Herbal Monograph
Motherwort
Leonurus cardiaca L.
Lamiaceae (Labiatae)
Premier cardiac-nervine herb for palpitations with anxiety, nervous heart con...
Overview
Plant Description
Herbaceous perennial, 60-150 cm tall, with erect, stiff, square (quadrangular) stems characteristic of the Lamiaceae, lightly pubescent and often purplish near the nodes. Stems branch sparingly below the inflorescence. Leaves opposite, palmately lobed and coarsely toothed; basal and lower leaves large (up to 12 cm long), long-petiolate, 3- to 5-lobed, resembling maple leaves; upper leaves become progressively smaller, more narrowly lobed, and nearly sessile moving up the stem, transitioning to 3-lobed and then linear-lanceolate near the inflorescence. Flowers sessile, arranged in dense axillary whorls (verticillasters) in the upper leaf axils, forming a long, interrupted spike-like inflorescence. Calyx tubular, 5-toothed, with rigid spine-tipped teeth that persist and become prickly in fruit. Corolla bilabiate (two-lipped), 8-12 mm long, pale pink to lilac-purple with purple spots on the lower lip; upper lip densely woolly with white hairs exceeding 1 mm in length, concave, entire; lower lip 3-lobed, deflexed. Stamens 4, in 2 pairs, ascending under the upper lip. Fruit comprises 4 trigonous (three-angled) nutlets, approximately 2 mm long, within the persistent calyx. Rootstock is perennial with short rhizomes. The entire plant has a strong, distinctive, somewhat unpleasant odor and an intensely bitter taste.
Habitat
Thrives in waste places, roadsides, hedgerows, railway embankments, field margins, and disturbed ground. Prefers partial shade to full sun. Grows best in moderately fertile, well-drained to slightly moist soils, tolerating a range of soil types including calcareous and slightly acidic substrates. Often found near human habitation, along fences, and in abandoned gardens — a typical ruderal species. Drought-tolerant once established. Hardy to USDA Zone 3 (approximately -40C).
Distribution
Native to central Asia and southeastern Europe. Widely naturalized throughout temperate Europe, North America, and parts of South America. In North America, introduced by early European settlers as a medicinal garden plant, now naturalized in every Canadian province and most U.S. states, where it is sometimes considered an invasive weed. Major wild-harvest and cultivation regions include eastern Europe (Poland, Ukraine, Russia, Baltic states), Germany, and parts of central Asia.
Parts Used
Aerial parts in flower (Leonuri cardiacae herba)
Preferred: Dried aerial parts for infusion and tincture; fresh plant tincture for acute cardiac-nervine symptoms
The above-ground portions — stems, leaves, and flowers — harvested during the flowering period are the official medicinal part. The European Pharmacopoeia and EMA monograph specify 'Leonuri cardiacae herba' as the drug. The aerial parts contain the full spectrum of active constituents including iridoids, flavonoids, phenylpropanoid glycosides (particularly lavandulifolioside), diterpenes, and alkaloids (stachydrine). The bitter taste is most pronounced in the flowering tops. Quality criteria include a minimum flavonoid content of 0.2% calculated as hyperoside (EMA). Both fresh and dried herb are used; fresh plant tincture is preferred by some practitioners for acute cardiac-nervine indications.
Key Constituents
Iridoid glycosides
The iridoid glycoside fraction contributes significantly to the intensely bitter taste of motherwort and supports its bitter tonic and digestive-stimulant activity. Iridoids are a recognized compound class in the Lamiaceae with anti-inflammatory, hepatoprotective, and mild sedative activity documented across the family.
Alkaloids
The alkaloid fraction contributes to motherwort's cardiovascular and uterotonic actions. Stachydrine is the most reliably present alkaloid in L. cardiaca and has documented cardioprotective, mild hypotensive, and oxytocic properties. The disputed presence of leonurine in L. cardiaca versus L. japonicus is an important pharmacognostic distinction — the two species are not interchangeable. The EMA assessment report acknowledges the alkaloid fraction's contribution to the traditional cardiovascular indications.
Flavonoids
The flavonoid fraction provides antioxidant, anti-inflammatory, and cardiovascular-protective effects. Flavonoids contribute to the overall cardioprotective profile of motherwort by reducing oxidative stress and supporting vascular integrity. The total flavonoid content calculated as hyperoside is a primary quality marker for commercial Leonuri cardiacae herba preparations.
