Agrimony

Agrimony (Agrimonia eupatoria L.): A Comprehensive Reference

1. Identity and Botanical Description

Taxonomic Classification and Names

Common agrimony (Agrimonia eupatoria L.) is also referred to as "church steeples" or "sticklewort." It belongs to the Rosaceae (rose) family and to the genus Agrimonia, which includes ten species common in the temperate zone of the Northern Hemisphere, South America, and in the mountains under the tropics. In pharmacy and regulatory documents, the herbal drug is referred to by its Latin pharmaceutical designation Agrimoniae herba. The genus name "Agrimony" derives from "Argemone," a word given by the Greeks to plants that were healing to the eyes, while the species epithet eupatoria refers to Mithridates Eupator, the last king of Pontus, who was a renowned concoctor of herbal remedies.

In the European Pharmacopoeia, only A. eupatoria can be used as source of herbal material in the genus Agrimonia, specifically the dried flowering tops. However, the German Commission E monograph considers the use of dried, above-ground parts of both A. eupatoria and/or Agrimonia procera Wallr. as valid sources of Agrimonia.

Botanical Features

Common agrimony grows as a deciduous, perennial herbaceous plant reaching heights of up to 100 cm. Its roots are deep rhizomes from which the stems spring. It is characterized by serrated-edged pinnate leaves, and short-stemmed flowers appear from June to September in long, spike-like, racemose inflorescences. The flower spikes have a spicy odor likened to apricots. The leaves are mildly aromatic and hairy above and below. The soft hairs aid in the plant's seed pods sticking to animals or persons coming into contact with the plant.

Geographical Distribution

Agrimonia eupatoria is a perennial herb native to Europe and Southwest Asia. It grows to approximately 0.6 m and is indigenous to middle and northern Europe, temperate Asia, and North America, found in fields, meadows, waste grounds, and roadsides. It grows especially on sunny meadows and fallows, usually from sea level up to 1000 m above sea level.

Common Forms and Preparations

Agrimony is the common name for the flowering tops of the plant Agrimonia eupatoria L. Preparations are obtained by comminuting (reducing into tiny pieces) the dried plant parts; these may also be used to prepare liquid extracts with water and alcohol. Infusions for internal use are prepared by pouring 250 ml of boiling water on 1.5–4 g of the dried drug, to be drunk two or three times a day; with liquid extracts the amounts are 1–3 ml, and with tinctures, 1–4 ml, taken three times per day. The herb is also commercially available as standardized capsules (aqueous extracts), dried tea blends, and topical preparations including decoctions for compresses and wound washes.

2. Traditional and Historical Use

Ancient Greece and Rome

Written accounts of its benefits date back to the 5th century. Dioscorides and Galen noted its utility in treating ulcers, often combined with swine fat, and for gastrointestinal and hepatic conditions when administered with wine. Since ancient times, agrimony has been recommended for individuals with complications related to ulcers and liver and gallbladder diseases.

Anglo-Saxon and Medieval Europe

Agrimony (or A. procera) was one of 57 herbs in the Anglo-Saxon magical "Holy Salve," said to provide active protection against goblins, evil, and poisons. It was also valued in medieval times for its astringent and diuretic properties, which kept it popular for a long period in herbal medicine for sprains and bruises. Later archaeological finds date from the Neolithic and Bronze Age (Sub-boreal), Roman, and Medieval periods, suggesting that the species could have been introduced to Britain and Ireland by Neolithic or later farmers and traders, making it an archaeophyte. Historically, agrimony was known as a "wound herb" in Medieval Europe.

European Folk Medicine (Multi-Country)

In the literature, the species was described in Europe — including Bulgaria, Czech Republic, Germany, Poland, Serbia, and Turkey — as being traditionally used as an infusion, often of the aerial parts, acting as an astringent and anti-inflammatory agent. It was also recommended for more serious ailments such as rheumatism, backache, and ailments of the liver, kidneys, and bladder, including jaundice. Water extracts (infusions and decoctions) were used in the treatment of airway and urinary system diseases, digestive tract diseases, and chronic wounds.

North America and Other Regions

When introduced to North America, A. eupatoria was said to have been used to treat fevers with great success by Native Indians and Canadians. It was also used in traditional medicine to treat catarrh, bleeding, tuberculosis, and skin diseases. Young stems, leaves, and flowers of agrimony were used to prepare a yellow pigment (by isolating the flavonoid quercitrin) and to increase the storage stability of beer.

