Greater celandine (Chelidonium majus)

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

  • Berberine, C. majus, chelerythrine, chelidonine, Chelidonium majus, Chelidonium-30 (Ch-30), Chelidonium-200 (Ch-200), coptisine, greater celandine grass, Iberogast®, NSC 61570, Papaveraceae (family), Schollkraut (German), STW 5 (Iberogast®), stylopine, Ukrain™, UKSR-222.

Background

  • Greater celandine has been used historically in Europe for the treatment of many diseases. Although celandine is considered somewhat toxic, it has been used in traditional Chinese medicine and by German doctors.

  • A semisynthetic drug that uses greater celandine extracts, called UkrainTM, has been studied for the treatment of cancer and may gain more attention in the future because of its antiosteoporosis effects.

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.

Cancer (general)

Ukrain™, a semisynthetic drug derived from Chelidonium majus, has been studied in patients with various types of cancer. These trials have resulted in consistently positive outcomes, with Ukrain™ demonstrating immune system-modulating and immune system-stimulating properties, toxic effects on malignant cells, and improvements in the clinical course of the disease. Additional research is needed in this area.

Biliary colic

Chelidonium majus and Curcuma longa have traditionally been used as liver and gallbladder herbs. However, there have been no high-quality studies to investigate this. Additional research is needed before a conclusion can be made.

Esophageal cancer

The majority of studies on the use of Chelidonium majus in the treatment of cancer use the semisynthetic drug UkrainTM. Limited research suggests that further research in this area is warranted.

Lung cancer

The effects of Ukrain™ in lung cancer patients are comparable to its effects in other types of cancer. It appears to improve immune system function in cancer patients who concurrently demonstrate clinical improvement. Limited research suggests that further research in this area is warranted.

Pancreatic cancer

Ukrain™ has demonstrated some benefit, such as increased survival time, even in the most advanced, untreatable forms of cancer. Patients with “untreatable” cancers are a suitable population for research into complementary cancer treatments, as they are not being deprived of other known therapies when participating in such studies. Further research is needed.

Tonsillitis

Traditionally, herbalists and naturopathic doctors have used herbs in the form of tinctures, or alcohol extracts. Chelidonium administered by mouth as a tincture has demonstrated immune-boosting properties in children with chronic tonsillitis. However, occasional reports of liver toxicity from Chelidonium are a concern. Additional research into the safety and efficacy of this herb are needed.

*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.

  • Analgesic (pain reliever), antidepressant, antifungal, anti-inflammatory, antimicrobial, antioxidant, antispasmodic (muscle spasms), antiviral, biliary/gallbladder disease, diabetes, dyspepsia (heartburn), encephalitis (tick-borne, inflammation of part of the brain), immunomodulator, irritable bowel syndrome, jaundice, liver disorders, oral hygiene, skin conditions (pruritic dermatoses), tumors (papillomas and condylomas), ulcers, warts.

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)

  • As a tea, one teaspoon of dried leaves per cup of water has traditionally been taken by mouth 2-3 times daily. One teaspoon of root or 2 teaspoons of herb per cup of water has traditionally been taking by mouth two times daily.

  • As a tincture, 8-10 drops or 1-2 milliliters has traditionally been taken by mouth three times daily.

  • According to some experts, only the dried leaves should be taken internally.

  • For advanced esophageal cancer, Chelidonium majus L. has been given intravenously or intramuscularly (not specified); however, the dosing information is unclear.

  • For cancer, Ukrain™ has been given intravenously in a dose of 10 milligrams every three days. For lung cancer, Ukrain™ has been given intravenously in a dose of 10 milligrams every three days.

  • For pancreatic cancer, Ukrain™ has been given intravenously or intramuscularly (not specified) in a dose of 20 milligrams weekly.

  • For stage III cancer (unknown type), Ukrain™ has been given intravenously in a dose of 10 milligrams every second day.

Children (under 18 years old)

  • For tonsillitis, Chelidonium majus L. has been taken by mouth.

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 with known allergy or hypersensitivity to greater celandine, its parts, or members of the Papaveraceae family, as contact dermatitis has been reported.

Side Effects and Warnings

  • Greater celandine may also cause contact dermatitis (skin inflammation), decreased bone mineral density, gas, hemolytic anemia (anemia due to the abnormal breakdown of red blood cells), increased body weight, jaundice, and rash. Use cautiously in patients taking amphetamines, morphine, or hexobarbital. Although it has not been well studied in humans, greater celandine may increase the action of these drugs.

  • Use cautiously in patients undergoing radiation therapy, as Ukrain™ may have a radioprotective effect.

  • Use cautiously in patients taking monoamine oxidase inhibitors (MAOIs), or dopaminergic or serotonergic drugs.

  • Avoid in patients with liver disease, as greater celandine may cause hepatitis (liver inflammation) and cholestasis (obstructed bile flow).

  • Avoid in pregnant or breastfeeding women, due to a lack of safety data.

