Herb & supplement monograph

Boneset Drug Interactions, Uses, Effectiveness, Safety & More

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS ·Updated July 2026

What is this page for?

First and foremost: how Boneset interacts with medications. The heart of this page is the interaction list — every drug Boneset is known to interact with, and how serious each one is.

But these pages have grown well beyond that into a full monograph — what Boneset is, what people use it for and how strong the evidence is, its safety and side effects, and answers to the questions we’re asked most — written and reviewed by the clinical staff at HelloPharmacist. It’s educational information from our licensed clinical databases, not medical advice, and we don’t sell or endorse products. Our editorial policy

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Boneset Drug Interactions: The Bottom Line

From the HelloPharmacist Editorial Team · Updated July 2026

Based on the available evidence, the overall risk of a clinically significant Boneset drug interaction appears low for most people, since every listed concern is theoretical rather than proven in humans. None of the interactions are rated major, and all of them rest on lab-based reasoning rather than documented human harm.

Interactions deserving the most attention

The one concern worth knowing about involves medications that speed up a liver enzyme called CYP3A4. Boneset comes from a plant family that can contain compounds called pyrrolizidine alkaloids, and in theory, enzyme-inducing drugs could convert more of these compounds into forms that stress the liver. The clearest examples are the seizure medicines carbamazepine and phenytoin, along with the antibiotic rifampin and phenobarbital. This has not been shown to happen in people, but because the possible harm involves the liver, it deserves the most caution.

What the rest of the list means

Although the number of listed medications looks large, every one of them traces back to this single theoretical mechanism. No human studies have confirmed that combining boneset with these drugs actually causes harm, so the long list reflects one shared prediction rather than dozens of separate proven problems.

Check your medications against Boneset

Based on HelloPharmacist’s Boneset interaction data and reviewed under our editorial standards.

Interaction report

Drugs that interact with Boneset

87 medications have a known interaction with Boneset, graded by severity. Select any drug for the full evidence-based detail.

Don’t want to scroll the list? Just ask.

Tell us the medications you take and we’ll check each one against Boneset using our pharmacist-reviewed interaction data.

AI summaries are generated from our Boneset interaction data for education only — always confirm with your pharmacist. How we use AI

2,830 drugs

Read The List Like a Pharmacist

What Severity, Likelihood & Evidence Mean

Severity — How Serious It Can Be

Major. Clinically significant; generally best avoided, or used only under direct professional supervision.
Moderate. May need monitoring, a dose adjustment, or separating the times you take each one.
Minor. Generally not clinically significant, but still worth noting and mentioning to your pharmacist.
No known interaction. Checked against our sources with nothing documented — not the same as proven safety.

Likelihood — How Well It’s Documented

Likely. Well-controlled human studies have demonstrated the likely existence of this interaction
Probable. Interaction has not been documented in well-controlled studies, however, the interaction has been demonstrated in some small human studies or in controlled animal studies in conjunction with multiple case reports.
Possible. Interaction has been documented in animal or in lab research, or the interaction has been documented in humans but is limited to case reports or conflicting clinical research exists
Unlikely. Interaction has been demonstrated in animal or in lab research but has been shown not to occur in humans.

Where This Data Comes From

Interaction records are evidence-graded and sourced from the Natural Medicines database (TRC Healthcare), the same reference used by pharmacists and hospitals.
Each drug listed above links to the full report for that exact Boneset combination — clinical detail, likelihood, evidence level, and citations.
Content is reviewed by licensed HelloPharmacist pharmacists — see our data sources and editorial standards.

The big picture

The kinds of drugs Boneset affects

Every type of medication (drug category) Boneset is known to interact with. Open any category for the detail — or search your exact drug in the checker above.

All 1 drug category Boneset interacts with

Cytochrome P450 3a4 (cyp3a4) Inducers

Cytochrome P450 3A4 (Cyp3A4) Inducers

Boneset belongs to the genus Eupatorium, and many species of this genus contain hepatotoxic pyrrolizidine alkaloids (PAs). Hepatotoxic PAs are substrates of cytochrome P450 3A4 (CYP3A4). Theoretically, drugs that induce CYP3A4 might increase the conversion of PAs to toxic metabolites. Some drugs that induce CYP3A4 include carbamazepine (Tegretol), phenobarbital, phenytoin (Dilantin), rifampin, rifabutin (Mycobutin), and others.

