Motherwort
LamiaceaeLeonurus cardiaca
Also known as: Lion's Ear, Lion's Tail, Throw-Wort
clinical_notes Clinical Summary
Motherwort (Leonurus cardiaca) is a perennial herb from the mint family (Lamiaceae) native to central Europe and Asia, used for millennia as a cardiotonic nervine and gynaecological herb.
Its primary alkaloids — leonurine and stachydrine — exert negative chronotropic (heart rate slowing), hypotensive, antispasmodic, and uterotonic effects.
EMA HMPC-approved as a traditional herbal medicinal product for nervous tension and cardiac palpitations after serious illness is excluded; clinical trials support its use for stress-related hypertension and postpartum hemorrhage prevention (injectable form in Chinese medicine).
Strictly contraindicated in pregnancy due to uterotonic alkaloids; caution required with CNS depressants and anticoagulants.
Pregnancy Safety
Contraindicated in pregnancy. Leonurine and stachydrine are uterotonic alkaloids that stimulate uterine contractions. Traditionally used only near term for labor preparation under skilled supervision. Avoid throughout pregnancy.
Lactation Safety
Traditionally used as a galactogogue (milk-promoting herb) in postnatal care. However, alkaloids may pass into breast milk. Safety data insufficient; use only under supervision of a skilled herbalist.
warning Contraindications
- Pregnancy (first and second trimester) (contraindicated)Clinically Proven
- Concurrent CNS depressants (sedatives, opioids, GHB/oxybate) (avoid)Theoretical
- Bleeding disorders or anticoagulant therapy (caution)Theoretical
- Cardiac arrhythmias (advanced/serious) (caution)Theoretical
vital_signs Clinical Profile
Primary Indications
- check_circle palpitations
- check_circle tachyarrhythmia
- check_circle hypertension (stress-related)
- check_circle anxiety with cardiac symptoms
- check_circle nervous exhaustion
- check_circle hyperthyroidism (cardiac symptoms)
- check_circle amenorrhea
- check_circle dysmenorrhea
- check_circle PMS
- check_circle menopausal symptoms
- check_circle postpartum hemorrhage prevention
- check_circle insomnia
Therapeutic Actions
System Affinities
- check_circle cardiovascular
- check_circle nervous system
- check_circle uterus
- check_circle thyroid
labs Active Constituents
leonurine
stachydrine
rutin
hyperoside
orientin
quercetin
rosmarinic acid
chlorogenic acid
labdane diterpenes
iridoids
tannins
phytosterols
history_edu Traditional Use
Traditional Chinese Medicine (TCM)
益母草 (Yi Mu Cao)
Nature: cool
- Invigorate Blood and resolve stasis
- Promote urination and reduce edema
- Regulate menstruation
- Clear Heat and toxins
Note: Yi Mu Cao in TCM refers primarily to Leonurus japonicus (Chinese motherwort), which is closely botanically related to L. cardiaca and shares similar alkaloid constituents and therapeutic applications. Both species are used interchangeably in many clinical references.
Traditional Uses Across Healing Systems
While many herbs lack controlled clinical trials, centuries of traditional practice across cultures provide valuable insight into their therapeutic applications.
Used since ancient times as a cardiotonic for palpitations, nervous tachycardia, and heart complaints secondary to stress and anxiety. Also a uterine tonic for amenorrhea, dysmenorrhea, and menopause. Nicholas Culpeper (1616-1654) prescribed it for melancholy, palpitations, and uterine ailments.
Recognized by EMA HMPC as a traditional herbal medicinal product for nervous tension and cardiac palpitations after serious illness excluded.
Yi Mu Cao (Leonurus japonicus) is a major herb for gynecological conditions, Blood invigoration, and postpartum recovery. Used to regulate menstruation, dispel blood stasis, promote urination, and reduce edema. Injectable preparations used in Chinese hospitals to prevent postpartum hemorrhage.
Systematic review of 46 RCTs confirmed motherwort injection (combined with oxytocin) significantly reduces postpartum hemorrhage and associated complications.
Used by Native American tribes for various gynaecological conditions and as a cardiac herb. European settlers adopted it from indigenous practices.
L. cardiaca is naturalized in North America (introduced from Europe) and grows in disturbed areas.
spa Parts Used
aerial parts
- cardiac palpitations
- tachyarrhythmia
- hypertension with anxiety
- amenorrhea
- dysmenorrhea
- menopausal symptoms
- insomnia
- anxiety
Flowering aerial parts (herba) harvested during flowering. European Pharmacopoeia requires minimum 0.2% flavonoids (as hyperoside). Traditionally prepared as tea, tincture, or oil extract. Avoid fresh plant sap (contact dermatitis risk). Daily dose: 3-10g dried herb.
shield Safety
Contraindications — Evidence Basis
Pregnancy (first and second trimester)
Motherwort is a uterotonic and emmenagogue. Leonurine and stachydrine stimulate uterine contractions. Contraindicated in pregnancy except near term under medical supervision for labor preparation. Traditional use as parturient herb only at end of pregnancy.
