Pulsatilla

Anemone pulsatilla, Easter flower, meadow anemone, passe flower, pasque flower, Pulsatilla pratensis, P. vulgaris, Pulsatillae herba

Pulsatilla is obtained from dried above ground parts of anemone pulsatilla (Pulsatilla vulgaris) and P. pratensis. It contains protoanemonin, ranunculin, and degradation products of ranunculin, including anemonin, anemoninic acid, and anemonic acid. Protoanemonin may cause stimulation and paralysis of the central nervous system (CNS); its alkylating action may inhibit cell regeneration, leading to kidney irritation. Protoanemonin also has anti-infective activity. Abortion and birth defects have been reported among grazing animals who consumed large amounts of protoanemonin containing plants. Pulsatilla is available as a dried herb, pellets, extracts, tincture, and tablets, in products such as Boiron Pulsatilla 9c and Pulsatilla 200ck.

Reported uses

Pulsatilla is used to treat inflammatory and infectious diseases of the skin and mucosa, diseases and functional disorders of the GI tract, and functional urogenital disorders. It’s also used to treatneuralgia, migraine, and general restlessness.

Administration

  • Dried herb: 100 to 300 mg as a tea by mouth three times a day
  • Liquid extract (1:1 in 25% alcohol): 0.1 to 0.3 ml (2 to 6 gtt) by mouth three times a day
  • Oral tablets and pellets: by mouth, as directed (see manufacturer package insert)
  • Tincture (1:10 in 40% alcohol): 0.5 to 3 ml (10 to 60 gtt) by mouth three times a day.

Hazards

Adverse effects associated with the use of pulsatilla include irritation of mucous membranes, nausea, vomiting, abdominal pain, colic, diarrhea, irritation of kidneys and urinary tract, asphyxiation, and rash. There are currently no reported interactions with pulsatilla.

Pregnant and breast-feeding patients shouldn’t use this herb. Alcoholic patients and those with liver disease shouldn’t use forms that contain alcohol.

Safety Risk

Fresh pulsatilla plant parts can cause severe skin and mucosal irritation in susceptible patients. Irrigate affected area with dilute potassium permanganate solution, and then apply mucilage preparation. Overdose may cause renal and urinary tract irritation and severe stomach irritation with colic and diarrhea. Urge patient to go to the emergency room, where he may undergo gastric lavage with activated charcoal.

Clinical considerations

  • Some products may contain alcohol and may not be suitable for use by children, alcoholic patients, patients with liver failure, or patients who take disulfiram or metronidazole.
  • Tell patient that fresh pulsatilla is considered poisonous and shouldn’t be ingested or placed on the skin. If patient uses pulsatilla, it should be dried.
  • Warn patient that kidney and urinary tract irritation can occur at higher than recommended doses.
  • If patient is pregnant or planning to get pregnant, caution her not to use this herb.
  • Tell patient to consult a licensed health care provider if symptoms last longer than 7 days, or if they worsen.
  • Tell patient to remind prescriber and pharmacist of any herbal and dietary supplement that he’s taking when obtaining a new prescription.
  • Advise patient to consult his health care provider before using an herbal preparation because a treatment with proven efficacy may be available.

Research summary

The concepts behind the use of pulsatilla and the claims made regarding its effects haven’t yet been validated scientifically.