Herbal Medicines in Pregnancy and Lactation : An Evidence-based ...

138 Herbal medicinesFOXGLOVEDigitalis lanata, D. purpureaSynonyms/common names/related substances 1Dead man’s bells, fairy cap, fairy finger, foxglove, lady’s thimble, lion’s mouth,purple foxglove, Scotch mercury, throatwort, witch’s bells, wolly foxgloveIndicationsCongestive heart failure: 2Evidence grade APregnancyMusculoskeletal malformations: 3Evidence level 1bA serial examination of 20 248 livebirths, stillbirths and abortions to assess correlationsbetween drug exposure and major malformations found a statisticallysignificant association between digitalis and anomalies of the musculoskeletalsystem.Treatment of hydrops fetalis: 4–6 Evidence level 2There are a few cases in the scientific literature of digitalis being used to treathydrops fetalis. 4–6 The treatment outcomes were successful in some cases andunsuccessful in others. 4–6Treatment of fetal cardiac disorders: 7–10 Evidence level 2There are cases in the scientific literature where digitalis was used to treat fetalcardiac disorders, such as fetal tachycardia and fetal atrial flutter. 7–10 The treatmentoutcomes were successful in some cases and unsuccessful in others. 7–10Can be prescribed during pregnancy: 11,12 Evidence level 4Two review articles report that digitalis drug preparations can be prescribedduring pregnancy. 11,12Cytotoxic: 13 Evidence level 4A review article on the potential value of plants as sources of anti-fertilityagents reported that foxglove has cytotoxic activity. 13Unsafe: 14 Evidence level 4A botanical safety compendium reports that digitalis is unsafe during pregnancy. 14Crosses the placenta: 15 Evidence level 4