Are there any side effects or interactions?
Coltsfoot contains potentially liver-damaging pyrrolizidine alkaloids, with much higher levels appearing in the root than in the leaves or the flowers. Animal studies using amounts of coltsfoot hundreds of times higher than those used as medicine have shown these alkaloids can cause cancer in animals.8 A single case of an baby who developed liver disease and died after the mother drank tea containing coltsfoot during pregnancy has been reported.9 This eventually led to the banning of coltsfoot in Germany in 1992.
Coltsfoot should not be taken during pregnancy or breast-feeding.10 Otherwise, coltsfoot is generally safe.11
Coltsfoot should be differentiated from the plant called western coltsfoot (Petastites frigidus), because western coltsfoot can contain higher amounts of pyrrolizidine alkaloids. Use of western coltsfoot is not recommended.
At the time of writing, there were no well-known drug interactions with coltsfoot.
References
1. Weiss RF. Herbal Medicine. Gothenburg, Sweden: Ab Arcanum and Beaconsfield, UK: Beaconsfield Publishers Ltd, 1988, 196–7.
2. Blumenthal M, Busse WR, Goldberg A, et al. (eds). The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. Austin: American Botanical Council and Boston: Integrative Medicine Communications, 1998, 114–5.
3. Foster S. Herbal Renaissance. Salt Lake City: Gibbs-Smith Publisher, 1993, 74–8.
4. Weiss RF. Herbal Medicine. Gothenburg, Sweden: Ab Arcanum and Beaconsfield, UK: Beaconsfield Publishers Ltd., 1988, 196–7.
5. Gruenwald J, Brendler T, Jaenicke C (eds). PDR for Herbal Medicines. Montvale, NJ: Medical Economics Company, 1998, 1993–5.
6. Weiss RF. Herbal Medicine. Gothenburg, Sweden: Ab Arcanum and Beaconsfield, UK: Beaconsfield Publishers Ltd., 1988, 196–7.
7. Weiss RF. Herbal Medicine. Gothenburg, Sweden: Ab Arcanum and Beaconsfield, UK: Beaconsfield Publishers Ltd., 1988, 196–7.
8. Weiss RF. Herbal Medicine. Gothenburg, Sweden: Ab Arcanum and Beaconsfield, UK: Beaconsfield Publishers Ltd., 1988, 196–7.
9. Roulet M, Laurini R, Rivier L, Calame A. Hepatic veno-occlusive disease in newborn infant of a woman drinking herbal tea. J Pediatrics 1988;112:433–6.
10. McGuffin M, Hobbs C, Upton R, Goldberg A. American Herbal Products Association’s Botanical Safety Handbook. Boca Raton, FL: CRC Press, 1997, 117–8.
11. Weiss RF. Herbal Medicine. Gothenburg, Sweden: Ab Arcanum and Beaconsfield, UK: Beaconsfield Publishers Ltd., 1988, 196–7.

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