Phenylpropanoid glycosides (phenylethanoid glycosides)
The phenylpropanoid glycoside fraction — especially lavandulifolioside — is a major contributor to motherwort's cardiovascular effects (negative chronotropy and blood pressure reduction). These compounds are characteristic of L. cardiaca and serve as both pharmacological agents and chemotaxonomic markers. Their cardioactive properties help explain the traditional use for nervous cardiac conditions and palpitations.
Labdane diterpenes
Labdane diterpenes are among the most structurally diverse compound classes in the Leonurus genus. While they are present in considerable quantities and are taxonomically important, pharmacological research on the diterpene fraction has been limited (only 20% of bioactivity studies have addressed diterpenes, compared to 57% focusing on the alkaloids leonurine and stachydrine). Classified as 'chemicals of concern' for food/supplement use in some regulatory contexts due to limited safety data.
Terpenoids and other constituents
Minor and accessory constituents that contribute to the overall pharmacological profile. Ursolic acid provides cardioprotective and antimicrobial effects. Rosmarinic acid supports the traditional indication for thyroid hyperfunction. The volatile oil and tannin fractions provide ancillary anti-inflammatory and astringent activity.
Herbal Actions
Motherwort is classified as a relaxing nervine, calming nervous tension and reducing anxiety without excessive sedation. Particularly indicated for anxiety that manifests with cardiac symptoms (palpitations, tachycardia, chest tightness). The GABA-A receptor binding demonstrated by Rauwald et al. (2015) provides a pharmacological basis for the anxiolytic action — the L. cardiaca extract bound with an IC50 of 21 microg/mL at the GABA site (not the benzodiazepine site). Hoffmann classifies motherwort as 'an excellent tonic for the heart and nervous system.' Commission E approved for nervous cardiac disorders.
[1, 2, 3, 9]Motherwort supports cardiac function through multiple mechanisms: negative chronotropic effect (slowing heart rate), mild antiarrhythmic activity via mixed L-type calcium channel (ICa.L) and rapid delayed rectifier potassium current (IKr) antagonism, and hypotensive action. The specific epithet 'cardiaca' reflects the ancient recognition of this heart-affinity. Lavandulifolioside is credited with negative chronotropic and hypotensive effects. The EMA monograph recognizes traditional use for 'nervous conditions of the heart.' Not a cardiac stimulant in the digitalis sense — rather a cardiac nervine that calms and regulates.
[1, 2, 4, 10]Relieves smooth muscle spasm
Spasmolytic activity on smooth muscle, including uterine and vascular smooth muscle. Relevant to its use for menstrual cramps (uterine spasm), intestinal colic, and vascular tension contributing to hypertension. The antispasmodic action combines with the nervine action to relieve tension-pattern conditions where both smooth muscle spasm and nervous agitation are present.
[3, 4, 6]Stimulates or increases menstrual flow
Promotes menstrual flow and relieves menstrual stagnation. The emmenagogue action is the basis for the AHPA Class 2b classification (not to be used during pregnancy). Stachydrine demonstrates oxytocic activity in pharmacological studies. This action underlies the traditional use as a 'mother's herb' for delayed, scanty, or painful menstruation with a congestive, tense presentation. Used traditionally to ease labor pains and promote postpartum recovery.
[3, 5, 6]Lowers blood pressure
Mild blood pressure-lowering activity. Shikov et al. (2011) demonstrated positive effects on arterial blood pressure in a clinical trial of 50 patients with stage 1-2 hypertension treated with 1200 mg/day Leonurus oil extract for 28 days. The hypotensive action is attributed to a combination of vascular relaxation, reduced cardiac output (negative chronotropy), and central nervous system calming. Most effective in stress-induced or anxiety-associated hypertension.
[3, 4, 8]The intensely bitter taste of motherwort stimulates digestive secretions and supports hepatic function. Classified as a hepatic in some herbal traditions. The bitterness is primarily attributable to the iridoid glycoside fraction. Used as a digestive bitter in European herbal practice, though this is a secondary application compared to the cardiac and nervine uses.
[3, 6]Promotes perspiration
Mild promotion of perspiration when taken as a warm infusion. Relevant to traditional use in febrile conditions. A secondary action used in combination with its nervine effects for fever with restlessness and anxiety.
