Meadowsweet (Filipendula ulmaria)
1. Identity, Botanical Description, and Common Forms
1.1 Nomenclature and Taxonomy
Meadowsweet is scientifically known as Filipendula ulmaria (formerly Spiraea ulmaria) and is a member of the Rosaceae family. It is known by several common names, including Bridewort, Dollof, Lady of the Meadow, Queen of the Meadow, Meadsweet, and Hardhack (in homeopathy), and is named for its frothy, cream-colored flowers that bloom in summer, filling meadows with a sweet, almond-like fragrance. The former botanical classification under the genus Spiraea carries significant historical weight: in 1899, scientists at the firm Bayer used salicylic acid derived from meadowsweet to synthesise acetylsalicylic acid (aspirin), which was named after the old botanical name for meadowsweet, Spiraea ulmaria.
1.2 Plant Morphology and Habitat
Meadowsweet is a large herbaceous plant with a height of up to 100–150 cm, with an erect, smooth-ribbed, thickly deciduous stem and a lobular root system represented by a short creeping rhizome. The stem leaves are regular, located throughout the stem, up to the inflorescence. The flowers are collected in a dense paniculate inflorescence up to 20 cm long. Meadowsweet is widely distributed in Europe, Asia, the European part of Russia, and the territory of western and eastern Siberia. The plant is found in wetlands, in wet meadows, on slopes, and along the banks of water bodies. On the territory of northern and eastern Europe, meadowsweet blooms in June–July and bears fruit in July–August.
1.3 Official Pharmacopoeial Standing and Recognized Parts
Its flowering tops (Filipendulae ulmariae herba), included in the European Pharmacopoeia (monograph 04/2013:1868), are used as a herbal substance (whole or cut), due to its contents of essential oils and salicylates. According to the European Pharmacopoeia (2020), the raw plant material of meadowsweet is made of its dried flowering tops (inflorescences, Filipendulae ulmariae herba) with a minimum of 1 mL/kg of essential oil (dried drug). The European Medicines Agency's Committee on Herbal Medicinal Products (HMPC) has published separate Community Herbal Monographs for both the herb (herba) and the flower (flos) of Filipendula ulmaria, with reference numbers EMA/HMPC/434881/2010 and EMA/HMPC/434892/2010 respectively, first published in 2011. The German Commission E monograph describes the same use for both herbal substances, with only a different daily dosage: 2.5–3.5 g of flowers is considered equivalent to 4–5 g of herb.
1.4 Common Forms and Preparations
Meadowsweet is commercially and traditionally prepared in several forms:
- Dried herb (herbal infusion/tea): Clustered white flowers are used in medicinal preparations such as teas and extracts.
- Tincture: In some countries of the European Union, tinctures or tincture-based products containing alcoholic extracts of Filipendulae Herba are on the market as food supplements used for complaints such as rheumatic and arthritic pain.
- Dry tincture/standardized extract: The dry tincture of Filipendulae ulmariae herba has been analyzed by HPLC and bioassayed for antioxidant, antiproliferative, and DNA-protective activities.
- Powdered herb capsules: Available in standardized capsule form commercially.
For medicinal purposes, both leaves and flowers of meadowsweet are gathered early in the blooming stage and used, without stems, fresh or dried.
2. Traditional and Historical Use
2.1 Ancient and Celtic Traditions
Meadowsweet's history spans over 2,000 years, rooted in Celtic, European, and folk traditions. Druids considered it one of three sacred herbs (alongside Vervain and Water Mint), using it in healing rituals and offerings. Meadowsweet was one of the three herbs held to be most sacred by the Celtic druids and was historically used to flavour mead — hence its folk name "mead wort".
2.2 Medieval European Use
Medieval herbalists like Culpeper praised it for "cheering the heart" and treating fevers, while its flowers adorned weddings and festivals, earning it the name Bridewort. Meadowsweet has been mentioned in various herbal compendiums including those written by Culpeper and Gerard. Culpeper was of the opinion that meadowsweet could be used to dry the body out, stop bleeding, vomiting, diarrhoea, and excessive menstruation. In the Middle Ages, meadowsweet was used to scent homes and churches, often strewn across floors for its sweet, almond-like fragrance. Queen Elizabeth I even preferred it over all other herbs to freshen her private chambers.
Meadwort, or Medwort, was one of fifty ingredients in a drink called 'Save' mentioned by English author Geoffrey Chaucer in a Knight's Tale.