  • Avoid with known allergy or hypersensitivity to greater celandine, its constituents, or members of the Papaveraceae family.

Pregnancy and Breastfeeding

  • Avoid in pregnant or breastfeeding women, due to a lack of safety data.

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

  • Greater celandine has been used traditionally to treat diabetes and may lower blood sugar levels. Caution is advised when using antidiabetic medications and medications that may also lower blood sugar. Patients taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

  • Greater celandine may interact with anticancer agents (such as Endoxan), antidepressants (specifically monoamine oxidase inhibitors (MAOIs) and selective serotonin reuptake inhibitors (SSRIs)), anti-inflammatories, antiulcer agents, apoptosis agents, biliary pain agents, bisphosphonates (for osteoporosis), central nervous system (CNS) depressants and stimulants (such as hexobarbital, amphetamine, and apomorphine), cytotoxic agents, dopamine agonists, dopamine antagonists, drugs with immune effects, HIV/AIDS agents, interferon-gamma, osteoporosis agents, and serotonin receptor antagonists.

Interactions with Herbs and Dietary Supplements

  • Greater celandine has been used traditionally to treat diabetes and 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.

  • Greater celandine may interact with anticancer agents, antidepressant herbs and supplements (specifically monoamine oxidase inhibitors (MAOIs) and selective serotonin reuptake inhibitors (SSRIs)), anti-inflammatories, antiulcer agents, antivirals, biliary pain agents, central nervous system (CNS) agents, dopaminergic agents, herbs and supplements with immune effects, osteoporosis agents, and turmeric.

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. Buzuk GN, Lovkova MI, Sokolova SM, et al. [Genetic aspects of the relationship between isoquinoline alkaloids and mineral elements in greater celandine (Chelidonium majus L.)] Prikl Biokhim Mikrobiol 2003;39(1):37-42. View Abstract
  2. Chitturi S, Farrell GC. Drug-induced cholestasis. Semin Gastrointest Dis 2001;12(2):113-124. View Abstract
  3. Cordes N, Plasswilm L, Bamberg M, et al. Ukrain, an alkaloid thiophosphoric acid derivative of Chelidonium majus L. protects human fibroblasts but not human tumour cells in vitro against ionizing radiation. Int J Radiat Biol 2002;78(1):17-27. View Abstract
  4. Crijns AP, de Smet PA, van den Heuvel M, et al. [Acute hepatitis after use of a herbal preparation with greater celandine (Chelidonium majus)]. Ned Tijdschr Geneeskd 2002;146(3):124-128. View Abstract
  5. Ernst E, Schmidt K. Ukrain – a new cancer cure? A systematic review of randomised clinical trials. BMC Cancer 2005;5(1):69. View Abstract
  6. Etxenagusia MA, Anda M, Gonzalez-Mahave I, et al. Contact dermatitis from Chelidonium majus (greater celandine). Contact Dermatitis 2000;43(1):47. View Abstract
  7. Gebhardt R. Antioxidative, antiproliferative and biochemical effects in HepG2 cells of a homeopathic remedy and its constituent plant tinctures tested separately or in combination Arzneimittelforschung 2003;53(12):823-830. View Abstract
  8. Habermehl D, Kammerer B, Handrick R, et al. Proapoptotic activity of Ukrain is based on Chelidonium majus L. alkaloids and mediated via a mitochondrial death pathway. BMC Cancer 2006;6:14. View Abstract
  9. Iagodina OV, Nikol’skaia EB, and Faddeeva MD [Inhibition of liver mitochondrial monoamine oxidase activity by alkaloids isolated from Chelidonium and Macleaya and by their derivative drugs]. Tsitologiia 2003;45(10):1032-1037. View Abstract
  10. Jang SI, Kim BH, Lee WY, et al. Stylopine from Chelidonium majus inhibits LPS-induced inflammatory mediators in RAW 264.7 cells. Arch Pharm Res 2004;27(9):923-929. View Abstract
  11. Roublevskaia IN, Haake AR, and Polevoda BV. Bcl-2 overexpression protects human keratinocyte cells from Ukrain-induced apoptosis but not from G2/M arrest. Drugs Exp Clin Res 2000;26(5-6):149-156. View Abstract
  12. Roublevskaia IN, Polevoda BV, Ludlow JW, et al. Induced G2/M arrest and apoptosis in human epidermoid carcinoma cell lines by semisynthetic drug Ukrain. Anticancer Res 2000;20(5A):3163-3167. View Abstract
  13. Song JY, Yang HO, Shim JY, et al. Radiation protective effect of an extract from Chelidonium majus. Int J Hematol 2003;78(3):226-232. View Abstract
  14. Spiridonov NA, Konovalov DA, Arkhipov VV. Cytotoxicity of some Russian ethnomedicinal plants and plant compounds. Phytother Res 2005;19(5):428-432. View Abstract
  15. Stickel F, Seitz HK, Hahn EG, et al. [Liver toxicity of drugs of plant origin]. Z Gastroenterol 2001;39(3):225-227. View Abstract

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.