Plant Comparison
Pygeum vs Common coltsfoot
A side-by-side comparison of two medicinal plants — every documented constituent, action, use, safety note and cited source, assembled automatically from the Omnia Sana database.
At a glance
Pygeum and Common coltsfoot: they share 3 indicated uses (arthritis / joint pain, inflammation (general), skin irritation); 1 pharmacological action in common.
Evidence face-off — shared uses
| Condition | Pygeum | Common coltsfoot | Verdict |
|---|---|---|---|
| Arthritis / joint pain | 5/10 | 1/10 | Stronger for Pygeum |
| Inflammation (general) | 2/10 | 2/10 | Comparable evidence |
| Skin irritation | 5/10 | 1/10 | Stronger for Pygeum |
Evidence scores (1–10) are computed from the tier of each cited source. “Comparable” means the two scores are within one point. Follow a score to its detailed sources.
Key Constituents
Hepatotoxic constituents that are the central safety concern for this plant; regulatory limits and PA-controlled/PA-reduced products exist specifically because of these compounds.
Demulcent polysaccharide contributing to the traditional soothing action on irritated airways.
Pharmacological Actions
Traditional & Indicated Uses
inferred from anti-inflammatory action
inferred from anti-inflammatory action
Supports lower urinary tract symptoms of benign prostatic hyperplasia (BPH) - a Cochrane meta-analysis of 18 RCTs (1562 men) found a moderate improvement in urinary symptoms and flow versus placebo, but the trials were small, short and methodologically weak, so the evidence remains uncertain
inferred from anti-inflammatory action
Supports lower urinary tract symptoms of benign prostatic hyperplasia (BPH) - a Cochrane meta-analysis of 18 RCTs (1562 men) found a moderate improvement in urinary symptoms and flow versus placebo, but the trials were small, short and methodologically weak, so the evidence remains uncertain
Supports lower urinary tract symptoms of benign prostatic hyperplasia (BPH) - a Cochrane meta-analysis of 18 RCTs (1562 men) found a moderate improvement in urinary symptoms and flow versus placebo, but the trials were small, short and methodologically weak, so the evidence remains uncertain
inferred from anti-inflammatory action
inferred from anti-inflammatory action
inferred from sedative action
Safety, Cautions & Contraindications
Lower urinary tract / prostate symptoms must be medically assessed first to exclude prostate cancer. The evidence is mixed and rests on small, short, methodologically weak trials, so men with moderate or severe BPH should not rely on it instead of proven treatment.
Generally well tolerated, with mild gastrointestinal effects the most common report.
Safety notes (contraindications, interactions, pregnancy/lactation notes, adverse effects, dose-duration cautions) Important: Coltsfoot naturally contains pyrrolizidine alkaloids (PAs)—plant chemicals that can damage the liver and may increase cancer risk with enough exposure (EMA, 2021; Kopp et al., 2020).
Because of this, European regulators set very strict limits for PA exposure from herbal products (EMA, 2021).
Many safety-focused herbal references recommend avoiding homemade/internal coltsfoot use, unless the product is specifically made to be PA-controlled / PA-reduced (EMA, 2021).
Avoid internal use if you are pregnant or breastfeeding, have liver disease, or for children—these groups are treated as “sensitive” in PA risk guidance (EMA, 2021).
Medication caution: if you take medicines that stress the liver (some prescription drugs can), it’s extra important to avoid unregulated PA exposure (general PA risk logic; consult a clinician) (EMA, 2021).
Topical use may still carry PA considerations; EMA discusses limits and recommends use only on intact skin for PA-containing products (EMA, 2021).
Duke (2002) provides clinical support (score 2) for coltsfoot's anti-inflammatory and expectorant effects, explaining its traditional use in bronchitis and coughs. However, the plant contains hepatotoxic pyrrolizidine alkaloids (PAs), and Duke notes a carcinogenic score (1) — a critical safety concern. Commission E has placed restrictions on coltsfoot use, recommending maximum internal use of 4–6 weeks per year and avoiding use in pregnancy, lactation, and in children under 12. Duke rates its overall safety as low (+) and emphasizes that preparations free of PAs are preferred (Duke, 2002).
External Ids
Botanical Description
Evergreen tree (Rosaceae), 10-30 m tall, with dark, fissured, red-brown bark (the source of the common name 'red stinkwood', from its unpleasant smell when cut). Leaves are glossy dark green, leathery, oblong with finely toothed margins. Small white, five-petalled flowers are borne in axillary racemes, followed by small reddish-brown, two-lobed fruit.
Low perennial herb notable for flowering before its leaves appear: solitary, bright yellow, dandelion-like flower heads emerge on scaly pinkish stalks in very early spring, followed later by large, hoof-shaped (heart-shaped with angular teeth), white-woolly-backed leaves arising directly from the creeping rhizome.[11]
Habitat
Native to montane forests of central and southern Africa (and Madagascar), growing at moderate to high altitude (roughly 900-3400 m). The species is CITES-listed and conservation-threatened owing to over-harvesting of bark for the pharmaceutical trade.