2.3 Traditional Austrian and European Folk Medicine
A tea made from Filipendula ulmaria flowers or leaves has been used in traditional Austrian herbal medicine for the treatment of rheumatism, gout, infections, and fever. Preparations from the herb and/or flowers of Filipendula ulmaria have been used traditionally since the late 16th and 17th centuries for the treatment of inflammatory diseases, as a diuretic and antirheumatic.
2.4 Persian and Near Eastern Use
Meadowsweet is a perennial herb native to Iran, Europe, and Western Asia, and several medicinal properties of the plant have been reported in Persian medicine. Filipendula ulmaria is traditionally used for fever, pain, inflammatory diseases (arthrosis, rheumatism, and arthritis), gastric disorders, liver dysfunction, and gout.
2.5 Traditional Chinese Medicine
Within traditional Chinese medicine (TCM), meadowsweet is understood to clear excess fire or heat particularly in the stomach and urinary system. It is considered cooling and tonifying and is used to clear Liver heat and stagnation.
2.6 The Aspirin Connection
The link between meadowsweet and modern pharmacology is historically significant. In 1834, Swiss pharmacist Johann Pagenstecher extracted a substance from meadowsweet which, he suggested, might reveal an "excellent therapeutic aspect." In 1838, Raffaele Piria obtained salicylic acid from the buds of meadowsweet. Bayer registered the trademark Aspirin for acetylsalicylic acid on March 6, 1899, with the name derived from the initial "a" denoting acetyl, "spir" referencing the Spiraea genus of plants (from which salicylic acid precursors were historically extracted), and the suffix "-in" typical of pharmaceutical nomenclature at the time.
3. Phytochemistry: Key Constituents and Active Compounds
3.1 Overview of Chemical Composition
The pharmacological properties of meadowsweet are derived from the presence of phenolic compounds of a diverse structure in sufficiently large quantities. Phytochemical studies indicate the presence of several active compounds, mainly phenolic acids, flavonoids, tannins, and terpenoids. A review of scientific information shows that the species has a rich chemical composition, in which various secondary metabolites are present, among which phenolic compounds occupy the largest share. Flavonoids, phenolic acids and terpenes have been isolated from plant extracts and their fractions, tannins, coumarins, organic acids, etc.
3.2 Salicylates
Salicylic acid and its derivatives are the most important compounds found in essential oil and extracts of different parts of the plant. The essential oil of the flowers contains notable proportions of salicylate-related volatiles: methyl salicylate and salicylaldehyde amounted to 28.2% and 2.8%, respectively, in F. ulmaria essential oil during the flowering stage. However, it is important to note that according to Schulz et al. (1998), infusions contain only trace amounts of salicylates, so meadowsweet tea is considered as an aromatic remedy rather than a salicylate medication. Indeed, there appears to be some doubt whether salicylates will play an important role in experimental or clinical effects (Steinegger and Casparis, 1945; Halkes, 1998).
3.3 Flavonoids
The leaves, flowers, fruits, and roots of meadowsweet are characterized by a high total phenolics content (up to 65 mg g−1). Results showed a high phenolic content in the leaves, flowers, and fruits with a lower amount in the stems. The flavonoids were richest in the flowers, then the leaves. Identified flavonoids include spiraeoside, kaempferol 4'-O-glucoside, astragalin 2''-O-gallate, hyperoside 2''-O-gallate, and isoquercitrin 2''-O-gallate. All parts of the plant contain high levels of phenolic compounds, including a newly discovered flavonoid glycoside, named ulmarioside, which is unique to Filipendula ulmaria.
3.4 Tannins
The tannin tellimagrandin II has been identified as one of the biologically active tannins in meadowsweet. The tannins in the plant possess astringent properties.
3.5 Quantified Phenolic Profile (HPLC Analysis)
An HPLC phenolic profile of a dry tincture showed 12 phenolics, of which salicylic acid (18.84 mg/g dry extract), rutin (9.97 mg/g de), p-coumaric acid (6.80 mg/g de), quercetin (4.47 mg/g de), rosmarinic acid (4.01 mg/g de) and vanillic acid (3.82 mg/g de) were the major components.
3.6 Other Constituents
Additional constituents include volatile oil containing salicylaldehyde, phenolic glycosides (including spiraein, monotropin and gaultherin), mucilage, flavonoids, tannins, vitamin C, and sugars. A heparin-plant protein complex in meadowsweet was found to have anticoagulant and fibrinolytic properties.
