Chanca piedra (Phyllanthus niruri)

While some complementary and alternative techniques have been studied scientifically, high-quality data regarding safety, effectiveness, and mechanism of action are limited or controversial for most therapies. Whenever possible, it is recommended that practitioners be licensed by a recognized professional organization that adheres to clearly published standards. In addition, before starting a new technique or engaging a practitioner, it is recommended that patients speak with their primary healthcare provider(s). Potential benefits, risks (including financial costs), and alternatives should be carefully considered. The below monograph is designed to provide historical background and an overview of clinically-oriented research, and neither advocates for or against the use of a particular therapy.

Related Terms

  • 1,2-Benzendicarboxylic acid, 1-galloyl-2,3-dehydrohexahydroxydiphenyl (DHHDP)-glucose, 1-O-galloyl-2,4-dehydrohexahydroxydiphenoyl-glucopyranose, 1-O-galloyl-6-O-luteoyl-a-D-glucose, 2-(4-hydroxyphenyl)-8-(3-methyl-but-2-enyl)-chroman-4-one, 2Z,6Z,10Z,14E,18E-farnesyl farnesol, 3-(3,4-dimethoxy-benzyl)-4-(7-methoxy-benzo[1,3]dioxol-5-yl-methyl)-dihydrofuran-2-one, 4-(3,4-dimethoxy-phenyl)-1-(7-methoxy-benzo[1,3]dioxol-5-yl)-2,3-bis-methoxymethyl-butan-1-ol, 4,4,8-trimethoxy chroman, 4′,4?’di-O-methyl cupressuflavone, 4-methoxy-nor-securinine, 6,10,14-trimethyl-2-pentadecanone, 8-(3-methyl-but-2-enyl)-2-phenyl chroman-4-one, 35kDa protein molecule, acyclic triterpene, alkaloids, amariin (1-galloyl-2,4:3,6-bis-dehydrohexahydroxydiphenoyl-glucopyranosid), amariinic acid, arabinogalactan, arranca-pedras, beta-sitosterol, bhumyamalaki, biflavonoid, bis (2-ethyl hexyl) ester, brevifolin carboxylic acid, (+)-catechin, Cim-Jeevan, CIM/NPA24, CIM/PA 117, CIM/PAG-1, corilagin, coumarins, cubebin dimethyl ether, dibenzylbutyrolactone, diterpenes, dotriacontanyl docosanoate, elaeocarpusin, ellagic acid, ent-norsecurinine, (-)-epicatechin, (-)-epicatechin 3-O-gallate, (-)-epigallocatechin, (-)-epigallocatechin 3-O-gallate, ethyl 3,4,5-trihydroxybenzoate, ethyl brevifolin carboxylate, ethyl oleate, Euphorbiaceae (family), flavonoids, gallic acid, (+)-gallocatechin, galloylglucose, geraniin, geraniinic acid B, glycoflavones, glycoside, hexahydrofarnesyl acetone, hydroxy-lignans, hypophyllanthin, isoquercetin, isocorilagin, isolintetralin, lactones, lignan, linalool, meniran, methyl brevifolin carboxylate, methyl brevifolincarboxylate, methyl dehydrochebulate, minerals, naphthalene, neolignan, niranthin, nirphyllin, nirtetralin, niruriflavone, niruriside, norsecurinine, Nymphanthus niruri, oleanolic acid, orthosiphol G, orthosiphol I, oxalates, Phyllanthus amarus [Phyllanthus niruri] cv. Navyakrit, para-parai mí, pentacosane, p-glucogallin, phyllanthin, phyllanthine (4-methoxy-securinine), Phyllanthus amarus Linn., Phyllanthus amarus Sch. et Thonn., Phyllanthus amarus Schum. and Thonn., Phyllanthus amarus Schumach., Phyllanthus carolinianus, Phyllanthus fraternus, Phyllanthus kirganella, Phyllanthus lathyroides, Phyllanthus lonphali, Phyllanthus niruri Hook.f., Phyllanthus sellowianus, Phyllanthus sellowianus Muller Arg., phyllanthusiin D, phyllnirurin, phyltetralin, phytol, quebra-pedra, quercetin, quercetin 3-O-beta-D-glucopyranosyl-(2–>1)-O-beta-D-xylopyranoside, quercetin 3-O-glucoside, quercetin-3-O-beta-D-glucopyranosyl(1->4)-alpha-rhamnopyranoside, repandusinic acid, repandusinic acid A, rutin, saponins, sarandi blanco, seco-lignan, securinega-type alkaloids (isobubbialine and epibubbialine), securinine, steroids, tannins, taung-ze-phyu, terpenoids, trans-phytol, triacontanal, triacontanol, urinatetralin, ursolic acid, volatile oil.