Traditional Chinese Medicine

In the scientific medicine of Western countries and Ukrainian folk medicine, A. eupatoria is used as a regulator of metabolic processes — specifically for the treatment of patients with disorders of mineral and sugar metabolism, including diabetes of various types. The related species Agrimonia pilosa is used in East Asian traditional systems; its root and aerial parts are employed in similar ways, and some pharmacological research on the genus has included this species as well as A. eupatoria.

Regulatory Traditional-Use Recognition

According to the European Union herbal monograph (EMA/HMPC/680597/2013), traditional medicinal use of A. eupatoria is associated with the symptomatic treatment of mild diarrhea, minor inflammatory conditions of the mouth, throat, or skin, and for small superficial wounds. The HMPC recognizes traditional use for mild diarrhea, moderate inflammation of the throat and pharynx, and skin wounds. The Commission E monograph approves its use internally for mild, non-specific diarrhea and externally for inflammation of mucous membranes of the mouth and throat; the ESCOP, WHO, and HMPC monographs also recognize external application as a compress or irrigation to support wound healing.

3. Key Constituents and Active Compounds

Overview of Phytochemical Classes

Phytochemical analyses of Agrimonia eupatoria L. have identified a variety of bioactive compounds including tannins, flavonoids, phenolic acids, triterpenoids, and volatile oils. The effects of A. eupatoria correlate with its high content of antioxidants, especially phenylpropanoids (tannins, flavonoids, phenolic acids, and anthocyanidins) and terpenoids. Specific components include thymol, α- and β-pinene, α- and β-cedrene, D-limonene, eucalyptol, geraniol acetate, linalool, and hexanal, which are responsible for its characteristic odor and taste. One comprehensive analysis summarized 68 terpenoids and 73 phenolic and flavonoid compounds in A. eupatoria; among phenolic and flavonoid compounds, agrimonin, derivatives of apigenin, quinic acid, kaempferol, luteolin, procyanidin, quercetin, quercitrin, and rutin were identified.

Tannins

Tannins — particularly procyanidins and ellagitannins — are the principal class of compounds, with agrimoniin recognized as the dominant component. According to the European Pharmacopoeia (11th edition), the herb contains a minimum of 2% tannins, expressed as pyrogallol equivalents. Specifically, Agrimonia eupatoria L. contains at least 2% of tannins, with pyrogallol (C₆H₆O₃, MW 126.1) as the building block. Three to 21% of tannins are condensed tannins, in particular proanthocyanidins (procyanidin B3), with proanthocyanidins present mainly as leuco-anthocyanins bioconverted by acid hydrolysis to cyanidin.

Agrimoniin is a particularly notable compound. Agrimoniin is a high-molecular-weight ellagitannin found primarily in Agrimonia L. species and other plants of the Rosoideae subfamily. Optimized extraction conditions have yielded agrimoniin at levels as high as 9.16 mg/g dry weight, along with strong antioxidant activity. The dominance of agrimoniin in optimized extracts (approximately 27% of total phenolics) highlights its potential as a pharmacologically active marker for quality control.

Flavonoids

The most commonly reported flavonoid compounds are astragalin, cynaroside, hyperoside, isoquercitrin, isovitexin, rutin, catechin, procyanidin B3, and agrimoniin. A. eupatoria contains a large number of various bioactive flavonoids, including quercetin, rutin, hyperoside, cyanidin quercetrin, luteolin, luteolin 7-glucoside, apigenin 7-glucoside, and astragalin. Among confirmed compounds are proanthocyanidins, apigenin, luteolin, quercetin, and kaempferol derivatives, as well as catechin, chlorogenic acid, and p-coumaric acid.

Phenolic Acids, Triterpenoids, and Other Compounds

The plant also contains hydroxycinnamic acids (caffeic, chlorogenic), terpenoids, coumarins, saponins, and carbohydrates (glucose, fructose, sucrose, galactose). Additional constituents include condensed tannins, polysaccharides, triterpenoids, silicic acid, salicylic acid, a nicotinamide complex, thiamine, and vitamin K. The full chemical profile includes flavonoids, tannins, aromatic acids, triterpenes, coumarins, terpenoids, glycosides, and vitamins B and K.

