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Medical Disclaimer: This information is for educational purposes only and is not a substitute for professional medical advice.
Copper-containing Intrauterine Device [EPC]
Viburnum Prunifolium Bark, commonly known as Black Haw, is a botanical agent primarily utilized in traditional and clinical phytotherapy as a uterine sedative and antispasmodic for the management of menstrual distress and related conditions.
Name
Viburnum Prunifolium Bark
Raw Name
VIBURNUM PRUNIFOLIUM BARK
Category
Copper-containing Intrauterine Device [EPC]
Drug Count
3
Variant Count
3
Last Verified
February 17, 2026
About Viburnum Prunifolium Bark
Viburnum Prunifolium Bark, commonly known as Black Haw, is a botanical agent primarily utilized in traditional and clinical phytotherapy as a uterine sedative and antispasmodic for the management of menstrual distress and related conditions.
Detailed information about Viburnum Prunifolium Bark
References used for this content
This page is for informational purposes only and does not replace medical advice. Consult a qualified healthcare professional before using any medication containing Viburnum Prunifolium Bark.
Viburnum Prunifolium Bark, derived from the root or stem bark of the Viburnum prunifolium L. plant (commonly known as Black Haw), is a botanical therapeutic agent with a long history of use in North American and European pharmacopeias. Within certain regulatory and clinical datasets, it has been categorized under the Copper-containing Intrauterine Device [EPC] classification, although it is physiologically distinct from mechanical devices. In clinical pharmacology, it is primarily recognized as a uterine sedative and smooth muscle relaxant.
The plant is a deciduous shrub native to the eastern and central United States. Historically, the bark was utilized by Native American populations and was later officially recognized in the United States Pharmacopeia (USP) from 1882 to 1926. It contains a complex matrix of bioactive phytochemicals, including coumarins (scopoletin), iridoid glycosides (viburitrol), triterpenes, and small amounts of salicin. While not currently FDA-approved as a primary pharmaceutical drug for acute conditions, it is widely available as a dietary supplement and is frequently prescribed by healthcare providers specializing in integrative medicine for the management of dysmenorrhea (painful menstruation) and threatened miscarriage (under strict supervision).
The mechanism of action for Viburnum Prunifolium Bark is multi-faceted, involving both direct and indirect pathways to modulate smooth muscle tone. The primary bioactive constituent, scopoletin (a coumarin derivative), is believed to exert a direct antispasmodic effect on the uterine musculature. At the molecular level, studies suggest that these compounds may inhibit the influx of calcium ions into smooth muscle cells or modulate the release of intracellular calcium stores, thereby preventing the intense contractions associated with primary dysmenorrhea.
Furthermore, the presence of salicin provides a secondary mechanism of action. Salicin is a precursor to salicylic acid, which acts as a mild cyclooxygenase (COX) inhibitor. By reducing the synthesis of pro-inflammatory prostaglandins (specifically PGF2α), Viburnum Prunifolium Bark helps alleviate the pain and inflammation that drive uterine cramping. Additionally, the iridoid glycosides found in the bark may contribute to a mild sedative effect on the central nervous system, helping to reduce the systemic perception of pain and anxiety often associated with pelvic distress.
Because Viburnum Prunifolium Bark is a complex botanical extract rather than a single isolated chemical entity, its pharmacokinetic profile is determined by its major active constituents:
While clinical evidence is largely based on traditional use and smaller pilot studies, Viburnum Prunifolium Bark is commonly utilized for the following indications:
Viburnum Prunifolium Bark is available in several preparations, including:
> Important: Only your healthcare provider can determine if Viburnum Prunifolium Bark is right for your specific condition. Botanical agents can have potent physiological effects and may interact with conventional treatments.
Dosage for Viburnum Prunifolium Bark varies significantly based on the preparation type and the concentration of active constituents. There is no single FDA-standardized dose, but common clinical ranges include:
Viburnum Prunifolium Bark is generally not recommended for use in children or adolescents under the age of 18 without explicit medical guidance. Due to the salicin content, there is a theoretical risk of Reye’s Syndrome, a rare but serious condition, if administered to children recovering from viral infections (similar to the risk associated with aspirin).
Patients with significant renal (kidney) dysfunction should use Viburnum Prunifolium Bark with extreme caution. The excretion of salicylate metabolites and coumarin derivatives depends on healthy kidney function. Dose reductions or increased intervals between doses may be necessary to prevent accumulation and toxicity.
