Huanglian

Purported Benefits, Side Effects & More
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Huanglian

Common Names

  • Goldthread
  • Chinese coptis
  • Coptis deltoidea
  • Coptis teetoides

For Patients & Caregivers

Tell your healthcare providers about any dietary supplements you’re taking, such as herbs, vitamins, minerals, and natural or home remedies. This will help them manage your care and keep you safe.


How It Works

Data are lacking on whether huanglian can help prevent or treat cancer.

Derived from the rhizome of the perennial herb Coptis chinensis, huanglian is used in traditional Chinese medicine for diarrhea, vomiting, abdominal fullness, jaundice, high fever, toothache, diabetes, and eczema.

Preclinical studies suggest antimicrobial, antidiabetic, antioxidant, anti-inflammatory, and anticancer effects. Alkaloids that include berberine are considered to be the active components.

Studies in humans are quite limited. Preliminary data suggest huanglian and berberine may lower blood sugar levels. Well-designed clinical trials are needed.

Purported Uses and Benefits
  • To treat infections
    Lab studies suggest that berberine, a compound in huanglian, stops the growth of bacteria. Human data are lacking.
  • To treat diarrhea and other GI symptoms
    Lab studies support this claim, but clinical data are lacking.
  • To lower high blood pressure
    Lab studies support this claim, but human data are needed.
Do Not Take If
  • You are taking CYP450 substrate drugs: Huanglian may increase the risk of side effects from these drugs. However, another study suggests huanglian can also induce CYP3A4, which may decrease the concentration of drugs metabolized by this enzyme. Clinical significance is not known.
Special Point
  • Huanglian displaces bilirubin and should not be administered to jaundiced neonates.
  • Berberine-containing botanicals may prolong QTc in patients with underlying heart disease.
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For Healthcare Professionals

Scientific Name
Coptis chinensis
Clinical Summary

Derived from the rhizome of the perennial herb Coptis chinensis, huanglian is used in traditional Chinese medicine for diarrhea, vomiting, abdominal fullness, jaundice, high fever, toothache, diabetes, and eczema.

Preclinical studies suggest antimicrobial, antidiabetic, antioxidant, hepatoprotective, anti-inflammatory, and anticancer effects (3) (5) (6) (9) (10) (14) (16) (19) (20). Alkaloids that include berberine are considered to be the bioactive components (1). Jatrorrhizine, a protoberberine, offset postoperative ileus-induced delayed gastric emptying and intestinal transit in mice (15).

Studies in humans are quite limited. Preliminary data suggest huanglian and berberine exert antihyperglycemic activity, but well-designed trials are lacking (17) (18). A meta-analysis of Huanglian Jiedu decoction for type 2 diabetes also cites low quality evidence and high risk of bias (21).

Purported Uses and Benefits
  • Infections
  • Diarrhea
  • Hypertension
Mechanism of Action

Potential biological effects of huanglian are attributed to berberine and berberine-like alkaloids. Berberine inhibits human hep-62 hepatoma cell growth via morphological changes and internucleosomal DNA fragmentation (3). Berberine also inhibits platelet aggregation and can antagonize thromboxane B2. In an animal model, it caused potassium channel blockade resulting in prolonged action potential in ventricular monocytes (1).

Huanglian inhibits topoisomerase I and is thought to suppress cyclin B1 protein expression, causing cancer cell arrest at the G2 phase (2). In other studies, it demonstrated antiangiogenic activity (6), induced apoptosis, and arrested cell growth by upregulating IFN-β and TNF-α in breast cancer cells (7).

