it. A trial in people new to feverfew, using an extract with a low parthenolide content, found no benefit. A small 1985 trial also suggests that stopping after long use can bring rebound symptoms. MIG-99, a standardised CO2 extract, for migraine preventionLow certaintyOne trial of 147 people found no overall benefit and a benefit only in a small subgroup with four or more attacks a month. A second, of 170 people, found about 0.6 attacks a month fewer than placebo (borderline significance). Both trials come from the same research group and the funding is not stated in the abstracts. Feverfew inside multi-ingredient supplementsVery low certaintyThe only placebo-controlled trial of a feverfew, magnesium and riboflavin blend found no difference from a low-dose riboflavin placebo. Three open-label studies of other blends report fewer migraine days, but they had no placebo group and two have manufacturer-linked authors. Treating a migraine attack earlyVery low certaintyA pilot trial of 60 people found more were pain-free at two hours with an under-the-tongue feverfew and ginger product (32%) than with placebo (16%). A tiny pilot of a feverfew, 5-HTP and magnesium tablet reported shorter auras. Both are combinations tested on very few people. Quality of life in women with chronic migraineVery low certaintyIn one Brazilian trial of 69 women, feverfew with acupuncture scored better than either alone, with feverfew alone doing least. There was no placebo group. Migraine in children and teenagersNot enough evidenceNo trial of feverfew alone in children was found, and the EU herbal committee does not recommend it under 18. Rheumatoid arthritisEvidence againstThe one placebo-controlled trial (41 women, 6 weeks) found no benefit in pain, stiffness, grip or blood markers of inflammation. It was small and short, so it cannot rule out a small effect. Red, irritated skin (creams with parthenolide-free extract)Very low certaintyA cosmetic extract with parthenolide removed calmed inflammation in cells and mice and reduced redness in a short skin test in people, in work by the developer. Some feverfew-allergic patients still reacted to such creams. General pain and inflammation (animal and cell studies)Not enough evidenceFeverfew extract and parthenolide reduced pain behaviour and paw swelling in mice and rats, and block inflammatory signals in cells. No human trial tests general pain. Cancer (laboratory research on parthenolide)Not enough evidenceParthenolide kills some cancer cells in a dish. In the one human safety trial, feverfew tablets were well tolerated but no parthenolide could be found in the blood. Feverfew is not a cancer treatment. Other traditional uses (fever, stomach ache, toothache, insect bites, menstrual problems)Not enough evidenceThese are old folk uses. No human trial was found for any of them.

Benefits, one by one

Each card is a research question, not a promise. Tap a goal to filter. Open a card to see the studies, doses and limits.

Preventing migraine attacks: what the reviews conclude

Low certainty

Reviews of the trials give a cautious answer. The latest Cochrane review (2015) found low-quality evidence and a small gain of about half an attack a month over placebo in the biggest trial. A 2025 meta-analysis reports a modest benefit, and a 2012 US neurology guideline rated one standardised extract (MIG-99) as probably effective. Earlier trials of ordinary leaf gave mixed results.

10 studiesTrials used dried leaf capsules, an alcoholic leaf extract and a CO2 …

Studies, doses and limits

What the trials found

Cochrane 2015 (Wider): six trials, 561 people, not pooled. The newest and largest (n=218; MIG-99 extract) cut attacks from 4.8 to 2.9 a month on feverfew and from 4.8 to 3.5 on placebo, a 0.6-attack difference; no significant difference in pain intensity, duration, nausea or vomiting. Three older positive trials were small (17 to 60 people); two rigorous trials (n=50 and n=147) found no difference. The 2004 Cochrane version had concluded the evidence was insufficient. Nelaturi 2025 pooled nine placebo-controlled trials (899 people) and reported fewer attacks (IV -1.11, 95% CI -1.23 to -0.99) and shorter attacks, but no clear effect on pain severity or on nausea and vomiting; its abstract does not give units or which products were included. Lopresti 2020 called feverfew results mixed. The 2012 AAN/AHS guideline rated MIG-99 'probably effective' (Level B). Older reviews (Vogler 1998, Ernst and Pittler 2000) leaned positive; Saranitzky 2009 saw benefit in some subsets. NCCIH calls results inconsistent.

Results

Small average benefit on how many attacks, with the strongest-looking results coming from small older trials and one extract. No clear help for how bad attacks are or for nausea and vomiting.

Effect sizes as reported

Largest trial: 1.9 fewer attacks a month on MIG-99 versus 1.3 on placebo (0.6 difference; Cochrane 2015). Meta-analysis: frequency IV -1.11 (95% CI -1.23 to -0.99, I2 28%); duration IV -4.43 (95% CI -7.63 to -1.23, I2 98%); pain severity IV -0.63 (95% CI -1.48 to 0.21, not significant).

Why this rating

Cochrane rates the evidence as low quality: small trials, unclear or high risk of bias, different products and no pooling. The 2025 meta-analysis shows high heterogeneity for duration and severity and has bias concerns of its own. Older reviews reached more positive conclusions, so reviews do not fully agree.

Form and dose studied

Trials used dried leaf capsules, an alcoholic leaf extract and a CO2 extract (MIG-99). Products differ in parthenolide content, so results from one product cannot be assumed for another. Ask a doctor or pharmacist about amounts.

Who was studied

Adults with migraine, with or without aura. Most trials excluded or did not study children, pregnant women and people on blood thinners.

Limits

Few, small, short trials; mixed results; placebo response in migraine trials is large; the largest trials used one proprietary extract; most reviews read only trial summaries.

Why researchers looked

Migraine is common and disabling, and many people cannot tolerate or do not want daily prescription preventers. Feverfew has been used for headaches in Europe for centuries, so it was one of the first herbs tested in controlled trials.

Traditional use

The plant's English name comes from the Latin for 'fever reducer'. The EU herbal committee lists dried feverfew as a traditional medicine for preventing migraine (after a doctor has ruled out serious causes), based on long use rather than on proof from trials.

Proposed mechanism Preliminary mechanism

Parthenolide, the main active compound, blocks several inflammation pathways in cells, and feverfew extracts reduce platelet release of serotonin and block serotonin receptors in rat tissue. None of this has been shown to be how feverfew might work in a person with migraine.

A proposed mechanism does not show that the effect happens in people.

Mostly mild: stomach upset and mouth ulcers. Stopping long-term use may bring rebound symptoms. Not for pregnancy. See the safety tab.

^{54 44 35 28 21 46 12 52 62 58}

Dried or fresh feverfew leaf and leaf extract for migraine prevention

Mixed findings

Three older double-blind trials tested plain feverfew leaf or leaf extract. Two small ones were positive and one found nothing. The positive ones mostly enrolled people who already used feverfew and thought it helped.

5 studiesFreeze-dried leaf capsules (Johnson), one capsule a day of dried leav…

Studies, doses and limits

What the trials found

Johnson 1985 (n=17, long-term users): when 9 people were switched to placebo, headache, nausea and vomiting got worse, while the 8 who stayed on freeze-dried leaf capsules did not change. Murphy 1988 (n=72 started, 60 finished; crossover, 4 months each): dried leaf, one capsule a day, gave fewer and less severe attacks and less vomiting than placebo; attack length did not change. De Weerdt 1996 (n=50, people new to feverfew; alcoholic extract with 0.5 mg parthenolide per capsule, 9 months): same number of attacks as on placebo, and no preventive effect.

Results

Two small trials in feverfew users favoured the leaf; one in new users found no benefit.

Effect sizes as reported

Numbers not given in the abstracts of Johnson and Murphy. De Weerdt: no difference in attack numbers.

Why this rating

The trials disagree. The positive ones were small, enrolled people who already believed in feverfew, and the Johnson trial may mostly show what happens when long-term users stop (a withdrawal effect), not benefit in new users.

Form and dose studied

Freeze-dried leaf capsules (Johnson), one capsule a day of dried leaves (Murphy), and a dried alcoholic extract (De Weerdt). Parthenolide content is not given for the first two.

Who was studied

Adults with migraine; two of three trials in people already using feverfew.

Limits

Tiny trials from the 1980s and 1990s; crossover designs; funding not stated in the abstracts; no standard product.

Why researchers looked

In the 1980s many people in the UK were eating fresh feverfew leaves for migraine, and doctors tested whether it was more than a placebo effect.

Traditional use

Chewing a few fresh leaves daily was the popular home use in Britain. The EU monograph covers dried powdered herb in solid forms, not fresh leaves.

Proposed mechanism Laboratory research

Fresh leaves are rich in parthenolide; some commercial dried-leaf products contain little or none. In the lab, extracts with parthenolide blocked platelet secretion and white-cell enzymes, but dried leaf without parthenolide still blocked some inflammatory chemicals.

A proposed mechanism does not show that the effect happens in people.

No serious side effects in these trials. The Johnson trial suggests that stopping suddenly after long use can bring unpleasant effects.

^{24 34 10 20 48}

MIG-99, a standardised CO2 feverfew extract, for migraine prevention

Low certainty

MIG-99 is a lab-made extract with a set amount of the active compounds. In the larger of two trials it cut attacks by about half an attack a month more than placebo. The earlier dose-finding trial was negative overall and helped only a small subgroup who had four or more attacks a month.

4 studiesMIG-99 only: a proprietary supercritical CO2 extract. The results do …

Studies, doses and limits

What the trials found

Pfaffenrath 2002 (n=147, 12 weeks; three levels of MIG-99 versus placebo): no significant difference in the whole group and no dose-response. In a pre-planned subgroup with at least four attacks in the baseline month (n=49), attacks fell by 1.8 per 28 days on 6.25 mg three times a day versus 0.3 on placebo (p=0.02). Diener 2005 (n=170 analysed, 16 weeks, 6.25 mg three times a day): attacks fell by 1.9 a month on MIG-99 versus 1.3 on placebo from a baseline of 4.76 (p=0.0456); responder odds ratio 3.4 (p=0.0049); possibly treatment-related side effects 8.4% versus 10.2%. The 2012 AAN/AHS guideline rated MIG-99 as probably effective (Level B).

Results

A small, borderline-significant gain in one trial after a negative or subgroup-only first trial.

Effect sizes as reported

Diener 2005: difference of about 0.6 attacks a month; odds ratio 3.4 for being a responder. Pfaffenrath 2002 subgroup: -1.8 versus -0.3 attacks per 28 days.

Why this rating

Two trials from the same group and same extract, one negative overall, one barely significant, and the Cochrane authors rate the combined evidence low. Funding is not stated in the abstracts and was not checked. A repeat by an independent group is missing.

Form and dose studied

MIG-99 only: a proprietary supercritical CO2 extract. The results do not apply to other feverfew capsules or teas.

Who was studied

Adults with migraine, with or without aura, with several attacks a month.

Limits

Same extract and research group in both trials; subgroup result in the first trial; modest effect; funding not read.

Why researchers looked

Earlier leaf trials gave mixed results, partly because products varied. A standardised extract was made to test feverfew fairly.

Traditional use

MIG-99 is a modern extract, not a traditional preparation.

Proposed mechanism Preliminary mechanism

Supercritical CO2 extraction keeps parthenolide and other fat-soluble compounds. Parthenolide blocks NF-kappa B inflammation signalling in cells; whether that matters in migraine is not shown.

A proposed mechanism does not show that the effect happens in people.

Adverse event rates were similar to placebo in both trials.

^{43 11 21 54}

Feverfew inside multi-ingredient supplements for migraine prevention

Very low certainty

Several products combine feverfew with magnesium, riboflavin (vitamin B2), coenzyme Q10 or willow bark. The one placebo-controlled trial found no benefit over a low-dose vitamin B2 placebo. Open-label studies, with no placebo, report fewer migraine days, but they cannot show that feverfew did anything.

4 studiesDifferent branded combinations; feverfew amounts differed (about 100 …

Studies, doses and limits

What the trials found

Maizels 2004 (RCT, n=49 finishers): riboflavin 400 mg + magnesium 300 mg + feverfew 100 mg versus a 25 mg riboflavin 'placebo'; a 50% or greater drop in migraines in 42% versus 44% (P=.87); both groups improved. Guilbot 2017 (observational, n=68, feverfew + coenzyme Q10 + magnesium, 3 months): migraine days fell from 4.9 to 1.3 a month; the study team works for the maker. Vikelis 2020 (open-label, n=113, magnesium, B2, feverfew, Andrographis and coenzyme Q10): migraine days fell from 9.4 to 6.1; 56.6% responders. Shrivastava 2006 (open-label, n=12, feverfew + white willow bark): attack frequency down 61.7% at 12 weeks.

Results

The only controlled trial was null; the open-label studies are positive but uncontrolled.

Effect sizes as reported

Maizels: 42% versus 44% responders (P=.87). Open-label: migraine days 4.9 to 1.3 (Guilbot), 9.4 to 6.1 (Vikelis).

Why this rating

One null controlled trial and three uncontrolled studies, each with several ingredients. Placebo response in migraine is large, and the open-label studies cannot separate feverfew from the other ingredients or from natural variation. Two of the four studies have manufacturer-linked authors.

Form and dose studied

Different branded combinations; feverfew amounts differed (about 100 to 300 mg of feverfew inside the blend).

Who was studied

Adults with episodic migraine.

Limits

Combination products; no placebo in most studies; small; industry-linked in places.

Why researchers looked

Many supplements for migraine are blends, so the blends are what people actually buy and what companies test.

Proposed mechanism Pharmacological theory

Magnesium, riboflavin and coenzyme Q10 are proposed to support energy use in nerve cells; feverfew is proposed to act on inflammation. These are ideas, not shown mechanisms in migraine.

A proposed mechanism does not show that the effect happens in people.

No serious problems reported, but the studies were short.

^{30 16 51 47}

Treating a migraine attack early: under-the-tongue feverfew-ginger and feverfew-based aura products

Very low certainty

A pilot trial of an under-the-tongue feverfew and ginger product found more people pain-free at two hours than with placebo. A small pilot of a feverfew, 5-HTP and magnesium tablet reported shorter auras. Both are combinations tested on very few people.

3 studiesSublingual feverfew plus ginger (LipiGesic M, GelStat Migraine); a fe…

Studies, doses and limits

What the trials found

Cady 2011 (RCT, 60 people, 208 evaluable attacks, sublingual feverfew/ginger versus placebo 3:1): pain-free at 2 hours 32% versus 16% (P=.02); pain relief 63% versus 39% (P=.002); oral numbness and nausea were the most common side effects. Cady 2005 (open-label, 29 people, one attack): 48% pain-free at 2 hours; 29% recurrence within 24 hours. Volta 2019 (single-centre pilot, 50 people with aura): >50% shorter aura in 96% with the feverfew/5-HTP/magnesium tablet versus 14% with magnesium alone.

Results

Positive but small and uncontrolled or lightly controlled studies of three different combinations.

Effect sizes as reported

Cady 2011: 32% versus 16% pain-free at 2 hours. Volta: 96% versus 14% with a >50% shorter aura.

Why this rating

One small pilot randomised trial (only 15 people on placebo), an open-label study and a non-blinded comparison across attacks, all with combination products and no independent repeat.

Form and dose studied

Sublingual feverfew plus ginger (LipiGesic M, GelStat Migraine); a feverfew 150 mg + 5-HTP + magnesium tablet (Aurastop).

Who was studied

Adults with migraine who can recognise a mild-pain phase (Cady) or have aura (Volta).