4. Established and Proposed Mechanisms of Action

Antioxidant Activity

Hydroalcoholic extracts of Agrimonia eupatoria have pronounced antioxidant activity against reactive species, mainly due to specific flavonoids and/or condensed tannins, identified as flavonol, flavone, and flavan-3-ol derivatives. Studies have shown that the antioxidant activity of agrimony is associated with high polyphenolic content, and extracts modified the expression of pro-inflammatory factors and enzymes from glutathione metabolism in cell culture and animal models. Tannins have demonstrated antiseptic, astringent, antioxidant, anti-inflammatory, and anti-mutagenic properties.

Anti-Inflammatory Mechanisms

In vitro experiments with agrimony showed anti-inflammatory effects; in vivo experiments in animals demonstrated anti-inflammatory, antidiabetic, and antioxidant properties. Research on the related species Agrimonia pilosa has helped elucidate potential mechanisms relevant to the genus: ethanolic extracts of Agrimonia pilosa Ledeb. demonstrated anti-inflammatory and anti-allergic activities, inhibiting inflammatory cytokine (IL-1β, IL-4, IL-6) and interferon-β (INF-β) production in induced RAW 264.7 cells, and an ethanolic extract was found to inhibit NO and PGE2 production by downregulating iNOS and COX-2 expression.

Antimicrobial Mechanisms

The antimicrobial activity of A. eupatoria has been documented in studies emphasizing its effectiveness against various bacterial species. The antibacterial effect depends on the type of extract used, and the effect was weaker on Gram-negative bacteria than on Gram-positive bacteria. The antibacterial and antibiofilm effect of plant extracts is related to their chemical composition; compounds such as polyphenols (flavonoids, tannins, anthocyanins, phenolic acids, and coumarins) can interfere with bacterial cell processes. Antibacterial activity of water, alcoholic, or acetone A. eupatoria extracts against Gram-positive bacteria such as Staphylococcus aureus and Gram-negative bacteria such as Vibrio cholerae, Pseudomonas aeruginosa, and Escherichia coli has been documented.

Antidiabetic Mechanisms

Plant extracts inhibit α-glucosidase, have an antidiabetic effect, and play an important role in regulating glucose metabolism. In a study using streptozotocin (STZ)-induced diabetic mice, agrimony decreased plasma glucose levels in experimental animals (reducing hyperglycemia) and reduced polydipsia. Administration of extracts prevented body mass gain and fat accumulation and normalized serum lipid profile in high-fructose-fed rats.

Astringent/Tissue-Protective Mechanisms

The tannin content — particularly the high-molecular-weight ellagitannin agrimoniin and the condensed proanthocyanidins — underpins agrimony's classical astringent action, which involves the precipitation of surface proteins and the tightening of mucous membranes and skin tissues. This accounts for its traditional use in diarrhea, oral inflammation, and wound care. Topical application of A. eupatoria extracts has been shown to accelerate wound healing by promoting collagen formation and granulation tissue development while reducing bacterial colonization, particularly by S. aureus, a common pathogen in wound infections.

Hepatoprotective Mechanisms

Korean scientists investigated its hepatoprotective effect in chronic ethanol-induced liver damage in rats and found that the hepatoprotective effect of A. eupatoria is associated with inhibition of peroxidation processes in hepatocytes. In preclinical research, the herb extract has been classified as practically non-toxic and demonstrated pronounced anti-inflammatory and hepatoprotective activity, reducing lipid peroxidation and stabilizing membrane structures of liver cells.

Antiviral Mechanisms

The antiviral activity of agrimony has been documented in several studies. An ethanolic extract of Agrimonia eupatoria L. exhibited an inhibitory effect on mengovirus (Columbia SK virus), a cardiovirus; the antiviral effect was also confirmed in negative-sense RNA viruses. Antiviral and antimicrobial action of Agrimonia species has been observed for hepatitis B virus (HBV), herpes simplex virus (HSV), and respiratory syncytial virus (RSV).

