Artemisia annua and Artemisinin: Safety and Precautions - CancerChoices



The dried leaf or extract of the Artemisia annua plant or its natural derivative artemisinin are available as supplements with anticancer, anti-inflammatory, and antimicrobial properties.

Safety and precautions

Side effects or adverse events

Liver toxicity has been reported among people using Arthrem, an Artemisia annua extract;1Warning of potential harm to liver associated with the natural medicine Arthrem. Ministry of Health—Manatū Hauora (New Zealand). February 19, 2018. Viewed October 18, 2022. routine monitoring of liver function routinely is advised during use.

Vomiting is the most common side effect reported among people treated with Artemisia annua tea for malaria.2Willcox ML, Burton S et al. Evaluation and pharmacovigilance of projects promoting cultivation and local use of Artemisia annua for malaria. Malaria Journal. 2011 Apr 11;10:84.

Interactions with other therapies

Artemisinin-based therapies have shown pharmacokinetic and pharmacodynamic drug interactions with HIV antiviral treatment and treatment failure in some studies with cardiovascular, antibiotic, and antiparasitic drugs.3Hernandez Maldonado J, Grundmann O. Drug-drug interactions of artemisinin-based combination therapies in malaria treatment: a narrative review of the literature. Journal of Clinical Pharmacology. 2022 Oct;62(10):1197-1205.

Do not use (contraindications)

Use during pregnancy may cause harm to the fetus.4Alschuler LN, Gazella KA. The Definitive Guide to Cancer, 3rd Edition: An Integrative Approach to Prevention, Treatment, and Healing. Berkeley, California: Celestial Arts. 2010. p. 162. Of about 3,000 cases of presumed malaria treated with A. annua teas, including 54 women in the first trimester of pregnancy, 2 miscarriages were reported.5Willcox ML, Burton S et al. Evaluation and pharmacovigilance of projects promoting cultivation and local use of Artemisia annua for malaria. Malaria Journal. 2011 Apr 11;10:84. 

Consult your pharmacist for interactions, and discuss using Artemisia annua or artemisinin with your doctor. We recommend that patients who use either of these therapies for cancer seek guidance about usage, dose, and formulation from an integrative cancer care clinician or traditional Chinese medicine practitioner with experience working with cancer patients.

Commentary

Neil McKinney, ND, describes some side effects of artemisinin:6McKinney N. Naturopathic Oncology, Fourth Edition. Victoria, BC, Canada: Liaison Press. 2020.

  • Mild and temporary symptoms: cold hands and feet, numbness, tinnitus, dizziness, headache, gastrointestinal discomfort, loss of appetite (anorexia), nausea, vomiting, and diarrhea
  • Increased liver enzymes
  • Anemia due to iron loss

Dr. McKinney also lists several precautions for artemisinin:

  • People with an iron deficiency should stop using antioxidant supplements during the week of artemisinin use. All antioxidants except vitamin E can be used during the week when artemisinin is not being used.
  • Artemisinin works better among people who are physically active, and so a sedentary lifestyle could be an indication against use.
  • Artemisinin use is contraindicated among people who use tobacco. People planning to use artemisinin should stop tobacco use 6 months before beginning artemisinin treatment.  
  • Don’t use artemisinin during or for 2 months after radiotherapy or surgery. One exception is use as a radiosensitizer in whole-brain radiation for glioblastoma.

Keep reading about Artemisia annua and artemisinin

Authors

Nancy Hepp, MS

Lead Researcher
View profile

Ms. Hepp is a researcher and communicator who has been writing and editing educational content on varied health topics for more than 20 years. She serves as lead researcher and writer for CancerChoices and also served as the first program manager. Her graduate work in research and cognitive psychology, her master’s degree in instructional design, and her certificate in web design have all guided her in writing and presenting information for a wide variety of audiences and uses. Nancy’s service as faculty development coordinator in the Department of Family Medicine at Wright State University also provided experience in medical research, plus insights into medical education and medical care from the professional’s perspective.

Nancy Hepp, MS Lead Researcher

Laura Pole, MSN, RN, OCNS

Senior Clinical Consultant
View profile

Laura Pole is senior clinical consultant for CancerChoices. Laura is an oncology clinical nurse specialist who has been providing integrative oncology clinical care, navigation, consultation, and education services for over 40 years. She is the co-creator and co-coordinator of the Integrative Oncology Navigation Training at Smith Center for Healing and the Arts in Washington, DC. Laura also manages the “Media Watch Cancer News That You Can Use” listserv for Smith Center/Commonweal. In her role as a palliative care educator and consultant, Laura has served as statewide Respecting Choices Faculty for the Virginia POST (Physician Orders for Scope of Treatment) Collaborative as well as provided statewide professional education on palliative and end-of-life care for the Virginia Association for Hospices and Palliative Care.

For CancerChoices, Laura curates content and research, networks with clinical and organizational partners, brings awareness and education of integrative oncology at professional and patient conferences and programs, and translates research into information relevant to the patient experience as well as clinical practice.

Laura sees her work with CancerChoices as a perfect alignment of all her passions, knowledge and skills in integrative oncology care. She is honored to serve you.

Laura Pole, MSN, RN, OCNS Senior Clinical Consultant

Last update: December 7, 2023

Last full literature review: October 2022

CancerChoices provides information about integrative in cancer care, a patient-centered approach combining the best of conventional care, self care and evidence-informed complementary care in an integrated plan cancer care. We review complementaryin cancer care, complementary care involves the use of therapies intended to enhance or add to standard conventional treatments; examples include supplements, mind-body approaches such as yoga or psychosocial therapy, and acupuncture therapies and self-care lifestyle actions and behaviors that may impact cancer outcomes; examples include eating health-promoting foods, limiting alcohol, increasing physical activity, and managing stress practices to help patients and professionals explore and integrate the best combination of conventionalthe cancer care offered by conventionally trained physicians and most hospitals; examples are chemotherapy, surgery, and radiotherapy and complementary therapies and practices for each person.

Our staff have no financial conflicts of interest to declare. We receive no funds from any manufacturers or retailers gaining financial profit by promoting or discouraging therapies mentioned on this site.

Learn more

References[+]