Image for Aristolochia spp.
Aristolochia spp.

Synonyms/Common Names/Related Substances:

  • Acretoside, Akebia mu tong, alkaloids, allantoin, arillatose B, aristofolin-E, aristolactam Ia, aristoliukine-C, Aristolochia bracteata, Aristolochia chilensis, Aristolochia chuan mu tong, Aristolochia clematitis, Aristolochia constricta, Aristolochia contorta Bunge, Aristolochia cretica, Aristolochia cucurbitifolia Hayata, Aristolochia cymbifera, Aristolochia debilis, Aristolochia durior, Aristolochia fangchi, Aristolochia longa, Aristolochia gibertii, Aristolochia gigantean, Aristolochia grandiflora, Aristolochia guang fang ji, Aristolochia indica, Aristolochia kaempferi, Aristolochia kwangsiensis, Aristolochia macedonica, Aristolochia macroura, Aristolochia ma dou ling, Aristolochia manshuriensis, Aristolochia manshuriensis Kom, Aristolochia maurorum, Aristolochia qing mu xiang, Aristolochia rigida, Aristolochia taliscana, Aristolochia westlandi, Aristolochia xun gu feng, Aristolochiae Debilis fructus, Aristolochiae Debilis radix, Aristolochiae Mollissimae radix, Aristolochiae Mollissimae ramulus, Aristolochia paucinervis Pomel, Aristolochia rugosa, Aristolochia spp., Aristolochia taliscana, Aristolochia triangularis, Aristolochia trilobata, Aristolochiaceae (family), aristolochic acid, aristolochic acid A, aristolochic acid I, aristolochic acid-Ia methyl ester, aristolochic acid II, aristolochic acid-III methyl ester, aristolochic acid IVa, aristolochic acid VII, aristololactam IV, aristololactam IVa, aristolochic acid nephropathy, aristomanoside, aristo-red, austrobailignan-7, Balkan nephropathy, Belgian slimmers' disease, benzenoids, beta-sitosterol, biflavonoid, birthwort, cepharanone C, columbin, crystalline magnoflorine, daucosterol, dehydrooxoperezinone, demethylaristofolin E, Dutchman's pipe, Dutchmanspipe, eicosanic acid, endemic (Balkan) nephropathy, endemic nephropathy, eupomatenoid-7, fang chi, fangchinoline, flavonoids, fragransin E1, guaco (Mexican Spanish), guan fang ji (Chinese), guan mu tong (Chinese), herba Aristolochia Mollissemae, ishwarane, isoquinoline alkaloids, licarin A, licarin B, lignoids, linoleic acid, longdan xieganwan, madolin-P, magnoflorine, mu tong (Chinese), N-glycosyl lactam, nitrophenanthrene carboxylic acids, palmitic acid, phenanthrene derivatives, phenylpropanoid glucose esters, pinitol, protopine, raiz de guaco (Mexican Spanish), Saussurea mu xiang, snakeroot, sodium 3,4-dimethoxybenzoate, sodium 7-hydroxyl-8-methoxyaristolate, steroids, sterols, sitogluside, talaumidin, terpenes, tetrandrine, tubeflower.
  • Combination product examples: 707 Gastropathy Capsules, Chi Kuan Yen Wan, Guan Zin Su He Wan, Guanxin Suhe Jiaonang, Internal Dissolution Pills, Kuanhsin Suhowan, Mei Bou Gin Mei Yuen, Pilule Cortex Eucommiae Et Os Tigridis, Tienchi Hugu Wan, Tri-snakegall and Fritillary Powder, Zuo Gu Shen Jin Tong Wan.

Clinical Bottom Line/Effectiveness

Brief Background:

  • Due to the known nephrotoxicity of aristolochic acid found in Aristolochia spp., the U.S. Food and Drug Administration (FDA) currently advises consumers to immediately discontinue use of any botanical products containing aristolochic acid. Currently, Britain's Committee on Safety of Medicines has prohibited Aristolochia spp. in all unlicensed medicines, and it may only be obtained by prescription from a licensed doctor or dentist.
  • Aristolochia spp. are found in diverse climates worldwide, but not in Australia. In many areas, it is used in ethnomedicine for conditions such as cancer (1;2;3;4;5), wounds (6;7), and intestinal worms (8). Since the 1950s, some Aristolochia spp. have been used as substitutes in Chinese herbal medicine for certain Akebia spp., Saussurea (Auklandia) spp., Clematis spp, and Stephania tetrandra (9). In fact, when nine samples of fangji (Stephania tetrandra) were purchased from Hong Kong herbal shops and analyzed for aristolochic acids, all of the samples contained aristolochic acids, a constituent of Aristolochia spp.; Stephania tetrandra does not contain aristolochic acids (10). This is a serious problem because aristolochic acid is nephrotoxic (11;12;13;14;15;16;17;18;19;20;21;22;23;24;25;26;27;28;29;30;31;32;33;34;35;36;37;38;39).
  • During 1990-1992, a clinic in Belgium prescribed a Chinese herbal remedy for weight loss that substituted Aristolochia fangchi for Stephania tetrandra (34). Many of these patients developed a progressive renal fibrosis known as aristolochic acid nephropathy and total doses of more than 200g were associated with a higher risk of urothelial carcinoma. Symptoms include early severe anemia, mild tubular proteinuria, and initially normal arterial blood pressure in half of the patients that progresses to unusual extensive cortical interstitial fibrosis associated with proximal tubular atrophy and global sclerosis of glomeruli decreasing from the outer to the inner cortex (20). There have been other case reports of aristolochic acid nephropathy (15;17;36;40;41), which can be identified by the presence of DNA adducts formed by aristolochic acid in the kidneys (34).
  • It is believed that the seeds of Aristolochia clematitis that have been accidentally harvested along with wheat from fields in Bosnia, Bulgaria, Croatia, Romania, and Serbia may be the cause of endemic (Balkan) nephropathy and a high rate of endemic renal failure in certain locations (16;42).

Dosing/Toxicology

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Precautions/Contraindications

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Interactions

Most herbs and supplements have not been thoroughly tested for interactions with other herbs, supplements, drugs, or foods. The interactions listed below are based on reports in scientific publications, laboratory experiments, or traditional use. You should always read product labels. If you have a medical condition, or are taking other drugs, herbs, or supplements, you should speak with a qualified healthcare provider before starting a new therapy.

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Mechanism of Action

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History

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Evidence Table

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Evidence Discussion

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Products Studied

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Author Information

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References

Natural Standard developed the above evidence-based information based on a thorough systematic review of the available scientific articles. For comprehensive information about alternative and complementary therapies on the professional level, go to www.naturalstandard.com. Selected references are listed below.

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The information in this monograph is intended for informational purposes only, and is meant to help users better understand health concerns. Information is based on review of scientific research data, historical practice patterns, and clinical experience. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions.