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hawthorne (Crataegus Species)

(haw-thorn) ,


(trade name),

cum flore

(trade name),


(trade name),


(trade name),


(trade name)


Therapeutic: antihypertensives
HypertensionMild to moderate HFAnginaSpasmolyticSedative


Active compounds in hawthorne include flavonoids and procyanidins.
Increase coronary blood flow.
Positive inotropic and chronotropic effects because of increased permeability to calcium and inhibition of phosphodiesterase.

Therapeutic effects

Increased cardiac output.
Decreased BP, myocardial workload, and oxygen consumption.


Absorption: Unknown.
Distribution: Unknown.
Metabolism and Excretion: Unknown.
Half-life: Unknown.

Time/action profile

POunknown6-8 wkunknown


Contraindicated in: Pregnancy (potential uterine activity); Lactation.
Use Cautiously in: Concurrent use with ACE inhibitors and digoxin; Do not discontinue use abruptly.

Adverse Reactions/Side Effects

Central nervous system

  • agitation
  • dizziness
  • fatigue
  • vertigo
  • headache
  • sedation (high dose)
  • sleeplessness
  • sweating


  • hypotension (high dose)
  • palpitations


  • rash


  • nausea


May potentiate effects of digoxin, calcium channel blockers, and beta blockers.Concurrent use with phosphodiesterase-5 inhibitors (sildenafil, tadalafil, vardenafil ) and nitrates may potentiate vasodilatory effects.May cause additive CNS depression when used with other CNS depressants.Additive effect with other cardiac glycoside–containing herbs (digitalis leaf, black hellebore, oleander leaf, and others).Additive hypotensive effects with herbs than lower BP such as ginger, panax ginseng, coenzyme Q-10and valerian.Additive effect with other cardioactive herbs (devil’s claw, fenugreek, and others).
Oral (Adults) Heart failure—160–1800 mg standardized hawthorne leaf with flower extract in 2–3 divided doses daily. Hawthorne fluid extract (1:1 in 25% alcohol)—0.5–1 mL tid; hawthorne fruit tincture (1:5 in 45% alcohol)—1–2 mL tid; dried hawthorne berries—300–1000 mg tid.

Availability (generic available)

Dried fruit: OTC
Liquid extract of the fruit or leaf: OTC
Tincture of the fruit or leaf: OTC

Nursing implications

Nursing assessment

  • Monitor intake and output rations and daily weight. Assess for peripheral edema, auscultate lungs for rales and crackles during therapy.
  • Assess BP and pulse periodically during therapy.

Potential Nursing Diagnoses

Decreased cardiac output (Indications)
Deficient knowledge, related to medication regimen (Patient/Family Teaching)


  • Administered as 2–3 divided doses daily at the same time.
  • May be taken without regard to food.

Patient/Family Teaching

  • Advise patients that there are other proven therapies available for treatment of heart failure. These therapies should be employed prior to initiating treatment with hawthorne.
  • Tell patient not to take hawthorne without the advice of health care professional.
  • Instruct patients in the symptoms of a heart attack (pain in the region of the heart, jaw, arm, or upper abdomen; sweating; chest tightness) and heart failure (shortness of breath, chest tightness, dizziness, sweating) and to promptly contact health care professional if they occur.
  • Advise patient to report weight gain or persistent swelling of the feet to health care professional.
  • May cause dizziness and fatigue. Patients should avoid driving or other activities that require mental alertness until response to herb is known.
  • Avoid alcohol and other CNS depressants while taking hawthorne without consulting health care professional.
  • Profuse sweating and dehydration under extreme heat may increase the BP-lowering properties of hawthorne, leading to severe hypotension. Warn patients to avoid exertion in hot weather to minimize the risk of side effects.
  • Instruct patients that hawthorne helps control the symptoms of heart failure but does not cure the disease. Lifestyle changes (salt restriction, weight management, exercise as tolerated, adherence to medication regimens) still need to be followed.
  • Instruct patient to consult health care professional before taking Rx, OTC, or other herbal products concurrently with hawthorne.
  • Advise female patients to use contraception during therapy and to notify health care professional if pregnancy is planned or suspected or if breastfeeding.

Evaluation/Desired Outcomes

  • Decrease in symptoms of HF. Effects may not be seen for 6 wks.
  • Improved cardiac output as evidenced by improved activity tolerance.
References in periodicals archive ?
In Hawthorne's era, the contentious, radical spirit of 1776 seemed regenerated in Concord once again, in the writers and thinkers who dwelled in or flowed through its borders--Thoreau, Emerson, Fuller, Alcott, Mann, the Peabody sisters, and, of course, the ever so shy, socially reluctant recluse, Nathaniel Hawthorne, living in this nest of literary illuminati off and on for seven short but significant years.
Though it seems apparent that both Horace Mann and Nathaniel Hawthorne loved her, both men ended up favoring Elizabeth's less assertive younger sisters.
In the case of In the House of the Seven Gables, Morrison points out, Nathaniel Hawthorne "others" Native Americans by simply banishing them from the narrative.
Brenda Wineapple has written the most detailed and accessible life of Nathaniel Hawthorne to date.
Hawthorne In Concord is no light reading biographical sketch, but a substantial, informative, and superbly presented in-depth account of the great American man of letters, Nathaniel Hawthorne, considering both his literary contribution and his influence on Concord's community of philosophers, poets, reformers and intellectuals as a whole.
Perhaps the one contemporary of Thoreau's who best understood the struggle he waged within himself and the toll it took upon him was Nathaniel Hawthorne, who returned to Concord from abroad in 1860 and found himself marginalized due to his unwillingness to align himself with Northern abolitionists.
Clearly, Melville's romantic enthusiasm for Nathaniel Hawthorne grew, and may even have been encouraged, but only up to a point.
1) Nathaniel Hawthorne, Our Old Home: A Series of English Sketches, ed.
This part of Rome was not only for visitors; it was also populated by famous British and American residents: Elizabeth Duchess of Devonshire lived there from 1810 till her death in 1824; the novelist George Eliot lived in Via del Babuino; William Thackeray stayed for a short time in Via Condotti;, American novelist Nathaniel Hawthorne stayed in Via di Porta Pinciana; Percy Bysshe Shelley was at Via del Corso and then 65 Via Sistina; Robert and Elizabeth Barrett Browning stayed at 41 Via Bocca di Leone, along with American novelist Henry James who was at the Hotel d'Inghilterra down the same street; Samuel Morse (the inventor of the Morse code) stayed in Via de Prefetti; the painter J.
Consequently, Kirk identified Nathaniel Hawthorne, one of J.
In Tourmaline Joanna Scott's lustrous Mediterranean landscapes echo the shadowy Italian romances of Nathaniel Hawthorne and John Hawkes.