4. Mechanisms of Action
4.1 Inhibition of Cyclooxygenase Enzymes (COX-1/COX-2)
The salicylates in meadowsweet inhibit cyclooxygenase enzymes (COX-1 and COX-2), which inhibit prostaglandin synthesis and reduce inflammation, pain, and swelling. In vitro anti-inflammatory activity was evaluated by testing the inhibition of NF-κB activation, COX-1 and COX-2 enzyme inhibition. The genuine as well as the metabolized extract showed a better inhibition of the COX-1 enzyme as compared to COX-2. The anti-inflammatory activity of F. ulmaria may be explained by an additive or synergistic effect of genuine constituents and metabolites.
4.2 NF-κB Pathway Inhibition
Meadowsweet contains many constituents, such as flavonoid glycosides, which are not absorbed, but metabolized in the colon by gut microbiota, producing potentially active metabolites that can be absorbed. The simulation of gastrointestinal biotransformation showed a decrease in the relative abundance of glycosylated flavonoids such as rutin, spiraeoside and isoquercitrin in the colon compartment. A mix of aglycons present after biotransformation showed a significant inhibition of COX-1.
4.3 Antioxidant Mechanisms
The high antioxidant potential of the species was confirmed by using four methods, best expressed by the results of the CUPRAC assay (10,605.91 μM TE/g de).
4.4 Anticoagulant/Fibrinolytic Properties
Extracts from the seeds and flowers of meadowsweet have shown anticoagulant activity in both in vitro and in vivo studies, which is believed to be associated with the heparin-like and salicylate compounds. Meadowsweet flowers and seeds demonstrated an increased level of anticoagulant activity in vitro and in vivo in another report (Liapina, 1993).
4.5 Astringent and Gastroprotective Mechanisms
Meadowsweet causes a decrease in capillary and cell membrane permeability, as well as local vasoconstriction, and it has antidiarrheal activity. The tannin-rich and mucilage components are proposed to form a protective film over the gastric mucosa, contributing to its gastroprotective reputation in traditional medicine.
5. Scientific Evidence by Area of Use
5.1 Anti-inflammatory and Analgesic Activity
Evidence level: Predominantly preclinical (in vitro and animal); no robust human RCTs available.
Anti-inflammatory activity has been documented through in vitro immunomodulatory studies of roots, herb and flower extracts; the effect of methanolic extracts (0–250 μg/mL) from the aerial parts on different markers of inflammation such as antioxidant capacity, leukocyte ROS production, the COX-2/PGE2 pathway and cytokine secretions; and in vivo animal studies, including a rat model of inflammation induced via intraplantar injection of carrageenan (flower infusion), and a model with cisplatin-induced liver and kidney oxidative stress in rats (methanol extract of aerial parts). This supports the use of meadowsweet preparations against inflammatory diseases.
A 2025 animal study published in Pharmacia (Pensoft) investigated the analgesic and anti-inflammatory effects of a methanolic aerial part extract. The performed experiments revealed that diclofenac possesses better anti-inflammatory and antinociceptive activity than F. ulmaria extracts (100 and 200 mg/kg). The results revealed a dose-dependent moderate inhibition of the inflammation and pain induced by 3 days of oral pretreatment with methanolic extract of F. ulmaria extracts. In the same experiment, F. ulmaria aerial part extract was practically non-toxic (oral LD50 > 2000 mg/kg).
A study in PubMed (PMID: 27725238) using a rat model of inflammatory pain concluded that the results support the use of F. ulmaria and F. vulgaris flowers in folk medicine for relieving pain in diseases with an inflammatory component. Further research is required to explore the benefits of meadowsweet in humans.
A study examining polyphenols from chamomile, meadowsweet, and willow bark in THP1 macrophages demonstrated inhibition of proinflammatory biomarkers in THP1 macrophages by polyphenols derived from chamomile, meadowsweet and willow bark. This was an in vitro cell-based model, not a clinical study.
Critically, as no adequate clinical studies are available, preparations of neither herba nor flos have been assessed for well-established medicinal use by the EMA. The EMA classifies meadowsweet exclusively under traditional herbal use on the basis of established historical use rather than confirmed clinical efficacy from controlled trials.
5.2 Gastroprotection and Digestive Health
Evidence level: Preclinical animal studies and in vitro; no clinical human trials identified.
A study on the anti-ulcerogenic activity in rats with the flowers of meadowsweet showed protective benefits of the aqueous extract through the plant's ability to generate healing in acetylsalicylic acid and ethanol-induced lesions of the stomach.
Anti-inflammatory activity of lyophilized flower infusions (LFIs) of F. ulmaria was examined ex vivo in human platelets by monitoring the effects on eicosanoid production. Gastroprotective activity was tested using the ethanol-induced acute mucosal injury in rats. This study provides ex vivo human platelet data alongside animal gastroprotection data, though it stops short of a human clinical trial.