[3]Commission E lists motherwort as an adjuvant for thyroid hyperfunction. The antithyrotropic effect is attributed primarily to rosmarinic acid, which inhibits TSH binding and reduces thyroid hormone overproduction. This is a supportive, symptomatic action — motherwort addresses the cardiac and nervous symptoms of hyperthyroidism (palpitations, anxiety, tremor) rather than directly correcting thyroid pathology. Used as a symptomatic adjunct, not as primary antithyroid therapy.
[1, 3, 4]Therapeutic Indications
Cardiovascular System
Nervous cardiac disorders (functional heart complaints of nervous origin)
Commission E approved indication. EMA traditional use monograph: 'for the relief of nervous cardiac complaints (e.g. palpitations) after serious conditions have been excluded by a medical doctor.' This is the primary indication for motherwort — cardiac symptoms driven by anxiety, stress, or nervous tension rather than structural heart disease. The combination of negative chronotropic, anxiolytic, and antispasmodic actions addresses the pathophysiology of functional cardiac complaints.
[1, 2, 3]Palpitations and sinus tachycardia (anxiety-associated)
Motherwort is one of the premier herbs for palpitations occurring in the context of anxiety, stress, or emotional distress. The negative chronotropic effect (slowing heart rate) mediated by calcium and potassium channel modulation, combined with the GABA-ergic anxiolytic action, specifically targets the heart-nervine crossover. BHP specific indication: cardiac debility. Ritter et al. demonstrated the electrophysiological basis for the antiarrhythmic effect.
[3, 4, 6, 10]Mild hypertension (stress-associated)
Shikov et al. (2011) conducted an open clinical trial of 50 patients with stage 1-2 arterial hypertension accompanied by anxiety and sleep disorders, treated with 1200 mg/day Leonurus oil extract for 28 days. Significant improvements in systolic and diastolic blood pressure, heart rate, and anxiety/depression scores were observed. Positive effects appeared 1 week earlier in stage 1 than stage 2 patients. Most appropriate for hypertension with a clear stress/anxiety component.
[3, 8]Nervous System
Anxiety and nervous tension
EMA traditional use indication: 'for the relief of mild symptoms of mental stress.' Commission E approved for nervous cardiac disorders (the anxiety component). Motherwort is particularly indicated when anxiety manifests with cardiac symptoms — the person who feels their heart pounding or racing when anxious. Rauwald et al. (2015) demonstrated GABA-A receptor binding (IC50 = 21 microg/mL) at the GABA site, providing a pharmacological basis for the anxiolytic action.
[1, 2, 3, 9]Insomnia (anxiety-related)
Traditional use for sleep difficulties associated with nervous tension, racing thoughts, and palpitations at night. Shikov et al. (2011) reported improvements in sleep disorder parameters alongside anxiety and blood pressure in their clinical trial. Most effective when insomnia is driven by an agitated mind and racing heart rather than by pain or other causes.
[3, 8]Nervous exhaustion with irritability
BHP and traditional European herbalism describe motherwort for nervous debility accompanied by irritation and restlessness — the exhausted but 'wired' state. Hoffmann describes it as useful for 'nervous debility' and the pattern of depletion with ongoing overstimulation. Supports recovery from chronic stress states.
[3, 6]reproductive (women's health)
Dysmenorrhea (painful menstruation)
Long traditional use as a 'mother's herb' for painful menstruation, particularly when associated with tension, anxiety, and spasm. The combination of antispasmodic (uterine smooth muscle relaxation), emmenagogue (promoting menstrual flow), and nervine (calming premenstrual anxiety) actions addresses multiple components of dysmenorrhea. Most indicated for congestive dysmenorrhea with scanty, dark flow and cramping pain.
[3, 4, 6]Amenorrhea and delayed menstruation
Traditional emmenagogue use for delayed or absent menstruation. The name 'motherwort' (literally 'mother-herb') reflects centuries of midwifery use for menstrual and reproductive conditions. Stachydrine's oxytocic properties may contribute to this action. Use with caution and only after ruling out pregnancy — the emmenagogue action underlies the pregnancy contraindication.
[3, 6]Menopausal symptoms (anxiety, palpitations, hot flashes)
Motherwort is particularly valued in menopausal formulas for women experiencing anxiety, palpitations, and emotional lability — symptoms that sit at the intersection of its cardiac, nervine, and reproductive actions. Culpeper (1652) noted it 'makes mothers joyful and settles the womb.' The cooling energetics are appropriate for the heat pattern often seen in menopausal symptoms.