Concurrent CNS depressants (sedatives, opioids, GHB/oxybate)
Motherwort has sedative properties and may additively increase CNS depression with benzodiazepines, opioids, alcohol, and other sedatives. Medscape specifically lists GHB/oxybate combination as requiring avoidance due to risk of profound sedation, respiratory depression, coma, and death.
Bleeding disorders or anticoagulant therapy
Motherwort inhibits platelet aggregation and PAF secretion; may potentiate anticoagulant effects of warfarin and antiplatelet drugs. Monitor for bleeding.
Cardiac arrhythmias (advanced/serious)
While motherwort is used for benign palpitations, ESCOP and HMPC specify that serious cardiac conditions must be excluded by a medical doctor before using motherwort for palpitations. Not a substitute for medical evaluation of arrhythmia.
Monitoring Parameters
Monitor during use, especially with prolonged or high-dose therapy.
Blood pressure
Baseline and at 4 weeks in hypertensive patients on medicationLeonurine has demonstrated hypotensive and vasorelaxant effects in preclinical studies; an open clinical trial showed improvement in stage 1 hypertension. Additive hypotension possible with antihypertensives.
flagThreshold: Systolic BP below 90 mmHg or symptomatic hypotension requires dose review
INR / Coagulation
Baseline and at 2 weeks in patients on warfarin or antiplatelet therapyMotherwort inhibits platelet aggregation and PAF secretion; additive anticoagulant effects possible with warfarin and antiplatelet agents.
flagThreshold: INR above 3.0 or unexpected bruising/bleeding requires review
Toxicity
Generally considered safe at recommended doses (up to 2 g/day dried herb). Fresh plant sap may cause contact dermatitis.
Excessive doses: uterine hyperstimulation in pregnant women; increased photosensitivity; diarrhea; increased uterine bleeding.
Discontinue herb. Supportive care. Monitor for uterine activity in pregnant patients. Fresh plant sap contact: wash skin thoroughly.
Adverse Effects
CYP Metabolism
Limited CYP450 interaction data for Leonurus cardiaca specifically. Rosmarinic acid may have weak CYP inhibitory effects in vitro. Alkaloid constituents (stachydrine) are metabolized hepatically. Given sedative interactions with CNS depressants (pharmacodynamic), caution is warranted with any CNS-depressant drug. No documented clinically significant CYP-mediated drug interactions identified in the current literature.
swap_horiz Interactions
Warfarin / Anticoagulants (Heparin, Aspirin, Clopidogrel, Apixaban, Rivaroxaban)
Class: Anticoagulant
Leonurus cardiaca extract reduces platelet aggregation and PAF (platelet-activating factor) secretion, as demonstrated in multiple in vitro and clinical studies. Motherwort is identified in cardiovascular pharmacotherapy reviews as an herb that reduces platelet aggregation, potentially potentiating warfarin and increasing bleeding risk.
Monitor INR closely when co-administering motherwort with warfarin. Exercise caution with all anticoagulants and antiplatelet agents. Discontinue motherwort at least 2 weeks before surgical procedures. Warn patients about signs of increased bleeding (unusual bruising, prolonged cut bleeding).
Digoxin / Cardiac Glycosides
Class: Cardiac Glycoside
Motherwort alkaloids (leonurine, stachydrine) exert cardiac glycoside-like negative chronotropic and cardiotonic effects via modulation of cardiac Na+/Ca2+ ion channels. Concurrent use with digoxin may produce additive cardiac effects, potentially causing clinically significant bradycardia, AV block, or altered cardiac conduction.
Monitor heart rate and ECG in patients on cardiac glycosides using motherwort. Consider digoxin serum level monitoring. Signs of digoxin toxicity (nausea, visual disturbances, arrhythmia) should prompt immediate evaluation.
Antihypertensive Agents (ACE Inhibitors, ARBs, Beta-Blockers, Calcium Channel Blockers)
Class: Antihypertensive
Leonurus cardiaca demonstrates clinically documented hypotensive activity via vasodilatory and negative chronotropic mechanisms. An open clinical trial showed significant reduction in Stage 1 arterial hypertension with motherwort 1200 mg/day. Co-administration with antihypertensives may cause additive blood pressure lowering with risk of symptomatic hypotension.
Monitor blood pressure regularly. Consider reducing antihypertensive dose if symptomatic hypotension occurs. Use with particular caution when combining with beta-blockers, given shared negative chronotropic cardiac effects.
CNS Depressants / Sedatives (Benzodiazepines, Barbiturates, Opioids, Zolpidem, Alcohol)
Class: CNS Depressant
Motherwort has documented sedative properties mediated via GABA-A receptor modulation and alkaloid-mediated CNS depression. Pharmacological studies confirm sedative and analgesic activity in vivo. Concurrent use with CNS depressants causes additive CNS and respiratory depression.
Warn patients about additive sedation. Avoid driving and operating heavy machinery when combining motherwort with sedative medications. Monitor for excessive CNS depression, particularly in elderly patients.
