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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 ?
Balcerski looks at how these two influences yielded an "intimate attachment" between Nathaniel Hawthorne and Franklin Pierce and, conversely, "intense resentments" toward some of their contemporaries (657).
"Feeling out of Place: Affective History, Nathaniel Hawthorne, and the Civil War." ESQ: A Journal of the American Renaissance 59, no.
Mellow's Nathaniel Hawthorne in His Times (Johns Hopkins University Press, 1980) has not yet been surpassed for its comprehensive, in-depth scholarly interpretation of Hawthorne's life.
Fields, Nathaniel Hawthorne's editor and partner in the powerful Ticknor and Fields publishing house, approached Hawthorne on the subject of her English letters and Italian journals in 1859.
This collection of essays had its origin and takes its title from the biannual summer meeting of the Nathaniel Hawthorne Society held in Boston in June of 2000.
Nathaniel Hawthorne (1804-64) was merciless in his fictional portrayals of merciless Puritans, those upholders of dour orthodoxy, hot in pursuit of witches and heretics.
She has presented papers on, among others, Willa Cather, Nathaniel Hawthorne, Jessie Redmon Fauset, and Toni Morrison.
Utopias always fail to deliver fully on their promises - and their dismal success rate in American settings has energized memorable fictional treatments ranging from Nathaniel Hawthorne's 1852 novel, The Blithedale Romance (which details the author's disheartening experience with the famous Brook Farm commune in Massachusetts), to F.
He lived, as the proverb states, in interesting times: his con temporaries included such literary luminaries as Herman Melville, Nathaniel Hawthorne, Louisa May Alcott, Walt Whitman, Edgar Allan Poe, and Emily Dickinson.
During his leisure hours while serving as the American consul at the port of Liverpool, England, Nathaniel Hawthorne frequented the sites of Europe.
This edition of The Blithedale Romance in the Bedford Cultural Editions series reprints Hawthorne's novel of 1852 in the authoritative text established for the 'Centenary Edition of the Works of Nathaniel Hawthorne' under the auspices of the Center for Editions of American Authors of the Modern Language Association.