[3, 4, 12]Postpartum recovery (after delivery only — NOT during pregnancy)
Traditional postpartum use for promoting uterine involution, easing afterpains, and calming postpartum anxiety. The ancient Greeks used motherwort to reduce anxiety in new mothers. Strictly postpartum — contraindicated during pregnancy itself. TCM uses the related L. japonicus (Yi Mu Cao) extensively for postpartum blood stasis conditions.
[3, 6]Endocrine System
Hyperthyroidism (adjuvant symptomatic treatment)
Commission E approved as 'an adjuvant for thyroid hyperfunction.' Motherwort addresses the cardiac and nervous symptoms of hyperthyroidism — tachycardia, palpitations, anxiety, tremor, and insomnia — through its combined cardiac-nervine action. Rosmarinic acid has been shown to inhibit TSH binding and reduce thyroid hormone overproduction. Used as symptomatic support alongside conventional treatment, not as a primary antithyroid agent. Mills and Bone recommend motherwort in combination with Bugleweed (Lycopus) for this indication.
[1, 3, 4]gastrointestinal
Nervous dyspepsia and intestinal colic
The bitter tonic and antispasmodic actions support digestive function in conditions where nervous tension contributes to gastrointestinal symptoms — the 'butterflies in the stomach' pattern. Not a primary digestive herb, but useful as a component in formulas where cardiac-nervine and digestive actions are both needed.
[3]Energetics
Temperature
cool
Moisture
slightly dry
Taste
Tissue States
heat/excitation, wind/tension, hot/constriction
Motherwort is cooling and slightly drying in Western energetic assessment. Its dominant bitterness (described by many herbalists as 'nauseatingly bitter') supports digestive and hepatic function and cools excess heat in the cardiovascular and nervous systems. The secondary pungency provides diffusive, moving quality that breaks stagnation and tension. Indicated for hot, tense, constricted tissue states — the pattern of the anxious individual with a racing heart, flushed face, and tight chest. Cools heat, relaxes tension, and moves stagnation in the cardiovascular-nervous axis. In the Matthew Wood tissue state framework, motherwort addresses excitation/irritation and constriction/tension, particularly in the heart and uterus. The bitter-cool quality contrasts with warming cardiac herbs like Hawthorn, making motherwort more appropriate when heat signs accompany the cardiac complaint.
Traditional Uses
European traditional herbalism
- Nervine and cardiac tonic for heart palpitations and anxiety
- Calming the nervous heart — 'heart that beats too fast from worry'
- Women's reproductive tonic for menstrual complaints
- Postpartum recovery herb for afterpains and anxiety
- Menopausal support for hot flashes, anxiety, and mood changes
- Mild febrifuge (fever remedy) as warm infusion
- Bitter digestive stimulant
"Hoffmann (2003): 'Motherwort is a relaxing nervine with a specific affinity for the heart... It is valuable in the stimulation of delayed or suppressed menstruation, especially where there is anxiety or tension involved. It is a useful relaxing tonic for aiding in menopausal changes. It may be used to ease false labor pains. It is an excellent tonic for the heart, strengthening without straining. It is a specific for over-rapid heartbeat brought about by anxiety and other such causes.' Hoffmann lists it as a cardiac tonic, nervine, antispasmodic, hepatic, emmenagogue, and hypotensive."
[3]
17th-century English herbalism (Culpeper, Gerard)
- Settling the womb and making mothers joyful
- Removing melancholy vapors from the heart
- Strengthening the heart and preventing swooning
- Treatment of trembling and fainting
- Promoting cheerfulness and alleviating despondency
"Nicholas Culpeper (1652, The English Physician): 'There is no better herb to take melancholy vapours from the heart, to strengthen it, and make a merry, cheerful, blithe soul... It makes women joyful mothers of children, and settles their wombs as they should be, therefore we call it Motherwort.' John Gerard (1597) also noted it for cattle ailments and women's complaints."