Anticancer Mechanisms (Preclinical Only)

Research indicates that agrimoniin is a potent anti-tumor tannin, with the anti-tumor effect possibly due to this tannin enhancing the immune response of host animals through actions on tumor cells. A 2026 in vitro study investigated the inhibitory effect of the A. eupatoria extract on cancer cells and its impact on the phosphoinositide 3-kinase (PI3K) signaling pathway, a key regulator of cancer-related processes. Molecular docking from that study identified tricoumaroyl spermidine as a potential PI3K inhibitor with high binding affinity, supporting the potential of A. eupatoria as a source of novel anticancer agents; however, the study is confined to in vitro and in silico models, and future in vivo validation and pharmacokinetic studies are necessary.

5. Scientific Evidence by Health Area

5.1 Gastrointestinal System: Diarrhea and Digestive Disorders

Evidence base: Traditional use; regulatory recognition; no rigorous modern clinical trials specifically for diarrhea.

Indications linked to references and documents published by regulatory authorities include the relief of diarrhea (EMA 2015), relief of minor inflammations of the mouth and throat (ESCOP 2005), and relief of skin inflammations and promotion of wound healing (EMA 2015). The astringent tannins are the most plausible pharmacological basis: by precipitating mucus proteins and reducing intestinal secretions, they mechanistically support the anti-diarrheal indication. While this use is recognized by the EMA, Commission E, and ESCOP, it is classified as a traditional use rather than being underpinned by controlled clinical trial data specific to diarrhea.

An older Bulgarian clinical study (Chakarski et al., 1982) evaluated a polyherbal combination containing Agrimonia eupatoria, Hypericum perforatum, Plantago major, Mentha piperita, and Matricaria chamomilla for the treatment of patients with chronic gastroduodenitis; however, as a multi-herb combination study, no specific conclusions about agrimony alone can be drawn.

5.2 Oral and Throat Mucosa: Anti-Inflammatory Gargle Use

Evidence base: Traditional use with regulatory recognition; supported by in vitro anti-inflammatory evidence.

The herbal drug, consisting of the dried flowering tops of Agrimonia eupatoria L., is recognized in the ESCOP monograph for mild diarrhea, as a gargle for inflammation of the oral and pharyngeal mucosa, and for wound healing as compresses or for irrigation. In vitro experiments with agrimony showed anti-inflammatory effects. No controlled clinical trials specifically evaluating agrimony as a gargle have been identified in the literature. The use rests on traditional authority (Commission E, ESCOP, EMA) and the documented in vitro astringent and anti-inflammatory properties of its tannins and flavonoids.

5.3 Liver Health: Hepatoprotective Effects

Evidence base: One randomized, double-blind, placebo-controlled clinical trial; preclinical (animal and in vitro) support.

The most notable clinical evidence for agrimony comes from a Korean study of liver function. The aim was to evaluate the effect of A. eupatoria L. aqueous extract (AEE) on 80 subjects with elevated alanine transaminase (ALT) levels in a randomized, double-blind, placebo-controlled, 8-week study conducted between January and July 2013 at the Oriental Medical Hospital of Semyung University. The trial included subjects aged 20 years or older with mildly to moderately elevated ALT levels (between 45 and 135 IU/L); subjects received two capsules of placebo or AEE twice a day for 8 weeks. Eighty subjects were randomized to placebo or AEE groups; during the 8 weeks of treatment, 11 subjects were excluded from the analysis for protocol violation or consent withdrawal, meaning efficacy was evaluated in 69 subjects. A. eupatoria L. aqueous extract consumption was safe and generally well tolerated without severe adverse events, and total protein, albumin, blood urea nitrogen, creatinine, and total cholesterol levels were normal in both groups.

Two clinical studies with the infusion of A. eupatoria have shown hepatoprotective properties as well as a protective role in cardiovascular disease, metabolic disorders, and diabetes. However, there is still limited pharmacological evidence that corroborates the ethnomedicinal uses of this plant species as well as regarding the specific bioactive compounds.

5.4 Metabolic Health: Diabetes, Lipid Profile, and Obesity

Evidence base: One small clinical study; preclinical (animal) evidence; no confirmed large-scale clinical trials.