Grows on disturbed, damp or clay-rich waste ground, riverbanks, railway embankments and bare soil; native to Europe, North Africa and temperate Asia and naturalised in North America.[11]
Harvesting
Bark is traditionally stripped from mature trees. Unsustainable stripping - especially removing bark all the way round the trunk - kills the tree and has driven population decline, so sustainable, partial and rotational bark harvesting or cultivated sources are recommended.
Flowers are gathered in very early spring before the leaves appear; leaves are gathered later in the season once expanded. Given the plant's pyrrolizidine alkaloid content, harvesting from a positively confirmed patch (not a look-alike) and preferring PA-tested commercial material for internal use is strongly advised.[2]
Traditional Uses
Prunus africana bark has a traditional use in East and Central African ethnomedicine for urinary complaints, and its extract (marketed as Pygeum) became one of the most widely used European phytotherapy remedies for benign prostatic hyperplasia (BPH) symptoms in the 20th century. Clinical evidence for symptom benefit is moderate but drawn from small, methodologically weak trials.[11]
Coltsfoot has an ancient European and Chinese tradition, reflected in its Latin name (tussis = cough), as an expectorant and demulcent remedy for coughs, bronchitis and irritated airways; because of its pyrrolizidine alkaloid content, contemporary use is restricted to short courses of PA-controlled preparations under regulatory limits (see contraindications).[1, 2, 12]
Preparations
The clinically studied commercial form, standardised for phytosterol content.
Commercially prepared, pyrrolizidine-alkaloid-tested extract or syrup, the only form recommended for internal use given the plant's natural PA content.
Dried flower or leaf infused in hot water; traditional but subject to strict duration/PA-content limits under EU herbal regulation.
Dosage
Clinical trials have most often used around 100-200 mg/day of standardised lipophilic bark extract, divided into two doses. Educational reference only, not a prescription; any prostate or urinary symptom should be medically assessed first.
EU regulatory guidance restricts internal use to PA-controlled preparations. The EMA public statement on unsaturated pyrrolizidine alkaloids records a maximum daily intake for internal use of 1 microgram of PAs for at most 6 weeks per year, or 0.1 microgram per day with no duration limit; for cutaneous use the limits are 100 micrograms for at most 6 weeks per year, or 10 micrograms without a duration limit. Not for use in pregnancy, breastfeeding, or children. Note that these are limits on PA intake, not a herb dose — no EMA monograph exists for Tussilago farfara, so there is no official posology for the herb itself. Educational reference only, not a prescription — consult a qualified practitioner and prefer tested commercial products.
References
Lookalikes Review
Dangerous Lookalikes
Not documented
References & Sources
- Thompson, R.Q., Katz, D. and Sheehan, B (2019) 'Chemical comparison of Prunus africana bark and pygeum products marketed for prostate health', Journal of Pharmaceutical and Biomedical Analysis, 163, pp. 162-169. doi:10.1016/j.jpba.2018.10.004 Preclinical
https://doi.org/10.1016/j.jpba.2018.10.004 - Dvorkin, L. and Song, K.Y (2002) 'Herbs for benign prostatic hyperplasia', The Annals of Pharmacotherapy, 36(9), pp. 1443-1452. doi:10.1345/aph.1A228 Meta-analysis / review
https://doi.org/10.1345/aph.1A228 - Keehn, A. and Lowe, F.C (2015) 'Complementary and alternative medications for benign prostatic hyperplasia', The Canadian Journal of Urology, 22(Suppl 1), pp. 18-23. Meta-analysis / review
https://scholar.google.com/scholar?q=Complementary%20and%20alternative%20medications%20for%20benign%20prostatic%20hyperplasia - Kim, T.H., Lim, H.J., Kim, M.S. and Lee, M.S (2012) 'Dietary supplements for benign prostatic hyperplasia: an overview of systematic reviews', Maturitas, 73(3), pp. 180-185. doi:10.1016/j.maturitas.2012.07.007 Meta-analysis / review