Limits

Pilot trials; combinations; funding not stated in the abstracts.

Why researchers looked

Some people want something gentler than triptans for mild attacks.

Traditional use

Not a traditional use; these are modern products.

Proposed mechanism Pharmacological theory

Ginger is proposed to ease nausea and inflammation; feverfew is proposed to act on inflammation and serotonin. Not shown in people.

A proposed mechanism does not show that the effect happens in people.

Mouth numbness and nausea reported with the under-the-tongue product. Mouth irritation is a known feverfew issue.

^{7 6 53}

Quality of life and disability in women with chronic migraine (feverfew with acupuncture)

Very low certainty

In one Brazilian trial of 69 women, feverfew plus acupuncture gave better quality-of-life and pain scores than either one alone. There was no placebo group, so the result cannot be assigned to feverfew.

1 studiesFeverfew 150 mg a day (product details not in the abstract).

Studies, doses and limits

What the trials found

Ferro 2012 (RCT, 69 women with chronic migraine): feverfew 150 mg a day alone, acupuncture alone (20 sessions in 10 weeks) or both. The combination was better than either alone on SF-36 quality of life, MIDAS disability (-42.5 combined, -35.1 acupuncture, -24.8 feverfew) and pain score (-6.4, -5.6, -3.7; p<0.05).

Results

The combined group improved most. Feverfew alone improved least of the three.

Effect sizes as reported

MIDAS change: -42.5 (both), -35.1 (acupuncture), -24.8 (feverfew). Pain score: -6.4, -5.6, -3.7.

Why this rating

One small trial with no placebo or untreated group and no blinding mentioned in the abstract; feverfew alone had the smallest effect.

Form and dose studied

Feverfew 150 mg a day (product details not in the abstract).

Who was studied

Women with chronic migraine in Brazil.

Limits

No placebo; small; one country; abstract only.

Why researchers looked

Chronic migraine affects work and daily life, so researchers measured quality of life as well as attack counts.

Proposed mechanism Pharmacological theory

No mechanism was tested in this trial.

A proposed mechanism does not show that the effect happens in people.

Tolerability was part of the aim; details are not in the abstract.

¹³

Migraine prevention in children and teenagers

Not enough evidence

No trial of feverfew on its own in children was found. A review of supplements for pediatric migraine mentions only a mixed product with feverfew, vitamin D and ginkgolide B, and says no firm conclusion is possible. The EU herbal committee does not recommend feverfew under 18.

2 studiesNot established for children.

Studies, doses and limits

What the trials found

Yamanaka 2021 (narrative review) lists a feverfew-containing combination among eight supplements for pediatric migraine. Combinations showed positive potential, but the effect of each ingredient was not reported; evidence was low quality and limited. Riboflavin had the strongest evidence among the eight. The EU monograph does not recommend use under 18 because of lack of adequate data.

Results

Insufficient to judge.

Why this rating

No controlled trial of feverfew alone in children; only a mixed product in a narrative review.

Form and dose studied

Not established for children.

Who was studied

Children and teenagers.

Limits

No data for feverfew alone.

Why researchers looked

Parents look for gentler options for children's migraine.

Traditional use

Not established.

Proposed mechanism Pharmacological theory

Not studied in children.

A proposed mechanism does not show that the effect happens in people.

Not recommended under 18 in the EU.

^{55 58}

Rheumatoid arthritis: stiffness, pain and joint swelling

Evidence against

Feverfew has an old reputation for arthritis, but the one controlled trial in people with rheumatoid arthritis found no benefit over placebo after six weeks. Cell studies hint at anti-inflammatory activity, but that has not turned into proof in patients.

4 studiesDried chopped leaf in capsules; parthenolide content not stated.

Studies, doses and limits

What the trials found

Pattrick 1989 (RCT, 41 women with symptomatic rheumatoid arthritis; 20 per group analysed): 70 to 86 mg of dried chopped feverfew leaf a day versus placebo for six weeks. No important difference in stiffness, pain, grip strength, joint index, blood counts, ESR, CRP, rheumatoid factor, immunoglobulins or global opinions. The authors found no apparent benefit. No other controlled human trial for arthritis was found.

Results

No benefit in the single trial.

Effect sizes as reported

No difference between groups on any measure (numbers not in the abstract).

Why this rating

The one controlled trial found no effect. It was small, short and used one dried-leaf product of unknown parthenolide content, so it cannot rule out a small benefit, but there is no human evidence for one.

Form and dose studied

Dried chopped leaf in capsules; parthenolide content not stated.

Who was studied

Women with rheumatoid arthritis.

Limits

Small, 6 weeks, women only, a single product.

Why researchers looked

Folklore recommended feverfew for arthritis, and lab studies showed it blocks inflammatory chemicals, so a trial was run in 1989.

Traditional use

Reviews list rheumatoid arthritis among its traditional uses; NCCIH lists joint support among current promoted uses and says there is little or no evidence for conditions other than migraine.

Proposed mechanism Laboratory research

Feverfew extracts and parthenolide blocked inflammatory chemicals (thromboxane, leukotriene) in white blood cells, and parthenolide slowed the growth of joint-lining cells from people with rheumatoid arthritis in a dish. These are cell results only.

A proposed mechanism does not show that the effect happens in people.

Feverfew may slow blood clotting; see the safety tab before combining with arthritis drugs such as NSAIDs.

^{39 37 48 38}

Calming red, irritated skin (creams with parthenolide-free feverfew extract)

Very low certainty

A cosmetic extract with the parthenolide removed reduced inflammation markers in cells and mice and reduced redness in a short skin test in people. Because parthenolide is the main allergen, the idea is a gentler feverfew. But some feverfew-allergic people still reacted to such creams, so it is not allergy-proof.

5 studiesCosmetic extract with parthenolide removed (not the same as whole fev…

Studies, doses and limits

What the trials found

Sur 2009 (lab, mouse and human skin model; written by Johnson & Johnson staff): the extract reduced dermatitis in mice and reduced redness in a methyl nicotinate skin test in people; the abstract gives no numbers. Paulsen 2010 (7 feverfew-allergic patients patch-tested): 4 reacted to one of two creams containing the depleted extract, along with parthenolide; no parthenolide was left in that cream when tested later. Killoran 2007 (two women): flares of Compositae-family dermatitis after a feverfew moisturizer.

Results

Lab and short model results are positive; real-world skin use can still cause allergy.

Effect sizes as reported

Not given in the Sur abstract. Paulsen: 4 of 7 allergic patients reacted.

Why this rating

Industry-linked lab and mouse work plus a short skin model in people; no trial in people with a skin condition; allergy reports pull the other way.

Form and dose studied

Cosmetic extract with parthenolide removed (not the same as whole feverfew).

Who was studied

Healthy volunteers in the skin model.

Limits

Funding by the product developer; no disease trial; abstract has no numbers.

Why researchers looked

Parthenolide causes skin allergy, so cosmetic companies tried to keep the soothing parts and remove it.

Traditional use

Topical use for skin irritation and insect bites is listed among traditional and promoted uses (Pareek; NCCIH).

Proposed mechanism Laboratory research

The parthenolide-free extract blocked 5-lipoxygenase and phosphodiesterase enzymes and the release of nitric oxide, PGE2 and TNF-alpha from immune cells in the lab.

A proposed mechanism does not show that the effect happens in people.

Feverfew is a known cause of contact allergy; people allergic to daisy-family plants should avoid it on skin too.

^{49 41 27 62 38}

General pain and inflammation (animal and cell studies)

Not enough evidence

In mice and rats, feverfew extract and parthenolide reduced pain behaviour and paw swelling. Cell studies show it blocks several inflammatory switches. No human trial tests feverfew for general pain.

5 studiesNot applicable to people.

Studies, doses and limits

Results

Animal and cell effects only.

Effect sizes as reported

Dose-dependent effects in animals; no human numbers.

Why this rating

Only animal and cell studies; no human trial.

Who was studied

Mice and rats; cells.

Limits

Animal doses cannot be converted to a human dose from these abstracts.

Why researchers looked

Feverfew's old uses (fevers, aches, toothache) suggested pain-relieving and anti-inflammatory activity.

Traditional use

Pareek lists traditional use for fevers and toothaches.

Proposed mechanism Animal research

Parthenolide reacts with proteins and blocks NF-kappa B and STAT signalling and the IKK-beta kinase; extracts also block 5-lipoxygenase and cyclo-oxygenase products. Naloxone did not reverse the pain effect in mice, so it is not opioid-like.

A proposed mechanism does not show that the effect happens in people.

The same blood-thinning-type action in the lab is why bleeding cautions exist.

^{22 31 14 48 5}

Cancer (parthenolide in the lab and one early human safety trial)

Not enough evidence

Parthenolide kills some cancer cells in a dish and in animals, and is the starting point for experimental drugs. In the only human trial found, feverfew tablets were safe but parthenolide could not be detected in the blood, so it is not known to reach tumours. Feverfew is not a cancer treatment.

4 studiesNot applicable.

Studies, doses and limits

What the trials found

Curry 2004 (phase I, patients with cancer): feverfew tablets giving 1 to 4 mg parthenolide a day for 28-day cycles; no significant toxicity and no maximum tolerated dose reached, but no parthenolide detectable in blood (limit 0.5 ng/mL). Caco-2 cell work (Khan 2003) suggested good absorption through gut cells, which the human trial did not confirm.

Results

Safe at that dose, no detectable blood levels, no cancer response reported in the abstract.

Why this rating

Only cell studies and a small phase I safety trial; no test of benefit in patients.

Who was studied

Patients with cancer in the phase I trial.

Limits

Phase I trials test safety and blood levels, not benefit.

Why researchers looked

Parthenolide targets cancer stem cells in the lab, which is attractive to drug developers.

Traditional use

Not a traditional use.

Proposed mechanism Laboratory research

Parthenolide blocks NF-kappa B and STAT signalling, causes oxidative stress that triggers cell death in tumour cells and affects microtubules. These findings are from cells.

A proposed mechanism does not show that the effect happens in people.

Do not use feverfew in place of cancer treatment. Tell your cancer team about any supplement.

^{8 26 31 14}

Other traditional uses with no human trials (fever, stomach ache, toothache, insect bites, menstrual problems)

Not enough evidence

Feverfew has been used for many other problems, but none of them has been tested in a human trial found for this page. They are listed so readers know they are tradition, not proven uses.

2 studiesNot applicable.

Studies, doses and limits

What the trials found

No human trial found for any of these uses. NCCIH says there is little or no evidence for conditions other than migraine.

Why this rating

No human studies; tradition only.

Limits

Traditional claims, not tested.

Why researchers looked

Reviews list these uses from folk medicine. Feverfew's English name comes from a Latin word for fever reducer.

Traditional use

Pareek 2011 lists fevers, stomach aches, toothaches, insect bites, infertility, and menstruation and labour problems, plus psoriasis, allergies, asthma, tinnitus, dizziness, nausea and vomiting. NCCIH adds respiratory, kidney and liver problems and anaemia. Pareek describes it as an emmenagogue (a herb used to bring on menstruation), which is one reason it is avoided in pregnancy.

Proposed mechanism Pharmacological theory

Not tested for these uses.

A proposed mechanism does not show that the effect happens in people.

Use to bring on a period or in pregnancy is unsafe; see the safety tab.

^{38 62}

Connections to the rest of health

How Feverfew connects to the rest of our health knowledge graph. Every link says what kind of connection it is. A safety link (for example to the liver) is a warning, not a benefit. A study that merely mentions a topic never creates a benefit link.

Explore every connection: goals, body systems, organs, symptoms, genes

Kind of connection Connected to Search

A. Wellness goals

Connected to	Kind of connection	Evidence status	Context	Studies
Brain Health	Potential benefit	Low certainty	Preventing migraine attacks: what the reviews conclude: Reviews of the trials give a cautious answer. The latest Cochrane review (2015) found low-quality evidence and a small gain of about half an attack a month over placebo in the biggest trial. A 2025 meta-analysis reports a modest benefit, and a 2012 US neurology guideline rated one standardised extract (MIG-99) as probably effective. Earlier trials of ordinary leaf gave mixed results. Dried or fresh feverfew leaf and leaf extract for migraine prevention: Three older double-blind trials tested plain feverfew leaf or leaf extract. Two small ones were positive and one found nothing. The positive ones mostly enrolled people who already used feverfew and thought it helped.	^{54 44 35 28 21 46 12 52 62 58 24 34 10 20 48 43 11 30 16 51 47 7 6 53 13 55}
Inflammation Balance	Potential benefit	Low certainty	Preventing migraine attacks: what the reviews conclude: Reviews of the trials give a cautious answer. The latest Cochrane review (2015) found low-quality evidence and a small gain of about half an attack a month over placebo in the biggest trial. A 2025 meta-analysis reports a modest benefit, and a 2012 US neurology guideline rated one standardised extract (MIG-99) as probably effective. Earlier trials of ordinary leaf gave mixed results.	^{54 44 35 28 21 46 12 52 62 58}
Resilience Support	Potential benefit	Very low certainty	Quality of life and disability in women with chronic migraine (feverfew with acupuncture): In one Brazilian trial of 69 women, feverfew plus acupuncture gave better quality-of-life and pain scores than either one alone. There was no placebo group, so the result cannot be assigned to feverfew.	¹³
Joint Support	Traditional use	Evidence against	Rheumatoid arthritis: stiffness, pain and joint swelling: Feverfew has an old reputation for arthritis, but the one controlled trial in people with rheumatoid arthritis found no benefit over placebo after six weeks. Cell studies hint at anti-inflammatory activity, but that has not turned into proof in patients.	^{39 37 48 38}
Inflammation Balance	Traditional use	Evidence against	Rheumatoid arthritis: stiffness, pain and joint swelling: Feverfew has an old reputation for arthritis, but the one controlled trial in people with rheumatoid arthritis found no benefit over placebo after six weeks. Cell studies hint at anti-inflammatory activity, but that has not turned into proof in patients.	^{39 37 48 38}
Healthy Skin	Preliminary mechanism	Very low certainty	Calming red, irritated skin (creams with parthenolide-free feverfew extract): A cosmetic extract with the parthenolide removed reduced inflammation markers in cells and mice and reduced redness in a short skin test in people. Because parthenolide is the main allergen, the idea is a gentler feverfew. But some feverfew-allergic people still reacted to such creams, so it is not allergy-proof.	^{49 41 27 62 38}
Inflammation Balance	Preliminary mechanism	Very low certainty	Calming red, irritated skin (creams with parthenolide-free feverfew extract): A cosmetic extract with the parthenolide removed reduced inflammation markers in cells and mice and reduced redness in a short skin test in people. Because parthenolide is the main allergen, the idea is a gentler feverfew. But some feverfew-allergic people still reacted to such creams, so it is not allergy-proof. General pain and inflammation (animal and cell studies): In mice and rats, feverfew extract and parthenolide reduced pain behaviour and paw swelling. Cell studies show it blocks several inflammatory switches. No human trial tests feverfew for general pain.	^{49 41 27 62 38 22 31 14 48 5}
Joint Support	Preliminary mechanism	Not enough evidence	General pain and inflammation (animal and cell studies): In mice and rats, feverfew extract and parthenolide reduced pain behaviour and paw swelling. Cell studies show it blocks several inflammatory switches. No human trial tests feverfew for general pain.	^{22 31 14 48 5}
Healthy Aging	Preliminary mechanism	Not enough evidence	Cancer (parthenolide in the lab and one early human safety trial): Parthenolide kills some cancer cells in a dish and in animals, and is the starting point for experimental drugs. In the only human trial found, feverfew tablets were safe but parthenolide could not be detected in the blood, so it is not known to reach tumours. Feverfew is not a cancer treatment.	^{8 26 31 14}
Digestive Support	Traditional use	Not enough evidence	Other traditional uses with no human trials (fever, stomach ache, toothache, insect bites, menstrual problems): Feverfew has been used for many other problems, but none of them has been tested in a human trial found for this page. They are listed so readers know they are tradition, not proven uses.	^{38 62}
Womens Wellness	Traditional use	Not enough evidence	Other traditional uses with no human trials (fever, stomach ache, toothache, insect bites, menstrual problems): Feverfew has been used for many other problems, but none of them has been tested in a human trial found for this page. They are listed so readers know they are tradition, not proven uses.	^{38 62}