The EMA and ESCOP recommend meadowsweet as a traditional herbal medicinal product for the supportive treatment of the common cold, and the EMA recognizes meadowsweet as a traditional herbal medicinal product for the relief of minor joint pain. These are "traditional use" designations, not well-established use, reflecting that the evidence base rests on long-standing use rather than completed clinical trials.
5.3 Antioxidant Activity
Evidence level: In vitro only.
One study reported for the first time the highly protective activities of meadowsweet dry tincture against oxidative DNA damage and its antiproliferative effect against hepatocellular carcinoma (HepG2 cell line). Meadowsweet dry tincture possesses great potential to prevent diseases caused by oxidative stress. However, these findings are from cell-line experiments and cannot be extrapolated directly to human therapeutic outcomes.
The tincture was rich in phenolic compounds, especially salicylic acid and flavonoids, and also demonstrated strong in vitro antioxidant and DNA protective effects at low concentrations.
5.4 Antimicrobial Activity
Evidence level: In vitro only.
Antimicrobial properties against five specific strains of bacteria have been shown mostly in extracts from the rhizomes, stems, and flowers of the meadowsweet plant. Research has demonstrated immunomodulatory properties of meadowsweet preparations extracted from both the flowers and roots of the plant. These findings have not been confirmed in human clinical trials.
5.5 Anticoagulant and Haemostatic Activity
Evidence level: In vitro and animal studies; no human clinical trials.
A heparin-plant protein complex in meadowsweet was found to have anticoagulant and fibrinolytic properties. Meadowsweet flowers and seeds demonstrated an increased level of anticoagulant activity in vitro and in vivo. However, there are no reports of interactions between meadowsweet and NSAIDs or any other blood thinners, and concerns regarding the simultaneous use of NSAIDs and this herbal supplement remain theoretical.
5.6 Anticancer / Antiproliferative Activity
Evidence level: Animal and in vitro studies only; no human clinical data.
A study (Bespalov) showed that meadowsweet (F. ulmaria) decoction was able to inhibit colorectal carcinogenesis induced by methylnitrosourea in rats. The chemical composition of meadowsweet had a statistically significant decrease in the overall tumor incidence and multiplicity by 1.4 and 2.9 times. It also showed antiproliferative activity against liver cancer cells. The study concluded that meadowsweet has potential in reducing oxidative stress-related diseases; however, further research is needed to explore its clinical application.
5.7 Diuretic and Urinary Tract Effects
Evidence level: Traditional use designation; no controlled clinical trials identified.
Meadowsweet is natriuretic, kaliuretic, and uricolytic (despite inhibition of proximal tubular uric acid secretion by salicylic acid). In traditional medicine, meadowsweet has been used to treat heartburn, stomach ulcers, colds, joint pain, arthritis, and gout. It has also been administered as a diuretic to increase urine output in people with kidney or bladder infections. These represent ethnopharmacological use, not clinically established indications.
6. Body Systems and Health Areas
Pharmacological evaluations have shown anti-arthritis, analgesic, anti-inflammatory, anti-oxidant, anti-cancer, anti-coagulant, anti-microbial, immunomodulatory, gastro-protective, and hepato-protective activity of F. ulmaria across in vitro and animal models. The body systems with which meadowsweet is most prominently associated include:
- Musculoskeletal system: Traditional use for rheumatism, arthritis, gout, and joint pain; supported by preclinical anti-inflammatory data.
- Digestive/gastrointestinal system: The dried herb is recommended for treating joint diseases, colds, digestive and kidney problems. Traditional use for gastric ulceration, heartburn, hyperacidity, and diarrhoea, supported by animal gastroprotection studies.
- Immune system: Research has demonstrated immunomodulatory properties of meadowsweet preparations extracted from both the flowers and roots of the plant.
- Cardiovascular/haemostatic system: Anticoagulant and fibrinolytic activity demonstrated in vitro and in animal models via heparin-like compounds.
- Urinary system: Traditional diuretic use, including for urinary tract infections and kidney support.
- Respiratory system: The EMA and ESCOP recommend meadowsweet as a traditional herbal medicinal product for the supportive treatment of the common cold.
7. Dosage Forms and Reported Dosages
The following dosages have been reported in official monographs and published sources:
- Herbal infusion (crushed plant material): Single dose 1.5–6 g in infusion; daily dose: 2–18 g.
