Table 1.
Compilation of reported cases with suspected hepatotoxicity by herbal traditional Chinese medicine (TCM).
| Name with ingredients | Cases (n) | References |
|---|---|---|
| Ai Ye Artemisia argyi | na | Ma et al., 2014 |
| An Shu Ling Lycopodium serratum or, rarely, Corydalis species, Panax ginseng, Pseudo ginseng, or two species of Stephania | 1 | Haller et al., 2002 |
| Bai Fang Angelica sinensis, Cyperus rotundus, Ginseng, Ligusticum wallichii, Paeonia alba, Rehmannia glutinosa | 1 | Estes et al., 2003 |
| Bai Shi Wan Atractylis, Carthamus tinctorius, Dalbergia odorifera, Dioscorea bulbifera, Glycyrrhiza, Lithospermum erythrorhizon, Paeonia suffruticosa, Polygonum multiflorum, Psoralea corylifolia, Salvia miltiorrhiza; Endoconcha sepiae, Ganoderma lucidum (mushroom) | 1 | Talari et al., 2010 |
| Bai Xian Pi Dictamnus dasycarpus | 1 | Perharic-Walton and Murray, 1992 |
| 1 | Kane et al., 1995 | |
| 1 | Vautier and Spiller, 1995 | |
| 2 | Yuen et al., 2006 | |
| 4 | Jang et al., 2008 | |
| 14 | Kang et al., 2008 | |
| 2 | Sohn et al., 2008 | |
| Bi Ma Zi Rhicinus communis | na | Ma et al., 2014 |
| Ban Tu Wan Angelica sinensis, Chaenomeles, Codonopsis pilosula, Notopterygium, Polygonum multiflorum, Rehmannia, Schisandra | 1 | Cortez et al., 2012 |
| Bo He Mentha haplocalyx | ||
| Bo Ye Qing Niu Dan Tinospora crispa | 2 | Sangsuwan et al., 2004 |
| Bofu Tsu Sho San Angelica, Atractylis, Cnidium, Gardenia, Ephedra, Forsythia, Glycyrrhhiza, Gypsum fibrosum, Ledebouriella, Mentha, Paeonia, Platycodon, Rheum, Schizonepeta, Scutellaria, Zingiber; Kadinum (talcum powder), sodium sulfuricum | 1 | Motoyama et al., 2008 |
| Boh Gol Zhee Psoralea corylifolia | 1 | Hwang et al., 2001 |
| 1 | Nam et al., 2005 | |
| 3 | Cheung et al., 2009 | |
| Cang Er Zi Xanthium sibiricum | na | Chau, 2008; |
| na | Ma et al., 2014 | |
| Chang Shan Dichora febrifuga Lour | na | Ma et al., 2014 |
| Chai Hu Bupleurum falcatum | 28 | Lee et al., 2011 |
| Chaso Camellia sinensis, Cassia tora (syn. Senna), Crataegus, Chrysanthenum morifolium Ramat., Lotus, Lycium barbarum; N-nitroso-fenfluramine | 27 | Adachi et al., 2003 |
| Chi R Yun Breynia officinalis | 2 | Lin et al., 2002 |
| 19 | Lin et al., 2003 | |
| Chinese herbal mixtures (various) Dictamnus dasycarpus, Gentiana scabra, Hedyotis diffusa, Paeonia suffructicosa, Paris polyphylla, Rehmannia glutinosa, Smilax glabra, Sophora subprostrata; | 1 | Perharic-Walton and Murray, 1992 |
| Angelica sinensis, Bupleurum chinese, Dictamnus dasycarpus, Paeonia suffructiosa, Philodendron chinese, Saposhnikovia divaricata, Shisandra chinesis, Shizonepeta tenuifolia, Tribulus terrestris; | 2 | Kane et al., 1995 |
| Cocculus trilobus, Dictamnus dasycarpus, Eurysolen gracilis, Glycyrrhiza, Lophatherum, Paeonia, Potentilla, Rehmannia glutinosa; | 1 | Vautier and Spiller, 1995 |
| Alisma plantago aquatica, Artemisia capillaris, Bupleurum, Chrysanthemum morifolium, Circuma, Gardenia jasminoidis, Gentiana scabra, Glycyrrhiza, Magnolia, Paeonia, Plantago asiatica, Saussurea lappa | 1 | Yoshida et al., 1996 |
| Chuan Lian Zi Melia toosendan | 1 | Yuen et al., 2006 |
| Ci Wu Jia Acanthopanax senticosus | 2 | Sohn et al., 2008 |
