Evening Primrose Oil

Updated | 2018-10-29


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Evening Primrose Oil


Overview

Botanical Name: Oenothera


Order: Myrtales


Family: Onagraceae


The seeds are pressed for their oil, which is high in the n-6 (omega-6) fatty acids, linoleic acid (LA) and gamma-linolenic acid (GLA).



Evidence

Strong:

-

Good:

  • Supplies the Body with Omega-6 Fatty Acids [1-5]

Promising:

  • Atopic Dermatitis (Eczema) in Infants, oral doses of evening primrose oil [6-8]

Conflicting (Unclear):

  • Arthritis [9-13]
  • Atopic Dermatitis (Eczema), oral consumption of evening primrose oil appears to produce conflicting results; however, evening primrose oil applied topically or added to bath water may be effective [14-26]
  • Breast Pain (Mastalgia) [27-36]

Limited Evidence:

  • Chronic Kidney Disease, treatment of skin symptoms [37]
  • Diabetic Neuropathy [38-39]
  • Dry Eyes due to Contact Lenses, oral dose of evening primrose oil [40]
  • Inflammatory Bowel Disease (IBD) [41]
  • Lowers Cholesterol [42]
  • Menopausal Complaints, a blend containing evening primrose oil / damiana / ginseng / royal jelly may be effective [43-45]
  • Mild to Moderate Hypertension [46]
  • Multiple Sclerosis, a blend of evening primrose oil / hemp seed oil [47]
  • Nail Health [48]
  • Raynaud’s Phenomenon [49]
  • Sjogren’s Syndrome [50-52]
  • Tardive Dyskinesia [53]
  • Type 1 Diabetes, improving fatty acid counts [54]
  • Type 2 Diabetes, improves fatty acid counts in adults and children [55-56]

No Evidence:

  • ADHD (Attention Deficit Hyperactivity Disorder); however, evening primrose oil in combination with zinc may be more effective [57-59]
  • Asthma, evening primrose oil in combination with fish oil may also not be effective [60-62]
  • Breast Cyst [63]
  • Breast Milk, improving fatty acid counts [64-67]
  • Cellulite [68]
  • Chronic Fatigue Syndrome [69]
  • Cystic Fibrosis [70]
  • Decreases Natural Killer Cell Activity [71]
  • Heart Health [72]
  • Hepatitis B [73]
  • Hypertriglyceridemia [74]
  • Liver Cancer [75]
  • Osteoporosis (Bone Density), when evening primrose oil is used independently [76]
  • Pre-eclampsia [77-79]
  • Premenstrual Syndrome (PMS) [80-83]
  • Psoriasis, evening primrose oil in combination with fish oil [84]
  • Peptic Ulcers [85]
  • Weight Loss [86]

No Clinical Research:

All other conditions.


Side Effects
Side effects may include:
  • Bloating
  • Diarrhea
  • Gastrointestinal Upset
  • Headache
  • Inflammation
  • Nausea
  • Rashes
  • Vomiting
Precautions and Adverse Events:
  • Use caution or contact a licensed healthcare practitioner if you have schizophrenia, seizures, or epilepsy because there have been reports of evening primrose oil lowering seizure threshold, but these reports may have actually been caused by other medications.
  • There have been cases of evening primrose oil causing lipid pneumonia, thrombosis (blood clots), inflammation, immunosuppression, an increase in the risk of bleeding, petechiae (red to purple spots in the skin).
[87-92]


Pregnant or Nursing

There is not enough research on the use of supplements containing evening primrose oil during pregnancy and breast-feeding, so consult a licensed healthcare practitioner before use or avoid use. Evening primrose oil is commonly used during breast-feeding to increase the amount of omega-6 fatty acids in breast milk, but there is not enough research about its safety and effectiveness. There had been one case of an infant born with transient petechiae to a mother taking evening primrose oil. [87-92]



Interactions

Major

  • Warfarin
  • Anti-Coagulants
  • Ant-Platelet Drugs
  • Lopinavir
[93-97]

Moderate

  • Anti-Convulsants
  • Chlorpromazine
  • Fluphenazine
  • Mesoridazine
  • Perphenazine
  • Phenothiazines
  • Prochlorperazine
  • Promethazine
  • Thioridazine
  • Thiothixene
  • Trifluoperazine
[93-97]

Potential

  • Protease Inhibitors including HIV/AIDS Drugs
[93-97]


Dosage

Evening primrose oil is not a "drug", so the best doses have not been thoroughly established. Make sure to follow the specific product instructions and take as directed on the label, or consult a licensed healthcare practitioner before use.



