Scientific Name(s): Eupatorium perfoliatum L.
Common Name(s): Agueweed, Boneset, Crosswort, Eupatorium, Feverwort, Indian sage, Sweating plant, Thoroughstem, Thoroughwax, Thoroughwort, Vegetable antimony, Wild Isaac
Medically reviewed by Drugs.com. Last updated on Jan 11, 2022.
There is no clinical evidence to guide the use of boneset. Limited in vitro experimental data suggest anti-inflammatory, antiviral, and cytotoxic activity.
There is no clinical evidence to guide the dosage of boneset. Traditional use was 2 g of leaves and flowers. Internal use should be cautioned due to the occurrence of hepatotoxic pyrrolizidine alkaloids present in the plant.
Contraindications have not yet been identified.
Documented adverse effects, including cytotoxic constituents. Avoid use.
None well documented.
The FDA has classified boneset as an "Herb of Undefined Safety."
The ingestion of large amounts of teas or extracts may result in severe diarrhea. The identification of pyrrolizidine alkaloids in Eupatorium species is cause for concern. This class of alkaloids is known to cause hepatic impairment after long-term ingestion. While direct evidence for a hepatotoxic effect from boneset does not exist, there is sufficient evidence to indicate that any plant containing unsaturated pyrrolizidine alkaloids should not be ingested.
- Asteraceae (daisy)
Boneset is a ubiquitous plant found growing in swamps, marshes, and shores from Canada to Florida and west to Texas and Nebraska. The plant is easily recognized by its long, tapering leaves that join each other around a single stout stem giving the impression of one long leaf pierced at the center by the stem. Hence its name perfolia, meaning "through the leaves." The plant grows from July to October to a height of about 1 meter. It flowers in late summer with white blossoms that appear in small upright bunches. The entire plant is hairy and light green.(Hensel 2011, USDA 2016)
Boneset has been used as a charm and as a medicinal remedy for centuries by indigenous North Americans. As a charm, the root fibers were applied to hunting whistles with the belief that they would increase the whistle's ability to call deer. As an herbal remedy, American Indians used boneset as an antipyretic. The early settlers used the plant to treat rheumatism, dropsy, dengue fever, malaria, pneumonia, and influenza. The name boneset was derived from the plant's use in the treatment of breakbone fever, a term describing the high fever that often accompanies influenza. Boneset was official in the US Pharmacopeia from 1820 to 1900. Based on data from early medical compendia, boneset is believed to have diuretic and laxative properties in small doses, while large doses may result in emesis and catharsis. Boneset had been used by physicians to treat fever, but its use was replaced by safer and more effective antipyretics.Bolyard 1981, Erichsen-Brown 1989, Hensel 2011, Herz 1972
Boneset leaves and roots contain a variety of sesquiterpene lactones(Bohlmann 1977, Herz 1977) as well as a number of sterols and triterpenes, including sitosterol and stigmasterol.(DomInguez 1974) The flavonoids quercetin, kaempferol, and eupatorine, as well as glycosides also have been identified in the plant.(Herz 1972, Wagner 1972) Eupafolin is an active flavonoid component of E. perfoliatum and in recent years, it has been reported to exhibit anti‑inflammatory, antioxidant, and antitumor cell proliferation effects.(Chen 2020) A number of species of Eupatorium have been shown to contain unsaturated pyrrolizidine alkaloids of the type that can cause serious liver damage.(Locock 1966) E. perfoliatum were shown to contain dehydropyrrolizidine alkaloids (0.0002 to 0.07% w/w), the majority dominated by lycopsamine and intermedine and their N‐oxides and acetylated derivatives. Alcoholic tinctures, hot water infusions and decoctions had high concentrations of these alkaloids.(Colegate 2018) Acidic polysaccharides containing principally xylose and glucuronic acid have been elucidated(Vollmar 1986) as well as caffeic acid derivatives.(Hensel 2011, Maas 2008)
Uses and Pharmacology
Animal and in vitro data
The isolated polysaccharides and an extract of E. perfoliatum combined with other herbs stimulate phagocytic activity in vitro by a carbon particle clearance technique.(Wagner 1991, Wagner 1985)
The in vitro anti-inflammatory properties of E. perfoliatum and its extracts have been demonstrated.(Maas 2011)
The ethanol extract of boneset leaves was shown to have modest antibacterial and cytotoxic activity.(Habtemariam 2009, Khan 2009)
In vitro activity against the influenza virus via preventing attachment to the host cell has been reported.(Derksen 2016) In addition, the in vitro antiviral action of E. perfoliatum against dengue virus infection has also been established.(Sinha 2020)
Eupafolin alleviates cerebral ischemia/reperfusion injury in rats via blocking the TLR4/NF‑kappaB signaling pathway.(Chen 2020) In vitro studies have also shown that eupafolin ameliorates lipopolysaccharide-induced cardiomyocyte autophagy via PI3K/AKT/mTOR signaling pathways by means of antiautophagy activity.(Gao 2019) In addition, the suppressive effects of eupafolin on various tumor types, including esophageal cancer, hepatocellular carcinoma, renal carcinoma and prostate cancer has been extensively studied in vitro.(Chen 2020)
There is no recent clinical evidence to guide dosage of boneset. Traditional use was at a dose of 2 g of leaves and flowers. Internal use should be cautioned due to the occurrence of hepatotoxic pyrrolizidine alkaloids in the plant.
Pregnancy / Lactation
Avoid use. Documented adverse effects, including cytotoxic constituents.Duke 2002, Ernst 2002
None well documented.
Diarrhea and nausea have been reported with the ingestion of large doses.(Duke 2002, Khan 2009)
The ingestion of large amounts of teas or extracts may result in severe diarrhea. The identification of pyrrolizidine alkaloids in Eupatorium species is cause for concern. This class of alkaloids is known to cause hepatic impairment after long-term ingestion. While direct evidence for a hepatotoxic effect from boneset does not exist, there is sufficient evidence to indicate that any plant containing unsaturated pyrrolizidine alkaloids should not be ingested. Concerns associated with dehydropyrrolizidine alkaloids provide a compelling reason for preclusive caution until further research can better define the toxicity and carcinogenicity of the dehydropyrrolizidine alkaloid content of E. perfoliatum.(Colegate 2018) E. perfoliatum is considered a toxic plant.(Duke 2002, Khan 2009, Quattrocchi 2012)
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