| Da Chai Hu Tang Bupleurum falcatum, Ginseng, Glycyrrhiza glabra, Pinellia, Scutellaria, Zingiber officinale, Zizyphus jujuba | 1 | Kamiyama et al., 1997 |
| Da Huang Rheum palmatum | 1 | Yuen et al., 2006 |
| Du Huo Angelica archangelica | 1 | Björnsson et al., 2013 |
| Fu Fang Qing Dai Wan Angelica dahurica, Isatis indigotica (Indigo naturalis), Massa medicata fermentata (yeast), Salvia milthiorrhiza, Smilax glabra | 1 | Verucchi et al., 2002 |
| Gan Cao Glycyrrhiza uralensis, syn. Liquorice | 1 | Yuen et al., 2006 |
| Ge Gen Pueraria lobata, syn. Arrowroot | 2 | Kim et al., 2009 |
| He Huan Pi Albizia julibrissin | na | Ma et al., 2014 |
| Ho Shou Wu Polygonum multiflorum, syn. He Shou Wu | 1 | Yuen et al., 2006 |
| na | Ma et al., 2014 | |
| 1 | Bae et al., 2010 | |
| Hu Bohe You Mentha pulegium, syn. Pennyroyal oil | na | Chau, 2008 |
| Hu Zhang Polygonum cuspidatum | na | Chau, 2008 |
| Huang Qin Scutellaria baicalensis | 19 | Gono et al., 2010 |
| 2 | Linnebur et al., 2010 | |
| 1 | Yang et al., 2012a; | |
| 1 | Dhanasekaran et al., 2013 | |
| Huang Yao Zi Dioscorea bulbifera | na | Chau, 2008; |
| na | Ma et al., 2014 | |
| Hwang Geun Cho Corydalis speciosa | 1 | Kang et al., 2009 |
| Ji Gu Cao Abrus cantoniensis | 1 | Yuen et al., 2006 |
| Ji Ji Chloranthus serratus | na | Chau, 2008 |
| Ji Xue Cao Centella asiatica, syn. Gotu Kola | 3 | Jorge and Jorge, 2005 |
| Jiguja Hovenia dulcis | 1 | Sohn et al., 2008 |
| 1 | Kang et al., 2008 | |
| 1 | Kim et al., 2012 | |
| Jin Bu Huan Lycopodium serratum or, rarely, Corydalis species, | 7 | Woolf et al., 1994 |
| Panax ginseng, Pseudo ginseng, or two species of Stephania | 3 | Horowitz et al., 1996 |
| 1 | Picciotti et al., 1998 | |
| 1 | Divinsky, 2002; | |
| 1 | Haller et al., 2002 | |
| Jue Ming Zi Cassia obtusifolia, syn. Senna obtusifolia | 1 | Yuen et al., 2006 |
| Kamishoyosan Angelica sinensis, Atractylodes racea, Bupleurum falcatum, Gardenia, Glycyrrhiza glabra, Mentha haplocalyx, Moutan, Paeonia alba, Sclerotium Poriae Cocos, Zingiber officinale | 1 | Inoue et al., 2011 |
| Kudzu Pueraria thunbergiana | 6 | Kang et al., 2008 |
| Ku Lian Zi Melia azedarach | na | Ma et al., 2014 |
| Lei Gong Teng Tripterygium wilfordii Hook | na | Chau, 2008 |
| na | Ma et al., 2014 | |
| Long Dan Xie Gan Tang Acebia, Alisma, Angelica sinensis, Bupleurum, Gardenia, Gentiana, Glycyrrhiza, Plantago, Rehmannia, Scutellaria | 17 | Lee et al., 2011 |
| Lu Cha Camellia sinensis, syn. Chinese green tea | 1 | Garcia-Moran et al., 2004 |
| 1 | Peyrin-Biroulet et al., 2004 | |
| 1 | Gloro et al., 2005 | |
| 1 | Bonkovsky, 2006 | |
| 1 | Jimenez-Saenz and Martinez-Sanchez, 2006 | |
| 1 | Bonkovsky, 2006 | |
| 1 | Molinari et al., 2006 | |
| 5 | Björnsson and Olsson, 2007 | |
| 3 | García-Cortés et al., 2008 | |
| 34 | Sarma et al., 2008 | |
| 36 | Mazzanti et al., 2009 | |
| 1 | Rohde et al., 2011 | |
| 47 | Navarro et al., 2013 | |
| Ma Huang Ephedra sinica | 1 | Nadir et al., 1996 |
| 1 | Borum, 2001 | |
| 3 | Estes et al., 2003 | |
| 1 | Skoulidis et al., 2005 | |
| 1 | Reuben et al., 2010 | |
| Mao Guo Tian Jie Cai Heliotropium lasiocarpum | 4 | Culvenor et al., 1986 |
| Onshido Aloe, Camellia sinensis, Crataegus, Gynostemma pentaphyllum makino, Raphanus; N-nitroso-fenfluramine | 141 | Adachi et al., 2003 |