[12]
German phytotherapy (Commission E / ESCOP)
- Nervous cardiac disorders
- Adjuvant for thyroid hyperfunction
- Cardiac complaints of nervous origin
"Commission E approved motherwort for 'nervous cardiac disorders' and as an 'adjuvant for thyroid hyperfunction.' The ESCOP monograph identifies therapeutic indications as 'mild cardiac complaints of nervous origin.' The EMA HMPC Community Herbal Monograph (2010) concluded that motherwort preparations can be used for 'the relief of nervous cardiac complaints (e.g. palpitations)' and 'for the relief of mild symptoms of mental stress,' qualified as traditional use based on long-standing use."
Traditional Chinese Medicine (via related species L. japonicus — Yi Mu Cao)
- Invigorating blood and dispelling stasis
- Regulating menstruation (amenorrhea, dysmenorrhea)
- Treating postpartum abdominal pain and hemorrhage
- Resolving fixed abdominal masses caused by blood stasis
- Promoting diuresis and reducing edema
- Supporting fertility
"In TCM, L. japonicus (Yi Mu Cao / 'beneficial for mothers herb') is used to move blood, break stasis, and regulate menstruation. First recorded in the Shennong Bencao Jing (c. 200 CE). It enters the Liver, Heart, and Urinary Bladder channels, and is sweet, pungent, and slightly cold. Primary functions: activate blood, regulate menstruation, promote diuresis, reduce swelling. Contraindicated in blood deficiency without stasis and in yin deficiency. Note: L. japonicus is the species used in TCM, not L. cardiaca — the two have overlapping gynecological indications but distinct phytochemical profiles and are not directly interchangeable."
[14]
Eclectic medicine (American)
- Amenorrhea and suppressed menstruation with nervous irritability
- Cardiac palpitations from nervous excitement
- Choreiform movements and spasmodic conditions
- Nervous restlessness with heart involvement
"The Eclectics used motherwort primarily as a nervine and emmenagogue. Felter (1922, The Eclectic Materia Medica) states: 'Leonurus is specifically indicated when there are functional cardiac disorders dependent upon or associated with uterine or menstrual derangements, and nervous disorders due to the same cause.' The Eclectic emphasis was on the connection between uterine/menstrual dysfunction and cardiac-nervous symptoms."
[13]
Modern Research
Anxiolytic mechanism (GABA-A receptor binding)
In vitro GABA-A receptor binding assays of standardized L. cardiaca and L. japonicus extracts and their isolated constituents.
Findings: Rauwald et al. (2015) demonstrated that a standardized L. cardiaca extract inhibited the concentration-dependent binding of [3H]-SR95531 to the GABA site of the GABA-A receptor with an IC50 of 21 microg/mL. The interaction occurred at the GABA-binding site, not the benzodiazepine-binding site. The structural similarity between leonurine and GABA may explain the binding. However, isolated individual constituents (lavandulifolioside, isoleosibirin, stegioside I, stachydrine) showed poor GABA-A binding affinity individually, suggesting that the anxiolytic activity requires the synergistic interaction of multiple compounds in the whole extract.
Limitations: In vitro receptor binding assay only — does not confirm in vivo anxiolytic efficacy. Individual constituents did not account for the whole-extract activity, leaving the precise mechanism incompletely resolved. Whole-extract effects may depend on synergistic or matrix interactions.
[9]
Hypertension with anxiety and sleep disorders (clinical trial)
Open clinical trial of Leonurus cardiaca oil extract in patients with arterial hypertension accompanied by anxiety and sleep disorders.
Findings: Shikov et al. (2011) treated 50 patients with stage 1-2 arterial hypertension accompanied by anxiety and sleep disorders with 1200 mg/day Leonurus oil extract for 28 days. Significant improvements in systolic blood pressure, diastolic blood pressure, heart rate, and ECG parameters were observed. Using the Clinical Global Impression (CGI) scale, significant improvement in anxiety and depression symptoms was observed in 32% of patients, moderate improvement in 48%, weak effect in 8%, and non-response in 12%. Positive effects appeared 1 week earlier in stage 1 hypertension patients than in stage 2 patients. Side effects were minimal.
Limitations: Open-label (non-blinded) study with no placebo control group. Relatively small sample size (n=50). Single-center study. 28-day treatment duration limits assessment of long-term efficacy and safety. Oil extract preparation may not be representative of all traditional preparations (infusion, tincture).
[8]
Electrophysiological cardiac effects
Investigation of the cardiac electrophysiological mechanisms of Leonurus cardiaca extract.
