What is it?

Evening Primrose is an herbal medicine used for treating breast pain, premenstrual syndrome (PMS), eczema (itchy, scaly skin), Raynaud's disease, arthritis, and high cholesterol. It is used on the skin for bruises and wound healing.

Other names for Evening Primrose include: King's Cureall and Oenothera biennis.

Ask your doctor, nurse, or pharmacist if you need more information about this medicine or if any information in this leaflet concerns you.

Before Using:

Tell your doctor if you

• are taking medicine or are allergic to any medicine (prescription or over-the-counter (OTC) or dietary supplement)
• are pregnant or plan to become pregnant while using this medicine
• are breastfeeding
• have epilepsy (seizures) or have schizophrenia and taking medication(s) that can cause seizures
• have any other health problems, such as high blood pressure or heart or blood vessel disease

Dosage:

Talk with your caregiver about how much Evening Primrose you should take. The amount depends on the strength of the medicine and the reason you are taking Evening Primrose. If you are using this medicine without instructions from your caregiver, follow the directions on the medicine bottle. Do not take more medicine or take it more often than the directions tell you to.

To store this medicine:

Keep all medicine locked up and away from children. Store medicine away from heat and direct light. Do not store your medicine in the bathroom, near the kitchen sink, or in other damp places. Heat or moisture may cause the medicine to break down and not work the way it should work. Throw away medicine that is out of date or that you do not need. Never share your medicine with others.

Drug and Food Interactions:

Do not take Evening Primrose without talking to your doctor first if you are taking:

• Medicine used to treat or prevent blood clots (examples: aspirin, clopidogrel (Plavix(R)), ticlopidine (Ticlid(R)), warfarin (Coumadin(R)), enoxaparin (Lovenox(R)))
• Medicines for mental conditions (examples: chlorpromazine (Thorazine(R)), thioridazine (Mellaril(R)), perphenazine (Trilafon(R)))
• Medicines for treating seizure disorders (examples: phenytoin (Dilantin(R)), valproic acid (Depakote(R), Depakene(R)), carbamazepine (Tegretol(R)), gabapentin (Neurontin(R)), lamotrigine (Lamictal(R)))

Warnings:

• If you are pregnant or breastfeeding talk to your doctor before taking Evening Primrose,
• Evening Primrose oil may bring out seizures (convulsions or uncontrollable shaking), especially in schizophrenic patients (1)

Side Effects:

Stop taking your medicine right away and talk to your doctor if you have any of the following side effects. Your medicine may be causing these symptoms which may mean you are allergic to it.

• Breathing problems or tightness in your throat or chest
• Chest pain
• Skin hives, rash, or itchy or swollen skin

Other Side Effects:

You may have the following side effects, but this medicine may also cause other side effects. Tell your doctor if you have side effects that you think are caused by this medicine.

• May cause nausea, diarrhea, bloating, throwing up, or gas (3,4)

References:

1. Newall CA, Anderson LA, Phillipson JD: Herbal Medicines: A Guide for Health-Care Professionals. The Pharmaceutical Press, London, UK; 1996.

2. Schalin-Karrila M, Mattila L, Jansen CT et al: Evening primrose oil in the treatment of atopic eczema: effect on clinical status, plasma phospholipid fatty acids and circulating blood prostaglandins. Br J Dermatol 1987; 117:11-19.

3. McFayden IJ, Forrest AP & Chetty U: Cyclical breast pain - some observations and the difficulties in treatment. BJCP 1992; 46:161-164.

4. Belch JJF, Ansell D, Madhok R et al: Effects of altering dietary essential fatty acids on requirements for non-steroidal anti-inflammatory drugs in patients with rheumatoid arthritis: a double blind placebo controlled study. Ann Rheum Dis 1988; 47:96-104.

5. Guivernau M, Meza N, Barja P et al: Clinical and experimental study on the long-term effect of dietary gamma-linolenic acid on plasma lipids, platelet aggregation, thromboxane formation, and prostacyclin production. Prostaglandins Leukotrienes and Essential Fatty Acids 1994; 51:311-316.

6. De La Cruz JP, Martin-Romero M, Carmona JA et al: Effect of evening primrose oil on platelet aggregation in rabbits fed an atherogenic diet. Thromb Res 1997; 87(1):141-149.