B. Body systems

Connected to	Kind of connection	Evidence status	Context	Studies
Nervous system (migraine)	Potential benefit	Low certainty	Small reduction in migraine attacks in the biggest trial; Cochrane: low-quality evidence. Preparation or compound: Feverfew leaf; MIG-99 CO2 extract	^{54 11 35}
Blood and clotting	Drug or supplement interaction	Very low certainty	Lab antiplatelet action, one bleeding case, theoretical interaction with anticoagulants and aspirin. Preparation or compound: Feverfew extract; parthenolide	^{18 2 17}
Reproductive system and pregnancy	Contraindication	Low certainty	Not recommended in pregnancy and breastfeeding (EU); rat embryo toxicity; traditional emmenagogue. Preparation or compound: Feverfew herb	^{58 56 62}
Mouth and digestive tract	Adverse effect or risk	Moderate certainty	Mouth ulcers and stomach upset were the commonest side effects in trials and reviews. Preparation or compound: Fresh leaf; dried leaf capsules	^{54 38 58}
Skin	Adverse effect or risk	Low certainty	Strong contact allergen, including reactions to parthenolide-depleted creams. Preparation or compound: Parthenolide; feverfew creams	^{41 27 40}
Liver	Adverse effect or risk	Not enough evidence	No liver injury reports found; LiverTox not read. Preparation or compound: Feverfew	¹¹
Nervous System	Biological association	Low certainty	Studied for: Preventing migraine attacks: what the reviews conclude Studied for: Dried or fresh feverfew leaf and leaf extract for migraine prevention	^{54 44 35 28 21 46 12 52 62 58 24 34 10 20 48 43 11 30 16 51 47 7 6 53 13 55 22 31 14 5}
Musculoskeletal System	Biological association	Evidence against	Studied for: Rheumatoid arthritis: stiffness, pain and joint swelling	^{39 37 48 38}
Immune System	Biological association	Evidence against	Studied for: Rheumatoid arthritis: stiffness, pain and joint swelling Studied for: General pain and inflammation (animal and cell studies)	^{39 37 48 38 22 31 14 5 8 26}
Integumentary System	Biological association	Very low certainty	Studied for: Calming red, irritated skin (creams with parthenolide-free feverfew extract)	^{49 41 27 62 38}
Digestive System	Biological association	Not enough evidence	Studied for: Other traditional uses with no human trials (fever, stomach ache, toothache, insect bites, menstrual problems)	^{38 62}
Reproductive System	Biological association	Not enough evidence	Studied for: Other traditional uses with no human trials (fever, stomach ache, toothache, insect bites, menstrual problems)	^{38 62}

E. Health conditions

Connected to	Kind of connection	Evidence status	Context	Studies
Allergy to the daisy family (Asteraceae)	Contraindication	Authoritative guidance	EU contraindication; cross-reactions among Compositae plants. Preparation or compound: Feverfew herb	^{58 42}
Post-feverfew syndrome (rebound after stopping)	Adverse effect or risk	Low certainty	Rebound headache, poor sleep, joint stiffness after stopping in long-term users. Preparation or compound: Feverfew leaf	^{24 38}

I. Biomarkers

Connected to	Kind of connection	Evidence status	Context	Studies
Number of migraine attacks per month	Biological association	Low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	^{11 43 35 10 54}
Pain intensity of attacks	Biological association	Low certainty	Measured in trials: no-change. A lab change is not the same as a health benefit.	^{35 54}
How long attacks last	Biological association	Very low certainty	Measured in trials: mixed. A lab change is not the same as a health benefit.	^{35 34 54}
Nausea and vomiting with attacks	Biological association	Low certainty	Measured in trials: mixed. A lab change is not the same as a health benefit.	^{34 35 54}
Days with migraine per month	Biological association	Very low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	^{16 51}
Responders: at least 50% fewer attacks	Biological association	Low certainty	Measured in trials: mixed. A lab change is not the same as a health benefit.	^{30 11}
Pain-free two hours after treating an attack	Biological association	Very low certainty	Measured in trials: raised. A lab change is not the same as a health benefit.	^{7 6}
Migraine disability and quality of life	Biological association	Very low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	¹³
C-reactive protein (CRP) and sedimentation rate (ESR)	Biological association	Low certainty	Measured in trials: no-change. A lab change is not the same as a health benefit.	³⁹
Joint pain, stiffness, grip strength and joint index	Biological association	Low certainty	Measured in trials: no-change. A lab change is not the same as a health benefit.	³⁹
Skin redness after a nicotinate challenge	Biological association	Very low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	^{49 41}
Parthenolide in blood	Biological association	Low certainty	Measured in trials: no-change. A lab change is not the same as a health benefit.	^{8 26}

J. Genes, receptors and enzymes

Connected to	Kind of connection	Evidence status	Context	Studies
IKK-beta kinase	Preliminary mechanism	In vitro	Directly inhibited by parthenolide in cells.	³¹
STAT family (signal transducers)	Preliminary mechanism	In vitro	Suppressed by parthenolide in cells and cancer-cell models.	^{31 14}
5-HT2A and 5-HT2B serotonin receptors	Preliminary mechanism	Animal	Blocked by feverfew extract in rat tissue.	³³
5-lipoxygenase and cyclo-oxygenase pathways	Preliminary mechanism	In vitro	Feverfew extracts reduced thromboxane and leukotriene output in white blood cells.	⁴⁸
Cytochrome P450 enzymes (CYP1A2, 2C8, 2C9, 2C19, 2D6, 3A4)	Preliminary mechanism	In vitro	Inhibited by feverfew herb in a test-tube screen.	⁵⁰
GABA-A receptor, benzodiazepine site	Preliminary mechanism	In vitro	Binding by ethanol extract and apigenin-containing extracts in vitro, via a review.	²⁵

K. Biological pathways

Connected to	Kind of connection	Evidence status	Context	Studies
NF-kappa B signalling	Preliminary mechanism	In vitro	Main lab target of parthenolide; reduces inflammatory gene switching in cells. Not shown to explain any effect in people.	^{31 49 45}
Alpha-tubulin (detyrosination)	Preliminary mechanism	In vitro	Parthenolide interferes with this change to the cell skeleton.	¹⁴
Platelets and megakaryocytes	Preliminary mechanism	In vitro	Reduced platelet secretion and aggregation in a dish; parthenolide increased platelet production from megakaryocytes in cell culture.	^{18 45}

L. Active compounds

Connected to	Kind of connection	Evidence status	Context	Studies
Parthenolide	Biological association	In vitro	The best-known active compound. A reactive molecule that binds proteins; blocks NF-kappa B inflammation signalling, reduces platelet secretion, and is a strong skin allergen. Falls during storage and with heat. Preparation or compound: Leaves, flowering tops and seeds; low in stalks and roots	^{36 9 3 20 14 31 25}
Costunolide	Biological association	In vitro	Listed among feverfew's sesquiterpene lactones in a review. Preparation or compound: Aerial parts	²⁵
Santamarine	Biological association	In vitro	Listed among feverfew's sesquiterpene lactones in a review. PubChem lists it as 'Santamarin'. Preparation or compound: Aerial parts	²⁵
3beta-Hydroxyparthenolide	Biological association	In vitro	Listed as a feverfew sesquiterpene lactone in a review. Preparation or compound: Aerial parts	²⁵
Camphor	Biological association	In vitro	Predominant component of feverfew oil. Monoterpenes released by the living plant have been tested for allergy; one woman's airborne dermatitis may have involved them. Preparation or compound: Aerial parts and roots (essential oil)	^{25 40}
Chrysanthenyl acetate	Biological association	In vitro	Another main oil component named in a review. Preparation or compound: Aerial parts and roots (essential oil)	²⁵
Apigenin	Biological association	In vitro	Feverfew extracts containing apigenin had the highest affinity for the benzodiazepine site of GABA-A receptors in one in-vitro study cited by a review; not tested in people. Preparation or compound: Aerial parts	²⁵
Luteolin	Biological association	In vitro	Listed among flavonoids isolated from feverfew in a review. Preparation or compound: Aerial parts	²⁵

Each connection is stored with the ingredient, the connected record, the kind of connection, the evidence status, the supporting studies, the preparation or compound involved, and a review date (last reviewed October 25, 2026).

Evidence at a glance: what changed in 12 lab markers

Tap a number to show only those markers. Counts are markers, not people.

Inflammatory1 Other4133

The evidence

The research centre for Feverfew. Every record here was checked against PubMed or the publisher's page; we never list a study we have not verified.

Evidence by outcome

Preventing migraine attacks: what the reviews conclude 10 studies Low certainty Dried or fresh feverfew leaf and leaf extract for migraine prevention 5 studies · 139 people in trials Mixed findings MIG-99, a standardised CO2 feverfew extract, for migraine prevention 4 studies · 317 people in trials Low certainty Feverfew inside multi-ingredient supplements for migraine prevention 4 studies · 49 people in trials Very low certainty Treating a migraine attack early: under-the-tongue feverfew-ginger and feverfew-based aura products 3 studies · 60 people in trials Very low certainty Quality of life and disability in women with chronic migraine (feverfew with acupuncture) 1 study · 69 people in trials Very low certainty Migraine prevention in children and teenagers 2 studies Not enough evidence Rheumatoid arthritis: stiffness, pain and joint swelling 4 studies · 41 people in trials Evidence against Calming red, irritated skin (creams with parthenolide-free feverfew extract) 5 studies · 7 people in trials Very low certainty General pain and inflammation (animal and cell studies) 5 studies Not enough evidence Cancer (parthenolide in the lab and one early human safety trial) 4 studies Not enough evidence Other traditional uses with no human trials (fever, stomach ache, toothache, insect bites, menstrual problems) 2 studies Not enough evidence

Bars show how many studies we found for each outcome, not how well it works. People are added up across trials only (reviews are not added, to avoid double counting).

How we rate evidence

High certainty

Several well-run trials or reviews agree; further research is unlikely to change the picture much.

Moderate certainty

Good trials point the same way, but some doubt remains.

Low certainty

Small, short or inconsistent trials. The finding could change with better research.

Very low certainty

Very little or very weak human data. Treat as a possibility only.

Mixed findings

Trials or reviews disagree with each other.

Not enough evidence

Not enough human research to say either way.

Evidence against

Good research found no benefit, or found harm.

We take the reviewers' own risk-of-bias and GRADE statements where they exist, and otherwise judge from study size, design, consistency, directness and whether a product matches what is sold. Many publications do not make evidence high. Method note: We searched PubMed, read the abstracts of the studies cited, read both versions of the EU herbal monograph on feverfew (2010 and the 2020 revision) and two open-access reviews and a case report in full, and checked the plant name and chemical IDs against GBIF, NCBI and PubChem. The NCCIH page was read through a summary tool; the LiverTox and LactMed entries could not be opened and are not quoted as facts.

