Downward-Draining Herbs (Intro)

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What precaution should you keep in mind when prescribing Da Huang (rhei radix et rhizoma) to a patient?

Da Huang is very bitter, moves downward, and strongly invigorates blood; use extreme caution during menstruation, pregnancy, and breastfeeding.
Da Huang is warm and acrid; it may cause heat signs and dryness if used long term.
Da Huang is toxic; it must be boiled 30-60 minutes longer than the rest of the decoction in order to reduce its toxicity.
Da Huang is very sweet, sticky, and cloying; it may cause digestive problems.

Da Huang invigorates blood and moves downward, so it should be avoided during menstruation and pregnancy. The bitter flavor and purgative effect can come through in the breastmilk, so Da Huang should be avoided during breastfeeding.

Source: Bensky, D. (2004). Chinese Herbal Medicine: Materia Medica. Seattle, WA: Eastland Press. pp. 236 [Q545]