White willow bark

Be careful of

Cautions

• AllergyDo not use it if you are allergic to aspirin, other salicylates or NSAIDs, or have asthma triggered by them. A case of anaphylaxis was reported in a person with an aspirin allergy.
• ConditionDo not use it with an active stomach ulcer, severe liver or kidney disease, a bleeding or clotting disorder, or G6PD deficiency (a woman with G6PD deficiency had severe breakdown of red blood cells after a salicin-containing product).
• ConditionNot for children or teenagers under 18, because of the risk of Reye's syndrome linked to salicylates.
• InteractionIt may add to the effect of blood thinners such as warfarin and antiplatelet drugs; a study of people on warfarin linked willow bark with bleeding events. Do not combine it with aspirin or other NSAIDs without medical advice.
• NoteSide effects include rash, itching, asthma, nausea, vomiting, stomach pain, diarrhea and heartburn. EU guidance: no more than 4 weeks for back or joint pain; see a doctor if fever lasts more than 3 days or a headache more than 1 day.
• PregnancyDo not use it in the third trimester of pregnancy. EU guidance is not to use it earlier in pregnancy or while breastfeeding either, because salicylates reach breast milk and safety is not established.
• Ask a clinicianTalk with a clinician or pharmacist before using this if you take prescription medicines, are pregnant or breastfeeding, or are giving it to a child.