Study library: every study we checked 62

Design Research type Plant part Year from Search

Study	Design	People	Product, dose, length	Result
Abebe 2002 Herbal medication: potential for adverse interactions with analgesic drugs. J Clin Pharm Ther · PMID 12472978 · DOI	Narrative review theoretical	Review of herbs and pain-relief drugs	Herbs with antiplatelet activity including feverfew varied	NSAIDs, particularly aspirin, may interact with herbs known to have antiplatelet activity, including feverfew, increasing bleeding risk. Most of the information is from case reports, animal studies and in-vitro data. Not applicable (not applicable) Methods, limits and funding Outcomes: Possible interactions with aspirin and NSAIDs Limitations: Theoretical interaction; no feverfew case reported in the abstract. Funding and conflicts: Not stated in the abstract Read: abstract
Alenzi 2021 Alteration of Coagulation Test Results and Vaginal Bleeding Associated With the Use of Feverfew (Tanacetum parthenium). J Med Cases · PMID 34434419 · DOI	Case report	1 A 36-year-old woman with migraine who had taken feverfew capsules for 9 months and had 3 months of vaginal bleeding, a long menstrual cycle and reddish skin	Feverfew 800 mg capsules, two to three times a day (the report is not consistent) 800 mg capsules, two to three times a day 9 months	Other causes of bleeding were excluded. Full text reports a low haemoglobin (10 g/dL), prolonged PT (27.3 s) and PTT (42 s). The Naranjo scale indicated a probable link between feverfew and the bleeding. The authors advise caution in people having elective surgery, with clotting disorders or taking antithrombotic drugs. Probable causal link (Naranjo) (not applicable) Methods, limits and funding Outcomes: Bleeding, clotting tests, Naranjo causality score Limitations: One case; the product was not tested for contents, the capsule amounts are very large and inconsistent in the report, and the outcome after stopping is not clear. Funding and conflicts: No conflict declared Read: full-text
Avula 2006 Quantification of parthenolide in Tanacetum species by LC-UV/LC-MS and microscopic comparison of Mexican/US feverfew samples. Pharmazie · PMID 16889065	Lab analysis product analysis	Mexican and US feverfew plant samples and commercial products	Feverfew samples aerial parts	Parthenolide was found in all samples analysed and is the major constituent. Samples from Oaxaca (0.28%) and Puebla (0.25%), Mexico, had the highest levels. 0.25% to 0.28% in the highest samples (not applicable) Methods, limits and funding Outcomes: Parthenolide content by LC-UV and LC-MS Limitations: Does not give the range in commercial products; abstract only. Funding and conflicts: Not stated in the abstract Read: abstract
Barsby 1993 Feverfew and vascular smooth muscle: extracts from fresh and dried plants show opposing pharmacological profiles, dependent upon sesquiterpene lactone content. Planta Med · PMID 8441776 · DOI	Laboratory research in-vitro	Rabbit aorta rings and rat muscle tissue	Extracts of fresh feverfew leaves versus commercial dried powdered leaves fresh leaf vs dried leaf	Fresh-leaf extracts, rich in parthenolide and related lactones, irreversibly blocked muscle contraction (the authors suggest a toxic effect), while extracts of commercial dried leaf contained no parthenolide by HPLC and instead caused strong contractions. The authors say the clinical profiles and side effects of preparations from the two sources need comparison. Opposite effects of fresh and dried extracts (not applicable) Methods, limits and funding Outcomes: Muscle response Limitations: Animal tissue in a dish; shows that products differ, not what happens in people. Funding and conflicts: Not stated in the abstract Read: abstract
Brown 1997 Pharmacological activity of feverfew (Tanacetum parthenium (L.) Schultz-Bip.): assessment by inhibition of human polymorphonuclear leukocyte chemiluminescence in-vitro. J Pharm Pharmacol · PMID 9178194 · DOI	Laboratory research in-vitro	Human white blood cells in a dish	Feverfew leaf extracts made with different solvents leaf	Parthenolide content of extracts tracked their activity, but activity was higher than parthenolide alone would explain, so the authors say parthenolide is a key but not the only active compound. Activity roughly 1.7 times that expected from parthenolide (not applicable) Methods, limits and funding Outcomes: Oxidative burst of white blood cells Limitations: Lab study. Funding and conflicts: Not stated in the abstract Read: abstract
Cady 2005 Gelstat Migraine (sublingually administered feverfew and ginger compound) for acute treatment of migraine when administered during the mild pain phase. Med Sci Monit · PMID 16127373	Open label study	29 29 evaluable people with migraine, 2 to 8 migraines a month, who treated one attack in the mild-pain phase	GelStat Migraine, sublingual feverfew plus ginger one attack treated single attack	48% were pain-free at 2 hours and 34% had only mild pain; 29% had a recurrence within 24 hours. Side effects were minimal. 48% pain-free at 2 hours (not given) Methods, limits and funding Outcomes: Pain-free at 2 hours; recurrence within 24 hours Limitations: Open-label with no control group, so it cannot separate the product from placebo or natural improvement; combination with ginger. Funding and conflicts: Not stated in the abstract Read: abstract
Cady 2011 A double-blind placebo-controlled pilot study of sublingual feverfew and ginger (LipiGesic M) in the treatment of migraine. Headache · PMID 21631494 · DOI	Controlled trial	60 60 adults with 2 to 6 migraine attacks a month who could recognise a mild-pain phase; 208 evaluable attacks over one month	Sublingual (under the tongue) feverfew plus ginger product (LipiGesic M) versus placebo, randomised 3:1 taken at the first sign of migraine (dose not stated in the abstract) one month · vs matching sublingual placebo	At 2 hours 32% on feverfew/ginger were pain-free versus 16% on placebo (P=.02); 63% had pain relief versus 39% (P=.002). Oral numbness and nausea were the most frequent side effects. 32% versus 16% pain-free at 2 hours (not given) Methods, limits and funding Outcomes: Pain-free and pain relief at 2 hours Limitations: Pilot study, only 15 people in the placebo group; combination of feverfew with ginger; treats attacks, not prevention. Funding and conflicts: Not stated in the abstract Read: abstract
Curry EA 3rd 2004 Phase I dose escalation trial of feverfew with standardized doses of parthenolide in patients with cancer. Invest New Drugs · PMID 15122077 · DOI	Phase 1 trial	Patients with cancer (number not stated in the abstract)	Feverfew tablet (Tanacet) giving 1, 2, 3 or 4 mg parthenolide a day feverfew product (part not stated) 1 to 4 mg of parthenolide a day 28-day cycles	No significant toxicity, and the maximum tolerated dose was not reached. At up to 4 mg of parthenolide a day there was no detectable parthenolide in plasma (limit 0.5 ng/mL), so pharmacokinetics could not be measured. Parthenolide not detectable in blood (not applicable) Methods, limits and funding Outcomes: Toxicity and plasma parthenolide levels Limitations: Phase I safety and absorption study, not a test of benefit. Patient numbers are not in the abstract. Funding and conflicts: Not stated in the abstract Read: abstract
Cutlan 2000 Intra-specific variability of feverfew: correlations between parthenolide, morphological traits and seed origin. Planta Med · PMID 11105564 · DOI	Plant analysis plant analysis	Thirty-one feverfew accessions of diverse origin grown together	Feverfew plants aerial parts (dry weight)	Mean parthenolide ranged from non-detectable to 1.68% of dry weight. Wild-collected seed and USDA accessions averaged 0.72%, commercial sources 0.34% to 0.35%. Light green-yellow leaved varieties had the most (1.61%). Not detectable to 1.68% (not applicable) Methods, limits and funding Outcomes: Parthenolide by HPLC-UV-MS Limitations: Plant breeding study. Funding and conflicts: Not stated in the abstract Read: abstract
De Weerdt 1996 Herbal medicines in migraine prevention. Randomized double-blind placebo-controlled crossover trial of a feverfew preparation. Phytomedicine · PMID 23195074 · DOI	Controlled trial	50 50 patients with migraine who had not used feverfew before (44 completed the 9-month study)	One capsule a day of a dried alcoholic feverfew extract on microcrystalline cellulose, containing 0.5 mg parthenolide leaf extract (dried alcoholic extract) one capsule a day (0.5 mg parthenolide) 9 months, crossover · vs placebo	Both groups had the same number of attacks. No preventive effect was shown. Patients seemed to use more symptom-relief drugs while taking feverfew. The authors suggested the earlier positive trials may differ because they enrolled people who already believed in feverfew. No difference in attack numbers (not given in the abstract) Methods, limits and funding Outcomes: Number of migraine attacks Limitations: Small; one product with a low parthenolide content. Funding and conflicts: Not stated in the abstract Read: abstract
Diener 2005 Efficacy and safety of 6.25 mg t.i.d. feverfew CO2-extract (MIG-99) in migraine prevention - a randomized, double-blind, multicentre, placebo-controlled study. Cephalalgia · PMID 16232154 · DOI	Controlled trial	170 170 adults with migraine in the intention-to-treat group (MIG-99 n=89, placebo n=81); 4-week baseline, 16 weeks of treatment	MIG-99 feverfew CO2 extract, 6.25 mg three times a day leaf, CO2 extract (MIG-99) 6.25 mg three times a day 16 weeks · vs placebo	Migraine frequency fell from 4.76 by 1.9 attacks a month on MIG-99 and by 1.3 on placebo (p=0.0456). Responder odds ratio 3.4 favouring MIG-99 (p=0.0049). Possibly treatment-related adverse events: 9 of 107 (8.4%) on MIG-99 and 11 of 108 (10.2%) on placebo (p=0.654). Difference of about 0.6 attacks a month; responder odds ratio 3.4 (not given in the abstract) Methods, limits and funding Outcomes: Average migraine attacks per 28 days in treatment months 2 and 3 compared with baseline; safety Limitations: The difference over placebo is small (about 0.6 attacks a month, borderline p-value); the Cochrane review counts 218 randomised people while the abstract analyses 170. Dose-finding study (p12230594) used the same extract. Funding and conflicts: Not stated in the abstract; MIG-99 is a proprietary extract. Sponsorship was not checked in the full text. Read: abstract
Ernst 2000 The efficacy and safety of feverfew (Tanacetum parthenium L.): an update of a systematic review. Public Health Nutr · PMID 11276299 · DOI	Systematic review	Six randomised double-blind placebo-controlled trials of feverfew single preparations for migraine prevention; searches to December 1999	Feverfew single preparations leaf varied varied · vs placebo	The majority favoured feverfew over placebo, with important caveats. Feverfew was linked only to mild and short-lived side effects. The authors concluded feverfew was likely to be effective for migraine prevention and had no major safety problems. Not pooled (not applicable) Methods, limits and funding Outcomes: Migraine prevention; safety Limitations: Older review (searches to 1999). Later, larger trials and the 2015 Cochrane update were less favourable (see p25892430). Funding and conflicts: Not stated in the abstract Read: abstract
Ferro 2012 The combined effect of acupuncture and Tanacetum parthenium on quality of life in women with headache: randomised study. Acupunct Med · PMID 22961605 · DOI	Controlled trial	69 69 women with chronic migraine in Brazil	Tanacetum parthenium 150 mg a day alone, acupuncture alone (20 sessions in 10 weeks), or both feverfew part not stated 150 mg a day 10 weeks (acupuncture course) · vs acupuncture alone / feverfew alone (no placebo)	Acupuncture plus feverfew did better than either alone on SF-36 (p<0.05), MIDAS (-42.5 versus -24.8 for feverfew alone and -35.1 for acupuncture) and pain scores (-6.4 versus -3.7 and -5.6; p<0.05). Combination better than either alone (not given) Methods, limits and funding Outcomes: Quality of life (SF-36), migraine disability (MIDAS), pain score Limitations: No placebo or untreated group, and no blinding is mentioned in the abstract, so it cannot show that feverfew itself did anything. Funding and conflicts: Not stated in the abstract Read: abstract
Freund 2020 Advances in chemistry and bioactivity of parthenolide. Nat Prod Rep · PMID 31763637 · DOI	Review in-vitro	Chemistry and biology review of parthenolide	Parthenolide pure compound	Parthenolide is a germacrane sesquiterpene lactone that acts as a covalently reactive compound; it has anti-inflammatory, redox-modulating and epigenetic activities, selective cytotoxicity to cancer stem cells, and changes microtubule behaviour by interfering with detyrosination of alpha-tubulin. Not applicable (not applicable) Methods, limits and funding Outcomes: Chemistry and targets Limitations: Chemistry review; not human data. Funding and conflicts: Not stated in the abstract Read: abstract
Groenewegen 1990 A comparison of the effects of an extract of feverfew and parthenolide, a component of feverfew, on human platelet activity in-vitro. J Pharm Pharmacol · PMID 1981582 · DOI	Laboratory research in-vitro	Human blood platelets in a dish	Feverfew extract and parthenolide leaf extract · vs untreated platelets	Feverfew extract and parthenolide had similar effects on platelet serotonin secretion and aggregation, suggesting parthenolide or similar compounds account for the extract's effect on platelets. Similar inhibition (not applicable) Methods, limits and funding Outcomes: Serotonin secretion and aggregation Limitations: Lab test only. Funding and conflicts: Not stated in the abstract Read: abstract
Guilbot 2017 A combination of coenzyme Q10, feverfew and magnesium for migraine prophylaxis: a prospective observational study. BMC Complement Altern Med · PMID 28854909 · DOI	Observational study	68 68 adults (intention to treat) with migraine, enrolled by general practitioners	Fixed combination (Antemig) with feverfew 100 mg, coenzyme Q10 100 mg and magnesium 112.5 mg a tablet feverfew part not stated one tablet a day 3 months after a 1-month baseline	Migraine days fell from 4.9 +/- 2.6 to 1.3 +/- 1.5 (p<0.0001); 75% (51/68) had at least a 50% reduction. Anxiety and depression scores also improved. Migraine days 4.9 to 1.3 per month (not given) Methods, limits and funding Outcomes: Days with migraine headache in month 3 compared with baseline Limitations: No placebo group; combination product; retrospectively registered (NCT02901756). Funding and conflicts: Industry-linked: three authors work for PiLeJe, the maker, and a fourth was paid by PiLeJe. Read: abstract
Heck 2000 Potential interactions between alternative therapies and warfarin. Am J Health Syst Pharm · PMID 10902065	Narrative review theoretical and case-based	Review of herbs that may interact with warfarin	Herbal products including feverfew varied	Feverfew is listed among herbs that may increase bleeding risk or add to warfarin. The authors state that nearly all information is from in-vitro data, animal studies or single case reports, so the clinical importance is unclear. Not applicable (not applicable) Methods, limits and funding Outcomes: Possible interactions with warfarin Limitations: Feverfew is on a list with about 30 herbs; no feverfew-specific warfarin case is described in the abstract. Funding and conflicts: Not stated in the abstract Read: abstract
Heptinstall 1985 Extracts of feverfew inhibit granule secretion in blood platelets and polymorphonuclear leucocytes. Lancet · PMID 2860288 · DOI	Laboratory research in-vitro	Human blood platelets and white blood cells in a dish	Feverfew extracts leaf extract · vs untreated cells	Extracts inhibited release of serotonin from platelets triggered by several agents and consistently inhibited platelet aggregation, but not thromboxane synthesis. They also inhibited enzyme release from white blood cells. Inhibition of release and aggregation (not applicable) Methods, limits and funding Outcomes: Serotonin release, aggregation, enzyme release Limitations: Lab test with extracts in a dish; concentrations are not comparable to blood levels after eating feverfew. Funding and conflicts: Not stated in the abstract Read: abstract
Heptinstall 1987 Extracts of feverfew may inhibit platelet behaviour via neutralization of sulphydryl groups. J Pharm Pharmacol · PMID 2886604 · DOI	Laboratory research in-vitro	Human platelets in a dish	Feverfew extract and parthenolide leaf extract · vs untreated platelets	Feverfew and parthenolide sharply reduced platelet sulphydryl (thiol) groups at concentrations that also inhibited platelet secretion; adding thiol compounds such as cysteine prevented the effect. Thiol depletion (not applicable) Methods, limits and funding Outcomes: Platelet sulphydryl groups and function Limitations: Lab mechanism study only. Funding and conflicts: Not stated in the abstract Read: abstract
