Crataegi folium cum flore

Crataegifolium cum flore, hawthorn leaves with flowers, refers to the dried, up to 7 cm long, flowering branch tips of the various Crataegus species (see hawthorn below).

Hawthorn leaves and flowers:

Quality is defined in the European Pharmacopoeia (Ph. Eur.) and in the German Pharmacopoeia Codex (DAC ).

HMPC monograph: Traditional-use: intermittent nervous heart complaints (e.g. palpitations, anxiety-induced extrasystoles) after exclusion of serious illness, for mild stress symptoms, as a sleep aid.

ESCOP monograph: only for finished medicinal products with alcoholic extracts as the active ingredient; for tea preparations the indication is "nervous heart complaints and support of cardiovascular function
Commission E-monograph: declining cardiac performance(cardiac insufficiency) corresponding to stage II according to NYHA (New York Heart Association).

Empirical medicine: functional heart complaints, coronary heart disease, cardiac arrhythmia, artherosclerosis prophylaxis

About 1% to 2% flavonoids mainly flavone glycosides, flavone glycosides such as vitexin, rutin, hyperoside and derivatives. Oligomeric procyanides, catechins, epicatechin, epicatechin tanning agents (see below tanning agents), crategussic acid, phenolic carboxylic acids, biogenic amines. The drugs contain no glycosides.

Crataegifolium cum flore improves coronary blood flow, has a positive inotropic and dromotropic effect, regulates blood pressure and has an antispasmodic effect.

The drug is used, among other things, in the treatment of incipient heart failure ,
if other measures are not yet required.

Hawthorn extracts are particularly suitable for treating declining cardiac performance. For cardiac insufficiency NYHA II-III, the optimal dosage is 900-1200mg dry extract.

Adults:

Depending on the form of administration - see EMA and package leaflet

Allergy to ingredients.

Not recommended for children under 12 years of age. Also not recommended for use in adolescents under 18 years of age due to concerns requiring medical advice.

In the absence of sufficient data, use during pregnancy and lactation is not recommended.No fertility data available.

Cardiac glycoids, e.g., digoxin.

Cor-Select® Ointment, Dr. Klinger's Heart and Circulation Tea®, Guttacor-Balsam® N, Orbis® Nerve and Calming Tea, Pectapas® Ointment, Species-Sklero-Diabeticum®,

Crataegutt® 600mg film-coated tablets (1-2x 1 film-coated tablet/day)

Crataegutt® drops (3x 20-40Tr/day)

Naturcor® 450mg filter tablets (2x 1 film-coated tablet/day)

Combination preparations (+ digitaloid drugs such as lily of the valley and adonis herb - controversially discussed)

Angioton H ® (Crategus+Convallaria majalis+Adonis vernalis+Cactus+Lobelia inflata): 1-3x each 5 tr/day

Convallocor ®

In recent communications of the EMA/HMPC on Crataegifolium cum flore, the indications and efficacy are not confirmed. Sufficient proof of efficacy was missing (EMA/HMPC - 2016).

1. EMA/HMPC: European Union herbal monograph on Crataegi folium cum flori-Final,Apr. 5, 2016; htpp//www.a-turl.de/?k=urba
2. Hellenbrand N et al. (2015) Isolation and quantification of oligomeric and polymeric procyanidins in leaves and flowers of Hawthorn (Crataegus spp.). Fitoterapia 104:14-22. https://pubmed.ncbi.nlm.nih.gov/25917901/.
3. Rayyan S et al. (2005) Isolation and identification of flavonoids, including flavone rotamers, from the herbal drug 'Crataegi folium cum flore' (hawthorn). Phytochem Anal 16:334-341. https://analyticalsciencejournals.onlinelibrary.wiley.com/doi/abs/10.1002/pca.853.
4. Wiesenhauer M (2008) Phytopraxis. Springer Medizin Verlag, Heidelberg pp.152-154.
5. Zumdick S et al,(2009) Preparative isolation of oligomeric procyanidins from Hawthorn (Crataegus spp.). Pharmacy 64:286-268.
6. https://www.ema.europa.eu/en/documents/herbal-monograph/final-european-union-herbal-monograph-crataegus-spp-folium-cum-flore_en.pdf
7. https://arzneipflanzenlexikon.info/hawthorn.php.
8. Wenigmann M.(2017) Phytotherapy medicinal drugs phytopharmaceuticals application. Urban & Fischer: 5.115 Tormentillae rhizoma p 214-215 http://Phytochem Anal 16:334-341.
9. Miller LG (1998) Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions. Arch Intern Med. 9;158(20):2200-2211. doi: 10.1001/archinte.158.20.2200. PMID: 9818800.