Crataegus azarolus (Crataegus azarolus): Benefits, Dosage, Safety & Evidence

Frequently asked questions

How does Crataegus azarolus work for heart conditions?

Crataegus azarolus exerts its cardiovascular effects primarily through its content of oligomeric proanthocyanidins (OPCs) and flavonoids. These compounds act as antioxidants and appear to dilate coronary arteries, improving oxygen supply to the heart muscle. They may also increase the force of heart contractions and improve circulation. While these mechanisms are well-documented in related hawthorn species, specific evidence for C. azarolus remains at Level C, relying on traditional use and pharmacological plausibility.

Does Crataegus azarolus interact with heart medications?

Yes, Crataegus azarolus has significant potential interactions with cardiovascular drugs. Due to its effects on heart muscle contractility and blood vessel dilation, it may have additive effects when taken with beta-blockers, calcium channel blockers, or digitalis medications. This could result in excessively low blood pressure or altered heart rates. Patients taking prescription heart medications should avoid this herb unless supervised by a physician. Evidence Level C.

What is the standard dosage for Crataegus azarolus?

The recommended adult dosage for Crataegus azarolus varies by preparation. For the dried fruit used as a tea or food, the typical dose is 10-15 grams daily. For standardized extracts, a dosage of 300-600 mg per day is common. Because evidence is limited (Level C), users should adhere to product label instructions or consult a medical herbalist. Consuming large amounts beyond these recommendations may increase the risk of side effects.

Is Crataegus azarolus safe to take during pregnancy?

No, Crataegus azarolus is considered unsafe during pregnancy when used in therapeutic doses. While the fruit is consumed as food in some Mediterranean cultures, medicinal preparations stimulate the cardiovascular system and may affect uterine tone. Due to the lack of safety data and potential for pharmacological activity, pregnant women should avoid concentrated extracts or therapeutic doses. It is rated as unsafe for pregnancy in clinical herbal practice.

What is Crataegus azarolus used for in traditional medicine?

In Mediterranean folk medicine, Crataegus azarolus is primarily used to support heart health and treat digestive complaints. Traditional applications include managing mild cardiovascular conditions and acting as a nutritive tonic. The fruit is valued for its antioxidant properties, attributed to flavonoids and tannins, which help protect cells from oxidative stress. Evidence supporting these specific uses is classified as Level C, based largely on traditional knowledge and phytochemical analysis.

PubMed-compiled information sheet

This sheet was compiled from PubMed (NIH) abstracts using AI assistance. Every factual claim is cited to a real PubMed article (see the source list). It has not yet been human-reviewed — confirm with a healthcare provider before use.

Compiled from 30 PubMed articles · model: gemma4:31b

Summary

Crataegus azarolus (Mediterranean hawthorn) is a medicinal plant used traditionally for cardiovascular and inflammation-related diseases [PMID:40274978]. It exhibits various pharmacological properties, including antioxidant, antihyperglycemic, and antiproliferative activities [PMID:28420354, PMID:26495895].

Background

Crataegus azarolus, also known as hawthorn or azarole, is a fruit species naturally growing in regions such as the Eastern Mediterranean of Türkiye and Lebanon [PMID:39794746, PMID:28769026]. It exists in varieties such as C. azarolus var. aronia (yellow fruits) and C. azarolus var. eu-azarolus (red fruits) [PMID:19634468].

Traditional uses

It is traditionally valued for treating cardiovascular and inflammation-related diseases, including diabetes, cancer, and rheumatism [PMID:40274978], and is used for various health benefits and culinary reasons [PMID:41855569].

Active compounds

The plant contains phenolics, flavonoids, tannins, and proanthocyanidins [PMID:33320393, PMID:37726053]. Specific identified compounds include hyperoside [PMID:26711781, PMID:24070066], rutin, salicylic acid [PMID:28420354], vitexin-2''-O-rhamnoside [PMID:25661350], fupenzic acid [PMID:40274978], azarolic acid [PMID:30475495], and digitoxin [PMID:41855569].

Mechanism of action

Mechanisms include the inhibition of $\alpha$-amylase and $\alpha$-glucosidase [PMID:42141147], induction of apoptosis via caspase-8 cleavage and loss of mitochondrial potential in colorectal cancer cells [PMID:26495895], and the modulation of macrophage lysosomal enzyme activity and nitric oxide release [PMID:26711781].

Clinical evidence

Evidence DHeart Failure (Rat Model)

Procyanidin extracted from C. azarolus was investigated for its ability to treat induced heart failure in rats [PMID:36905256]

Evidence DRenovascular Hypertension (Rat Model)

Hydroalcoholic extract of C. azarolus subspecies aronia fruit demonstrated antihypertensive effects in rats [PMID:28533575]

Evidence DUlcerative Colitis (Rat Model)

Berries decoction extract (CAB-DE) significantly protected colonic mucosa against acetic acid-induced ulcerative colitis [PMID:38223297]

Evidence DDiarrhea (Rat Model)

Berries aqueous extract (CABAE) protected against castor oil-induced diarrhea and intestinal fluid accumulation [PMID:33320393]

Evidence DConstipation (Rat Model)

Leaves decoction extract (CALDE) improved gastric emptying and accelerated gastrointestinal transit in loperamide-induced constipation [PMID:40107769]

Evidence DColorectal Cancer (In Vitro)

Safety & adverse effects

Oral administration of berries decoction extract (CAB-DE) showed no signs of toxicity or abnormal behavior in rats, with an LD50 higher than 3500 mg/kg bw [PMID:39924696].

Evidence summary

The evidence is primarily based on in vitro studies and animal models (Level D), demonstrating significant antioxidant, anti-inflammatory, and protective effects across various organ systems. No human clinical trial data for C. azarolus specifically was provided in the abstracts.

PubMed sources

1.PMID: 39794746 (2025) — Elucidation of genetic diversity in hawthorn (Crataegus azarolus L.) accessions naturally growing in the Eastern Mediterranean region of Türkiye using morphological, pomological, and inter simple sequence repeat markers. · BMC plant biology
2.PMID: 28420354 (2017) — Therapeutic potentials of Crataegus azarolus var. eu- azarolus Maire leaves and its isolated compounds. · BMC complementary and alternative medicine
3.PMID: 26495895 (2016) — Crataegus azarolus Leaves Induce Antiproliferative Activity, Cell Cycle Arrest, and Apoptosis in Human HT-29 and HCT-116 Colorectal Cancer Cells. · Journal of cellular biochemistry
4.PMID: 26711781 (2016) — Immunomodulatory potencies of isolated compounds from Crataegus azarolus through their antioxidant activities. · Tumour biology : the journal of the International Society for Oncodevelopmental Biology and Medicine
5.PMID: 41855569

Crataegus azarolus

Sources & Citations

Calculate a safe dose of Crataegus azarolus