Findings: Ritter et al. (2010) demonstrated that L. cardiaca extract acts as a mixed L-type calcium channel (ICa.L) and rapid delayed rectifier potassium current (IKr) antagonist. The extract prolonged the PQ interval and reduced ventricular rate, providing an electrophysiological basis for the negative chronotropic and antiarrhythmic effects observed clinically. These channel-blocking properties are consistent with the traditional use for tachycardia and cardiac arrhythmias.
Limitations: In vitro electrophysiology study on isolated cardiac cells. Dose extrapolation to clinical use is indirect. Does not establish safety margins for antiarrhythmic use in humans.
[10]
Cardioprotective and anti-inflammatory effects of ursolic acid
Investigation of the mitochondrial and anti-biofilm effects of ursolic acid from L. cardiaca.
Findings: Liobikas et al. (2011) demonstrated that ursolic acid from L. cardiaca acts as a mitochondrial uncoupler in cardiac tissue, reducing H2O2 production and oxidative stress. Micota et al. (2014, 2015) showed that ursolic acid inhibited Staphylococcus aureus biofilm formation by 85% at 3/4 MIC (MIC = 0.25 mg/mL), and inhibited bacterial adhesion to host extracellular matrix proteins.
Limitations: In vitro studies. Clinical relevance of the mitochondrial uncoupling effect at oral doses not established. Ursolic acid bioavailability from oral L. cardiaca preparations is unknown.
[11]
Comprehensive phytochemistry and pharmacology review
Systematic review updating the 2010 EMA assessment report with evidence from 2010-2018.
Findings: Wojtyniak et al. (2019) reviewed 176 research articles published since the 2010 EMA assessment report. The review confirmed the presence of alkaloids (stachydrine primarily; leonurine presence disputed in L. cardiaca), iridoids, labdane diterpenes, flavonoids, and phenylpropanoid glycosides. Pharmacological activities documented include cardiovascular (antiarrhythmic, hypotensive, cardioprotective), anti-inflammatory, antioxidant, antimicrobial, analgesic, and neuroprotective effects. The authors noted that 57% of bioactivity research focused on the alkaloids leonurine and stachydrine, while only 20% addressed the diterpene fraction despite its quantitative prominence. The disputed presence of leonurine in L. cardiaca (versus L. japonicus) was flagged as an important unresolved issue.
Limitations: Narrative review without formal systematic methodology or meta-analysis. Much of the pharmacological evidence derives from in vitro and animal studies. Clinical evidence remains limited to the single Shikov (2011) trial for L. cardiaca specifically.
[11]
Preparations & Dosage
Infusion (Tea)
Strength: 2-4 g dried aerial parts per 250 mL water
Pour 250 mL boiling water over 1-2 teaspoons (2-4 g) of dried motherwort aerial parts. Cover and steep for 10-15 minutes. Strain. The infusion is intensely bitter — honey or a small amount of licorice root may be added to improve palatability, though some practitioners consider the bitterness part of the therapeutic action.
2-4 g dried herb per cup, 3 times daily
3 times daily for chronic conditions; up to every 2-3 hours for acute anxiety or palpitations (at lower dose)
EMA recommends use limited to 4 weeks without medical consultation. For chronic use, reassess every 4 weeks with a qualified practitioner.
Not recommended for children under 12 without practitioner guidance due to emmenagogue activity
The aqueous infusion extracts flavonoids, iridoid glycosides, phenylpropanoids, alkaloids, tannins, and polysaccharides effectively. The intense bitterness is a consistent challenge for compliance — cold infusion (steeping in cold water for 4-8 hours) produces a somewhat less bitter preparation while still extracting key water-soluble compounds. Some practitioners prefer the tincture for ease of administration.
Tincture
Strength: 1:5 dried herb in 45-60% ethanol; 1:2 fresh herb in 70-95% ethanol
Macerate dried motherwort aerial parts in 45-60% ethanol at a ratio of 1:5 for 2-4 weeks. Press and filter. Fresh plant tincture prepared at 1:2 ratio in 70-95% ethanol.
2-6 mL of 1:5 tincture (in 45-60% ethanol), 3 times daily. BHP recommends 2-4 mL, 3 times daily. Some practitioners recommend up to 5 mL (100 drops) 3 times daily for acute cardiac-nervine symptoms.
3 times daily; up to 5 times daily in acute situations under practitioner guidance
2-4 weeks, then reassess. Can be used long-term under practitioner supervision.