Likelihood Possible Evidence D

Monograph

Boneset: Uses, Safety & Side Effects

Medically reviewed by Dr. Brian Staiger, PharmD, BCPS · Reviewed July 2026 ·

The bottom line

Boneset is a traditional North American herb long used in teas for fevers, colds, and flu, but modern human studies are very limited. It contains compounds (pyrrolizidine alkaloids) that may harm the liver, so it should be used cautiously and avoided during pregnancy and breastfeeding.

Scientific name: Eupatorium perfoliatum
Family: Asteraceae
Part used: Dried above-ground parts (leaves and flowering tops)
Common forms: Tea, tincture, capsules, dried herb

People commonly use it for

Colds and flu
Fever
Body aches
Congestion
Immune support

Popular and traditional uses — not proof it works. See “Uses & effectiveness” below for the evidence.

Safety at a glance

OverallUse caution

Limited safety data and possible liver-toxic alkaloids mean it should be used carefully and short-term, if at all.

PregnancyPossibly Unsafe

When used orally. Hepatotoxic PAs are common in this genus of plants; however, the alkaloids in boneset have not been adequately characterized to dete...

Read the full pregnancy detail

BreastfeedingPossibly Unsafe

When used orally. Hepatotoxic PAs are common in this genus of plants; however, the alkaloids in boneset have not been adequately characterized to dete...

Read the full breastfeeding detail

Pregnancy & breastfeeding ratings are from Natural Medicines (Therapeutic Research Center). Safety guidance is general; always confirm with your pharmacist or doctor for your situation.

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Overview

Boneset (Eupatorium perfoliatum) is a flowering plant in the daisy family (Asteraceae) that grows naturally in wet meadows, marshes, and along streams across eastern North America. It has clusters of small white flowers and distinctive leaves that wrap around the stem.

Native American and early American settlers used boneset widely as a folk remedy, especially as a hot tea to treat fevers, colds, and flu-like illness. The name "boneset" is thought to come from its traditional use during a flu nicknamed "break-bone fever," not because it heals broken bones.

Today it is sold as a dried herb, tea, tincture, or capsule, mostly within herbal and traditional medicine circles.

How it works

Boneset contains a mix of plant compounds, including flavonoids, sesquiterpene lactones, and polysaccharides, that researchers think may be responsible for any effects.

In laboratory and animal studies, some of these compounds have shown anti-inflammatory and immune-cell-stimulating activity, which is the basis for its traditional cold-and-flu reputation. It is also thought to act as a diaphoretic, meaning it may promote sweating that some traditions believe helps "break" a fever.

Importantly, these mechanisms are largely theoretical or based on early research, and it is not clear that they translate into real benefits in people.

Effectiveness

Does Boneset work?

Here’s what the research actually shows for each use — graded by Natural Medicines and reviewed by Dr. Brian Staiger, PharmD.

Evidence overview · 1 use evaluated

1 Insufficient evidence

How to read these evidence grades

Natural Medicines’ 7-point scale. We show each rating’s label word-for-word.

1EffectiveStrong, consistent evidence it works.

2Likely EffectiveGood evidence, though not yet conclusive.

3Possibly EffectiveSome evidence suggests a benefit.

4Possibly IneffectiveSome evidence it may not help.

5Likely IneffectiveFairly strong evidence it doesn’t help.

6IneffectiveStrong evidence it doesn’t work.

7Insufficient Reliable Evidence to RateToo little research to say either way.

For Boneset, current evidence isn’t strong enough to rate any specific use. The conditions it has been studied for are listed below.

Also studied for 1 condition — evidence insufficient to rate

Insufficient Reliable Evidence To Rate Common Cold

Rating & evidence shown verbatim from Natural Medicines

Preliminary clinical research shows that taking a specific homeopathic product (Eupatorium perfoliatum D2) derived from boneset has a similar effect to aspirin on symptoms of the common cold.

Sources Ref 36793

Source & disclaimer. Effectiveness ratings and evidence summaries are provided by Natural Medicines (Therapeutic Research Center) and shown as licensed. Where Natural Medicines hasn’t rated a use, HelloPharmacist’s pharmacists may add their own reviewed rating and evidence (each such entry is labeled). This is educational information, not medical advice — talk with your pharmacist or doctor before starting, stopping, or changing a supplement.

Safety & precautions

Boneset may contain pyrrolizidine alkaloids (PAs), a class of natural compounds that can be toxic to the liver and may be cancer-causing with high or long-term exposure. For this reason, many experts advise against prolonged use and recommend caution overall.

People with liver disease should avoid boneset. Those allergic to plants in the daisy/ragweed family (Asteraceae), such as ragweed, marigolds, or chamomile, may also react to boneset and should be careful.