Because the liver is the primary site for the metabolism of salicin and scopoletin, patients with hepatic (liver) impairment (e.g., cirrhosis or hepatitis) may experience prolonged effects or increased side effects. Use should be monitored closely by a physician.
Geriatric patients often have reduced renal clearance and may be taking multiple medications (polypharmacy). In this population, it is advisable to start at the lowest end of the dosing range to assess tolerance and minimize the risk of gastrointestinal or renal adverse effects.
If you miss a dose, take it as soon as you remember. However, if it is nearly time for your next scheduled dose, skip the missed dose and resume your regular schedule. Do not double the dose to make up for a missed one, as this increases the risk of gastrointestinal upset.
Signs of an overdose of Viburnum Prunifolium Bark may resemble salicylate toxicity or excessive sedation. Symptoms include:
In the event of a suspected overdose, contact your local poison control center or seek emergency medical attention immediately. Treatment is generally supportive, focusing on gastric lavage and fluid replacement.
> Important: Follow your healthcare provider's dosing instructions. Do not adjust your dose without medical guidance, as botanical products can vary in potency.
While generally well-tolerated when used at recommended dosages, the most common side effects of Viburnum Prunifolium Bark involve the gastrointestinal system. These may include:
These symptoms typically resolve once the body acclimates to the herb or when the dosage is reduced.
> Warning: Stop taking Viburnum Prunifolium Bark and call your doctor immediately if you experience any of these.
Prolonged use of Viburnum Prunifolium Bark (beyond several months) has not been extensively studied. Potential long-term risks include:
There are currently no FDA black box warnings for Viburnum Prunifolium Bark, as it is primarily regulated as a dietary supplement. However, healthcare providers often apply the same precautions as they would for aspirin-containing products regarding the risk of Reye's Syndrome in children and the risk of bleeding in patients with peptic ulcers.
Report any unusual symptoms to your healthcare provider. Monitoring of liver and kidney function may be recommended for those using the herb on a long-term basis.
Viburnum Prunifolium Bark is a potent botanical agent and should be treated with the same respect as pharmaceutical medications. It is not a 'simple' herbal tea and can have significant systemic effects. Patients should be aware that because botanical supplements are not regulated as strictly as prescription drugs, the concentration of active ingredients like scopoletin and salicin can vary between brands.
No FDA black box warnings for Viburnum Prunifolium Bark. However, clinical literature strongly cautions against its use in children and teenagers due to the potential association between salicylates and Reye's Syndrome.
For patients using Viburnum Prunifolium Bark for chronic conditions, the following monitoring may be appropriate:
Viburnum Prunifolium Bark may cause drowsiness or dizziness in some individuals due to its sedative effects. Patients should assess their reaction to the herb before driving or operating heavy machinery. This effect may be amplified if the herb is taken in combination with other sedatives.
Concurrent use of alcohol and Viburnum Prunifolium Bark is generally discouraged. Alcohol can increase the risk of gastric irritation and bleeding when combined with salicylates. Furthermore, the sedative effects of both substances may be additive, leading to excessive impairment.
There is no evidence of a formal withdrawal syndrome associated with Viburnum Prunifolium Bark. However, if used for severe dysmenorrhea, symptoms may return immediately upon discontinuation. It is generally best to taper the dose over several days if it has been used daily for an extended period.
> Important: Discuss all your medical conditions, especially any history of ulcers or bleeding problems, with your healthcare provider before starting Viburnum Prunifolium Bark.
> Important: Tell your doctor about ALL medications, supplements, and herbal products you are taking. A complete medication review is essential for safety.
In the following scenarios, Viburnum Prunifolium Bark must NEVER be used:
Conditions requiring a careful risk-benefit analysis by a healthcare professional include:
Patients who react to the following substances should be cautious of Viburnum Prunifolium Bark:
> Important: Your healthcare provider will evaluate your complete medical history before prescribing or recommending Viburnum Prunifolium Bark to ensure it does not conflict with existing conditions.
Historically, Viburnum Prunifolium Bark has been used as a 'uterine tonic' to prevent miscarriage and ease false labor pains. However, modern clinical guidelines are much more conservative. The presence of salicin (a salicylate) poses a theoretical risk, especially in the third trimester, where it could affect fetal circulation or prolong labor. Do not use this herb during pregnancy unless specifically directed and monitored by an obstetrician.