Not recommended for children under 12 without practitioner guidance
Tincture is the most commonly used preparation in clinical practice due to the extreme bitterness of the infusion and the convenience of drop-dosing. The hydroethanolic extract captures both water-soluble (flavonoids, iridoids, alkaloids) and lipophilic (diterpenes, ursolic acid) constituents. Fresh plant tincture is preferred by some practitioners for acute palpitation and anxiety episodes, taken in a small glass of water. Can be combined with Hawthorn (Crataegus) tincture for cardiac support or with Skullcap (Scutellaria) for enhanced nervine effect.
capsule/tablet
Strength: 250-500 mg powdered aerial parts per capsule; or standardized extract (standardized to flavonoid content)
Powdered dried aerial parts in capsule form, or standardized dry extract tablets. Typical capsule size 250-500 mg.
250-500 mg powdered herb, 1-2 capsules, 3 times daily (total daily dose up to 2-3 g)
3 times daily with meals
4 weeks, then reassess
Not recommended under 12
Capsules bypass the bitter taste issue that limits compliance with infusions. Standardization to minimum 0.2% flavonoids (calculated as hyperoside) is recommended per EMA quality criteria. The Shikov (2011) clinical trial used 1200 mg/day of a Leonurus oil extract, which is a different preparation form than standard powdered herb capsules.
[2]
combination formula
Strength: Variable depending on formula
Motherwort combines well with other herbs based on the specific clinical picture. Common combinations include: (1) Motherwort + Hawthorn (Crataegus) for cardiac support with palpitations; (2) Motherwort + Bugleweed (Lycopus) for hyperthyroidism symptoms; (3) Motherwort + Skullcap (Scutellaria) or Passionflower (Passiflora) for anxiety with cardiac symptoms; (4) Motherwort + Black Cohosh (Actaea) for menopausal anxiety and palpitations.
Proportions vary by formula; motherwort typically comprises 25-50% of cardiac-nervine formulas
Per formula design, typically 3 times daily
Per practitioner guidance
Not applicable
Motherwort's strength lies at the intersection of cardiac, nervine, and reproductive actions, making it an excellent formula herb that bridges body systems. Hoffmann specifically recommends the combination with Hawthorn berries for cardiac tonic support and with Bugleweed for thyrotoxicosis symptoms. In formulation, motherwort's bitterness should be balanced with pleasanter-tasting herbs or administered as a tincture combination.
Safety & Interactions
Class 2b
Not to be used during lactation (AHPA Botanical Safety Handbook)
Contraindications
AHPA Class 2b: 'Not to be used during pregnancy.' Motherwort is a recognized emmenagogue and uterine stimulant. Stachydrine has demonstrated oxytocic activity. Use during pregnancy may promote uterine contractions and increase risk of miscarriage, particularly in the first trimester. This is the basis for the Class 2b restriction. Strictly contraindicated throughout pregnancy. Postpartum use (after delivery) is traditional and generally considered acceptable under practitioner guidance.
The emmenagogue action may exacerbate heavy menstrual bleeding. Avoid in women with menorrhagia or a tendency toward heavy periods. The traditional indication is for scanty, delayed, or congestive menstrual patterns — not for excessive flow.
