The Basics

What is Peony / Paeonia lactiflora Paeonia officinalis Paeonia suffruticosa?

Peony is used for gout, osteoarthritis, fever, respiratory tract illnesses, and cough; sometimes also used for menstrual cramps and PCOS.

Brand names for Peony / Paeonia lactiflora Paeonia officinalis Paeonia suffruticosa

Na

How Peony / Paeonia lactiflora Paeonia officinalis Paeonia suffruticosa is classified

Complementary Therapies, Phytotherapy, Plants, Medicinal

Peony / Paeonia lactiflora Paeonia officinalis Paeonia suffruticosa During Pregnancy

Peony / Paeonia lactiflora Paeonia officinalis Paeonia suffruticosa 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 Peony / Paeonia lactiflora Paeonia officinalis Paeonia suffruticosa while pregnant

N/A

Taking Peony / Paeonia lactiflora Paeonia officinalis Paeonia suffruticosa While Breastfeeding

What are recommendations for lactation if you're taking Peony / Paeonia lactiflora Paeonia officinalis Paeonia suffruticosa?

Peony (Paeonia sp.) root contains paeoniflorin which is thought to be the primary ingredient that decreases serum prolactin. Other ingredients include albiflorin, benzoylpaeoniflorin, liquiritin, flavonoids, proanthocyanidins, tannins, terpenoids, triterpenoids, and complex polysaccharides. Peony has no specific lactation-related uses. It is most commonly used to treat heart disease, menstrual irregularities, uterine fibroids, arthritis, and cough, although data supporting these uses is poor. No data exist on the excretion of any components of peony into breastmilk or on the safety and efficacy of peony in nursing mothers or infants. Peony is generally well tolerated, but can occasionally cause gastrointestinal upset, and allergic skin reactions, especially when applied topically. Peony can lower serum prolactin, so it might suppress lactation; therefore, it is probably best to avoid peony during breastfeeding. 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

Peony (Paeonia sp.) root contains paeoniflorin which is thought to be the primary ingredient that decreases serum prolactin. Other ingredients include albiflorin, benzoylpaeoniflorin, liquiritin, flavonoids, proanthocyanidins, tannins, terpenoids, triterpenoids, and complex polysaccharides. Peony has no specific lactation-related uses. It is most commonly used to treat heart disease, menstrual irregularities, uterine fibroids, arthritis, and cough, although data supporting these uses is poor. No data exist on the excretion of any components of peony into breastmilk or on the safety and efficacy of peony in nursing mothers or infants. Peony is generally well tolerated, but can occasionally cause gastrointestinal upset, and allergic skin reactions, especially when applied topically. Peony can lower serum prolactin, so it might suppress lactation; therefore, it is probably best to avoid peony during breastfeeding. 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 Peony / Paeonia lactiflora Paeonia officinalis Paeonia suffruticosa on milk supply

A traditional, nonstandardized decoction of peony and licorice roots called Shaoyao-Gancao-Tang in Chinese and Shakuyaku-Kanzo-To in Japanese was studied in women with elevated serum prolactin caused by long-term (>6 months) ingestion of risperidone. Patients received either bromocriptine 5 mg daily for 4 weeks followed by 4 weeks of 22.5 grams daily of the peony-licorice decoction, or the same drugs in the reverse order. Evaluation of serum prolactin found that both treatments reduced serum prolactin by 21 to 28% from baseline at 4 and 8 weeks.[1] The prolactin level in a mother with established lactation may not affect her ability to breastfeed.

Possible alternatives to Peony / Paeonia lactiflora Paeonia officinalis Paeonia suffruticosa

None listed

List of References

Lactation sources: Drugs and Lactation Database (LactMed) [Internet]. Bethesda (MD): National Library of Medicine (US); 2006-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK501922/1. Yuan HN, Wang CY, Sze CW et al. A randomized, crossover comparison of herbal medicine and bromocriptine against risperidone-induced hyperprolactinemia in patients with schizophrenia. J Clin Psychopharmacol. 2008;28:264-370. PMID: 18480682

Disclaimer: This material is provided for educational purposes only and is not intended for medical advice, diagnosis, or treatment. Consult your healthcare provider with any questions.

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