| Qian Li Guang Senecio scandens | na | Chau, 2008; |
| na | Ma et al., 2014 | |
| Ren Shen Panax ginseng | 6 | Kang et al., 2008 |
| Sairei To Alisma, Atractylis, Bupleurum, Cinnamomum, Ginseng, Glycyrrhiza, | 1 | Aiba et al., 2007 |
| Pinellia, Polyporus, Poria, Scutellaria, Zingiber, Zizyphus | 1 | Tsuda et al., 2010 |
| Shang Lu Phytolacca acinosa | na | Ma et al., 2014 |
| Shen Min Black cohosh, Burdock, Cayenne pepper, Ginkgo biloba, Horse chestnut, Piper nigrum, Polygonum multiflorum, uva ursi; biotin, collagen (hydrolyzed), niacin, pantothenic acid, silica (from plant sources), soy isoflavones, vitamin A, vitamin B6 | 1 | Cárdenas et al., 2006 |
| Shi Can Teucrium chamaedrys, syn. Germander | na | Chau, 2008 |
| Shi Liu Pi Pericarpium granati | na | Chau, 2008 |
| Shou Wu Pian Achyranthes bidentata, Cuscuta chinensis, Eclipta prostrata, | 1 | But et al., 1996 |
| Ligustrum lucidum, Lonicera japonica, Morus alba, Polygonum multiflorum, | 1 | Park et al., 2001 |
| Psoralea corylifolia, Rehmannia glutinosa, Rosa laevigata, Sesemum indicum, | 1 | Battinelli et al., 2004 |
| Siegesbeckia orientalis | 1 | Panis et al., 2005 |
| 3 | Sohn et al., 2008 | |
| 1 | Laird et al., 2008 | |
| 1 | Furukawa et al., 2010 | |
| 1 | Valente et al., 2010 | |
| 25 | Jung et al., 2011 | |
| 1 | Banarova et al., 2012 | |
| Tian Hua Fen Trichosanthes kirilowii | na | Chau, 2008 |
| Tu San Qi Gynura segetum | 2 | Dai et al., 2006 |
| 1 | Chen et al., 2007 | |
| 1 | Li et al., 2010 | |
| 52 | Lin et al., 2011; | |
| 116 | Gao et al., 2012 | |
| White flood Qian Ceng Ta (Huperzia serrata), Wu Zhu Yu (Evodia rutaecarpa); beet root, caffein, cocoa bean, vinpocetine (from Vinca plant); acesulfame potassium, calcium silicate, carnitine tartrate, Carno-Syn® beta-alanine, citrulline, cryptoxanthin, folic acid, gamma-aminobutyric acid (GABA), glucuronolactone, selenium, L-norvaline, L-tyrosine, lutein, malic acid, ornithine, potassium gluconate, sucralose, sugar cane, watermelon flavor, zeaxanthin | 1 | Cohen et al., 2012 |
| Wu Bei Zi Galla chinensis | na | Chau, 2008 |
| Xi Shu Camptotheca acuminata | na | Chau, 2008 |
| Xian Si Zi Abrus Precatorius | na | Ma et al., 2014 |
| Xiao Chai Hu Tang Bupleurum falcatum, Ginseng, Glycyrrhiza glabra, | 4 | Itoh et al., 1995 |
| Pinellia tuber, Scutellaria baicalensis, Zingiber officinale, Zizyphus jujuba | 19 | Lee et al., 2011 |
| 1 | Hsu et al., 2006 | |
| Yin Chen Hao Artemisia capillaris | 7 | Kang et al., 2008 |
| 1 | Sohn et al., 2008 | |
| Zexie Alisma orientalis | 1 | Yuen et al., 2006 |
| Zhen Chu Cao Phyllanthus urinaria | 1 | Yuen et al., 2006 |
Data represent an update of cases retrieved from a selective literature search for published cases of herbal TCM associated with suspected hepatotoxicity (Teschke, 2014; Teschke et al., 2014c, 2015b) and of a recent compilation most common Chinese herbal medicines with hepatotoxicity (Ma et al., 2014). In some cases, causality for individual herbs and herbal mixtures was established using the CIOMS (Council for International Organizations of Medical Sciences) scale or its modifications, and by positive reexposure test results. For other cases, information was fragmentary and did not necessarily allow a firm causal attribution.