Evening Primrose Oil - Get the Facts on Herbal Supplements

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  • Patients who plan to undergo surgery requiring anesthesia should stop taking EPO two weeks ahead of time because of the possibility of seizure.<a href="#hdng0">(More...)</a>



<a name="hdng0"></a>Patients who plan to undergo surgery requiring anesthesia should stop taking EPO two weeks ahead of time because of the possibility of seizure. Other reports describe occasional headache, abdominal pain, nausea, and loose stools in people taking EPO. In animal studies, gamma-linolenic acid (an ingredient of evening primrose oil) is reported to decrease blood pressure. <a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Because of reported seizures in people taking evening primrose oil alone or in combination with certain medications used to treat mental illness, patients should use caution when combining evening primrose oil with medications like chlorpromazine (Thorazine®), thioridazine (Mellaril®), trifluoperazine (Stelazine®), or fluphenazine (Prolixin®).<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a>

In animal studies, gamma-linolenic acid (an ingredient of evening primrose oil) is reported to lower blood pressure. Therefore, in theory, evening primrose oil may have effects on blood pressure, and should be used cautiously when combined with other agents that may lower blood pressure.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Studies in children treated for skin conditions have used 3 grams of evening primrose oil daily, taken by mouth, divided into several smaller doses throughout the day. It is reported that the maximum dose should not be greater than 0.5 gram per kilogram of body weight daily.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Theoretically, evening primrose oil may have additive effects when taken concomitantly with thyme, because a fixed combination of thyme fluid extract and primrose root tincture (Bronchicum Tropfen) has been used in studies to treat bronchitis.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Yoshimoto-Furuie K, Yoshimoto K, Tanaka T, et al. Effects of oral supplementation with evening primrose oil for six weeks on plasma essential fatty acids and uremic skin symptoms in hemodialysis patients.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Evening primrose oil (EPO) contains an omega-6 essential fatty acid, gamma-linolenic acid (GLA), which is believed to be the active ingredient. EPO has been studied in a wide variety of disorders, particularly those affected by metabolic products of essential fatty acids. High-quality evidence for its use in most conditions is still lacking.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Gamma-linolenic acid (GLA), one of the components of evening primrose oil, may be helpful in people with diabetic neuropathy.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Allergy or hypersensitivity to evening primrose oil has not been widely reported. Individuals with allergy or adverse reactions to plants in the Onagraceae family, gamma-linolenic acid, or other ingredients in evening primrose oil should avoid its use.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Available evidence does not support the use of evening primrose oil as a treatment for asthma. Further research is needed to confirm this conclusion.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Not enough scientific information is available to advise the use of evening primrose oil for dry skin.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Not enough information is available to advise the use of evening primrose oil for symptoms of chronic fatigue syndrome or fatigue following a viral infection.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Not enough information is available to advise the use of evening primrose oil for breast cancer.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Not enough scientific information is available to advise the use of evening primrose oil for Raynaud's phenomenon.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> There is not enough information to recommend the safe use of evening primrose oil during pregnancy or breastfeeding.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Results from studies of mixed quality do not support the use of evening primrose oil for schizophrenia. Fish oils have shown some promise in this disease, and further study is merited.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> A small number of laboratory studies and theory suggests that evening primrose oil may be helpful in diabetes, but more information is needed before a firm recommendation can be made.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Available studies do not show evening primrose oil to be helpful with these potential complications of menopause.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> The limited available research does not demonstrate that evening primrose oil has a significant effect on treating breast cysts.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Jack AM, Keegan A, Cotter MA, et al. Effects of diabetes and evening primrose oil treatment on responses of aorta, corpus cavernosum and mesenteric vasculature in rats.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Whitaker DK, Cilliers J, de Beer C. Evening primrose oil (Epogam) in the treatment of chronic hand dermatitis: disappointing therapeutic results.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Blommers J, de Lange-De Klerk ES, Kuik DJ, et al. Evening primrose oil and fish oil for severe chronic mastalgia: a randomized, double-blind, controlled trial.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Gateley CA, Pye JK, Harrison BJ et al. Evening primrose oil (Efamol), a safe treatment option for breast disease.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Hederos CA, Berg A. Epogam evening primrose oil treatment in atopic dermatitis and asthma.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Initial research does not show a benefit from evening primrose oil in the treatment of psoriasis.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Benefits of evening primrose oil in the treatment of arthritis have not clearly been shown.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Small human studies show a lack of benefit from evening primrose oil in ADHD. Further research is needed to confirm this conclusion.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Small human studies do not report that evening primrose oil is helpful for the symptoms of PMS.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Although human studies do not show clear changes in blood pressure, people taking certain blood pressure medications should consult with a healthcare professional before starting evening primrose oil.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> In people with a history of seizures, doses of anti-seizure medications may require adjustment because evening primrose oil may increase the risk of seizures.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Individuals undergoing surgery requiring general anesthesia may be more sensitive to developing seizures, and should stop taking evening primrose oil two weeks ahead of time.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Early study of evening primrose oil shows a lack of beneficial effects on cardiovascular function and health.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Initial human study is unclear about the effects that evening primrose oil may have on weight loss.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Evening primrose oil is proposed to have effects on chemicals in the blood called prostaglandins, which may play a role in pre-eclampsia.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> There are several studies of evening primrose oil taken by mouth for eczema.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Evening primrose oil is approved for skin disorders in several countries outside of the United States.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Evening primrose oil may have modest benefits for eczema, and it may be useful for rheumatoid arthritis and breast pain.<a href="http://nccam.nih.gov/health/eveningprimrose/" TARGET="_blank" [2]</a>