Heptinstall 1992 Parthenolide content and bioactivity of feverfew (Tanacetum parthenium (L.) Schultz-Bip.). Estimation of commercial and authenticated feverfew products. J Pharm Pharmacol · PMID 1359053 · DOI	Lab analysis product analysis	Authenticated UK-grown feverfew and commercial products sold as feverfew	Feverfew leaves, flowering tops, seeds, stalks, roots and commercial products several parts	Three methods gave consistent parthenolide values. Authenticated leaves, flowering tops and seeds were high in parthenolide; stalks and roots were low. Parthenolide in powdered leaf fell during storage. Products sold as feverfew varied widely and in some products parthenolide was not detected. The authors suggest manufacturers standardise on parthenolide. Wide variation; some products had none detected (not applicable) Methods, limits and funding Outcomes: Parthenolide content and platelet-secretion bioassay Limitations: Old study (1992); today's products may differ. Funding and conflicts: Not stated in the abstract Read: abstract
Holland 2012 Evidence-based guideline update: NSAIDs and other complementary treatments for episodic migraine prevention in adults: report of the Quality Standards Subcommittee of the American Academy of Neurology and the American Headache Society. Neurology · PMID 22529203 · DOI	Practice guideline	Adults with episodic migraine; studies from June 1999 to May 2009 (284 abstracts reviewed, 49 Class I or II articles)	Various, including MIG-99 (feverfew CO2 extract) leaf extract · vs placebo	The guideline lists MIG-99 (feverfew) among treatments that are probably effective for migraine prevention (Level B), alongside several NSAIDs, magnesium and riboflavin. Butterbur was Level A. Not applicable (not applicable) Methods, limits and funding Outcomes: Migraine prevention Limitations: Guideline from 2012 using studies up to 2009; it is older than the 2015 Cochrane update and the 2025 meta-analysis. The Level B rating applies to the MIG-99 extract, not to all feverfew products. Funding and conflicts: Guideline of two professional societies Read: abstract
Jain 1999 Antinociceptive and anti-inflammatory effects of Tanacetum parthenium L. extract in mice and rats. J Ethnopharmacol · PMID 10624885 · DOI	Animal research animal	Mice (writhing test) and rats (paw swelling test)	Feverfew extract by mouth (10, 20, 40 mg/kg) and parthenolide by injection (1, 2 mg/kg) extract (part not stated) 10 to 40 mg/kg by mouth acute · vs untreated animals	The extract and parthenolide reduced pain behaviour and paw swelling in a dose-dependent way. Naloxone did not reverse it. Higher doses (40 and 60 mg/kg) did not change movement or sleep time. Dose-dependent effects (not applicable) Methods, limits and funding Outcomes: Pain behaviour and paw swelling Limitations: Animal study; says nothing about doses or effects in people. Funding and conflicts: Not stated in the abstract Read: abstract
Jin 2007 The solution and solid state stability and excipient compatibility of parthenolide in feverfew. AAPS PharmSciTech · PMID 18181526 · DOI	Lab analysis product analysis	Feverfew extract and powder stored under different conditions	Feverfew extract extract 6 months of storage	Parthenolide was fairly stable at pH 5 to 7 and unstable below pH 3 or above 7. At 5 C and 31% humidity it stayed constant for 6 months, but about 40% degraded at 50 C. Moisture and heat both sped degradation. About 40% lost at 50 C in 6 months (not applicable) Methods, limits and funding Outcomes: Parthenolide degradation Limitations: Storage test only. Funding and conflicts: Not stated in the abstract Read: abstract
Johnson 1985 Efficacy of feverfew as prophylactic treatment of migraine. Br Med J (Clin Res Ed) · PMID 3929876 · DOI	Controlled trial	17 Seventeen people who already ate fresh feverfew leaves daily to prevent migraine	Freeze-dried feverfew leaf powder in capsules (8 people) versus placebo (9 people) leaf, freeze-dried · vs placebo capsules	People who were switched to placebo had a significant increase in frequency and severity of headache, nausea and vomiting, with unwanted effects emerging in the early months. The feverfew group showed no change in migraine symptoms. Placebo group worsened; feverfew group unchanged (not given in the abstract) Methods, limits and funding Outcomes: Frequency and severity of headache, nausea and vomiting Limitations: Very small. All participants were already long-term feverfew users who believed it helped, so stopping may have produced a withdrawal-type reaction rather than a loss of benefit. The authors themselves asked for confirmation in people who have never used feverfew. Funding and conflicts: Not stated in the abstract Read: abstract
Kashkooe 2024 Exploring the Phytochemistry, Signaling Pathways, and Mechanisms of Action of Tanacetum parthenium (L.) Sch.Bip.: A Comprehensive Literature Review. Biomedicines · PMID 39457613 · DOI	Narrative review mixed	Review of the plant's chemistry, mechanisms, safety	Feverfew aerial parts	Open-access review (read in full). Describes the plant (0.3 to 1 m tall perennial, yellow-green leaves, yellow-centre flowers about 2 cm wide, native to the Balkan Peninsula), over 30 sesquiterpene lactones with parthenolide the main one (up to 85% of total), flavonoids, and an essential oil in which camphor is predominant. Its safety section advises avoiding use in pregnancy and breastfeeding (leaves described as emmenagogic), in children under 2, and before surgery; notes a 'post-feverfew syndrome' on stopping; mouth ulcers and GI symptoms; and that parthenolide is a strong contact allergen. Not applicable (not applicable) Methods, limits and funding Outcomes: Chemistry, mechanisms, safety Limitations: Narrative review; its safety statements repeat earlier sources, several of which are not checked here. Funding and conflicts: Not stated Read: full-text
Khan 2003 Transport of parthenolide across human intestinal cells (Caco-2). Planta Med · PMID 14735438 · DOI	Laboratory research in-vitro	Human colon-lining cell model (Caco-2) in a dish	Parthenolide pure compound 250 micromolar · vs atenolol comparison	Parthenolide crossed the cell layer by passive diffusion and was concluded to be well absorbed through the gut lining in this model. Substantial linear transport (not applicable) Methods, limits and funding Outcomes: Transport across the cell layer Limitations: Lab model; contradicted in people by the phase I trial that could not detect parthenolide in blood (p15122077). Funding and conflicts: Not stated in the abstract Read: abstract
Killoran 2007 Two cases of compositae dermatitis exacerbated by moisturizer containing feverfew. Dermatitis · PMID 18021604 · DOI	Case report	2 Two women (45 and 25) with face and scalp rashes after a moisturizer containing feverfew	Moisturizer containing feverfew aerial parts extract topical weeks	Both flared after the moisturizer. Both reacted on patch testing to the sesquiterpene lactone mix, Compositae mix and the moisturizer; one also reacted to parthenolide and tansy (Tanacetum vulgare). 2 of 2 positive (not applicable) Methods, limits and funding Outcomes: Patch test results Limitations: Two cases. Funding and conflicts: Not stated in the abstract Read: abstract
Lopresti 2020 Herbal treatments for migraine: A systematic review of randomised-controlled studies. Phytother Res · PMID 32310327 · DOI	Systematic review	Nineteen randomised controlled studies of single-ingredient herbal treatments for acute or preventive migraine treatment, covering feverfew, butterbur, curcumin, peppermint oil and others	Single-ingredient herbal products including feverfew varied varied varied · vs placebo or other	Overall findings for feverfew were mixed. Butterbur had positive but limited evidence. Risk of bias was high for many studies. Not pooled (not applicable) Methods, limits and funding Outcomes: Migraine outcomes Limitations: The abstract gives no feverfew-specific numbers. Funding and conflicts: Not stated in the abstract Read: abstract
Losche 1987 An extract of feverfew inhibits interactions of human platelets with collagen substrates. Thromb Res · PMID 3441902 · DOI	Laboratory research in-vitro	Human platelets on collagen-coated surfaces in a dish	Feverfew extract leaf extract · vs untreated platelets	The extract reduced platelet deposition on collagen and platelet spreading in a dose-dependent way. Dose-dependent inhibition (not applicable) Methods, limits and funding Outcomes: Platelet sticking and spreading on collagen Limitations: Lab test only. Funding and conflicts: Not stated in the abstract Read: abstract
Maizels 2004 A combination of riboflavin, magnesium, and feverfew for migraine prophylaxis: a randomized trial. Headache · PMID 15447697 · DOI	Controlled trial	49 49 people with migraine who completed the 3-month trial (120 planned; interim analysis at 48)	Combination of riboflavin 400 mg, magnesium 300 mg and feverfew 100 mg a day feverfew part not stated feverfew 100 mg a day inside the combination 3 months after a 1-month run-in · vs 'placebo' with 25 mg riboflavin	No difference between groups: a 50% or greater reduction in migraines in 10 (42%) of active versus 11 (44%) of 'placebo' (P=.87). Both groups improved from baseline, more than usual placebo responses; the authors suggest riboflavin 25 mg may itself be active. 42% versus 44% responders (not given) Methods, limits and funding Outcomes: 50% or greater reduction in migraines; migraine days; migraine index; triptan doses Limitations: Combination product so feverfew cannot be separated; the comparison tablet contained some riboflavin; small and stopped at interim analysis. Funding and conflicts: Not stated in the abstract Read: abstract
Mathema 2012 Parthenolide, a sesquiterpene lactone, expresses multiple anti-cancer and anti-inflammatory activities. Inflammation · PMID 21603970 · DOI	Review in-vitro	Laboratory studies of parthenolide	Parthenolide pure compound	Review: parthenolide strongly blocks NF-kappa B and STAT signalling, can directly inhibit the IKK-beta kinase, and causes reactive-oxygen-species driven cell death in tumour cells while sparing normal cells in the lab. Not applicable (not applicable) Methods, limits and funding Outcomes: Molecular effects Limitations: A review of cell and animal work; the authors' language about cancer treatment is not supported by human trials. Funding and conflicts: Not stated in the abstract Read: abstract
McEwen 2015 The influence of herbal medicine on platelet function and coagulation: a narrative review. Semin Thromb Hemost · PMID 25839871 · DOI	Narrative review lab and clinical reports	Review of herbs and platelet function or clotting	Herbs including feverfew varied	Feverfew is among herbs found to reduce platelet aggregation (listed among herbs that reduced it and, in vitro studies, among those with promise for reducing aggregation). The author suggests repeat platelet and clotting tests may be needed in people on warfarin after excluding herbs. Not applicable (not applicable) Methods, limits and funding Outcomes: Platelet aggregation, clotting tests, interactions Limitations: Narrative review. Funding and conflicts: Not stated in the abstract Read: abstract
Mittra 2000 5-Hydroxytryptamine-inhibiting property of Feverfew: role of parthenolide content. Acta Pharmacol Sin · PMID 11603284	Animal and in vitro animal and in-vitro	Rat stomach-fundus and gut tissue; rats fed feverfew for 30 days	Feverfew extract, feverfew powder and parthenolide leaf extract and powder 20 mg/kg powder in rats 30 days · vs degraded versus fresh extract	Feverfew extract potently blocked 5-HT2B and 5-HT2A receptors and neuronal 5-HT release in rat tissue. When the extract lost more than about 10% of its parthenolide by heat, the effect fell markedly, the authors report. Effect lost with degradation of parthenolide (not applicable) Methods, limits and funding Outcomes: Blocking of serotonin (5-HT) receptors and release Limitations: Rat tissue; the abstract was cut off in the part read, so later results are not stated. Study authors work for a pharmaceutical company. Funding and conflicts: Possible industry link (Panacea Biotec) Read: abstract
Murphy 1988 Randomised double-blind placebo-controlled trial of feverfew in migraine prevention. Lancet · PMID 2899663 · DOI	Controlled trial	72 72 volunteers with migraine (60 completed; 59 with full data); one-month single-blind placebo run-in	One capsule a day of dried feverfew leaves leaf, dried one capsule a day (leaf weight not stated in the abstract) 4 months on each treatment in a crossover (8 months total) · vs matching placebo capsule	Feverfew was linked to fewer and less severe attacks in each two-month period, less vomiting, and better visual analogue scores. The duration of individual attacks did not change. No serious side effects. Reduced mean number and severity of attacks (numbers not given in the abstract) (not given in the abstract) Methods, limits and funding Outcomes: Attack frequency and severity from diary cards; vomiting; visual analogue scores Limitations: Crossover design with possible carry-over; 12 of 72 did not finish. Numbers are not in the abstract. Funding and conflicts: Not stated in the abstract Read: abstract
Nelaturi 2025 Systematic review and meta-analysis of Tanacetum parthenium: evaluating its efficacy in migraine relief. Nat Prod Res · PMID 41422534 · DOI	Meta-analysis	899 Nine double-masked placebo-controlled randomised trials in people with migraine (899 participants); searches to August 2025	Tanacetum parthenium (feverfew) products · vs placebo	Feverfew reduced attack frequency (IV -1.11, 95% CI -1.23 to -0.99, p<0.00001, I2 28%) and migraine duration (IV -4.43, 95% CI -7.63 to -1.23, p=0.007, I2 98%). Pain severity showed a non-significant trend (IV -0.63, 95% CI -1.48 to 0.21, p=0.14, I2 85%). No significant effect on nausea, vomiting, photophobia or phonophobia. Frequency -1.11 (units not stated in the abstract) (-1.23 to -0.99) Methods, limits and funding Outcomes: Migraine attack frequency, duration, pain severity, nausea, vomiting, sensitivity to light and sound Limitations: Authors note selection and attrition bias and moderate to very high heterogeneity. Units of the pooled numbers and which products were included are not stated in the abstract, so the size of the effect cannot be judged from the abstract alone. Published online ahead of print Dec 2025. Funding and conflicts: Not stated in the abstract Read: abstract
Nelson 2002 Variations in parthenolide content and daily dose of feverfew products. Am J Health Syst Pharm · PMID 12185827 · DOI	Lab analysis product analysis	Commercial US feverfew products bought by consumers	Feverfew products, analysed by HPLC leaf (where dried leaf) label directions	Parthenolide per dosage form varied 150-fold (0.02 to 3.0 mg) and percent parthenolide varied 5.3-fold (0.14% to 0.74%). Following label directions, daily dried leaf would range from 225 to 2246 mg (10-fold) and parthenolide from 0.06 to 9.7 mg a day (160-fold). 150-fold range in parthenolide per capsule (not applicable) Methods, limits and funding Outcomes: Parthenolide per dose Limitations: Products were from the early 2000s and may differ from today's. Funding and conflicts: Not stated in the abstract Read: abstract
Parada-Turska 2008 Parthenolide inhibits proliferation of fibroblast-like synoviocytes in vitro. Inflammation · PMID 18568393 · DOI	Laboratory research in-vitro	Rabbit joint-lining cells, human rheumatoid arthritis joint-lining cells and human skin cells in a dish	Parthenolide pure compound · vs untreated cells	Parthenolide slowed the growth of rabbit and human rheumatoid arthritis joint-lining cells; skin cells were affected less. Slowed cell growth (not applicable) Methods, limits and funding Outcomes: Cell proliferation Limitations: Cell experiment only. It says nothing about whether feverfew helps arthritis in people (the only human trial, p2673080, found no benefit). Funding and conflicts: Not stated in the abstract Read: abstract
Pareek 2011 Feverfew (Tanacetum parthenium L.): A systematic review. Pharmacogn Rev · PMID 22096324 · DOI	Narrative review human and lab	Review of the plant, its chemistry, traditional uses and pharmacology	Feverfew aerial parts	The review lists traditional uses for fevers, migraine, rheumatoid arthritis, stomach aches, toothaches, insect bites, infertility, and menstrual and labour problems. In the full text it describes a 'post-feverfew syndrome' (headaches, insomnia, joint pain, nervousness, poor sleep, stiffness, tension, tiredness) in people who stopped feverfew after several years, mouth ulceration in 11% in a larger series of users with 18% reporting some adverse effect, oral inflammation and dermatitis, and says safety in long-term use and in pregnancy has not been established. Not applicable (not applicable) Methods, limits and funding Outcomes: Traditional uses, chemistry, safety Limitations: Despite its title, a narrative review, not a systematic one. The percentages come from earlier reports that are cited in it, not from trials read here. Funding and conflicts: None declared Read: full-text
Pattrick 1989 Feverfew in rheumatoid arthritis: a double blind, placebo controlled study. Ann Rheum Dis · PMID 2673080 · DOI	Controlled trial	41 41 women with symptomatic rheumatoid arthritis (20 per group analysed)	Dried chopped feverfew leaf, 70 to 86 mg once a day, in capsules leaf, dried and chopped 70 to 86 mg once a day 6 weeks · vs placebo capsules	No important differences between feverfew and placebo in any clinical or laboratory measure. The authors conclude there was no apparent benefit from oral feverfew in rheumatoid arthritis. No difference (not given) Methods, limits and funding Outcomes: Stiffness, pain, grip strength, joint index, blood counts, ESR, CRP, rheumatoid factor, immunoglobulins, function, global opinions Limitations: Small, short (6 weeks), women only, one dried-leaf product whose parthenolide content is not stated. Funding and conflicts: Not stated in the abstract Read: abstract