  • Note: Although there are over 600 species in the Phyllanthus genus, three are considered to be chanca piedra: Phyllanthus sellowianus, Phyllanthus amarus, and Phyllanthus niruri. These species are very similar, and the terms are often used interchangeably.

Background

  • Chanca piedra is a plant found in the Amazon rainforests and other tropical areas. It can grow to a height of 30-40 centimeters.

  • Chanca piedra has a history in herbal medicine. It has been used to treat bacterial infections, diabetes, hepatitis, high blood pressure, liver diseases, and viral infections, as well as bile duct, intestine, liver, stomach, and urinary conditions.

  • At this time, there is a lack of studies to support chanca piedra for any use. Early research suggests its abilities to fight viruses, prevent formation of calculi (mineral stones in organs), protect the liver, and reduce blood sugar and blood pressure. Additional information is needed in these areas.

Scientific Evidence

Uses

These uses have been tested in humans or animals. Safety and effectiveness have not always been proven. Some of these conditions are potentially serious, and should be evaluated by a qualified healthcare provider.

Acute viral hepatitis

Research using chanca piedra in viral hepatitis patients has reached conflicting conclusions. Additional research is needed in this area.

Diabetes

Early research suggests that chanca piedra may reduce blood sugar in some individuals with diabetes. However, the effect of chanca piedra on blood sugar is inconclusive.

Hepatitis B

Research using chanca piedra in hepatitis B individuals has conflicting conclusions. Additional research is needed in this area.

High blood pressure

Early research suggests that chanca piedra may reduce blood pressure and blood sugar in individuals with high blood pressure. Additional research is needed in this area.

HIV/AIDS

Early research suggests that chanca piedra may reduce HIV replication. Additional research is needed in this area.

Liver disease

Early research suggests that chanca piedra may prevent liver damage in individuals with liver disease. Additional research is needed in this area.

Tonsillitis (throat infection)

Early research suggests a combination of black cumin and chanca piedra extract may benefit throat infection. The effect of chanca piedra alone is unclear. Additional research in this area is needed.

Urinary stones

Early research suggests that chanca piedra may benefits patients after shock therapy for kidney stones. However, other research suggests that chanca piedra may only affect urinary calcium levels. Additional research is needed before conclusions may be made.

*Key to grades:

Tradition

The below uses are based on tradition or scientific theories. They often have not been thoroughly tested in humans, and safety and effectiveness have not always been proven. Some of these conditions are potentially serious and should be evaluated by a qualified health care professional.

  • Alzheimer’s disease, anemia (low red blood cell count), antiaging, anti-inflammatory, antimicrobial, antioxidant, antispasmodic, antitoxin (antibody produced against toxins), antiviral, asthma, bladder disorders (cystitis), blood thinner, burn and wound care, cancer, colic, diarrhea, digestive, diuretic (increasing urination), emmenagogue (menstrual flow stimulant), eye disorders, fever, flu, fluid retention, heart disease, high cholesterol, immune system regulation, inducing (causing) abortion, insecticide, jaundice (yellowing of the skin), laxative, liver damage from toxins/drugs, lung disorders, malaria, memory enhancement, pain relief, prostate disorders, radioprotection (protection from radioactivity), tonic (gastrointestinal), tonic (kidney), tuberculosis (bacterial lung infection), ulcers, urinary tract infections, vaginitis, weight loss.

Dosing

The below doses are based on scientific research, publications, traditional use, or expert opinion. Many herbs and supplements have not been thoroughly tested, and safety and effectiveness may not be proven. Brands may be made differently, with variable ingredients, even within the same brand. The below doses may not apply to all products. You should read product labels, and discuss doses with a qualified healthcare provider before starting therapy.

Adults (18 years and older)

  • Generally, an infusion or weak tea of chanca piedra has been taken by mouth. Traditionally, individuals drink 1-3 cups daily or weekly. Some pharmacies in South America sell concentrated extracts with a daily dose of 2-6 milliliters, taken twice or thrice daily.

  • To treat acute viral hepatitis, 900 milligrams of powdered chanca piedra capsules has been taken by mouth three times daily for seven days.

  • To treat diabetes, 100 milliliters of chanca piedra extract has been taken by mouth twice daily for one week. Additionally, two pellets of chanca piedra, each 0.8 grams, have been taken three times daily by mouth for 10 days.

  • To treat hepatitis B, 200-1,100 milligrams of dried chanca piedra has been taken by mouth three times daily for up to three months.

  • To treat high blood pressure, two 0.8-gram pellets have been taken by mouth three times daily for 10 days.

  • To treat liver disease, three grams of chanca piedra powder has been taken by mouth three times daily for 30-45 days.

  • To treat urinary stones, 450 milligrams of chanca piedra has been taken by mouth three times daily for three months.