It is unknown if the specific constituents of Viburnum Prunifolium Bark pass into breast milk in significant quantities. However, salicylates are known to be excreted in milk. There is a theoretical risk of skin rashes or platelet dysfunction in the nursing infant. Most experts recommend avoiding the use of this herb while breastfeeding or monitoring the infant closely for any adverse changes.
Viburnum Prunifolium Bark is generally considered unsafe for children. The primary concern is Reye's Syndrome, which is associated with salicylate use in the context of viral illnesses. Additionally, the safety and appropriate dosing for children have never been established through clinical trials.
Older adults are at an increased risk for the side effects of Viburnum Prunifolium Bark, particularly gastrointestinal bleeding and kidney dysfunction. Because many elderly patients are on 'blood thinners' for cardiovascular health, the risk of drug interactions is high. Healthcare providers should perform a thorough review of the patient's medication list before recommending this botanical.
In patients with a Glomerular Filtration Rate (GFR) below 30 mL/min, the use of this herb is generally discouraged. The accumulation of salicylate metabolites can lead to metabolic acidosis and other systemic complications. For those with mild impairment, doses should be kept at the lowest effective level.
Patients with Child-Pugh Class B or C hepatic impairment should avoid this herb. The liver's reduced ability to conjugate and detoxify coumarins and salicylates increases the risk of toxicity. Even in mild liver disease, frequent monitoring of liver enzymes is recommended if the herb is used.
> Important: Special populations require individualized medical assessment. Never self-prescribe botanical extracts if you fall into one of these categories.
Viburnum Prunifolium Bark acts through a synergistic combination of phytochemicals. The scopoletin component acts as a competitive antagonist at certain muscarinic receptors or modulates calcium channel activity in smooth muscle, leading to direct relaxation of the uterus. This 'antispasmodic' effect is specific to the smooth muscle of the pelvic organs. Simultaneously, the salicin content is metabolized into salicylic acid, which inhibits the enzyme cyclooxygenase (COX). This reduces the production of prostaglandins like PGF2α, which are the primary chemical messengers that trigger painful uterine contractions and systemic inflammation during menstruation.
The onset of the antispasmodic effect typically occurs within 30 to 60 minutes of oral administration. The duration of action for a single dose is generally 4 to 8 hours. Unlike synthetic NSAIDs, the whole-plant extract also contains tannins which may have a localized astringent effect, potentially reducing excessive menstrual bleeding (menorrhagia) in some clinical observations, though this effect is less well-documented than the antispasmodic action.
| Parameter | Value |
|---|---|
| Bioavailability | Estimated 60-80% (for Salicin/Scopoletin) |
| Protein Binding | 80-90% (as Salicylic acid) |
| Half-life | 2-4 hours (Salicylates); Variable (Coumarins) |
| Tmax | 1-2 hours |
| Metabolism | Hepatic (Hydrolysis and Glucuronidation) |
| Excretion | Renal (80-95% as metabolites) |
Viburnum Prunifolium Bark is classified as a Uterine Antispasmodic and Botanical Sedative. In some therapeutic classification systems, it is associated with the Copper-containing Intrauterine Device [EPC] group, though it functions as a pharmacological agent rather than a mechanical contraceptive. It is related to other 'uterine herbs' such as Viburnum opulus (Crampbark) and Chamaelirium luteum (False Unicorn).
Common questions about Viburnum Prunifolium Bark
Viburnum Prunifolium Bark, also known as Black Haw, is primarily used to relieve painful menstrual cramps (dysmenorrhea) and other types of uterine spasms. Healthcare providers in integrative medicine may also use it to manage uterine irritability or as a traditional remedy for threatened miscarriage, though this requires strict medical supervision. The bark contains compounds like scopoletin and salicin that help relax smooth muscles and reduce inflammation. It is also sometimes used to treat general pelvic pain and congestion. Always consult a doctor to ensure your symptoms aren't caused by a more serious underlying condition.
The most frequently reported side effects are gastrointestinal in nature, including nausea, stomach upset, and mild diarrhea. These effects are often due to the high tannin and salicin content of the bark, which can irritate the stomach lining. Some users may also experience mild dizziness, lightheadedness, or a faint ringing in the ears (tinnitus). Taking the supplement with food can significantly reduce the likelihood of stomach irritation. If you experience severe abdominal pain or black, tarry stools, you should stop use and contact a doctor immediately. Most common side effects are mild and resolve when the dosage is adjusted.