Paulsen 2002 Do monoterpenes released from feverfew (Tanacetum parthenium) plants cause airborne Compositae dermatitis? Contact Dermatitis · PMID 12225407 · DOI	Case series	17 17 patients allergic to feverfew and parthenolide	Patch tests with monoterpenes from feverfew aerial parts volatiles patch test single test	Feverfew is an important sensitizer in Europe and has been suspected of causing airborne dermatitis. 13 of 17 had positive or doubtful reactions to at least one monoterpene; the authors say monoterpene allergy may contribute to airborne dermatitis, mainly in one woman whose symptoms cleared when the plants were removed. 13 of 17 reacted (not applicable) Methods, limits and funding Outcomes: Patch-test reactions Limitations: Small; mostly doubtful reactions. Funding and conflicts: Not stated in the abstract Read: abstract
Paulsen 2010 Patch test reactivity to feverfew-containing creams in feverfew-allergic patients. Contact Dermatitis · PMID 20690937 · DOI	Case series	7 Seven patients with proven contact allergy to feverfew	Two creams containing parthenolide-depleted feverfew extract, patch tested aerial parts extract (parthenolide-depleted) patch test single test	Four of seven patients reacted to one of the creams, together with positive reactions to parthenolide. Later analysis found no parthenolide in that cream, probably because it had degraded. The authors conclude that 'parthenolide-depleted' extracts can still trigger reactions in feverfew-sensitive people. 4 of 7 reacted to one cream (not applicable) Methods, limits and funding Outcomes: Skin patch-test reaction Limitations: Seven people only, all already allergic. Funding and conflicts: Not stated in the abstract Read: abstract
Paulsen 2017 Systemic allergic dermatitis caused by sesquiterpene lactones. Contact Dermatitis · PMID 27568784 · DOI	Review	Review of reactions to eating or taking plants containing sesquiterpene lactones in people allergic to the daisy family	Compositae plants including feverfew varied	People allergic to daisy-family plants are routinely warned against eating them, but evidence for systemic reactions is mostly anecdotal. Feverfew is listed among species suspected of causing systemic reactions. Not applicable (not applicable) Methods, limits and funding Outcomes: Systemic allergic reactions Limitations: Evidence level for feverfew specifically is low and anecdotal. Funding and conflicts: Not stated in the abstract Read: abstract
Pfaffenrath 2002 The efficacy and safety of Tanacetum parthenium (feverfew) in migraine prophylaxis - a double-blind, multicentre, randomized placebo-controlled dose-response study. Cephalalgia · PMID 12230594 · DOI	Controlled trial	147 147 adults with migraine with or without aura; 4-week baseline then 12 weeks of treatment	MIG-99, a supercritical CO2 extract of feverfew, at three levels (2.08 mg, 6.25 mg or 18.75 mg three times a day) versus placebo leaf, CO2 extract (MIG-99) 2.08 mg, 6.25 mg or 18.75 mg three times a day 12 weeks · vs placebo	In the whole group there was no significant difference and no dose-response. In a pre-planned subgroup with at least four attacks in the baseline month (n=49), attacks fell in a dose-dependent way (p=0.001); the biggest change was with 6.25 mg three times a day (-1.8 +/- 1.5 per 28 days versus -0.3 +/- 1.9 on placebo, p=0.02). 52 of 147 (35%) had at least one adverse event, with similar rates in all groups. -1.8 versus -0.3 attacks per 28 days in the high-attack subgroup (not given in the abstract) Methods, limits and funding Outcomes: Number of migraine attacks in the last 28 days compared with baseline; secondary measures of duration, intensity, days unable to work Limitations: The overall result was negative; the benefit was seen only in a small subgroup (n=49), so it needs repeating. The authors say MIG-99 failed to show a migraine preventive effect in general. Funding and conflicts: Not stated in the abstract; MIG-99 is a proprietary extract. Sponsorship was not checked in the full text. Read: abstract
Pittler 2004 Feverfew for preventing migraine. Cochrane Database Syst Rev · PMID 14973986 · DOI	Systematic review	343 Five double-blind placebo-controlled trials of feverfew for migraine prevention (343 patients); searches to July 2003	Feverfew preparations leaf (as described by the trials) varied varied · vs placebo	Results were mixed and did not convincingly show that feverfew works for preventing migraine. Only mild, short-lived side effects were reported. This is an earlier version of the review that was updated in 2015. Not pooled (not applicable) Methods, limits and funding Outcomes: Migraine frequency and severity, adverse events Limitations: Earlier version, replaced by the 2015 update (p25892430). Funding and conflicts: Not stated in the abstract Read: abstract
Sahler 2011 The Feverfew plant-derived compound, parthenolide enhances platelet production and attenuates platelet activation through NF-kB inhibition. Thromb Res · PMID 21272923 · DOI	Laboratory research in-vitro	Human and mouse megakaryocytes and human blood platelets in a dish	Parthenolide pure compound · vs untreated cells	Parthenolide increased platelet production from megakaryocytes in cells and reduced activation (P-selectin, soluble CD40 ligand) in platelets treated before collagen or thrombin. Not given in the abstract (not applicable) Methods, limits and funding Outcomes: Platelet production and activation Limitations: Lab study; pure parthenolide, not feverfew products. Funding and conflicts: Not stated in the abstract Read: abstract
Saranitzky 2009 Feverfew for migraine prophylaxis: a systematic review. J Diet Suppl · PMID 22435410 · DOI	Systematic review	Randomised controlled trials of feverfew for migraine prevention	Feverfew · vs placebo	Results could not be pooled but suggest benefit in at least some subsets of people with migraine. The authors raise a theoretical concern about long-term use because of cyclo-oxygenase-2 inhibiting effects, particularly in people with coronary disease, and say longer studies are needed. Not pooled (not applicable) Methods, limits and funding Outcomes: Migraine prevention; theoretical safety Limitations: Abstract only; no numbers. The coronary-disease concern is theoretical, not an observed harm. Funding and conflicts: Not stated in the abstract Read: abstract
Shrivastava 2006 Tanacetum parthenium and Salix alba (Mig-RL) combination in migraine prophylaxis: a prospective, open-label study. Clin Drug Investig · PMID 17163262 · DOI	Open label study	12 12 patients with migraine without aura (10 analysed)	Feverfew 300 mg plus white willow (Salix alba) bark 300 mg (Mig-RL) twice a day feverfew part not stated 300 mg feverfew plus 300 mg willow twice a day 12 weeks	Attack frequency fell 61.7% at 12 weeks (p<0.025). Intensity and duration also fell. No adverse events. Frequency down 61.7% at 12 weeks (not given) Methods, limits and funding Outcomes: Attack frequency, intensity, duration Limitations: Only 12 people, no control group, combined with willow bark (a salicylate source); authors are affiliated with the product company's research institute (not confirmed). Funding and conflicts: Possible industry link (Naturveda-Vitro-Bio affiliation); not confirmed Read: abstract
Sumner 1992 Inhibition of 5-lipoxygenase and cyclo-oxygenase in leukocytes by feverfew. Involvement of sesquiterpene lactones and other components. Biochem Pharmacol · PMID 1319159 · DOI	Laboratory research in-vitro	Rat and human white blood cells in a dish	Chloroform extracts of fresh feverfew leaves and of commercial powdered leaves leaf · vs untreated cells	Both extracts (including the lactone-free powdered leaves) inhibited thromboxane B2 and leukotriene B4 production with IC50 about 5 to 50 micrograms per mL. The authors conclude feverfew contains a mix of lactone and non-lactone inhibitors of these inflammatory chemicals. IC50 5 to 50 ug/mL (not applicable) Methods, limits and funding Outcomes: Thromboxane B2 and leukotriene B4 production Limitations: Lab study. Funding and conflicts: Not stated in the abstract Read: abstract
Sur 2009 Anti-inflammatory activity of parthenolide-depleted Feverfew (Tanacetum parthenium). Inflammopharmacology · PMID 19112586 · DOI	Lab and clinical model mixed (in-vitro, mouse, human skin model)	Cell tests, mouse skin tests, and a skin-redness test in people (methyl nicotinate model)	Parthenolide-depleted feverfew extract (PD-Feverfew) made for cosmetics aerial parts extract with parthenolide removed (as described) · vs whole feverfew (in mouse test); untreated skin	The extract blocked inflammatory enzymes and chemicals in cells (5-lipoxygenase, phosphodiesterases, nitric oxide, PGE2, TNF-alpha), reduced dermatitis in mice, and reduced redness in a methyl nicotinate skin test in people. The abstract gives no numbers or numbers of volunteers. Not given in the abstract (not given) Methods, limits and funding Outcomes: Inflammation markers in cells and mice; erythema (redness) in a methyl nicotinate vasodilation model in people Limitations: Mostly lab and animal work; the human part is a short skin-redness model, not a disease trial. Written by staff of Johnson & Johnson Consumer Companies (see funding). Funding and conflicts: Industry-linked: authors are from the J&J Skin Research Center; product developed for cosmetics Read: abstract
Unger 2004 Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction. Rapid Commun Mass Spectrom · PMID 15384148 · DOI	Laboratory research in-vitro	Human drug-metabolising enzymes (CYP1A2, 2C8, 2C9, 2C19, 2D6, 3A4) made in insect cells	Herbal extracts including feverfew herb herb · vs known inhibitors	Feverfew herb was among several herbal remedies identified as inhibitors of the tested enzymes, with IC50 values between 20 and 1000 micrograms per mL across the herbs. The abstract does not say which enzymes feverfew inhibited. IC50 20 to 1000 ug/mL across all herbs listed (not applicable) Methods, limits and funding Outcomes: Enzyme inhibition (IC50) Limitations: Test-tube study; feverfew-specific values and the importance in people are not given. Funding and conflicts: Not stated in the abstract Read: abstract
Vikelis 2020 Open Label Prospective Experience of Supplementation with a Fixed Combination of Magnesium, Vitamin B2, Feverfew, Andrographis Paniculata and Coenzyme Q10 for Episodic Migraine Prophylaxis. J Clin Med · PMID 33375459 · DOI	Open label study	113 113 Greek adults with episodic migraine, one-month baseline	Fixed supplement combining magnesium, vitamin B2, feverfew, Andrographis paniculata and coenzyme Q10 feverfew part not stated 3 months	Migraine days fell from 9.4 +/- 3.7 to 6.1 +/- 3.5 (p<0.001); 56.6% (64 people) were responders. No safety concerns reported. Migraine days 9.4 to 6.1 (not given) Methods, limits and funding Outcomes: Monthly migraine days at month 3 compared with baseline Limitations: Single-arm open-label pilot; five-ingredient combination so feverfew cannot be separated; no placebo. Funding and conflicts: Authors declare no conflict of interest Read: abstract
Vogler 1998 Feverfew as a preventive treatment for migraine: a systematic review. Cephalalgia · PMID 9950629 · DOI	Systematic review	Five randomised placebo-controlled double-blind trials; searches to April 1998	Feverfew leaf varied varied · vs placebo	The majority favoured feverfew over placebo with important caveats. The authors concluded that effectiveness for migraine prevention had not been established beyond reasonable doubt. Not pooled (not applicable) Methods, limits and funding Outcomes: Migraine prevention Limitations: Superseded by later reviews. Funding and conflicts: Not stated in the abstract Read: abstract
Volta 2019 Comparison of the Effect of Tanacethum Parthenium, 5-Hydroxy Tryptophan, and Magnesium (Aurastop) versus Magnesium Alone on Aura Phenomenon and Its Evolution. Pain Res Manag · PMID 31687058 · DOI	Non randomised pilot	50 50 consecutive patients with migraine with aura	Aurastop: feverfew 150 mg (0.8% parthenolide) plus 5-hydroxytryptophan 20 mg plus magnesium 185 mg, taken at the start of aura, versus magnesium alone for other attacks feverfew part not stated one tablet at the start of aura 4 aura attacks · vs magnesium alone (same patients, other attacks)	96% had more than a 50% reduction in aura duration with the combination versus 14% with magnesium alone (p<0.001). 96% versus 14% with a >50% shorter aura (not given) Methods, limits and funding Outcomes: Aura duration and aura-related disability Limitations: Single-centre pilot, same patients compared across different attacks, not blinded, three-ingredient combination. Funding and conflicts: Authors declare no conflict of interest Read: abstract
Wider 2015 Feverfew for preventing migraine. Cochrane Database Syst Rev · PMID 25892430 · DOI	Systematic review	561 Six double-blind placebo-controlled trials of feverfew on its own for migraine prevention (561 patients); searches to January 2015	Feverfew monopreparations (dried leaf, alcoholic extract, CO2 extract) leaf (as described by the trials) varied by trial varied (about 2 to 8 months per trial) · vs placebo	Pooling was not possible. The newest and largest trial (n=218) found feverfew cut attacks by 1.9 a month (4.8 to 2.9) and placebo by 1.3 (4.8 to 3.5), a difference of 0.6 attacks a month. No significant differences for intensity, duration, nausea or vomiting, or global assessment. Three earlier positive trials were small (17 to 60 people); two rigorous trials (n=50 and n=147) found no significant difference. Only mild, short-lived side effects were reported, most often stomach upset and mouth ulcers. Difference between feverfew and placebo of 0.6 attacks per month in the largest trial (not given in the abstract) Methods, limits and funding Outcomes: Migraine frequency (5 of 6 trials), intensity, duration, nausea and vomiting, global assessment, adverse events Limitations: Authors rate it low quality evidence. All trials were at unclear or high risk of bias for sample size. No pooled analysis. Funding and conflicts: Authors declare no conflicts Read: abstract
Yamanaka 2021 Complementary and Integrative Medicines as Prophylactic Agents for Pediatric Migraine: A Narrative Literature Review. J Clin Med · PMID 33401551 · DOI	Narrative review	Children and adolescents with migraine; review of eight complementary medicines including a combination of feverfew, vitamin D and ginkgolide B	Riboflavin, coenzyme Q10, magnesium, melatonin, fatty acids and a feverfew-containing combination varied varied varied · vs varied	Combination therapy (including feverfew) showed positive potential, but reports on the individual effect of each ingredient were lacking. No firm conclusion was reached because of low-quality evidence and few studies. The authors say the medicines do not cause serious side effects. Not applicable (not applicable) Methods, limits and funding Outcomes: Efficacy and safety for pediatric migraine prevention Limitations: Narrative review; feverfew only appears in a combination. The reassurance on side effects comes from small studies. Funding and conflicts: Authors declare no conflicts Read: abstract
Yao 2006 A reproductive screening test of feverfew: is a full reproductive study warranted? Reprod Toxicol · PMID 16781113 · DOI	Animal research animal	5 Pregnant rats (five females per group) and cultured rat embryos	Feverfew by mouth 839 mg/kg daily on gestation days 1 to 8 or 8 to 15; extract added to embryo culture plant material (part not stated) 839 mg/kg a day 8 days of pregnancy, or 26 hours in embryo culture · vs ethanol control	Pre-implantation loss appeared higher but not significantly. Fetuses exposed on days 8 to 15 were smaller, with more runts. The extract was toxic to cultured embryos. The authors say a full reproductive study is warranted. Smaller fetuses; embryo toxicity in culture (not applicable) Methods, limits and funding Outcomes: Fetal weight, malformations, pre-implantation loss, embryo toxicity Limitations: Very small screening study in rats at a high dose; the weight of the herb dose is not comparable to human use. Funding and conflicts: Not stated in the abstract Read: abstract
s-ema-hmpc-feverfew-2010 Community herbal monograph on Tanacetum parthenium (L.) Schulz Bip., herba, Final (EMA/HMPC/587578/2009, 25 November 2010), European Medicines Agency, HMPC · Source	Regulatory monograph n/a			Methods, limits and funding Read: full-text
s-ema-hmpc-feverfew-2020 European Union herbal monograph on Tanacetum parthenium (L.) Schultz Bip., herba, Final - Revision 1 (EMA/HMPC/48715/2017, adopted 8 July 2020), European Medicines Agency, HMPC · Source	Regulatory monograph n/a			Methods, limits and funding Read: full-text
s-gbif-tanacetum-parthenium GBIF Backbone Taxonomy: Tanacetum parthenium (L.) Sch.Bip. (usageKey 3118430) · Source	Database n/a			Methods, limits and funding Read: full-text
s-lactmed-feverfew LactMed: Feverfew (Drugs and Lactation Database, NCBI Bookshelf NBK501861, revised 30 November 2022) · Source	Authoritative guidance			Methods, limits and funding Read: summary-only
s-ncbi-taxonomy-feverfew NCBI Taxonomy: Tanacetum parthenium (taxid 127999) · Source	Database n/a			Methods, limits and funding Read: full-text
s-nccih-feverfew NCCIH: Feverfew (National Center for Complementary and Integrative Health, NIH) · Source	Authoritative guidance			Methods, limits and funding Read: summary-only