Compounds
Evening Primrose Oil compounds


References

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Encapsulated fish oil enriched in alpha-tocopherol alters plasma phospholipid and mononuclear cell fatty acid compositions but not mononuclear cell functions. Eur J Clin Invest. 2000 Mar;30(3):260-74. 6. Biagi PL, Bordoni A, Hrelia S, Celadon M, Ricci GP, Cannella V, Patrizi A, Specchia F, Masi M. The effect of gamma-linolenic acid on clinical status, red cell fatty acid composition and membrane microviscosity in infants with atopic dermatitis. Drugs Exp Clin Res. 1994;20(2):77-84. 7. Biagi PL, Bordoni A, Masi M, Ricci G, Fanelli C, Patrizi A, Ceccolini E. A long-term study on the use of evening primrose oil (Efamol) in atopic children. Drugs Exp Clin Res. 1988;14(4):285-90. 8. Bordoni A, Biagi PL, Masi M, Ricci G, Fanelli C, Patrizi A, Ceccolini E. Evening primrose oil (Efamol) in the treatment of children with atopic eczema. Drugs Exp Clin Res. 1988;14(4):291-7. 9. Belch JJ, Ansell D, Madhok R, O'Dowd A, Sturrock RD. 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 Feb;47(2):96-104. 10. Brzeski M, Madhok R, Capell HA. Evening primrose oil in patients with rheumatoid arthritis and side-effects of non-steroidal anti-inflammatory drugs. Br J Rheumatol. 1991 Oct;30(5):370-2. 11. Jäntti J, Nikkari T, Solakivi T, Vapaatalo H, Isomäki H. Evening primrose oil in rheumatoid arthritis: changes in serum lipids and fatty acids. Ann Rheum Dis. 1989 Feb;48(2):124-7. 12. Jäntti J, Seppälä E, Vapaatalo H, Isomäki H. Evening primrose oil and olive oil in treatment of rheumatoid arthritis. Clin Rheumatol. 1989 Jun;8(2):238-44. 13. Veale DJ, Torley HI, Richards IM, O'Dowd A, Fitzsimons C, Belch JJ, Sturrock RD. A double-blind placebo controlled trial of Efamol Marine on skin and joint symptoms of psoriatic arthritis. Br J Rheumatol. 1994 Oct;33(10):954-8. 14. Bamford JT, Gibson RW, Renier CM. Atopic eczema unresponsive to evening primrose oil (linoleic and gamma-linolenic acids). J Am Acad Dermatol. 1985 Dec;13(6):959-65. 15. Berth-Jones J, Graham-Brown RA. Placebo-controlled trial of essential fatty acid supplementation in atopic dermatitis. Lancet. 1993 Jun 19;341(8860):1557-60. 16. De Paepe K, Hachem JP, Vanpee E, Roseeuw D, Rogiers V. Effect of rice starch as a bath additive on the barrier function of healthy but SLS-damaged skin and skin of atopic patients. Acta Derm Venereol. 2002;82(3):184-6. 17. Gehring W, Bopp R, Rippke F, Gloor M. Effect of topically applied evening primrose oil on epidermal barrier function in atopic dermatitis as a function of vehicle. Arzneimittelforschung. 1999 Jul;49(7):635-42. 18. Hederos CA, Berg A. Epogam evening primrose oil treatment in atopic dermatitis and asthma. Arch Dis Child. 1996 Dec;75(6):494-7. 19. Manku MS, Horrobin DF, Morse N, Kyte V, Jenkins K, Wright S, Burton JL. 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Br J Dermatol. 1987 Jul;117(1):11-9. 24. Senapati S, Banerjee S, Gangopadhyay DN. Evening primrose oil is effective in atopic dermatitis: a randomized placebo-controlled trial. Indian J Dermatol Venereol Leprol. 2008 Sep-Oct;74(5):447-52. 25. Whitaker DK, Cilliers J, de Beer C. Evening primrose oil (Epogam) in the treatment of chronic hand dermatitis: disappointing therapeutic results. Dermatology. 1996;193(2):115-20. 26. Wright S. Atopic dermatitis and essential fatty acids: a biochemical basis for atopy? Acta Derm Venereol Suppl (Stockh). 1985;114:143-5. 27. Blommers J, de Lange-De Klerk ES, Kuik DJ, Bezemer PD, Meijer S. Evening primrose oil and fish oil for severe chronic mastalgia: a randomized, double-blind, controlled trial. Am J Obstet Gynecol. 2002 Nov;187(5):1389-94. 28. Gateley CA, Maddox PR, Mansel RE, Hughes LE. Mastalgia refractory to drug treatment. Br J Surg. 1990 Oct;77(10):1110-2. 29. Gateley CA, Mansel RE. Management of cyclical breast pain. 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Lack of effect of supplementation with essential fatty acids on bone mineral density in healthy pre- and postmenopausal women: two randomized controlled trials of Efacal v. calcium alone. Br J Nutr. 2000 Jun;83(6):629-35. 49. Belch JJ, Shaw B, O'Dowd A, Saniabadi A, Leiberman P, Sturrock RD, Forbes CD. Evening primrose oil (Efamol) in the treatment of Raynaud's phenomenon: a double blind study. Thromb Haemost. 