Drug Interactions
| Drug / Class | Severity | Mechanism |
|---|---|---|
| Anticoagulant and antiplatelet medications (warfarin, heparin, aspirin, clopidogrel) (Anticoagulants / antiplatelets) | theoretical | L. cardiaca extracts have been reported to reduce platelet aggregation and fibrinogen levels. Theoretical additive effect on bleeding risk when combined with anticoagulant or antiplatelet therapy. |
| Cardiac glycosides (digoxin) and antiarrhythmic drugs (Cardiac medications) | theoretical | Motherwort demonstrates calcium channel and potassium channel blocking activity. Theoretical potential for pharmacodynamic interaction with digoxin, calcium channel blockers, beta-blockers, and antiarrhythmic agents. Combined use could theoretically produce additive bradycardia or QT prolongation. |
| Thyroid medications (levothyroxine, methimazole, propylthiouracil) (Thyroid hormones / antithyroid agents) | theoretical | Rosmarinic acid content inhibits TSH binding and may reduce thyroid hormone production. Theoretical potential to alter thyroid hormone levels in patients on thyroid replacement therapy (reducing efficacy of levothyroxine) or to potentiate antithyroid drugs. |
| Sedative and hypnotic medications (benzodiazepines, barbiturates, zolpidem) (CNS depressants) | theoretical | GABA-A receptor binding demonstrated in vitro (Rauwald et al. 2015). Theoretical additive CNS depression with concurrent sedative use. Some sources have raised concern about coma risk with benzodiazepine co-administration, though this is not supported by clinical case reports. |
Pregnancy & Lactation
Pregnancy
unsafe
Lactation
likely safe
PREGNANCY: Contraindicated. AHPA Class 2b — not to be used during pregnancy. Stachydrine has documented oxytocic activity. Emmenagogue and uterine stimulant actions pose a risk of miscarriage. The EMA assessment report recommends against use during pregnancy due to insufficient safety data and traditional emmenagogue classification. LACTATION: Traditionally used postpartum and considered compatible with breastfeeding. Motherwort has historical use as a galactogogue and for postpartum anxiety. No adverse effects on nursing infants reported in the traditional literature. However, formal lactation safety studies are lacking. The EMA recommends against use during breastfeeding due to insufficient data, though this reflects regulatory caution rather than documented harm.
Adverse Effects
References
Monograph Sources
- [1] Blumenthal, M., Busse, W.R., Goldberg, A., et al.. The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council / Integrative Medicine Communications (1998) . ISBN: 978-0965555500
- [2] Committee on Herbal Medicinal Products (HMPC). Community herbal monograph on Leonurus cardiaca L., herba. European Medicines Agency (2010)
- [3] Hoffmann, D.. Medical Herbalism: The Science and Practice of Herbal Medicine. Healing Arts Press (2003) . ISBN: 978-0892817498
- [4] Mills, S., Bone, K.. Principles and Practice of Phytotherapy: Modern Herbal Medicine (2nd edition). Churchill Livingstone / Elsevier (2013) . ISBN: 978-0443069925
- [5] Gardner, Z., McGuffin, M. (eds.). American Herbal Products Association's Botanical Safety Handbook (2nd edition). CRC Press (2013) . ISBN: 978-1466516946
- [6] British Herbal Medicine Association. British Herbal Pharmacopoeia. BHMA (1983)
- [7] Brinker, F.. Herbal Contraindications and Drug Interactions (4th edition). Eclectic Medical Publications (2010) . ISBN: 978-1888483147
Clinical Studies
- [8] Shikov, A.N., Pozharitskaya, O.N., Makarov, V.G., et al.. Effect of Leonurus cardiaca oil extract in patients with arterial hypertension accompanied by anxiety and sleep disorders. Phytotherapy Research (2011) ; 25 : 540-543 . DOI: 10.1002/ptr.3292 . PMID: 20839214
- [9] Rauwald, H.W., Savtschenko, A., Merten, A., et al.. GABA-A receptor binding assays of standardized Leonurus cardiaca and Leonurus japonicus extracts as well as their isolated constituents. Planta Medica (2015) ; 81 : 1103-1110 . DOI: 10.1055/s-0035-1546234 . PMID: 26218338
- [10] Ritter, M., Melichar, K., Slansky, S., et al.. Cardiac channel currents of Leonurus cardiaca extract are caused by a unique labdane diterpene fraction. Planta Medica (2010) ; 76 : 572-582
- [11] Wojtyniak, K., Szymanski, M., Matlawska, I.. Leonurus cardiaca L. as a Source of Bioactive Compounds: An Update of the European Medicines Agency Assessment Report (2010). BioMed Research International (2019) ; 2019 : 4303215 . DOI: 10.1155/2019/4303215 . PMID: 31143773
Traditional Texts
- [12] Culpeper, N.. The English Physician (Culpeper's Complete Herbal). Peter Cole (original); various modern reprints (1652)
- [13] Felter, H.W.. The Eclectic Materia Medica, Pharmacology and Therapeutics. John K. Scudder (1922)
- [14] Chen, J.K., Chen, T.T.. Chinese Medical Herbology and Pharmacology. Art of Medicine Press (2004) . ISBN: 978-0974063508
Pharmacopeias & Reviews
- [15] European Pharmacopoeia Commission. European Pharmacopoeia — Leonuri cardiacae herba (Motherwort). Council of Europe / EDQM (2023)
Last updated: 2026-03-02 | Status: review
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