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Duodenal ulcer on devil’s claw root tea (e.g. TEUFELSKRALLE tea): After several weeks’ consumption of devil’s claw root tea (TEUFELSKRALLE tea; see a-t 2001; 32: 120) for joint pain and taking paracetamol (BEN-U-RON, generics) as required, an 81-year-old developed abdominal pain, eructation and tarry stools. Gastroscopy revealed Helicobacter pylori-negative antral gastritis and a large duodenal ulcer, which completely healed after cessation and treatment with a proton pump inhibitor (NETZWERK Report 16.063). The Federal Institute for Drugs and Medical Devices (BfArM) overviews five other reports of gastrointestinal bleeding on devil’s claw root extract, including one report in the presence of duodenal and jejunal diverticula (BfArM: letter dated 1 February 2012). The tea, offered as an aid for symptoms of wear of the locomotor system and to counter gastrointestinal complaints, reportedly has no known side effects according to the supplier Aurica. However, it should not be used in the case of gastric and duodenal ulcers (Aurica: product information TEUFELSKRALLE tea; as at 1 April 2011). Suppliers of devil’s claw root extract in tablet form quote these as absolute contraindications and include gastrointestinal complaints as known adverse effects (e.g. Stadapharm: SPC TEUFELSKRALLE STADA, as at June 2007). The European Medicines Agency (EMA) does not see sufficient evidence of a consistent clinically relevant effect, especially for pain relief (EMA: Assessment Report on Harpagophytum procumbens DC. and/or Harpagophytum zeyheri Decne, radix, as at 12 March 2009; http://www.ema.europa.eu, search: Harpagophytum). We advise against its use. –Ed.
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