1985 Aug 30;54(2):490-4. 50. Manthorpe R, Hagen Petersen S, Prause JU. Primary Sjögren's syndrome treated with Efamol/Efavit. A double-blind cross-over investigation. Rheumatol Int. 1984;4(4):165-7. 51. Oxholm P, Manthorpe R, Prause JU, Horrobin D. Patients with primary Sjögren's syndrome treated for two months with evening primrose oil. Scand J Rheumatol. 1986;15(2):103-8. 52. Theander E, Horrobin DF, Jacobsson LT, Manthorpe R. Gammalinolenic acid treatment of fatigue associated with primary Sjögren's syndrome. Scand J Rheumatol. 2002;31(2):72-9. 53. 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Evening primose oil and fish oil are ineffective as supplementary treatment of bronchial asthma. Ann Allergy. 1989 Jun;62(6):534-7. 63. Mansel RE, Harrison BJ, Melhuish J, Sheridan W, Pye JK, Pritchard G, Maddox PR, Webster DJ, Hughes LE. A randomized trial of dietary intervention with essential fatty acids in patients with categorized cysts. Ann N Y Acad Sci. 1990;586:288-94. 64. Cant A, Shay J, Horrobin DF. The effect of maternal supplementation with linoleic and gamma-linolenic acids on the fat composition and content of human milk: a placebo-controlled trial. J Nutr Sci Vitaminol (Tokyo). 1991 Dec;37(6):573-9. 65. Makrides M, Neumann MA, Simmer K, Gibson RA. Erythrocyte fatty acids of term infants fed either breast milk, standard formula, or formula supplemented with long-chain polyunsaturates. Lipids. 1995 Oct;30(10):941-8. 66. Ribeiro P, Carvalho FD, Abreu Ade A, Sant'anna Mde T, Lima RJ, Carvalho Pde O. 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Obstet Gynecol. 1993 Jan;81(1):93-8. 82. Khoo SK, Munro C, Battistutta D. Evening primrose oil and treatment of premenstrual syndrome. Med J Aust. 1990 Aug 20;153(4):189-92. 83. Puolakka J, Mäkäräinen L, Viinikka L, Ylikorkala O. Biochemical and clinical effects of treating the premenstrual syndrome with prostaglandin synthesis precursors. J Reprod Med. 1985 Mar;30(3):149-53. 84. Oliwiecki S, Burton JL. Evening primrose oil and marine oil in the treatment of psoriasis. Clin Exp Dermatol. 1994 Mar;19(2):127-9. 85. Prichard P, Brown G, Bhaskar N, Hawkey C. The effect of dietary fatty acids on the gastric production of prostaglandins and aspirin-induced injury. Aliment Pharmacol Ther. 1988 Apr;2(2):179-84. 86. Haslett C, Douglas JG, Chalmers SR, Weighhill A, Munro JF. A double-blind evaluation of evening primrose oil as an antiobesity agent. Int J Obes. 1983;7(6):549-53. 87. Bamford JT, Ray S, Musekiwa A, van Gool C, Humphreys R, Ernst E. Oral evening primrose oil and borage oil for eczema. Cochrane Database Syst Rev. 2013 Apr 30;4:CD004416. 88. DerMarderosian A, Beutler JA. The review of natural products: the most complete source of natural product information. 7th ed. St. Louis, MO, USA: Wolters Kluwer Health; 2012. 89. Fetrow CW, Avila JR. The complete guide to herbal medicines. Spring House, PA, USA: Springhouse Corporation; 2000. 90. Gruenwald J, Brendler T, Jaenicke C, editors. PDR for herbal medicines. 4th ed. Montvale, NJ, USA: Thomson Healthcare; 2007. 91. Rabahi MF, Ferreira AA, Madeira JG, Galvao PM, Pinto SA. Lipoid pneumonia secondary to long-term use of evening primrose oil. J Bras Pneumol. 2010 Sep-Oct;36(5):657-61. 92. Tsai HH, Lin HW, Simon Pickard A, Tsai HY, Mahady GB. Evaluation of documented drug interactions and contraindications associated with herbs and dietary supplements: a systematic literature review. Int J Clin Pract. 2012 Nov;66(11):1056-78. 93. Bamford JT, Ray S, Musekiwa A, van Gool C, Humphreys R, Ernst E. Oral evening primrose oil and borage oil for eczema. Cochrane Database Syst Rev. 2013 Apr 30;4:CD004416. 94. DerMarderosian A, Beutler JA. The review of natural products: the most complete source of natural product information. 7th ed. St. Louis, MO, USA: Wolters Kluwer Health; 2012. 95. Fetrow CW, Avila JR. The complete guide to herbal medicines. Spring House, PA, USA: Springhouse Corporation; 2000. 96. Gruenwald J, Brendler T, Jaenicke C, editors. PDR for herbal medicines. 4th ed. Montvale, NJ, USA: Thomson Healthcare; 2007. 97. Tsai HH, Lin HW, Simon Pickard A, Tsai HY, Mahady GB. Evaluation of documented drug interactions and contraindications associated with herbs and dietary supplements: a systematic literature review. Int J Clin Pract. 2012 Nov;66(11):1056-78.

The "-" means that there is no information.