The first clinical study (Ivanova et al., 2013) included 19 healthy volunteers from Bulgaria, aged 18–55 years, and assessed the consumption of A. eupatoria tea (200 mL, prepared from a commercial product) twice a day for 30 days, focusing on lipid metabolism and oxidative stress. In this small study evaluating the effect of agrimony on lipid profile and antioxidant status, 200 mL of boiled water was added to 1 g of dried aerial parts of A. eupatoria and consumed twice a day for one month. Animal studies have demonstrated that administration of extracts prevented body mass gain and fat accumulation and normalized serum lipid profile in high-fructose-fed rats, suggesting that agrimony may be a perspective therapeutic agent, especially for treatment of socially significant diseases such as diabetes and obesity accompanied by low-grade inflammation. This area of evidence is currently preliminary — the human studies are very small and uncontrolled for this particular indication, and the antidiabetic and antiobesity claims are primarily supported by animal and cell-culture research.

5.5 Wound Healing and Dermatological Applications

Evidence base: Regulatory recognition; in vitro and animal studies; no independent clinical RCTs for topical wound healing.

A. eupatoria L., a perennial herbaceous plant long utilized in traditional European and Asian medicine, has recently attracted significant scientific attention for its wound-healing properties. Rich in polyphenols, flavonoids, tannins, and triterpenoids, A. eupatoria exhibits a broad range of bioactivities relevant to each phase of wound healing, including antioxidant effects that mitigate oxidative stress, anti-inflammatory actions that regulate immune responses, and stimulatory effects on keratinocyte proliferation, fibroblast activation, and angiogenesis.

One study showed that the water extract of A. eupatoria is a valuable source of polyphenols with excellent antioxidant properties and clinical potential for the prevention and/or adjuvant therapy of cardiovascular complications associated with diabetes; the same research examined whether the extract improves skin wound healing in a series of in vitro and in vivo experiments, specifically investigating the ability of the extract to induce fibroblast-to-myofibroblast conversion, extracellular matrix deposition, and keratinocyte proliferation and differentiation in vitro. An ointment prepared from the ethanolic extract of A. eupatoria was shown to have significant wound-healing properties in rats, with the ethanolic extract exhibiting faster wound-healing times compared to the control group; the researchers concluded that agrimony's tannin and flavonoid constituents contributed to the observed accelerated wound-healing process due to their antibacterial properties.

The photosensitizing property of agrimony has also been studied in the context of dermatology. Grieve referred to Agrimonia eupatoria L. as a photosensitive plant; while photosensitivity can be a source of possible skin adverse reactions, photosensitizing agents are often used in dermatology. Conditions such as vitiligo, psoriasis, and mycosis fungoides are often treated by combining ultraviolet A-rays or B-rays with photosensitizing agents; the photosensitizing potential of agrimony might help explain its therapeutic effect in inflammatory conditions such as eczema and psoriasis.

5.6 Antimicrobial and Antibiofilm Activity

Evidence base: Multiple in vitro studies; no clinical trials.

One study evaluated the antibiofilm activity of ethanol, acetone, and ethyl acetate extracts of A. eupatoria against Staphylococcus aureus, Proteus spp., and Pseudomonas aeruginosa strains isolated from human wounds, and investigated the effects of these extracts on bacterial auto-aggregation, surface hydrophobicity, and motility. Results showed that the antibacterial effect depended on the type of extract used, and the effect was generally weaker on Gram-negative bacteria than on Gram-positive bacteria. The antibiofilm evidence is confined to in vitro work. Whether these effects translate into clinically relevant antimicrobial activity when agrimony preparations are used topically has not been established through clinical trials.

5.7 Cardiovascular Effects

Evidence base: One ex vivo study in human arteries; limited preclinical data.

Agrimonia eupatoria L. has been traditionally used for the treatment of inflammatory diseases and as a hypotensive. Only one study had previously suggested an improvement in vascular endothelial function in diabetic conditions. One study assessed the direct vascular effects of A. eupatoria in human arteries, finding that the infusion elicited a mild increase in basal vascular tone and a significant potentiation of adrenergic contraction of 49.18% at 0.02 mg/mL, suggesting the presence of compounds with mild vasoconstrictor activity. This is a single ex vivo pharmacological experiment; no clinical cardiovascular endpoint trials exist.

5.8 Anticancer Activity

Evidence base: In vitro and in silico only; no clinical evidence.