Antiarrhythmic Agents (Amiodarone, Sotalol, Flecainide, Quinidine)
Class: Antiarrhythmic
Motherwort alkaloids (leonurine, stachydrine) modulate cardiac rhythm via effects on sodium and calcium cardiac ion channels. Co-administration with antiarrhythmic drugs may produce additive or unpredictable effects on cardiac conduction, potentially causing bradycardia or QTc prolongation.
Avoid concurrent use with antiarrhythmic medications unless under close cardiological supervision with ECG monitoring. Motherwort should be used cautiously in patients with pre-existing cardiac conduction disorders or QTc prolongation risk.
Thyroid Medications (Levothyroxine, Methimazole, Propylthiouracil)
Class: Thyroid Agent
Leonurus cardiaca has been used traditionally for hormonal and thyroid-related conditions. Iridoid alkaloids and flavonoids may influence thyroid hormone synthesis or metabolism, potentially altering levothyroxine dose requirements. This interaction is based primarily on traditional use and phytochemical evidence.
Monitor thyroid function (TSH, free T4) periodically in patients on thyroid medications who use motherwort. This is a low-risk interaction but warrants awareness, especially with long-term concurrent use.
hub Combinations
Synergistic pairings can enhance therapeutic outcomes, while knowing suitable substitutes helps when specific herbs are unavailable or contraindicated.
Synergistic Combinations
3Hawthorn
Moderate EvidenceClassic Western herbal cardiotonic combination. Hawthorn strengthens cardiac muscle function, dilates coronary arteries, and improves cardiac output; Motherwort modulates rate, reduces palpitations, and addresses the anxiety component of cardiac complaints. Together they provide comprehensive cardiac support for functional heart conditions.
Both herbs have individual clinical trial support for cardiovascular indications. Traditional pairing widely used in European phytotherapy.
Passionflower
Traditional UseBoth are nervine anxiolytics for stress-related cardiac symptoms. Passionflower modulates GABA-A receptors for generalized anxiety; Motherwort specifically addresses anxiety manifesting as palpitations and chest tension. Complementary targets in the anxiety-cardiac symptom pathway.
Traditional combination for cardiac neurosis and anxiety with palpitations. Both herbs recognized in European phytotherapy.
Valerian
Limited EvidenceComplementary nervine and sedative herbs. Valerian acts via GABA receptors to promote sleep; Motherwort provides additional cardiac calming and antispasmodic actions. Combination particularly useful for insomnia with cardiac anxiety and palpitations.
Combination with valerian, hops, and lemon balm (including motherwort) showed improved sleep in alcohol withdrawal patients.
science Studies
Leonurus cardiaca L. as a Source of Bioactive Compounds: An Update of the European Medicines Agency Assessment Report (2010)
Systematic ReviewThis 2019 review updated the 2010 European Medicines Agency assessment of Leonurus cardiaca by synthesizing research published between 2010 and 2018. The update catalogued advances in understanding motherwort's bioactive constituents and confirmed traditional applications including cardiotonic, gynaecological, and anxiolytic uses. New findings strengthened evidence for anti-inflammatory, antioxidant, and anti-aggregation activities, while phytochemical profiling revealed additional compounds with cardiovascular relevance. The review identified several specific alkaloids and phenolic acids as likely mediators of the herb's clinical effects and outlined future research priorities for human clinical trials.
The effect of Leonurus cardiaca herb extract and some of its flavonoids on mitochondrial oxidative phosphorylation in the heart
In VitroThis in vitro study examined the effects of Leonurus cardiaca herb extract and isolated flavonoid constituents on cardiac mitochondrial function using Clark-type oxygen electrode measurements and fluorimetric ROS assays in isolated rabbit cardiac mitochondria. Key constituents including chlorogenic acid, orientin, quercetin, hyperoside, and rutin were found to uncouple mitochondrial oxidative phosphorylation by 20-90% and partially inhibit respiratory chain activity. Critically, these same constituents significantly attenuated mitochondrial free radical generation. The authors proposed that this partial mitochondrial uncoupling with reduced ROS production represents a plausible cardioprotective mechanism.
medication Dosing
tea
2-4 g dried herb per 150 mL water
3x/day
Pour boiling water over dried herb; steep 10 minutes; strain. Bitter taste; may add honey or lemon. Daily dose 3-10g dried herb per ESCOP. Best taken 30-60 min before sleep for insomnia/anxiety.
tincture
2-4 mL (1:5 in 45% ethanol)
3x/day
Liquid tincture; dilute in water. Can be used for acute anxiety-related palpitations. Bitter taste.
capsule
200-500 mg dried herb extract
2-3x/day
Encapsulated dried herb or extract. Up to 2g/day considered safe. Pilot study used 1200 mg/day and showed modest blood pressure reduction.
Disclaimer: This information is largely AI-generated and reviewed by human experts at Evara Health. It is intended for educational and clinical reference purposes only and should not replace professional medical advice.
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