Dong Quai / Angelica sinensis

The Basics

What is Dong Quai / Angelica sinensis?

Commonly taken by mouth for menopausal symptoms, including migraines and many other conditions.

Brand names for Dong Quai / Angelica sinensis

Na

How Dong Quai / Angelica sinensis is classified

Complementary Therapies, Phytotherapy, Plants, Medicinal

Dong Quai / Angelica sinensis During Pregnancy

Dong Quai / Angelica sinensis pregnancy category

Category N/ANote that the FDA has deprecated the use of pregnancy categories, so for some medications, this information isn’t available. We still think it’s useful to list historical info, however, given what a common proxy this has been in the past.

What we know about taking Dong Quai / Angelica sinensis while pregnant

N/A

Taking Dong Quai / Angelica sinensis While Breastfeeding

What are recommendations for lactation if you're taking Dong Quai / Angelica sinensis?

Dong quai (Angelica sinensis) root contains a number of chemicals, including ligustilide, ferulic acid, angelicide. Dong quai has no generally recognized lactation-related uses, although some midwives in the United States reportedly have used it for postpartum blues or depression.[1] It is often used as part of a postpartum herbal mixture in Asia[2][3] and is used as a women’s herb in Chinese medicine for symptoms associated with menstruation and menopause. No data exist on the excretion of any components of dong quai into breastmilk or on the safety and efficacy of dong quai in nursing mothers or infants. Although it is usually well tolerated in general use, it may increase the risk of bleeding in patients taking warfarin and antiplatelet drugs and cause photosensitivity reactions. Dong quai is best avoided during breast feeding.[4] Dietary supplements do not require extensive pre-marketing approval from the U.S. Food and Drug Administration. Manufacturers are responsible to ensure the safety, but do not need to prove the safety and effectiveness of dietary supplements before they are marketed. Dietary supplements may contain multiple ingredients, and differences are often found between labeled and actual ingredients or their amounts. A manufacturer may contract with an independent organization to verify the quality of a product or its ingredients, but that does not certify the safety or effectiveness of a product. Because of the above issues, clinical testing results on one product may not be applicable to other products.

Maternal / infant drug levels

Dong quai (Angelica sinensis) root contains a number of chemicals, including ligustilide, ferulic acid, angelicide. Dong quai has no generally recognized lactation-related uses, although some midwives in the United States reportedly have used it for postpartum blues or depression.[1] It is often used as part of a postpartum herbal mixture in Asia[2][3] and is used as a women’s herb in Chinese medicine for symptoms associated with menstruation and menopause. No data exist on the excretion of any components of dong quai into breastmilk or on the safety and efficacy of dong quai in nursing mothers or infants. Although it is usually well tolerated in general use, it may increase the risk of bleeding in patients taking warfarin and antiplatelet drugs and cause photosensitivity reactions. Dong quai is best avoided during breast feeding.[4] Dietary supplements do not require extensive pre-marketing approval from the U.S. Food and Drug Administration. Manufacturers are responsible to ensure the safety, but do not need to prove the safety and effectiveness of dietary supplements before they are marketed. Dietary supplements may contain multiple ingredients, and differences are often found between labeled and actual ingredients or their amounts. A manufacturer may contract with an independent organization to verify the quality of a product or its ingredients, but that does not certify the safety or effectiveness of a product. Because of the above issues, clinical testing results on one product may not be applicable to other products.

Possible effects of Dong Quai / Angelica sinensis on milk supply

A study in Japan compared the use of a mixture of 13 herbs, including dong quai, to ergonovine for their effects on lactation and serum prolactin in postpartum women. The herbal mixture, called Xiong-gui-tiao-xue-yin, was given in a randomized fashion to 41 women in a dose of 2 grams of a dried aqueous extract 3 times daily. A comparable group of 41 women were randomized to receive methylergonovine 0.375 mg daily. Therapy was started on the day of delivery, but the duration of therapy was not specified. Plasma oxytocin and prolactin were measured on days 1 and 6; milk volumes were measured daily, although the method of measuring milk volume was not specified. Serum prolactin was higher on days 1 and 6 in the women who received the herbals; plasma oxytocin was lower on day 1 in the women who received the herbal, but not different on day 6. Milk volumes were greater on days 4, 5, and 6 in women who received the herbal mixture.[5] This study has serious flaws that make its interpretation impossible. First, milk volume measurement is subject to considerable variability depending on the measurement method used, but the method was not specified. Second, methylergonovine has caused decreases in serum prolactin and milk production in some studies.[6][7] Because of the lack of a placebo group, the differences found could be a negative effect of methylergonovine rather than a positive effect of the herbal preparation. Because this study used a multi-ingredient combination products in which dong quai was only one component, the results might be different from studies in which dong quai was used alone.

Possible alternatives to Dong Quai / Angelica sinensis

None listed