What we do not know yet

What the evidence supports: nothing reaches moderate certainty. Preventing migraine is rated low (the extract MIG-99 and the reviews) or mixed (plain leaf); everything else is very low, insufficient, or against (rheumatoid arthritis, one trial).
What is uncertain: the trials are small, short and use different products. The 2025 meta-analysis's units and the exact funding of the MIG-99 trials were not clear from the abstracts, and only abstracts were read for most trials.
What has never been tested: feverfew alone in children, for acute attacks, against a standard migraine preventer, or beyond about 4 months; how often post-feverfew syndrome happens and whether tapering helps; feverfew with warfarin or aspirin; pregnancy and breastfeeding in people.
Product quality: parthenolide content varies widely and the product analyses found are from 1992 to 2006.
Not read: the LiverTox entry, the LactMed page (seen only as a summary), the EMA assessment report and the monographs of other agencies; a 2022 trial of feverfew on clotting tests could not be read.

How new research is added

New studies are found by a saved PubMed search and are placed in a review queue. A person reads each one before it changes any evidence rating or safety wording.

Lab markers

What changed in blood or saliva tests during trials. A changed number is not the same as feeling or being healthier, and we give no "normal ranges".

Inflammatory 1

●

C-reactive protein (CRP) and sedimentation rate (ESR)

No clear change in trials

Blood tests that rise with body-wide inflammation.

Low certainty

Results and what it means

Why it was measured

Used to follow rheumatoid arthritis activity.

Statistical vs. clinical meaning

No change in inflammation markers in one small short trial.

Safety implication

No safety signal in the abstract.

Study	Result	People	Product
³⁹	No important difference between feverfew and placebo in ESR, CRP, complement breakdown products, rheumatoid factor or immunoglobulins	40 women with rheumatoid arthritis analysed	Dried leaf, 70 to 86 mg a day, 6 weeks

³⁹

Other 11

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Number of migraine attacks per month

Lowered in trials

How many separate migraine attacks a person has in a month, usually from a diary.

Low certainty

Results and what it means

Why it was measured

The main outcome in migraine prevention trials.

Statistical vs. clinical meaning

Statistically significant but small: about half an attack a month more than placebo in the biggest trial. Whether this matters to a person depends on how bad their attacks are.

Safety implication

No safety link.

Study	Result	People	Product
¹¹	Attacks fell from 4.76 by 1.9 a month on MIG-99 versus 1.3 on placebo (p=0.0456); responder odds ratio 3.4	170 adults with migraine	MIG-99, 6.25 mg three times a day, 16 weeks
⁴³	Whole group: no significant difference. Subgroup with 4 or more baseline attacks (n=49): -1.8 versus -0.3 attacks per 28 days (p=0.02)	147 adults with migraine	MIG-99 at three levels, 12 weeks
³⁵	Pooled IV -1.11 (95% CI -1.23 to -0.99); units not stated in the abstract	899 people in nine trials	Feverfew products versus placebo
¹⁰	Same number of attacks as on placebo	44 completers	Alcoholic extract, one capsule a day, 9 months

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Pain intensity of attacks

No clear change in trials

How bad the pain is during an attack, on a scale the patient fills in.

Low certainty

Results and what it means

Why it was measured

Shows whether attacks are milder, not only fewer.

Statistical vs. clinical meaning

No clear change in severity.

Safety implication

No safety link.

Study	Result	People	Product
³⁵	Non-significant trend: IV -0.63 (95% CI -1.48 to 0.21, p=0.14)	899 people	Feverfew versus placebo
⁵⁴	No significant difference for intensity in the included trials	561 people	Feverfew versus placebo

^{35 54}

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How long attacks last

Mixed results in trials

Length of a single attack, in hours.

Very low certainty

Results and what it means

Why it was measured

Shorter attacks mean less time lost.

Statistical vs. clinical meaning

The meta-analysis result is highly inconsistent between trials (I2 98%), and two other sources find no change.

Safety implication

No safety link.

Study	Result	People	Product
³⁵	Pooled IV -4.43 (95% CI -7.63 to -1.23, I2 98%); units not stated	899 people	Feverfew versus placebo
³⁴	Duration of individual attacks did not change	59 with full data	Dried leaf, one capsule a day
⁵⁴	No significant difference for duration	561 people	Feverfew versus placebo

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Nausea and vomiting with attacks

Mixed results in trials

How often attacks come with nausea or vomiting.

Low certainty

Results and what it means

Why it was measured

A common and distressing part of migraine.

Statistical vs. clinical meaning

Only the old Murphy trial found less vomiting; the reviews do not.

Safety implication

No safety link.

Study	Result	People	Product
³⁴	Less vomiting on dried leaf than on placebo	59 with full data	Dried leaf, 4 months
³⁵	No significant effect on nausea, vomiting, photophobia or phonophobia	899 people	Feverfew versus placebo
⁵⁴	No significant difference for nausea and vomiting incidence or severity	561 people	Feverfew versus placebo

^{34 35 54}

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Days with migraine per month

Lowered in trials

Number of days each month that have a migraine headache.

Very low certainty

Results and what it means

Why it was measured

Used in open-label supplement studies.

Statistical vs. clinical meaning

Large before-and-after drops, but no placebo group.

Safety implication

No safety link.

Study	Result	People	Product
¹⁶	4.9 to 1.3 days (month 3 versus baseline, p<0.0001)	68 adults	Feverfew + coenzyme Q10 + magnesium, open-label
⁵¹	9.4 to 6.1 days (p<0.001)	113 adults	Five-ingredient combination, open-label

^{16 51}

↕

Responders: at least 50% fewer attacks

Mixed results in trials

Share of people whose attacks fall by half or more.

Low certainty

Results and what it means

Why it was measured

Easy to understand outcome used in many trials.

Statistical vs. clinical meaning

The two trials point in opposite directions, and one used a combination.

Safety implication

No safety link.

Study	Result	People	Product
³⁰	42% on the combination versus 44% on low-dose riboflavin 'placebo' (P=.87)	49 finishers	Riboflavin + magnesium + feverfew, 3 months
¹¹	Odds ratio 3.4 for being a responder on MIG-99 (p=0.0049)	170 adults	MIG-99, 16 weeks

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Pain-free two hours after treating an attack

Raised in trials

Whether the headache has gone two hours after taking the treatment.

Very low certainty

Results and what it means

Why it was measured

Standard outcome for treating attacks.

Statistical vs. clinical meaning

A pilot with only 15 placebo patients; combination with ginger.

Safety implication

Mouth numbness and nausea were the most common side effects in the trial.

Study	Result	People	Product
⁷	32% versus 16% on placebo (P=.02); pain relief 63% versus 39% (P=.002)	60 adults, 208 attacks	Sublingual feverfew/ginger
⁶	48% pain-free at 2 hours (no placebo)	29 evaluable adults	Sublingual feverfew/ginger, open-label

^{7 6}

▼

Migraine disability and quality of life

Lowered in trials

Questionnaires (MIDAS, SF-36) that score how much migraine limits daily life.

Very low certainty

Results and what it means

Why it was measured

Shows impact beyond attack counts.

Statistical vs. clinical meaning

No placebo group, so the part due to feverfew is unknown.

Safety implication

No safety link.

Study	Result	People	Product
¹³	MIDAS change -42.5 (feverfew + acupuncture), -35.1 (acupuncture), -24.8 (feverfew alone); SF-36 better with the combination (p<0.05)	69 women with chronic migraine	Feverfew 150 mg a day, acupuncture, or both

¹³

●

Joint pain, stiffness, grip strength and joint index

No clear change in trials

How painful and stiff the joints are and how strong the grip is.

Low certainty

Results and what it means

Why it was measured

Direct measures of how arthritis feels.

Statistical vs. clinical meaning

No benefit in the trial.

Safety implication

None noted.

Study	Result	People	Product
³⁹	No important differences in stiffness, pain (visual scale), grip strength or articular index	40 women with rheumatoid arthritis analysed	Dried leaf, 70 to 86 mg a day, 6 weeks

³⁹

▼

Skin redness after a nicotinate challenge

Lowered in trials

Redness of skin after methyl nicotinate is applied, a lab model of short-term skin inflammation.

Very low certainty

Results and what it means

Why it was measured

Used to test anti-inflammatory skin products quickly.

Statistical vs. clinical meaning

A short model of redness, not a skin disease; industry-linked.

Safety implication

The same extract class can still trigger allergy in feverfew-sensitive people (p20690937).

Study	Result	People	Product
⁴⁹	Reduced erythema in the model (numbers and volunteer count not in the abstract)	Volunteers in a skin model	Parthenolide-depleted feverfew extract

^{49 41}

●

Parthenolide in blood

No clear change in trials

The amount of parthenolide measured in blood after taking feverfew.

Low certainty

Results and what it means

Why it was measured

Tells whether the main active compound reaches the body.

Statistical vs. clinical meaning

Lab and human results disagree; the blood test was in a few cancer patients.

Safety implication

Cannot be assumed to reach tissues.

Study	Result	People	Product
⁸	Not detectable (limit 0.5 ng/mL) after tablets giving up to 4 mg parthenolide a day	Patients with cancer	Feverfew tablet, 1 to 4 mg parthenolide a day, 28-day cycles
²⁶	Parthenolide crossed a human gut-cell layer by passive diffusion in a dish	Caco-2 cells	Parthenolide

^{8 26}

Safety

What studies and official sources say about side effects, medicines and who should check first. Each point shows what kind of evidence it comes from.

Main points to know 7

Stopping feverfew after long use may bring rebound symptoms ('post-feverfew syndrome'). In a small 1985 trial of 17 long-term users, the nine people switched to placebo had more headaches, nausea and vomiting, with unwanted effects appearing in the early months, while eight kept on feverfew did not change. A review (Pareek 2011) describes a cluster of reactions in people who stopped feverfew after several years: headaches, poor sleep, nervousness, tension, tiredness, joint pain and muscle and joint stiffness, often called 'post-feverfew syndrome'. A 2021 case report and a 2024 review repeat this. How often it happens, how long it lasts and whether tapering helps have not been studied. If you have used feverfew for a long time, ask your doctor or pharmacist before stopping. Controlled trial ^{24 38 2 25}
Mouth ulcers, mouth swelling and stomach upset, especially with fresh leaves. Cochrane (2015) says the side effects seen in trials were mild and short-lived, most often stomach complaints and mouth ulcers. Pareek 2011 reports mouth ulceration in 11% of a larger series of users, with 18% reporting any adverse effect, and describes wider inflammation of the mouth and tongue with lip swelling and loss of taste. NCCIH says chewing fresh leaves can irritate or sore the mouth. The EU monograph lists gastrointestinal disturbances, frequency not known. An under-the-tongue product caused mouth numbness in one trial. Systematic review ^{54 38 62 58 7}
Do not use if you are allergic to the daisy family (Asteraceae/Compositae). The EU monograph lists allergy to feverfew or to other Asteraceae plants (reviews name chamomile, ragweed, chrysanthemum, tansy, sunflower and yarrow as examples) as a contraindication. Parthenolide is a strong skin allergen. Case reports show rashes from feverfew creams, including creams made with 'parthenolide-depleted' extract, and patients allergic to one daisy-family plant may react to feverfew. Airborne reactions from the living plant have been suspected. Authoritative guidance ^{58 41 27 40 42}
Not recommended in pregnancy or breastfeeding. The EU herbal committee says safety in pregnancy and breastfeeding has not been established, animal studies show signs of reproductive toxicity, and use is not recommended. NCCIH says not to take feverfew in pregnancy because it may affect uterine contractions. Reviews describe it as a traditional emmenagogue (a herb used to bring on periods). In rats, a high oral dose reduced fetal size and was toxic to cultured embryos. No human pregnancy data were found. LactMed (seen only as a summary) says no data exist on feverfew in breast milk. Authoritative guidance ^{58 57 62 56 38 60}
May slow blood clotting: care with blood thinners, aspirin-type drugs and before surgery. In test-tube studies, feverfew extract and parthenolide reduce platelet clumping and secretion. The only human report found is a single case of a woman who had months of vaginal bleeding and prolonged clotting tests while taking feverfew capsules, rated 'probable' by the authors. No trial of feverfew with warfarin or aspirin was found. NCCIH advises stopping at least 2 weeks before scheduled surgery. The EU monograph lists no interactions, so sources disagree on how much this matters. Laboratory research ^{18 15 19 29 2 17 1 32 62 58}
Not recommended under 18 and little is known about long-term use. The EU monograph does not recommend feverfew in children and adolescents under 18 because of lack of adequate data. No trial of feverfew alone in children was found. No long-term toxicity studies are known, and the EU says tests for genotoxicity and carcinogenicity have not been done. A review (Pareek) cites a study of 30 migraine patients taking feverfew for 11 months that found no unexpected chromosome changes; that study was not read. Authoritative guidance ^{58 57 55 38}
Products vary: parthenolide content ranges from none to high. Commercial feverfew capsules have had a 150-fold range of parthenolide per capsule (0.02 to 3.0 mg), and some products sold as feverfew had none detected. Parthenolide falls during storage and with heat. So two bottles labelled feverfew may act and cause side effects differently, and trial results for one product do not carry over to another. Lab analysis ^{36 20 23 9}

Side effects 9

Effect	How often	Severity and recovery	Evidence
Stomach upset, nausea, bloating, abdominal pain The most common side effect in trials and the one the EU monograph lists.	Not known (EU); not given as a rate in the Cochrane abstract	mild reversible	Systematic review ^{54 58 62}
Mouth ulcers or sore mouth Linked to chewing fresh leaves; also seen with dried-leaf capsules in trials.	11% in a larger series of users, as cited in Pareek 2011	mild to moderate reversible	Review ^{54 38 62}
Swollen lips, tongue or mouth lining, loss of taste Reported as part of oral inflammation (Pareek 2011). A swelling that includes the throat needs emergency care.	Not known	moderate reversible	Review ^{38 25}
Post-feverfew syndrome after stopping: rebound headache, poor sleep, nervousness, tension, tiredness, joint and muscle stiffness Seen in long-term users switched to placebo (n=9). Only one small trial and review descriptions.	Not known	mild to moderate settles over time (duration not studied)	Controlled trial ^{24 38}
Skin allergy (contact dermatitis) from touching the plant or creams Parthenolide is a strong contact allergen. Even parthenolide-depleted extract caused reactions in 4 of 7 allergic patients.	Not known	mild to severe reversible when stopped	Case series ^{41 27 40}
Faster heart rate Pareek reports heart rate rising by up to 26 beats a minute in 2 treated patients; the original trial was not read.	2 of 8 patients in one trial summarised in a review	unclear not stated	Review ³⁸
Bleeding: prolonged vaginal bleeding with prolonged clotting tests The report gives very large capsule amounts and is not consistent about them. One case cannot show how often this happens.	One case	moderate not clear from the report; the patient was treated with a hormone medicine and iron	Case report ²
Mouth numbness with under-the-tongue feverfew-ginger Nausea was also frequent in that trial.	Among the most frequent side effects in one trial	mild reversible	Controlled trial ⁷
Allergic reaction in someone sensitive to ragweed or daisy-family plants Do not use if allergic to this plant family.	Not known	mild to severe depends	Authoritative guidance ^{62 58}

Liver

No published case of liver injury from feverfew was found in the PubMed searches done for this page, and the trial abstracts report no liver problems. The Diener 2005 trial measured laboratory safety parameters and reported a favourable benefit-risk balance, without liver detail in the abstract. The LiverTox entry for feverfew could not be opened, so its rating is not stated here. Parthenolide in the lab acts on liver-cell pathways, but no human harm has been shown. ^{11 54}

How often. No frequency of liver injury could be found. The LiverTox page was not read.