Several studies have reported cytotoxic activity of A. eupatoria against different cancer cell lines in vitro, and some authors have also reported the antitumor effect of agrimonin, one of the main components of the extract. One study evaluated anti-tumor potentials of Agrimonia eupatoria L. extracts (aqueous and methanol) against human cervical cancer (HeLa), Rhabdomyosarcoma (RD) cell lines, and a primary mouse embryo fibroblast cell culture. All anticancer evidence remains at the preclinical (in vitro / in silico) stage. Clinical trial data are lacking to support use for any indication.

6. Body Systems and Health Areas Associated with Agrimony

• Digestive system: Its water extracts (infusions and decoctions) are used in the treatment of digestive tract diseases. Specific traditional and regulatory-recognized uses include mild diarrhea, gastroduodenal inflammation, and liver and gallbladder support.
• Hepatobiliary system: Since ancient times, agrimony has been recommended for individuals with complications related to ulcers, liver, and gallbladder diseases.
• Respiratory system: Due to its favorable properties, agrimony is used in traditional medicine in Europe to treat bronchitis and sore throats.
• Urinary system: Water extracts are used in the treatment of urinary system diseases.
• Integumentary system (skin and wound healing): Traditional medicinal use of A. eupatoria includes minor inflammatory conditions of the skin and for small, superficial wounds.
• Oropharyngeal mucosa: The herbal drug is recognized for use as a gargle for inflammation of the oral and pharyngeal mucosa.
• Metabolic/Endocrine system: In Western scientific medicine and Ukrainian folk medicine, A. eupatoria is used for treatment of patients with disorders of mineral and sugar metabolism, including diabetes of various types.
• Musculoskeletal system: Agrimony was recommended for rheumatism and backache.
• Immune system: Compounds in A. eupatoria possess immunomodulatory activities.

7. Dosage Forms and Reported Dosages

Dosages below are reported as stated in the cited sources; they do not represent clinical recommendations.

• Dried herb (internal infusion): Infusions for internal use are prepared by pouring 250 ml of boiling water on 1.5–4 g of dried drug, to be consumed twice or three times a day.
• Liquid extract: With liquid extracts, the amounts are 1–3 ml, taken three times per day.
• Tincture: With tinctures, 1–4 ml to be taken three times per day.
• Daily dose range (Commission E/pharmacopoeial): The daily dose of the drug agrimony lies between 3 and 6 g.
• External use (compress): In the case of external use, compresses with a 10% decoction are used several times a day.
• Clinical trial dose (aqueous extract capsules — liver study): Subjects in the randomized controlled trial received two capsules of aqueous extract (AEE) twice a day for 8 weeks.
• Clinical trial dose (tea — lipid/antioxidant study): In a small study evaluating the effect on lipid profile and antioxidant status, 200 mL of boiled water was added to 1 g of dried aerial parts of A. eupatoria and consumed twice a day for one month.
• Oral safety data: Agrimony is considered possibly safe when used in doses up to 3 grams daily short-term, or when its extract is used in doses of 160 mg daily for up to 8 weeks.

8. Safety Considerations and Notable Interactions

General Safety Profile

Agrimonia eupatoria belongs to practically non-toxic substances based on preclinical research. In the largest clinical trial, aqueous extract consumption was safe and generally well tolerated without severe adverse events. The safety of its consumption has been shown clinically.

Contraindications

According to the EMA assessment report, the only contraindication reported is hypersensitivity to the active substance. No interactions with other medicinal products have been established. People with allergies to the Rosaceae family may also present allergy to this plant.

Photosensitivity

Photoallergic reactions are possible after local application of agrimony and subsequent UV exposure. The herb can cause photodermatitis from sensitization of the skin to ultraviolet light, possibly due to furanocoumarins, and sun or UV light exposure should be avoided during use.

Pregnancy and Lactation

No data are available about the effect of agrimony-based remedies in children below 12 years of age, and in pregnant and breastfeeding women (EMA 2015). Information regarding safety and efficacy in pregnancy and lactation is lacking.

Potential Drug Interactions (Theoretical)

There is speculation that this herb may lower blood sugar levels, which would be relevant in the context of concurrent antidiabetic pharmacotherapy; however, no formal clinical pharmacokinetic drug interaction studies have been published.

The presence of vitamin K in agrimony is noteworthy: constituents include vitamin K, which theoretically could affect the anticoagulant activity of vitamin K antagonist drugs such as warfarin, though no clinical interaction data confirm this.