Pregnancy and breastfeeding: Avoid boneset during pregnancy and while breastfeeding. There is not enough safety information, and the possibility of liver-toxic alkaloids makes it an unnecessary risk for both parent and baby.

Always talk with a pharmacist or doctor before using boneset, especially if you take other medications or have a health condition.

Side effects

At typical traditional amounts, boneset may cause nausea, vomiting, or diarrhea, particularly with large or fresh-plant doses.

More serious concerns relate to its possible pyrrolizidine alkaloid content, which over time could cause liver damage. Signs of liver problems include yellowing of the skin or eyes, dark urine, severe stomach pain, or unusual tiredness — stop using it and seek medical care if these occur.

Allergic reactions are possible in people sensitive to the daisy family. Fresh (uncooked or unprocessed) plant material is considered more likely to cause stomach upset and toxicity than properly dried, prepared products.

Boneset: Reported Adverse Effects

Documented safety reports on Boneset from the evidence-graded Natural Medicines (TRC Healthcare) database, shown word-for-word from the licensed record.

Orally, boneset is reported to cause nausea and severe diarrhea and vomiting. Additionally, other plants in the Eupatorium genus contain the hepatotoxic pyrrolizidine alkaloids (PAs). However, the alkaloids in boneset have not been adequately characterized to determine their toxic potential. Liver toxicity and liver damage may be possible in high doses.

Roeder E. Medicinal plants in Europe containing pyrrolizidine alkaloids. Pharmazie 1995;50:83-98.
Colegate SM, Upton R, Gardner DR, Panter KE, Betz JM. Potentially toxic pyrrolizidine alkaloids in Eupatorium perfoliatum and three related species. Implications for herbal use as boneset. Phytochem Anal. 2018;29(6):613-626.

Reports by condition

Diarrhea Gastrointestinal

Orally, boneset has been reported to cause nausea and severe diarrhea and vomiting.

Roeder E. Medicinal plants in Europe containing pyrrolizidine alkaloids. Pharmazie 1995;50:83-98.

DISCLAIMER: This tool is intended for informational purposes only, and should not be interpreted as specific medical advice. Patients should consult with a qualified healthcare provider before making decisions about therapies and/or health conditions.

Adverse-effects data: Natural Medicines, Therapeutic Research Center

Dosing

There is no well-established, standardized dose for boneset. Traditional preparations were usually made as a hot tea from the dried herb, but reliable modern dosing guidelines are not available.

If you choose to use a commercial product, follow the directions on the label and do not exceed them. Because of liver-safety concerns, any use should be short-term rather than ongoing.

Talk with a pharmacist or doctor before starting boneset so they can help you weigh the risks and decide whether it is appropriate for you.

Pregnancy & Breastfeeding

Boneset & Pregnancy

Possibly Unsafe

When used orally. Hepatotoxic PAs are common in this genus of plants; however, the alkaloids in boneset have not been adequately characterized to determine their toxic potential. Hepatotoxic PAs might be teratogenic; avoid using.

Roeder E. Medicinal plants in Europe containing pyrrolizidine alkaloids. Pharmazie 1995;50:83-98.
Colegate SM, Upton R, Gardner DR, Panter KE, Betz JM. Potentially toxic pyrrolizidine alkaloids in Eupatorium perfoliatum and three related species. Implications for herbal use as boneset. Phytochem Anal. 2018;29(6):613-626.

Boneset & Breastfeeding

Possibly Unsafe

Roeder E. Medicinal plants in Europe containing pyrrolizidine alkaloids. Pharmazie 1995;50:83-98.
Colegate SM, Upton R, Gardner DR, Panter KE, Betz JM. Potentially toxic pyrrolizidine alkaloids in Eupatorium perfoliatum and three related species. Implications for herbal use as boneset. Phytochem Anal. 2018;29(6):613-626.

Pregnancy & lactation ratings: Natural Medicines, Therapeutic Research Center

References & further reading

The 5 references that drive our Boneset monograph and interaction data, from the evidence-graded Natural Medicines (TRC Healthcare) database. Citations with a link open the study on PubMed or the publisher’s site.

