Jin Bu Huan

Woolf GM et al. (1994) Acute hepatitis associated with the Chinese herbal product jin bu huan. Ann Int Med 121(10) 729-735... 

Divinsky M (2002) Case report jin bu huan—not so benign herbal medicine. Can Fam Physician 48 1640-1642... 

Psoralea corylifolia (bakuchi) Azadirachta indica (bead tree) Stephania species (Jin bu huan)... 

Stephanie species (jin bu huan) Menispermaceae Camphor tree Cinnamonum camphora... 

Jin bu huan Stephania species Tobacco Nicotiana tabacum... 

Horowitz RS, Feldhaus K, Dart RC, Stermitz FR, Beck JJ. The clinical spectrum of Jin Bu Huan toxicity. Arch Intern Med 1996 156(8) 899-903. 

Lycopodium serratum (clubmoss, Jin bu huan) has been used in Chinese medicine for more than 1000 years. It contains the alkaloid serratidine and triterpenoids, such as oxolycoclavinol, oxoserratenetriol, tohogeninol, and tohogenol. 

A 49-year-old man developed signs of hepatitis after taking three tablets of Jin bu huan per day for 2 months for insomnia. No other potential causes for the liver... 

Picciotto A, Campo N, Brizzolara R, Giusto R, Guido G, SineUiN, Lapertosa G, Celle G. Chronic hepatitis induced by Jin Bu Huan. J Hepatol 1998 28(l) 165-7. 

Centers for Disease Control and Prevention (CDC). Jin bu huan toxicity in adults—Los Angeles, 1993. MMWR Morb Mortal Wkly Rep 1993 42(47) 920-2. 

Various species of Corydalis (fumewort, Fumariaceae) and Stephania (Jin bu huan) contain tetrahydropalmatine (1), which is the active constituent in Chinese Jin Bu Huan Anodyne tablets, sold on the Western market. The package insert suggested that Polygala chinensis is the source plant, but in reality this alkaloid comes from a species of Stephania. Both 1-tetrahydropalmatine and its racemic dl-form are used in Chinese medicine as analgesic and hypnotic agents. 

The reported adverse effects of Jin bu huan include vertigo, fatigue, nausea and drowsiness, which could make users unfit for driving. Life-threatening bradycardia and respiratory depression occur in small children after unintentional overdosage (4) and acute hepatitis in adults (5). 

Horowitz RS, Gomez H, Moore LL, Fulton B, Feldhaus K, Brent J, Stermitz FR, Beck JJ, Alessi JR, De Smet PAGM Centers for Disease Control and Prevention (CDC). Jin bu huan toxicity in children—Colorado, 1993. MMWR Morb Mortal Wkly Rep 1993 42(33) 633-6. 

Cases of acute hepatitis linked to the use of Jin Bu Huan are less clear, because adulteration with levo-tetrahydropalmatine, an alkaloid present in Stephania and Corydalis, has been implicated (Brent, 1998 Woolf et al., 1994). Similarly, adulteration may be the cause of a fatal case of VOD attributed to skullcap (Scutellaria lateriflora), because this plant does not contain pyrrolizidine alkaloids associated with this syndrome. Nonetheless, in one instance, skullcap was implicated in a case of mild flulike symptoms associated with jaundice and abnormal liver function test results (Enlow, 1996). 

A person s use of alternative medicine must be solicited. Many herbal remedies were once wisely abandoned because of their common adverse reactions. Comfrey tea is a common cause of hepatocellular damage. As in the case of the Chinese remedy jin bu huan, or as in the case of the more elegantly presented chaparral capsules containing grease wood leaves, the end of therapy with these types of agents is occasionally severe disability or death from fulminant hepatic failure." Pennyroyal oil, maragosa oil, and clove oil cause a dose-related hepatotoxicity." ... 

Jin bu huan /-Tetrahydropalmatine Chinese traditional medicine Acute CNS depression and bradycardia chronic hepatitis. 

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