Tannins are substances that can decrease the absorption of iron, suggesting that agrimony preparations taken internally may reduce dietary iron bioavailability if taken with meals or alongside iron supplementation.

Evidence Gaps and Research Limitations

More scientific data are needed to explain the favorable traditional effects of Agrimonia eupatoria L. Clinical trial data are lacking to support use for any specific indication, and clinical data are lacking to provide robust dosing recommendations. Detailed pharmacokinetic data in humans for key compounds such as agrimoniin are limited. The overwhelming bulk of pharmacological research consists of in vitro cell culture experiments and rodent studies; the two completed human clinical trials — while methodologically controlled — are small, limited in duration, and have not been independently replicated at scale. The regulatory traditional-use classification granted by the EMA, Commission E, and ESCOP reflects this evidence landscape: agrimony is recognized as a traditional herbal medicine, not as one with well-established clinical efficacy in the regulatory sense.

References

• Paluch Z et al. (2020). The Therapeutic Effects of Agrimonia eupatoria L. — PMC, Physiological Research
• Huzio N et al. (2022). Phytochemical and Pharmacological Research in Agrimonia eupatoria L. Herb Extract with Anti-Inflammatory and Hepatoprotective Properties. Plants 11(18):2371 — PMC
• Malheiros et al. (2022). Agrimonia eupatoria L.: An integrative perspective on ethnomedicinal use, phenolic composition and pharmacological activity. Journal of Ethnopharmacology — ScienceDirect
• Springer Nature (2025). Phytotherapeutic insights into wound healing: unveiling the potential of Agrimonia eupatoria L. Phytochemistry Reviews
• Cho YM et al. (2018). Agrimonia eupatoria L. (Agrimony) Extract Alters Liver Health in Subjects with Elevated Alanine Transaminase Levels: A Controlled, Randomized, and Double-Blind Trial. Journal of Medicinal Food 21(3):282-288 — PubMed
• Correia HS et al. (2017). Antioxidant, Anti-Inflammatory, and Analgesic Activities of Agrimonia eupatoria L. Infusion. Evidence-Based Complementary and Alternative Medicine — PMC
• Muruzović MŽ et al. (2022). Extracts of Agrimonia eupatoria L. as sources of biologically active compounds and evaluation of their antioxidant, antimicrobial, and antibiofilm activities — PMC
• Skowron K et al. (2023). Effect of Agrimonia eupatoria L. and Origanum vulgare L. Leaf, Flower, Stem, and Root Extracts on the Survival of Pseudomonas aeruginosa — PMC
• Vasilenko T et al. (2022). Agrimonia eupatoria L. Aqueous Extract Improves Skin Wound Healing: An In Vitro Study in Fibroblasts and Keratinocytes and In Vivo Study in Rats. In Vivo 36(3):1236-1244
• Vascular Effects of Polyphenols from Agrimonia eupatoria L. and Role of Isoquercitrin in Its Vasorelaxant Potential in Human Arteries — PMC (2022)
• Optimisation of Phenolic Compound Extraction from Agrimonia eupatoria L. Using Response Surface Methodology — PMC (2025)
• Antibiofilm Activity of Agrimonia eupatoria Extracts Against Clinically Relevant Pathogens — PMC (2025)
• From Traditional Medicine to the Laboratory: A Multidisciplinary Investigation on Agrimonia eupatoria L. Collected in Valle Imagna (North Italy) — PMC (2025)
• Inhibition of the PI3K Signaling Pathway in Cancer Cells by Agrimonia eupatoria L. Ethanolic Extract — PMC / BMC Complementary Medicine and Therapies (2026)
• Ad'hiah AH et al. (2013). Cytotoxic effects of Agrimonia eupatoria L. against cancer cell lines in vitro. Journal of the Association of Arab Universities for Basic and Applied Sciences — ScienceDirect
• European Medicines Agency (EMA). Agrimoniae herba — Herbal medicinal product page
• ESCOP Monograph: Agrimoniae herba (Agrimony)
• Altmeyer's Encyclopedia — Agrimoniae herba (Phytotherapy monograph)
• Wikipedia: Agrimonia eupatoria
• BSBI (Botanical Society of Britain and Ireland): Agrimonia eupatoria L. species account