Chojkier M. Hepatic sinusoidal-obstruction syndrome: toxicity of pyrrolizidine alkaloids. J Hepatol 2003;39:437-46. PubMed
Roeder E. Medicinal plants in Europe containing pyrrolizidine alkaloids. Pharmazie 1995;50:83-98.
Wang YP, Yan J, Fu PP, Chou MW. Human liver microsomal reduction of pyrrolizidine alkaloid N-oxides to form the corresponding carcinogenic parent alkaloid. Toxicol Lett 2005;155:411-20. PubMed
Gassinger, C. A., Wunstel, G., and Netter, P. [A controlled clinical trial for testing the efficacy of the homeopathic drug eupatorium perfoliatum D2 inthe treatment of common cold (author's transl)]. Arzneimittelforschung. 1981;31(4):732-736.
Colegate SM, Upton R, Gardner DR, Panter KE, Betz JM. Potentially toxic pyrrolizidine alkaloids in Eupatorium perfoliatum and three related species. Implications for herbal use as boneset. Phytochem Anal. 2018;29(6):613-626.

Keep reading

This information is for education only and is not a substitute for professional medical advice. Always check with your pharmacist or doctor before starting, stopping, or combining supplements and medications.

Parts of this content are provided by the Therapeutic Research Center, LLC.

DISCLAIMER: Currently this does not check for drug-drug interactions. This is not an all-inclusive comprehensive list of potential interactions and is for informational purposes only. Not all interactions are known or well-reported in the scientific literature, and new interactions are continually being reported. Input is needed from a qualified healthcare provider including a pharmacist before starting any therapy. Application of clinical judgment is necessary.

Brand directory

Brands that make products with Boneset

39 brands in our database make a supplement containing Boneset.

Biotics Research Corporation 250 products BIOVEA 1,494 products BIOVEA Homeopathics 4 products Douglas Laboratories 3,067 products Dr. Clark Research Association Dr. Clark Zentrum 89 products Dr. Mercola 590 products Dr. Mercola Premium Supplements 45 products Hawaii Pharm 4,726 products Herb Pharm 3,320 products Herbal Nutrition 30 products Herbal Terra 3,138 products Herbalist & Alchemist 613 products HerbaMe 15 products Herbs, Etc. 388 products L.A. Naturals 201 products LifeSeasons 110 products LifeSeasons Therapeutics 40 products Maine Coast Herbals 33 products Mannatech 39 products Microbe Formulas 19 products Natura Health Products 1 product Nature's Answer 1,655 products Nature's Magic 2 products Nature's Sunshine 1,360 products

Product directory

Supplement products with Boneset

118 products in our database contain Boneset. Open any to see its full ingredient list and every drug interaction we check.

Pharmacist Counseling Corner

Boneset: Common Questions

What is Boneset used for, and does it work?

People use Boneset for a range of reasons, but according to the Natural Medicines database the current clinical evidence is insufficient to confirm it works for the specific conditions it has been studied for. See the graded list on this page, and talk to your pharmacist or doctor before relying on it for any condition.

Does Boneset interact with prescription medications?

Yes. We list 87 medications with a known interaction with Boneset. Use the checker above to see how Boneset interacts with a specific drug.

How are Boneset interactions rated?

Each interaction is graded major, moderate, or minor based on how clinically significant it is and the strength of the evidence behind it. Major interactions are the most serious and are best avoided, or used only under close professional supervision.

Is it safe to take Boneset with my medications?

It depends on the specific medication. Some combinations are fine, while others call for monitoring, timing changes, or should be avoided. Check your exact drug above and confirm with your pharmacist or doctor before starting, stopping, or changing anything.

Where does this Boneset interaction information come from?

Our interaction data is built on the Natural Medicines database — an evidence-graded reference for vitamins, herbs, and supplements — and is reviewed by licensed HelloPharmacist pharmacists, who may add clinical context.

What is Boneset used for?

Boneset is a traditional herb used mainly for colds, flu, fevers, congestion, and body aches. These uses come from folk medicine, and strong scientific proof that it works is lacking.

Is Boneset safe to take?

It may be used short-term by some healthy adults, but it can contain liver-toxic compounds called pyrrolizidine alkaloids, so caution is advised. People with liver disease, allergies to the daisy family, and those who are pregnant or breastfeeding should avoid it.

Can I take Boneset while pregnant or breastfeeding?

No. Because there is not enough safety data and it may contain harmful alkaloids, Boneset should be avoided during pregnancy and breastfeeding.

Does Boneset help heal broken bones?

No. Despite its name, Boneset does not heal fractures. The name likely refers to its historical use during a fever illness called "break-bone fever."

Written and reviewed by the HelloPharmacist editorial staff. Our editorial policy

Keep exploring

Products that contain Boneset

A rotating sample of real supplements in our database that list Boneset — open any to see its full ingredients and every drug interaction we check.

See all 118 products with Boneset →

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