Contraindications
  • Huanglian displaces bilirubin and should not be administered to jaundiced neonates.
  • Berberine-containing botanicals may prolong QTc in patients with underlying heart disease (4).
Herb-Drug Interactions
  • CYP450 substrates: Huanglian inhibits 2D6, 2C9, and 3A4 (11) (13), and may affect drugs metabolized by these enzymes. Prolonged use of huanglian can also induce 3A4 by activating pregnane X receptor (12). Clinical significance is not known.
Dosage (OneMSK Only)
References
  1. Huang KC. The Pharmacology of Chinese Herbs, 2nd ed. New York: CRC Press; 1999.
  2. Kobayashi Y, et al. Inhibitors of DNA topoisomerase I and II isolated from the Coptis rhizomes. Planta Med 1995;61:414-8.
  3. Lin HL, et al. Up-regulation of multidrug resistance transporter expression by berberine in human and murine hepatoma cells. Cancer 1999;85:1937-42.
  4. Brinker F. Herb Contraindications and Drug Interactions, 3rd ed. Sandy (OR): Eclectic Medical Publications; 2001.
  5. Li XK, et al. Huanglian, A Chinese herbal extract, inhibits cell growth by suppressing the expression of cyclin B1 and inhibiting CDC2 kinase activity in human cancer cells. Mol Pharmacol 2000;58:1287-93.
  6. Wang S, et al. Angiogenesis and anti-angiogenesis activity of Chinese medicinal herbal extracts. Life Sci. 2004 Apr 2;74(20):2467-78.
  7. Kang JX, Liu J, Wang J, et al. The extract of huanglian, a medicinal herb, induces cell growth arrest and apoptosis by upregulation of interferon-beta and TNF-alpha in human breast cancer cells. Carcinogenesis 2005;26(11):1934-9.
  8. Auyeung KK, Ko JK. Coptis chinensis inhibits hepatocellular carcinoma cell growth through nonsteroidal anti-inflammatory drug-activated gene activation. Int J Mol Med. 2009 Oct;24(4):571-7.
  9. Feng Y, Siu KY, Ye X, et al. Hepatoprotective effects of berberine on carbon tetrachloride-induced acute hepatotoxicity in rats. Chin Med. 2010 Sep 18;5:33.
  10. Xia X, Yan J, Shen Y, et al. Berberine improves glucose metabolism in diabetic rats by inhibition of hepatic gluconeogenesis. PLoS One. 2011 Feb 3;6(2):e16556.
  11. Han YL, Yu HL, Li D, et al. In Vitro Inhibition of Huanglian [Rhizoma coptidis (L.)] and its Six Active Alkaloids on Six Cytochrome P450 Isoforms in Human Liver Microsomes. Phytother Res.  2011 Nov;25(11):1660-5.
  12. Yu C, Chai X, Yu L, Chen S, Zeng S. Identification of novel pregnane X receptor activators from traditional Chinese medicines. J Ethnopharmacol. 2011 Jun 14;136(1):137-43.
  13. Guo Y, Chen Y, Tan ZR, et al. Repeated administration of berberine inhibits cytochromes P450 in humans. Eur J Clin Pharmacol. 2012 Feb;68(2):213-7.
  14. Zhang Q, Piao XL, Piao XS, Lu T, Wang D, Kim SW. Preventive effect of Coptis chinensis and berberine on intestinal injury in rats challenged with lipopolysaccharides. Food Chem Toxicol. 2011 Jan;49(1):61-9.
  15. Zhang B, Cao A, Zhou J, Hu Z, Wu D.Effect of jatrorrhizine on delayed gastrointestinal transit in rat postoperative ileus. J Pharm Pharmacol. 2012 Mar;64(3):413-9.
  16. Wang J, Wang L, Lou GH, et al. Coptidis Rhizoma: a comprehensive review of its traditional uses, botany, phytochemistry, pharmacology and toxicology. Pharm Biol. 2019 Dec;57(1):193-225.
  17. Wang H, Mu W, Shang H, Lin J, Lei X. The antihyperglycemic effects of Rhizoma Coptidis and mechanism of actions: a review of systematic reviews and pharmacological research. Biomed Res Int. 2014;2014:798093.
  18. Dong H, Wang N, Zhao L, Lu F. Berberine in the treatment of type 2 diabetes mellitus: a systemic review and meta-analysis. Evid Based Complement Alternat Med. 2012;2012:591654.
  19. Wang N, Tan HY, Li L, Yuen MF, Feng Y. Berberine and Coptidis Rhizoma as potential anticancer agents: Recent updates and future perspectives. J Ethnopharmacol. 2015 Dec 24;176:35-48.
  20. Liu Y, Hua W, Li Y, et al. Berberine suppresses colon cancer cell proliferation by inhibiting the SCAP/SREBP-1 signaling pathway-mediated lipogenesis. Biochem Pharmacol. 2019 Dec 23;174:113776.
  21. Hu Z, Yang M, Liu Y, et al. Effect of Huang-Lian Jie-Du Decoction on Glucose and Lipid Metabolism in Type 2 Diabetes Mellitus: A Systematic Review and Meta-Analysis. Front Pharmacol. 2021;12:648861.
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