Children (under 18 years old)

  • There is no proven safe or effective dose for chanca piedra in children.

Safety

The U.S. Food and Drug Administration does not strictly regulate herbs and supplements. There is no guarantee of strength, purity or safety of products, and effects may vary. 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. Consult a healthcare provider immediately if you experience side effects.

Allergies

  • Avoid in people with known allergy or sensitivity to chanca piedra, Phyllanthus amarus, Phyllanthus niruri, Phyllanthus sellowianus, their parts, or members of the Euphorbiaceae family.

Side Effects and Warnings

  • In general, side effects were lacking in human studies. Chanca piedra is likely safe when taken up to 400 milligrams three times daily for one month, under the care of a healthcare practitioner.

  • Chanca piedra may lower blood sugar levels. Caution is advised in people with diabetes or hypoglycemia, and in those taking drugs, herbs, or supplements that affect blood sugar. Blood glucose levels may need to be monitored by a qualified healthcare professional, including a pharmacist, and medication adjustments may be necessary.

  • Chanca piedra may increase the risk of bleeding. Caution is advised in people with bleeding disorders or those taking drugs that may increase the risk of bleeding. Dosing adjustments may be necessary.

  • Chanca piedra may cause low blood pressure. Caution is advised in people taking agents that lower blood pressure.

  • Drowsiness or sedation may occur. Use caution if driving or operating heavy machinery.

  • Use cautiously in people with liver disease.

  • Use cautiously people taking diuretics, agents that lower cholesterol, or agents that affect the immune system.

  • Avoid in pregnant or breastfeeding women, or in those trying to become pregnant.

  • Avoid in people with known allergy or sensitivity to chanca piedra, Phyllanthus amarus, Phyllanthus niruri, Phyllanthus sellowianus, their parts, or members of the Euphorbiaceae family.

  • Chanca piedra may also cause abdominal pain or discomfort; altered immune system function; altered levels of certain white blood cells; anorexia; chills; diarrhea; disturbed sleep; dizziness; enlarged lymph nodes; fatigue; fever; headache; hives; increased sodium, potassium, and chloride in the urine; increased urine volume; joint pain; lung disease; malaise (discomfort); muscle pain; nausea; rash; skin prickling; and sore mouth.

Pregnancy and Breastfeeding

  • There is a lack of scientific evidence on the use of chanca piedra during pregnancy or breastfeeding.

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.

Interactions with Drugs

  • Chanca piedra may lower blood sugar levels. Caution is advised when using medications that may also lower blood sugar. People taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

  • Chanca piedra may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners) such as warfarin (Coumadin®) or heparin, antiplatelet drugs such as clopidogrel (Plavix®), and nonsteroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

  • Chanca piedra may cause low blood pressure. Caution is advised in people taking drugs that lower blood pressure.

  • Chanca piedra may increase the amount of drowsiness caused by some drugs. Examples include benzodiazepines such as lorazepam (Ativan®) or diazepam (Valium®), barbiturates such as phenobarbital, narcotics such as codeine, some antidepressants, and alcohol. Caution is advised while driving or operating machinery.

  • Chanca piedra may interact with agents for inflammation, pain relief, or wound healing; agents that alter immune function; agents that damage the liver; agents that increase urine output; agents that inhibit angiotensin-converting enzyme (ACE), angiotensin-converting enzyme receptor (ARB), or endothelin; agents that mimic acetylcholine (a neurotransmitter); agents that protect against radiation; agents that protect against toxic effects of chemotherapy; agents that treat disorders of the blood, digestive tract, eyes, heart, or kidneys; agents that treat gout or inhibit xanthine oxidase (enzyme that breaks down purine); agents that widen blood vessels; agents used for cancer, diarrhea, fever, HIV/AIDS, malaria, obesity, or urinary stones; antibiotics, antivirals, cholesterol0lowering agents, fertility agents, interferons (man-made version of an immune system protein), and nonsteroidal anti-inflammatories (NSAIDs, medications that reduce swelling and pain).

Interactions with Herbs and Dietary Supplements

  • Chanca piedra may lower blood sugar levels. Caution is advised when using herbs or supplements that may also lower blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

  • Chanca piedra may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

  • Chanca piedra may cause low blood pressure. Caution is advised in people taking herbs or supplements that lower blood pressure.

  • Chanca piedra may increase the amount of drowsiness caused by some herbs or supplements.