https://doi.org/10.1016/j.maturitas.2012.07.007 - Cambronero, J., Osca-Garcia, J.M., Merino-Salas, S., Miguel, J.M. and others (2022) 'Effectiveness of treatment with Pygeum africanum in patients with lower urinary tract symptoms and benign prostatic hyperplasia: a cross-sectional study in the real-world clinical practice in Spain (The PROFIT Study)', Archivos Espanoles de Urologia, 75(3), pp. 219-227. Clinical study
https://scholar.google.com/scholar?q=Effectiveness%20of%20treatment%20with%20Pygeum%20africanum%20in%20patients%20with%20lower%20urinary%20tract%20symptoms%20and%20benign%20prostatic%20hyperplasia%3A%20a%20cross-sectional%20study%20in%20the%20real-world%20clinical%20practice%20in%20Spain%20%28The%20PROFIT%20Study%29 - Quiles, M.T., Arbos, M.A., Fraga, A., de Torres, I.M. and others (2010) 'Antiproliferative and apoptotic effects of the herbal agent Pygeum africanum on cultured prostate stromal cells from patients with benign prostatic hyperplasia (BPH)', The Prostate, 70(10), pp. 1044-1053. doi:10.1002/pros.21138 Preclinical
https://doi.org/10.1002/pros.21138 - Salinas-Casado, J., Esteban-Fuertes, M., Carballido-Rodriguez, J. and Cozar-Olmo, J.M (2020) 'Review of the experience and evidence of Pygeum africanum in urological practice', Actas Urologicas Espanolas, 44(1), pp. 9-13. doi:10.1016/j.acuro.2019.08.002 Meta-analysis / review
https://doi.org/10.1016/j.acuro.2019.08.002 - Villar, A., Silva-Fuentes, F., Mula, A. and Zangara, A (2024) 'Anti-Inflammatory Potential of Prunus africana Bark Extract: An In Vitro Study of Cytokine Release by Lipopolysaccharide-Stimulated Human Peripheral Blood Mononuclear Cells', International Journal of Molecular Sciences, 25(15), pp. 8298. doi:10.3390/ijms25158298 Preclinical
https://doi.org/10.3390/ijms25158298 - Larre, S., Camparo, P., Comperat, E., Boulbes, D. and others (2012) 'Biological effect of human serum collected before and after oral intake of Pygeum africanum on various benign prostate cell cultures', Asian Journal of Andrology, 14(3), pp. 499-504. doi:10.1038/aja.2011.132 Preclinical
https://doi.org/10.1038/aja.2011.132 - Rubegeta, E., Makolo, F., Kamatou, G., Enslin, G. and others (2023) 'The African cherry: A review of the botany, traditional uses, phytochemistry, and biological activities of Prunus africana (Hook.f.) Kalkman', Journal of Ethnopharmacology, 305, pp. 116004. doi:10.1016/j.jep.2022.116004 Meta-analysis / review
https://doi.org/10.1016/j.jep.2022.116004 - Keehn, A. and Lowe, F.C (2015) 'Complementary and alternative medications for benign prostatic hyperplasia', The Canadian Journal of Urology. Randomized trial
https://scholar.google.com/scholar?q=Complementary%20and%20alternative%20medications%20for%20benign%20prostatic%20hyperplasia - Dedhia, R.C. and McVary, K.T (2008) 'Phytotherapy for lower urinary tract symptoms secondary to benign prostatic hyperplasia', The Journal of Urology, 179(6), pp. 2119--2125. doi:10.1016/j.juro.2008.01.094 Meta-analysis / review
https://doi.org/10.1016/j.juro.2008.01.094 - Wilt, T. and Ishani, A. and Mac Donald, R. and Rutks, I. and Stark, G (2002) 'Pygeum africanum for benign prostatic hyperplasia', Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD001044 Meta-analysis / review
https://doi.org/10.1002/14651858.CD001044
- Ahmad, I., Kudaibergenova, B., Ahmad, M. and others (2025) 'Coltsfoot (Tussilago farfara L.; Asteraceae): modern methods of extraction, phytochemistry, nanoparticles synthesis, ethnopharmacology, and biological activities', Natural Product Research, pp. 1-20. doi:10.1080/14786419.2025.2548616 Traditional / reference
https://doi.org/10.1080/14786419.2025.2548616 - Chen, S., Dong, L., Quan, H., Zhou, X. and others (2020) 'A review of the ethnobotanical value, phytochemistry, pharmacology, toxicity and quality control of Tussilago farfara L. (coltsfoot)', Journal of Ethnopharmacology, 267, pp. 113478. doi:10.1016/j.jep.2020.113478 Traditional / reference
https://doi.org/10.1016/j.jep.2020.113478 - Feng, J., Zhang, Y., Qin, X., Gao, T. and others (2022) 'Novel Quinic Acid Glycerates from Tussilago farfara Inhibit Polypeptide GalNAc-Transferase', ChemBioChem, 23(3), pp. e202100539. doi:10.1002/cbic.202100539 Preclinical
https://doi.org/10.1002/cbic.202100539 - Zhao, J., Evangelopoulos, D., Bhakta, S., Gray, A.I. and Seidel, V (2014) 'Antitubercular activity of Arctium lappa and Tussilago farfara extracts and constituents', Journal of Ethnopharmacology, 155(1), pp. 796-800. doi:10.1016/j.jep.2014.06.034 Preclinical