Monitoring. No agency monitoring advice was found. Stop and seek care for yellow skin or eyes, dark urine, pale stools or severe tiredness.

This is a safety connection. It is not evidence that Feverfew supports liver health.

Medicines and supplements 7

With	Why it matters	Importance	Evidence	What to do
Warfarin and other anticoagulants (including newer blood thinners) prescription	Feverfew extract and parthenolide reduce platelet clumping and secretion in the lab, which could add to bleeding.	Listed as a potential warfarin interaction in a review that stresses nearly all evidence is lab, animal or single case reports. One case of bleeding with abnormal clotting tests on feverfew alone. No human study of feverfew with warfarin was found.	Laboratory research Very low certainty ^{17 2 18 15 32}	Do not combine without asking your doctor or pharmacist; clotting tests may need checking. Stop feverfew before surgery as your surgeon advises.
Aspirin, clopidogrel and other antiplatelet drugs; NSAIDs such as ibuprofen and naproxen prescription	Antiplatelet action in the lab could add to the bleeding effect of these drugs.	A review lists feverfew among herbs with antiplatelet activity that may interact with aspirin and NSAIDs. Based on case reports, animal and lab data; no feverfew-specific human case found in the abstract.	Pharmacological theory Very low certainty ^{1 32}	Ask a pharmacist before combining, especially if you take aspirin daily.
Surgery and dental procedures procedure	Possible slowing of clotting.	NCCIH advises stopping at least 2 weeks before scheduled surgery. The authors of the case report advise tapering and stopping 2 to 3 weeks before surgery; this is their advice, not tested.	Authoritative guidance Very low certainty ^{62 2}	Tell your surgeon and anaesthetist about feverfew and stop in advance as they advise.
Other herbs and supplements that affect clotting (for example ginkgo, garlic, ginger, willow bark) herb	Added antiplatelet effects are theoretically possible.	Reviews list these herbs together as having antiplatelet activity; no study of combinations with feverfew was found.	Pharmacological theory Very low certainty ^{1 32}	Tell your pharmacist about every supplement you take.
Medicines broken down by liver enzymes (CYP1A2, 2C8, 2C9, 2C19, 2D6, 3A4) prescription	Feverfew herb was among herbs that inhibited human drug-metabolising enzymes in a test-tube screen.	Which enzymes feverfew inhibited and at what strength is not given in the abstract; IC50 values for all herbs tested ranged from 20 to 1000 micrograms per mL. Importance in people is unknown.	Laboratory research Very low certainty ⁵⁰	Ask a pharmacist if you take drugs with a narrow safety margin.
Prescription migraine medicines prescription		NCCIH says feverfew may interact with some medicines, including those used for migraine, without naming them. The EU monograph lists no interactions. Authors of one trial noted patients seemed to use more symptom-relief drugs while on feverfew.	Authoritative guidance Not enough evidence ^{62 58 10}	Tell the doctor treating your migraine that you take feverfew.
Heart conditions (theoretical, long-term) condition	Feverfew blocks cyclo-oxygenase products in lab tests; a review raises a theoretical concern about long-term dosing in coronary disease.	No harm in people has been shown.	Pharmacological theory Very low certainty ^{46 48}	Ask your cardiologist if you have coronary disease.

Who should check first 7

Situation	Advice	Evidence
Known allergy to feverfew or to other Asteraceae (Compositae) plants such as chamomile, ragweed, chrysanthemum, tansy	Do not use (EU contraindication). This includes creams.	Authoritative guidance ^{58 41}
Pregnancy	Not recommended; safety not established; animal signs of reproductive toxicity.	Authoritative guidance ^{58 62 56}
Breastfeeding	Not recommended by the EU; LactMed (summary only) found no data.	Authoritative guidance ^{58 60}
Children and teenagers under 18	Not recommended (lack of adequate data).	Authoritative guidance ⁵⁸
Bleeding disorders, or taking anticoagulant or antiplatelet drugs	Ask a doctor first; possible added bleeding.	Pharmacological theory ^{2 17 1}
Before scheduled surgery	Stop in advance (NCCIH: at least 2 weeks) as advised by the surgical team.	Authoritative guidance ⁶²
New or changing headache	The EU monograph says to use only after serious causes are excluded by a doctor, and to see a doctor if migraines return after 2 months of use or symptoms worsen.	Authoritative guidance ⁵⁸

Overdose, product quality and regulators

Summary. Feverfew has a record of mostly mild side effects in trials, but real toxicity data are thin. No chronic-toxicity studies were found, the EU says genotoxicity and carcinogenicity tests have not been done, and a rat study showed harm to pregnancy at a high dose. The EU reports no case of overdose.

Animal. In pregnant rats given 839 mg/kg a day by mouth, fetuses exposed from gestation days 8 to 15 were smaller with more runts, and the extract was toxic to cultured rat embryos (Yao 2006, 5 rats per group). The EU monographs cite a single rat study showing maternal toxicity and embryotoxicity. In mice and rats, 40 and 60 mg/kg of extract did not change movement or pentobarbitone sleep time (Jain 1999).

Human doses studied. Dried leaf capsules in older trials for up to 4 months at a time; the CO2 extract MIG-99 up to 16 weeks (adverse events similar to placebo); a phase I trial of tablets giving up to 4 mg parthenolide a day for 28-day cycles with no significant toxicity. Doses are not given as advice here.

High dose or long term signals. One case of months of vaginal bleeding with prolonged clotting tests after 9 months on very large capsule amounts (Alenzi 2021). A review cites a genotoxicity study in 30 migraine patients after 11 months that found no unexpected chromosome changes (not read). No long-term safety studies were found.

Overdose response. The EU monograph states no case of overdose has been reported.

Genotoxicity. EU monograph (2010): tests on genotoxicity and carcinogenicity have not been performed. Pareek cites a human study of chromosome changes with no unexpected aberrations; the original was not read.

Toxic plant parts. Fresh leaves are the main contact and mouth irritant: they are rich in parthenolide, the strong allergen and (in the lab) the compound that irreversibly blocked muscle contraction in fresh-leaf extracts (Barsby 1993). Leaves, flowering tops and seeds are high in parthenolide, stalks and roots low (Heptinstall 1992). Airborne contact dermatitis from living plants has been suspected.

The main practical risk is that products differ widely: parthenolide content ranges from none to high, falls during storage, and some products sold as feverfew had none. No studies of pesticides, heavy metals or microbes in feverfew products were found.

Parthenolide content across US products. Parthenolide per capsule varied 150-fold (0.02 to 3.0 mg); following label directions, daily parthenolide would range 160-fold (0.06 to 9.7 mg). ³⁶

Products with no parthenolide. In a UK analysis, several commercial products sold as feverfew varied widely and in some products parthenolide was not detected; powdered leaf lost parthenolide during storage. ²⁰

Plant variety and origin. Parthenolide ranged from not detectable to 1.68% of dry weight across 31 feverfew accessions; wild-collected seed averaged higher than commercial seed. ⁹

Storage and heat. About 40% of parthenolide in an extract degraded in 6 months at 50 C, but it stayed constant at 5 C and low humidity. ²³

Mexican and US plant samples. Parthenolide was present in all samples analysed, highest in samples from Oaxaca and Puebla (0.28% and 0.25%). ³

Name confusion and look-alikes. Some reviews list 'Parthenium hysterophorus' among the common names of feverfew. That is a different plant, a weed known for skin and airway allergy; reports on it should not be assumed to apply to feverfew. Chamomile and other daisy-family plants look similar but have different chemistry. ^{25 59}

Body	Action	Date
European Medicines Agency, HMPC (European Union)	EU herbal monograph on Tanacetum parthenium herba, Final Revision 1 (EMA/HMPC/48715/2017): traditional herbal medicine for prevention of migraine headaches after serious conditions are excluded by a doctor; powdered herb in solid oral forms; contraindicated in hypersensitivity to Asteraceae; not recommended under 18; pregnancy and breastfeeding not recommended (animal reproductive toxicity); no interactions reported; side effects: gastrointestinal disturbances, frequency unknown; no case of overdose. source	2020-07-08
European Medicines Agency, HMPC (European Union)	Original Community herbal monograph (EMA/HMPC/587578/2009), replaced by Revision 1: notes a single rat study with maternal toxicity and embryotoxicity; genotoxicity and carcinogenicity tests not performed. source	2010-11-25
NCCIH (US National Institutes of Health) (United States)	Consumer page: inconsistent evidence for migraine; no serious side effects reported; mouth irritation from chewing fresh leaves; do not use in pregnancy; stop at least 2 weeks before surgery. source	not stated

When to get medical help

Swelling of the face, lips, tongue or throat, trouble breathing, wheezing or widespread hives after feverfew: call emergency services.
Heavy or long-lasting bleeding, black stools, vomiting blood, easy bruising or nosebleeds that will not stop, especially on blood thinners: get medical care.
Pregnant, or possibly pregnant, and taking feverfew: stop and call your doctor or midwife.
Mouth sores or swelling that do not heal within a few days of stopping.
A sudden severe 'worst-ever' headache, or a headache with fever and stiff neck, weakness, confusion, vision loss or fainting: emergency care (general medical advice, not feverfew-specific).
Rash that blisters, spreads or follows contact with the plant or a cream: stop and see a doctor.

Stop the supplement and contact a clinician or emergency service. In the US, Poison Control is 1-800-222-1222.

General information only, not medical advice. Ask a clinician or pharmacist before use, especially with medicines, in pregnancy or with a health condition. See the Natural Remedy Safety guide.

Frequently asked questions

Does feverfew prevent migraine?

Possibly a little, but the evidence is low quality. The 2015 Cochrane review found that in the largest trial feverfew cut attacks by 1.9 a month and placebo by 1.3. Earlier trials were mixed, and a 2025 meta-analysis found fewer attacks but no clear effect on pain severity, nausea or vomiting. The 2012 US guideline rated one extract, MIG-99, as probably effective.

^{54 11 35 21 28}

What is MIG-99 and is it better than ordinary feverfew?

MIG-99 is a standardised CO2 extract of feverfew used in two trials. The first (147 people) found no overall benefit, with benefit only in a small subgroup with four or more attacks a month. The second (170 people) found a small gain over placebo. There has been no head-to-head test against ordinary leaf, so it is not known to be better.

^{43 11 21 10}

Can feverfew treat a migraine that has already started?

Only a pilot trial of an under-the-tongue feverfew and ginger product suggests it might: 32% were pain-free at two hours versus 16% on placebo, in 60 people. That is a combination product tested on very few people, and mouth numbness and nausea were reported.

^{7 6}

What is post-feverfew syndrome and can I stop suddenly?

It is the name for rebound symptoms after stopping feverfew following long use: headaches, poor sleep, nervousness, tension, tiredness and joint and muscle stiffness. In a 1985 trial of 17 long-term users, people switched to placebo had more headache, nausea and vomiting. How common it is and whether tapering helps has not been studied. Ask your doctor or pharmacist before stopping if you have used feverfew for a long time.

^{24 38 2}

Does feverfew cause mouth ulcers?

It can. Mouth ulcers and stomach upset were the most common side effects in trials according to Cochrane. A review reports mouth ulceration in 11% of a larger series of users, with swollen lips and tongue and loss of taste in some. NCCIH says chewing fresh leaves can irritate the mouth.

^{54 38 62}

Is feverfew safe in pregnancy or breastfeeding?

No. The EU herbal committee says safety has not been established, animal studies show signs of reproductive toxicity, and it does not recommend use in pregnancy or breastfeeding. NCCIH says not to take it in pregnancy because it may affect contractions of the womb. In rats, a high dose produced smaller fetuses and was toxic to cultured embryos. There are no human pregnancy studies.

^{58 57 62 56}

Can I take feverfew with blood thinners or before surgery?

Ask first. In test-tube studies feverfew extract and parthenolide reduce platelet clumping, and one woman had months of vaginal bleeding and abnormal clotting tests on feverfew capsules. No study of feverfew with warfarin or aspirin in people was found, and the EU monograph lists no interactions, so sources disagree. NCCIH advises stopping at least 2 weeks before scheduled surgery.

^{18 2 17 1 62 58}

Who should not use feverfew?

Anyone allergic to feverfew or other daisy-family plants (such as chamomile, ragweed, chrysanthemum or tansy), as the EU monograph states. Also not recommended in pregnancy, breastfeeding and under 18. People with bleeding problems, those on blood thinners and those about to have surgery should ask a doctor first.

^{58 62 41 27}

Is feverfew safe for children?

The EU herbal committee does not recommend it under 18 because of a lack of adequate data. No trial of feverfew alone in children was found; a review of supplements for children's migraine mentions only a mixed product containing feverfew.

^{58 55}

Does feverfew help arthritis?

Not in the one trial done. In 41 women with rheumatoid arthritis, six weeks of dried feverfew leaf did no better than placebo on pain, stiffness, grip or inflammation blood tests. Cell studies show anti-inflammatory activity, but that has not been confirmed in patients.

^{39 37 48}

Why do feverfew products differ so much?

Their parthenolide content varies enormously. US capsules ranged 150-fold per capsule (0.02 to 3.0 mg), some products sold as feverfew had none detected, and parthenolide falls with storage and heat. So results from one tested product, like MIG-99, cannot be assumed for another. Ask a pharmacist about the product and amounts.

^{36 20 9 23}

Does feverfew reduce fever, treat cancer or harm the liver?

No human trial supports fever or cancer use. Parthenolide kills some cancer cells in a dish, but in the one human safety trial it could not be found in the blood, and feverfew is not a cancer treatment. No case of liver injury from feverfew was found in the searches done, but one reference database entry on liver safety could not be opened.

^{8 31 62 38}

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Editorial transparency

Written by: AlternativeMed editorial team. Research compiled with AI assistance, then checked against PubMed records.
Medical review: None. This page has not been reviewed by a physician or pharmacist.
First published: 2026-10-25
Last substantive update: 2026-10-25
How we research: We searched PubMed, read the abstracts of the studies cited, read both versions of the EU herbal monograph on feverfew (2010 and the 2020 revision) and two open-access reviews and a case report in full, and checked the plant name and chemical IDs against GBIF, NCBI and PubChem. The NCCIH page was read through a summary tool; the LiverTox and LactMed entries could not be opened and are not quoted as facts.
How we rate evidence: See "How we rate evidence" in the Evidence tab.
Independence: No product is promoted on this page. No affiliate links are shown. If one is added later it will be labelled and kept apart from the evidence.

Sources 62

Each source was opened and checked. Where we read only the abstract, it says so. The small numbers in the text point here.

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