It is generally recommended to avoid alcohol while using Viburnum Prunifolium Bark. Alcohol can increase the risk of stomach irritation and gastrointestinal bleeding when combined with the salicylate compounds found in the bark. Additionally, both alcohol and Black Haw have mild sedative effects on the central nervous system, and combining them can lead to excessive drowsiness or impaired coordination. This combination may also put unnecessary strain on the liver, which must process both substances. If you do choose to drink, limit your intake significantly and monitor for increased side effects. Discuss your lifestyle habits with your healthcare provider for personalized safety advice.
The safety of Viburnum Prunifolium Bark during pregnancy is a subject of debate and requires caution. Historically, it was used to prevent miscarriage, but modern medicine warns that its salicin content could potentially affect fetal circulation, especially in the later stages of pregnancy. There is also a lack of rigorous clinical trials to prove its safety for the developing fetus. Using any herbal supplement during pregnancy carries risks of uterine stimulation or hormonal interference. Therefore, you should never use this bark while pregnant unless it is specifically recommended and monitored by your obstetrician. Most doctors suggest safer, better-studied alternatives for pregnancy-related discomfort.
For acute menstrual cramps, many patients report feeling relief within 30 to 60 minutes of taking a liquid tincture or decoction. Capsules may take slightly longer, usually 1 to 2 hours, as they must be broken down in the digestive tract. For the best results in managing dysmenorrhea, some clinicians suggest starting the herb one or two days before your period is expected to begin. This 'loading' period allows the active compounds to begin modulating prostaglandin levels before the most intense cramping starts. The duration of the effect typically lasts between 4 and 6 hours. If you do not see improvement after several doses, consult your healthcare provider.
Yes, you can generally stop taking Viburnum Prunifolium Bark suddenly without experiencing physical withdrawal symptoms, as it is not known to be habit-forming. However, if you are using it to manage chronic pelvic pain or severe menstrual symptoms, those symptoms are likely to return once the herb is discontinued. If you have been taking high doses for a long period, it is always a good practice to consult your doctor before stopping. They may recommend a gradual taper to see if your symptoms return or to transition you to a different therapy. Stopping suddenly is not dangerous, but it may lead to a recurrence of the discomfort you were treating.
If you miss a dose, you should take it as soon as you remember to maintain the levels of active compounds in your system. However, if it is almost time for your next scheduled dose, skip the missed one and continue with your regular timing. You should never take two doses at once to 'catch up,' as this significantly increases the risk of stomach irritation or salicylate toxicity. Maintaining a consistent schedule is most effective for managing pain. If you find yourself frequently forgetting doses, consider using a pill organizer or a phone reminder. Consistency is key to achieving the best therapeutic results with botanical extracts.
There is currently no clinical evidence to suggest that Viburnum Prunifolium Bark causes weight gain. It does not contain significant calories, nor does it appear to affect metabolic rate or appetite in a way that would lead to increased body fat. Some women may experience bloating or water retention during their menstrual cycle, which could be mistaken for weight gain, but the herb itself is actually intended to help relieve the pelvic congestion associated with these symptoms. If you notice sudden or unexplained weight gain while taking this supplement, it is likely due to another factor. You should discuss any significant weight changes with your healthcare provider to rule out other medical conditions.
Viburnum Prunifolium Bark can interact with several types of medications, particularly blood thinners like Warfarin, aspirin, and NSAIDs like Ibuprofen. Because it contains salicylates and coumarin-like compounds, it can increase the risk of bleeding when taken with these drugs. It may also interact with blood pressure medications and diuretics, potentially making them more or less effective. Furthermore, it can enhance the effects of other sedatives or anti-anxiety medications. Because of these potential interactions, it is crucial to provide your doctor with a full list of all prescriptions and over-the-counter supplements you are using. They can help you determine a safe dosing schedule or suggest alternatives.
Viburnum Prunifolium Bark is a natural botanical product and is not a 'brand-name' drug in the traditional pharmaceutical sense, so the concept of 'generic' does not strictly apply. Instead, it is available from many different supplement manufacturers under its common name, Black Haw. You can find it in various forms like bulk dried bark, liquid tinctures, and standardized capsules. When shopping, look for products that specify the species name (*Viburnum prunifolium*) and are tested for purity by third-party organizations. While it is widely available without a prescription, the quality and potency can vary significantly between different brands. It is best to choose a reputable source recommended by a healthcare professional.