https://doi.org/10.1016/j.jep.2014.06.034 - Avila, C., Breakspear, I., Hawrelak, J., Salmond, S. and Evans, S (2020) 'A systematic review and quality assessment of case reports of adverse events for borage (Borago officinalis), coltsfoot (Tussilago farfara) and comfrey (Symphytum officinale)', Fitoterapia, 142, pp. 104519. doi:10.1016/j.fitote.2020.104519 Meta-analysis / review
https://doi.org/10.1016/j.fitote.2020.104519 - Lee, J., Park, S., Kim, M.J., Kwon, S.J. and others (2019) 'Sesquiterpenoids from Tussilago farfara Flower Bud Extract for the Eco-Friendly Synthesis of Silver and Gold Nanoparticles Possessing Antibacterial and Anticancer Activities', Nanomaterials (Basel), 9(6), pp. 819. doi:10.3390/nano9060819 Preclinical
https://doi.org/10.3390/nano9060819 - Bota, V.B., Neamtu, A.A., Olah, N.K., Chiselita, O. and others (2022) 'A Comparative Analysis of the Anatomy, Phenolic Profile, and Antioxidant Capacity of Tussilago farfara L. Vegetative Organs', Plants (Basel), 11(13), pp. 1663. doi:10.3390/plants11131663 Preclinical
https://doi.org/10.3390/plants11131663 - Boucher, M.A., Cote, H., Pichette, A., Ripoll, L. and Legault, J (2020) 'Chemical composition and antibacterial activity of Tussilago farfara (L.) essential oil from Quebec, Canada', Natural Product Research, 34(4), pp. 545-548. doi:10.1080/14786419.2018.1489384 Preclinical
https://doi.org/10.1080/14786419.2018.1489384 - Li, Z.Y., Zhang, J., Zhang, Y.B., Yang, X.W. and others (2022) 'Polyhydroxylated eudesmane sesquiterpenoids and sesquiterpenoid glucoside from the flower buds of Tussilago farfara', Chinese Journal of Natural Medicines, 20(4), pp. 301-308. doi:10.1016/S1875-5364(21)60120-6 Preclinical
https://doi.org/10.1016/S1875-5364(21)60120-6 - Jang, H., Lee, J.W., Lee, C., Jin, Q. and others (2016) 'Sesquiterpenoids from Tussilago farfara inhibit LPS-induced nitric oxide production in macrophage RAW 264.7 cells', Archives of Pharmacal Research, 39(1), pp. 127-132. doi:10.1007/s12272-015-0667-7 Preclinical
https://doi.org/10.1007/s12272-015-0667-7 - Royal Botanic Gardens, Kew (n.d.). Available at: https://powo.science.kew.org Traditional / reference
https://powo.science.kew.org - Westendorf, J., Czok, G., Marquardt, R., Nausner, M., Krauer, B. and Paul, H.L (1988) 'Pyrrolizidine alkaloid content of Tussilago farfara plants from different regions and preparations', pp. 903--909. Traditional / reference
https://scholar.google.com/scholar?q=Pyrrolizidine%20alkaloid%20content%20of%20Tussilago%20farfara%20plants%20from%20different%20regions%20and%20preparations - European Medicines Agency (HMPC) (2021) 'Public statement on the use of herbal medicinal products containing toxic, unsaturated pyrrolizidine alkaloids (PAs), including recommendations regarding contamination of herbal medicinal products with PAs, Revision 1'. Available at: https://www.ema.europa.eu/en/documents/public-statement/public-statement-use-herbal-medicinal-products-containing-toxic-unsaturated-pyrrolizidine-alkaloids-pas-including-recommendations-regarding-contamination-herbal-medicinal-products-pyrrolizidine_en.pdf Traditional / reference
https://www.ema.europa.eu/en/documents/public-statement/public-statement-use-herbal-medicinal-products-containing-toxic-unsaturated-pyrrolizidine-alkaloids-pas-including-recommendations-regarding-contamination-herbal-medicinal-products-pyrrolizidine_en.pdf - Duke, J.A (2002) 'Handbook of Medicinal Herbs, Second Edition'. Traditional / reference
https://scholar.google.com/scholar?q=Handbook%20of%20Medicinal%20Herbs%2C%20Second%20Edition - Sperl, W. and Stuppner, H. and Gassner, I. and Judmaier, W. and Dietze, O. and Vogel, W (1995) 'Reversible hepatic veno-occlusive disease in an infant after consumption of pyrrolizidine-containing herbal tea', European Journal of Pediatrics, 154(2), pp. 112-6. doi:10.1007/BF01991912 Clinical study
https://doi.org/10.1007/BF01991912
Generated automatically from the Omnia Sana plant database and its cited sources. For educational purposes only — not medical advice. Always consult a qualified practitioner before using medicinal plants.