Although some clinical trials have shown a benefit of evening primrose oil for premenstrual syndrome, the best-designed trials found no effect.<a href="http://nccam.nih.gov/health/eveningprimrose/" TARGET="_blank" [2]</a> There is not enough evidence to support the use of evening primrose oil for other health conditions.<a href="http://nccam.nih.gov/health/eveningprimrose/" TARGET="_blank" [2]</a> Evening primrose oil contains gamma-linolenic acid (GLA), an essential fatty acid.<a href="http://nccam.nih.gov/health/eveningprimrose/" TARGET="_blank" [2]</a>

Qureshi S, Sultan N. Topical nonsteroidal anti-inflammatory drugs versus oil of evening primrose in the treatment of mastalgia.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> In a double blind, placebo controlled, parallel group study 58 out of 60 children, with atopic dermatitis and the need for regular treatment with topical skin steroids, completed a 16 weeks' treatment period with either Epogam evening primrose oil or placebo capsules. Twenty two of these subjects also had asthma.<a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1511801" TARGET="_blank" [3]</a> Bordoni A, Biagi PL, Masi M, Ricci G, Fanelli C, Patrizi A, Ceccolini E. Evening primrose oil (Efamol) in the treatment of children with atopic eczema.<a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1511801" TARGET="_blank" [3]</a>

In 1995 the Department of Health commissioned me and a colleague to conduct an individual patient meta-analysis of 20 studies of oral evening primrose oil supplementation for treatment of atopic dermatitis, which included 10 unpublished studies held by the company (Li Wan Po A, Williams HC. A systematic overview of clinical trials of Epogam in atopic eczema.<a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=292973" TARGET="_blank" [4]</a> Nobody would have been happier than myself if evening primrose oil had produced a clinically worthwhile benefit for eczema sufferers. The history of its development has been marred by lack of data in the public domain. As we bid goodnight to the evening primrose oil story, perhaps we can awaken to a world where all clinical trial data, derived from people who are good enough to volunteer for such studies, reach the light of day, where they can be openly debated in the public domain.<a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=292973" TARGET="_blank" [4]</a>

Lovell CR, Burton JL, Horrobin DF. Treatment of atopic eczema with evening primrose oil.<a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=292973" TARGET="_blank" [4]</a> Bamford JT, Gibson RW, Renier CM. Atopic eczema unresponsive to evening primrose oil (linoleic and gamma-linolenic acids).<a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=292973" TARGET="_blank" [4]</a> Schmidt K, Pittler MH, Wilson N, van Gool C, Humphreys R, Ernst E. Oral evening primrose oil and borage oil for atopic eczema (protocol).<a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=292973" TARGET="_blank" [4]</a> In fairness to the innovators of evening primrose oil for atopic dermatitis, they evaluated their product more than many other products used in dermatology.<a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=292973" TARGET="_blank" [4]</a> A year later, two British dermatologists wrote a detailed review article on evening primrose oil and atopic dermatitis. Out of courtesy, they showed a copy of the peer reviewed article to the manufacturers, who intimated their intent to pursue the matter legally further if the authors did not withdraw or modify the article substantially. (J Marsden, written communication, 27 November 2003).<a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=292973" TARGET="_blank" [4]</a>

