At a glance: Feverfew, Tanacetum parthenium (L.) Sch.Bip., is an Asteraceae herb best known for migraine prevention. The evidence is suggestive rather than decisive: systematic reviews have found small and inconsistent effects, and the result depends heavily on the preparation used. Feverfew is not an acute treatment for a severe headache, and new or unusual headache symptoms still require appropriate medical assessment.[1][2][3]
Botanical profile
- Accepted name: Tanacetum parthenium (L.) Sch.Bip.
- Common name: feverfew.
- Family: Asteraceae.
- Medicinal part: above-ground parts / herb.
- EMA herbal drug name: Tanaceti parthenii herba.[1]
Feverfew is a perennial aromatic herb with divided leaves and small daisy-like flower heads. It should not be confused with unrelated plants that share “feverfew” as part of a common name.
Major constituent groups
The best-known constituents are sesquiterpene lactones, particularly parthenolide. Feverfew also contains flavonoids and volatile constituents.
Parthenolide content varies with cultivar, plant part, drying and manufacture. A trial using a characterised extract therefore cannot automatically validate a random home-grown plant or commercial tablet.
Traditional use
Feverfew has traditionally been used for recurrent headaches and migraine, fevers, menstrual pain and delayed or difficult menstruation. It also has a history of use for arthritic and rheumatic pain, digestive discomfort and as a general household bitter-aromatic herb. Fresh leaves were sometimes eaten directly, while dried herb, tinctures and later tablets became more common preparations.
Contemporary herbal practice
Feverfew is principally used by contemporary herbalists as a preventive herb for recurrent migraine rather than as an acute analgesic. Regular use over time is the usual practitioner model, and the preparation is selected with attention to tolerability because fresh leaf can irritate the mouth. It may be combined with other nervous-system or vascular herbs depending on the individual headache pattern.
EMA regulatory assessment
The EMA HMPC has an EU herbal monograph for dried and powdered feverfew herb within the pain-and-inflammation therapeutic area. Revision 1 was published in 2020. A further periodic-review call for scientific data closed in June 2026, so this remains an actively reviewed monograph.[1]
Migraine prevention: what does the evidence say?
Feverfew is principally studied for prevention of migraine attacks rather than treatment of an attack once it has started.
A Cochrane review of double-blind randomised trials found that the available studies were small and used different feverfew preparations. The later update suggested a modest reduction in migraine frequency in one larger, more rigorous trial, but the overall evidence remained low quality and required confirmation.[3]
NCCIH likewise concludes that some research suggests benefit for migraine prevention but that findings are mixed and evidence remains limited.[2]
Why preparation matters
Early feverfew studies used different dried-leaf products and extracts with variable parthenolide content. Some commercial preparations may contain little or no measurable parthenolide, while high-parthenolide products are not automatically more effective.
Students should therefore record:
- plant part;
- whether the product was powdered herb or an extract;
- parthenolide standardisation, if reported; and
- whether the outcome was attack frequency, severity, duration or associated symptoms.
Pharmacology
Parthenolide and other feverfew constituents have been investigated for effects on inflammatory signalling, platelet activity, vascular responses and serotonin-related pathways. These mechanisms may help generate hypotheses about migraine prevention but do not establish clinical effectiveness by themselves.
Prevention is not acute treatment
A preventive herb is assessed by whether regular use changes the frequency or pattern of attacks over time. That is different from treating acute migraine pain. Feverfew should not be presented as a substitute for emergency assessment of a sudden “worst-ever” headache, headache with neurological deficit, head injury, fever/neck stiffness or other red-flag features.
Safety
Reported adverse effects include nausea, digestive upset and bloating. Chewing fresh feverfew leaves can cause mouth ulcers and irritation.[2]
Because feverfew is an Asteraceae plant, allergic reactions are more plausible in people sensitive to ragweed, chrysanthemums and related species.
Bleeding and surgery
Feverfew may affect platelet function and can slow blood clotting. NCCIH advises stopping feverfew before planned surgery and highlights potential medicine interactions.[2]
Medication review is particularly sensible with anticoagulant and antiplatelet drugs.
Pregnancy and breastfeeding
Feverfew should not be used during pregnancy because of concern that it may affect uterine contractions. Breastfeeding safety is inadequately characterised.[2]
Student note: common evidence traps
- Migraine prevention is not the same outcome as acute migraine treatment.
- Do not pool every feverfew product as though parthenolide content and extraction were irrelevant.
- Low-quality evidence can show a numerical effect without establishing a robust clinical conclusion.
- Do not treat parthenolide as the whole plant.
- Mouth irritation from chewing fresh leaves is a dosage-form-specific adverse effect.
- Headache is a symptom with red flags; a monograph should not encourage indiscriminate self-treatment.
References
- European Medicines Agency, Committee on Herbal Medicinal Products. Tanaceti parthenii herba — Tanacetum parthenium (L.) Sch.Bip., herba. EU herbal monograph and assessment report. EMA. Revision 1 published 2020; periodic-review data consultation closed June 2026.
- National Center for Complementary and Integrative Health. Feverfew: Usefulness and Safety. NCCIH. Updated February 2025; consulted September 2026.
- Wider B, Pittler MH, Ernst E. Feverfew for preventing migraine. Cochrane Database of Systematic Reviews. 2015;4:CD002286. doi:10.1002/14651858.CD002286.pub3. PubMed.
- NCCIH. Headaches and complementary health approaches: science summary discussing feverfew evidence and guideline disagreement. NCCIH. Consulted September 2026.
Additional materia medica sources
- ESCOP. Tanaceti parthenii herba — Feverfew, ESCOP Monographs.
- British Herbal Medicine Association. British Herbal Pharmacopoeia 1983 and related traditional-use references.
- Hoffmann D. Medical Herbalism. Healing Arts Press; 2003.
- Mills S, Bone K. Principles and Practice of Phytotherapy. 2nd ed. Elsevier; 2013.
Last reviewed: 20 September 2026. Educational reference only; not an individual prescribing or headache-diagnosis guide.
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