- Plant material in powder form: Single dose 250–500 mg; daily dose: 250–1500 mg.
- Tincture (1:5): Single dose 2–4 ml; daily dose: 6–12 ml.
- Commission E flower dosage: The Commission E monograph specifies 2.5–3.5 g of flowers daily; traditionally meadowsweet has been used in doses of 4–5 grams of the herb by mouth daily.
- Duration: Not to be used for more than 4 weeks, according to the EMA Community Herbal Monograph.
8. Safety Considerations and Drug Interactions
8.1 General Safety Profile
When taken by mouth, meadowsweet is possibly safe when used short-term. Taking meadowsweet in large amounts or for a long period of time is possibly unsafe. Meadowsweet, when taken appropriately, might be safe for most people. It can cause stomach complaints including nausea. Skin rashes and lung tightness can also occur. No case of overdose has been reported per the EMA monograph.
8.2 Salicylate Hypersensitivity
Hypersensitivity to salicylates is listed as a contraindication in the EMA Community Herbal Monograph. Meadowsweet contains chemicals that are similar to the chemicals in aspirin. There is a concern that people who are allergic to aspirin might also be allergic to meadowsweet. Meadowsweet can cause lung spasms, so there is a concern that it might make asthma worse.
8.3 Anticoagulant and Antiplatelet Drug Interactions
Because meadowsweet contains salicylates, it may increase the risk of bleeding when given concomitantly with antiplatelet or anticoagulant drugs, with nonsteroidal anti-inflammatory drugs (NSAIDs), or with any alternative medicines with antiplatelet properties. Caution is advised in case of co-administration of antiaggregants, anticoagulants and nonsteroidal anti-inflammatory drugs. The EMA recommends medical monitoring in the event of an association. Monitoring biology (INR) is advised in case of association with anticoagulants.
8.4 Pregnancy and Lactation
Uteroactivity from meadowsweet has been observed in vitro; avoid administration during pregnancy and lactation. There is some evidence that it could make the uterus contract, causing a miscarriage. It should be avoided in pregnancy and lactation.
8.5 Paediatric Safety Concern
A herbal syrup including salicylate-rich ingredients willow and meadowsweet was withdrawn from the Italian market after being associated with gastrointestinal bleeding in a child.
8.6 Tannin-related Cautions
Avoidance is advised in constipation, iron deficiency anaemia, and malnutrition, due to the high tannin content.
8.7 Genotoxicity Assessment
Meadowsweet extracts have not shown genotoxic activity, and have even demonstrated antigenotoxic effects in vivo and in vitro.
8.8 Overdose and Large-Dose Effects
Too much meadowsweet can cause blood in the stool, vomiting, ringing in the ears, kidney problems, and other side effects. These effects are attributed to the salicylate load at high doses.
References
- Farzaneh A. et al. (2022). Filipendula ulmaria (L.) Maxim. (Meadowsweet): a Review of Traditional Uses, Phytochemistry and Pharmacology. Research Journal of Pharmacognosy, 9(3), 85–106.
- Savina T. et al. (2023). Variation in Phenolic Compounds, Antioxidant and Antibacterial Activities of Extracts from Different Plant Organs of Meadowsweet. Molecules, 28(8), 3512. PMC10140895.
- Liaudanskas M. et al. (2023). Variations in Yield, Essential Oil, and Salicylates of Filipendula ulmaria Inflorescences at Different Blooming Stages. PMC9862637.
- DNA-Protective, Antioxidant and Anti-Carcinogenic Potential of Meadowsweet (Filipendula ulmaria) Dry Tincture. PMC11504252.
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- Anti-inflammatory and analgesic effects of Filipendula ulmaria extract. Pharmacia (Pensoft), 2025.
- Antihyperalgesic activity of Filipendula ulmaria and Filipendula vulgaris in a rat model of inflammation. PubMed PMID: 27725238.
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- A First Step in the Quest for the Active Constituents in Filipendula ulmaria (Meadowsweet): Comprehensive Phytochemical Identification by LC-QTOF-MS. PubMed PMID: 26845709.
- The Anti-inflammatory Properties of Meadowsweet. The Pharmaceutical Journal (Royal Pharmaceutical Society).
- Review of herbal medications with the potential to cause bleeding: dental implications. PMC6496865.
- Filipendula ulmaria. Wikipedia.
- History of Aspirin. Wikipedia.
- Meadowsweet Uses, Benefits & Dosage. Drugs.com Natural Products Database.
- Meadowsweet (Filipendula ulmaria): Benefits, Uses, Safety. Herbal Reality.
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