Sho-saiko-to
Sho-saiko-to
This information describes the common uses of Sho-saiko-to, how it works, and its possible side effects.

Common Name

Xiao-chai-hu-tang, Xiaochaihutang, XCHT, Minor bupleurum decoction

How It Works

Sho-saiko-to may have liver-protective effects in some circumstances, but it may also cause serious lung or liver problems. Therefore, Sho-saiko-to should only be used in limited situations under the supervision of a doctor.

Sho-saiko-to or “Xiao Chai Hu Tang” is a plant formula that is a mixture of 7 botanicals: Bupleurum root (Chai hu), Pinellia tuber (Ban xia), Scutellaria root (Huang qin), Ginseng (Ren shen), Jujube (da zao), Licorice (Gan cao), and Ginger (Sheng jiang). It is used in both China and Japan as traditional medicine to treat fever, gastrointestinal disorders, chronic liver diseases, and inflammatory conditions.

In laboratory and animal studies, Sho-saiko-to appears to prevent liver injury, reduce inflammation, and stimulate or enhance immune functioning. However, only a few clinical trials have been conducted in humans. These studies suggest it may be helpful for some types of patients with hepatitis, but studies to confirm this are needed. In addition, there have been cases of serious lung or liver problems with the use of Sho-saiko-to. Therefore, it should only be used under the supervision of a qualified practitioner.

Purported Uses

  • To prevent and treat cancer
    The prescribing information for Sho-saiko-to does not recommend its use in patients with liver cancer due to risks for interstitial pneumonia, a serious and potentially life-threatening condition.
  • To treat some liver diseases
    A few studies suggest it may improve liver pathology in some patients with hepatitis. However, there are also reports of serious lung and liver problems with the use of Sho-saiko-to. Therefore, it should only be used in limited situations under close supervision by a qualified practitioner.
  • To reduce fevers or treat infections
    Although used for these purposes in traditional medicine, human studies are lacking.
  • To treat gastrointestinal disorders
    Although used for these purposes in traditional medicine, human studies are lacking.

Patient Warnings

  • Discontinue product and contact physician immediately if fever, cough, or difficulty and/or labored breathing occurs.

  • Sho-saiko-to may cause a serious lung condition called interstitial pneumonitis, which can be potentially fatal. Use of interferon or low platelet counts may increase this risk.

Do Not Take If

  • You are pregnant or nursing.
  • You are currently undergoing interferon treatment: Using Sho-saiko-to at the same time can increase the risk of interstitial pneumonitis, a potentially fatal condition.
  • You have liver cancer or cirrhosis: Interstitial pneumonia may occur and cause death if not treated in its early stages.
  • You have chronic hepatitis and low platelet counts.
  • You are taking drugs metabolized by Cytochrome P450 enzymes: Lab and animal studies show that Sho-saiko-to can affect the blood concentrations of these drugs. One study in healthy humans also suggests it may interact with some drugs. Although clinical relevance has yet to be determined, patients should not use Sho-saiko-to without close supervision of a qualified practitioner.
  • You are taking tolbutamide: In an animal study, Sho-saiko-to reduces the bioavailability of this drug. Although clinical relevance has yet to be determined, patients should not use Sho-saiko-to without close supervision of a qualified practitioner.

Side Effects

  • Rash with fever, anorexia, nausea, diarrhea, or cystitis
  • Lung scarring or inflammation
  • Liver injuries and hepatitis

Case reports

Recurrent drug-induced liver injury: In a 67-year-old woman who received shosaikoto and saikokeishikankyoto extracts among other drugs on two separate occasions. Her condition improved after the discontinuation of all medications. Scutellariae radix as a component of both extracts were the suspected cause.

Liver injuries and hepatitis: Various cases associated with Sho-saiko-to.