  • Chanca piedra may interact with antibiotics; antioxidants; antivirals; Azadirachta indica (neem); cholesterol-lowering herbs and supplements; fertility herbs and supplements; herbs and supplements for cancer; herbs or supplements for HIV/AIDS; herbs and supplements for inflammation, pain relief, or wound healing; herbs and supplements for urinary stones, diarrhea, fever, gout, obesity, or malaria; herbs and supplements that alter immune function; herbs and supplements that damage the liver; herbs and supplements that increase urine output; herbs and supplements that inhibit angiotensin-converting enzyme (ACE), angiotensin-converting enzyme receptor (ARB), or endothelin; herbs and supplements that mimic acetylcholine (a neurotransmitter); herbs and supplements that protect against radiation; herbs and supplements that treat disorders of the blood, digestive tract, eyes, heart, or kidneys; herbs and supplements that widen blood vessels; Gymnema sylvestre; phytochemicals (bioactive molecules in plants); and silymarin (milk thistle extract).

Author Information

  • This information is based on a systematic review of scientific literature edited and peer-reviewed by contributors to the Natural Standard Research Collaboration (www.naturalstandard.com).

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.

  1. Boim, M. A., Heilberg, I. P., and Schor, N. Phyllanthus niruri as a promising alternative treatment for nephrolithiasis. Int.Braz.J Urol. 2010;36(6):657-664. View Abstract
  2. Celia A, Micali S Sighinolfi M et al. May phyllanthus niruri (Uriston®) affect the efficacy of ESWL on renal stones? A prospective, randomised short term study [abstract no: 178] . The Cochrane Library 2005;(1)
  3. Dirjomuljono, M., Kristyono, I., Tjandrawinata, R. R., and Nofiarny, D. Symptomatic treatment of acute tonsillo-pharyngitis patients with a combination of Nigella sativa and Phyllanthus niruri extract. Int.J Clin Pharmacol.Ther. 2008;46(6):295-306. View Abstract
  4. Doshi, J. C., Vaidya, A. B., Antarkar, D. S., Deolalikar, R., and Antani, D. H. A two-stage clinical trial of Phyllanthus amarus in hepatitis B carriers: failure to eradicate the surface antigen. Indian J Gastroenterol. 1994;13(1):7-8. View Abstract
  5. Huang ZR, Zhong JP, and Zhu GL. Therapeutic observation of Phyllanthus amarus for treatment of hepatitis B . The Cochrane Library 1993;(1)
  6. Jayaram S, Thyagarajan SP Sumathi S et al. Efficacy of Phyllanthus amarus treatment in acute viral hepatitis A, B and non A non B: an open clinical trial. Indian Journal of Virology 1997;13(1):59-64.
  7. McPartland JM. Viral hepatitis treated with Phyllanthus amarus and milk thistle (Silybum marianum): a case report [corrected]. Complementary Medicine International 1996;3(2):40-42.
  8. Milne, A., Hopkirk, N., Lucas, C. R., Waldon, J., and Foo, Y. Failure of New Zealand hepatitis B carriers to respond to Phyllanthus amarus. N.Z.Med J 6-22-1994;107(980):243. View Abstract
  9. Moshi, M. J., Lutale, J. J., Rimoy, G. H., Abbas, Z. G., Josiah, R. M., and Swai, A. B. The effect of Phyllanthus amarus aqueous extract on blood glucose in non-insulin dependent diabetic patients. Phytother.Res 2001;15(7):577-580. View Abstract
  10. Narendranathan, M., Remla, A., Mini, P. C., and Satheesh, P. A trial of Phyllanthus amarus in acute viral hepatitis. Trop.Gastroenterol. 1999;20(4):164-166. View Abstract
  11. Nishiura, J. L., Campos, A. H., Boim, M. A., Heilberg, I. P., and Schor, N. Phyllanthus niruri normalizes elevated urinary calcium levels in calcium stone forming (CSF) patients. Urol.Res 2004;32(5):362-366. View Abstract
  12. Patel HJ, Patel JS Patel KN. Clinical study of hepatoprotective drug Phyllanthus amarus. Research Journal of Pharmaceutical Biological and Chemical Sciences. Research Journal of Pharmaceutical Biological and Chemical Sciences 2010;335-340.
  13. Wang XH, Li CQ Guo XB et al. Clinical observation on 40 cases of chronic hepatitis B using compound Phyllanthus amarus combined with interferon. Chinese Journal of Integrated Traditional & Western Medicine on Liver Diseases 1999;12-31.
  14. Xin-Hua, W., Chang-Qing, L., Xing-Bo, G., and Lin-Chun, F. A comparative study of Phyllanthus amarus compound and interferon in the treatment of chronic viral hepatitis B. Southeast Asian J Trop.Med Public Health 2001;32(1):140-142. View Abstract
  15. Zhang JL, He WN Ye P. Clinic observation on Phyllanthus amarus for treating chronic HBV infection. Chinese Journal of Integrated Traditional & Western Medicine on Liver Diseases 1992;8-10.

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.