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Section Contents:
  • Although primrose oil is used for breast pain in several European countries, high-quality human studies using this treatment are lacking.<a href="#hdng1">(More...)</a>

  • Ebden P, Bevan C, Banks J, Fennerty A, Walters EH. A study of evening primrose seed oil in atopic asthma.<a href="#hdng2">(More...)</a>



<a name="hdng1"></a>Although primrose oil is used for breast pain in several European countries, high-quality human studies using this treatment are lacking. Therefore, the available information does not allow recommendation for or against the use of primrose oil in this condition. <a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> There is evidence that primrose oil, in combination with thyme, may have some benefits in the treatment of acute bronchitis. It is unclear if primrose alone is useful in treating bronchitis.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Primrose oil has been suggested as a possible treatment for bone loss/osteoporosis.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Possible additive effects may occur when primrose oil is taken with anticoagulants (blood thinners) and drugs used to treat arthritis.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Cancelo Hidalgo MJ, Castelo-Branco C, et al. Effect of a compound containing isoflavones, primrose oil and vitamin E in two different doses on climacteric symptoms.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Bronchipret TP FCT, Echte Nachtkerze, EPO, fever plant, gamma-linolenic acid, herbe aux anes, Huile D'Onagre, kaempe natlys, king's cureall, la belle de nuit, linoleic acid, nachtkerzenol, night willow-herb, Oenothera communis Leveill, Oenothera graveolens Gilib, omega-6 essential fatty acid, Onagra biennis Scop, Onogra vulgaris, onagre bisannuelle, primrose, primrose oil, scabish, Spach, stella di sera, sun drop, Teunisbloem.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> It is theorized that primrose oil may be helpful in patients with MS based on laboratory studies.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> More studies are needed to examine the effectiveness of primrose oil alone as a therapy for bronchitis.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Well-designed human trials are needed before primrose oil can be recommended for osteoporosis therapy.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Primrose oil may potentially interact with herbs and supplements used to treat arthritis, gastrointestinal disorders, obesity, seizures, viral infections, and psychosis.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a>

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<a name="hdng2"></a>Ebden P, Bevan C, Banks J, Fennerty A, Walters EH. A study of evening primrose seed oil in atopic asthma. <a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1511801" TARGET="_blank" [3]</a> This fact sheet provides basic information about evening primrose oilcommon names, uses, potential side effects, and resources for more information.<a href="http://nccam.nih.gov/health/eveningprimrose/" TARGET="_blank" [2]</a> Evening primrose is a plant native to North America, but it grows in Europe and parts of the Southern Hemisphere as well. It has yellow flowers that bloom in the evening.<a href="http://nccam.nih.gov/health/eveningprimrose/" TARGET="_blank" [2]</a>

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Section Contents:
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  • More evidence of effectiveness is needed before primrose can be recommended as a treatment for menopausal symptoms.<a href="#hdng3">(More...)</a>



<a name="hdng3"></a>More evidence of effectiveness is needed before primrose can be recommended as a treatment for menopausal symptoms. <a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a>

Gruenwald J, Graubaum HJ, Busch R. Evaluation of the non-inferiority of a fixed combination of thyme fluid- and primrose root extract in comparison to a fixed combination of thyme fluid extract and primrose root tincture in patients with acute bronchitis.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a> Kemmerich B. Evaluation of efficacy and tolerability of a fixed combination of dry extracts of thyme herb and primrose root in adults suffering from acute bronchitis with productive cough.<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank" [1]</a>
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1. <a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank">MedlinePlus Herbs and Supplements: Evening primrose oil (Oenothera biennis L.)</a>
<a href="http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html" TARGET="_blank">http://www.nlm.nih.gov/medlineplus/druginfo/natural/patient-primrose.html</a>

2. <a href="http://nccam.nih.gov/health/eveningprimrose/" TARGET="_blank">Evening Primrose Oil [NCCAM Herbs at a Glance]</a>
<a href="http://nccam.nih.gov/health/eveningprimrose/" TARGET="_blank">http://nccam.nih.gov/health/eveningprimrose/</a>

3. <a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1511801" TARGET="_blank">Epogam evening primrose oil treatment in atopic dermatitis and asthma.</a>
<a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1511801" TARGET="_blank">http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=1511801</a>

4. <a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=292973" TARGET="_blank">Evening primrose oil for atopic dermatitis</a>
<a href="http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=292973" TARGET="_blank">http://www.pubmedcentral.nih.gov/articlerender.fcgi?artid=292973</a>

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