Traditionally used for
- Headaches
- Dizziness
- Digestion
- Mood & calm
- Nerves & recovery
- Blood pressure
- Skin
Cautions & contraindications
- Liver conditions
- Diabetes
- Toxic — professional use only
☯ TCM Properties
Calms the Shen and soothes the nerves; Clears Heat, resolves toxicity, cools the Blood and subdues hyperactivity of Liver Yang and lowers blood pressure
Traditional Chinese Uses
Chang Chun Hua is the Madagascar periwinkle, Catharanthus roseus. Bitter and cool, entering the Liver and Kidney channels, it clears Heat and resolves toxicity, cools the Blood, and subdues hyperactive Liver Yang. In folk and modern Chinese practice it is used to settle the Shen and calm the nerves, and especially to pacify rising Liver Yang presenting as dizziness, headache and hypertension; it is also applied to Heat-toxin sores and, notably, to diabetes ("wasting-thirst") and to leukemia and other malignancies.
The plant is the botanical source of the anticancer alkaloids vinblastine and vincristine and is considered toxic. Adverse effects include bone-marrow suppression, hair loss, abdominal pain, nausea and peripheral numbness; it is contraindicated where marrow function is already deficient and should only be used under qualified supervision, not as a home remedy.
Relationships
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Botanical Description
Chang Chun Hua is the Madagascar periwinkle, Catharanthus roseus (L.) G.Don (Apocynaceae), a perennial herb or subshrub 30-100 cm tall, originally native to Madagascar and widely naturalized throughout tropical and subtropical Asia, including southern China. Stems are erect, slightly woody at the base, exuding white latex when broken. The opposite, oblong-obovate leaves are glossy dark green, 3-9 cm long, with a short petiole and prominent midrib. Solitary or paired axillary flowers display a salverform corolla 3-4 cm across with five pink, rose-purple, or white petals around a darker eye. Slender paired follicles 2-4 cm long contain numerous small black seeds. The plant accumulates over 70 indole alkaloids, including vinblastine and vincristine, which became cornerstone anticancer drugs in modern oncology. The whole plant is highly toxic if ingested.
Active Constituents
Vincristine
Bisindole (dimeric terpenoid indole) alkaloidBinds the beta-subunit of tubulin and prevents microtubule propagation, causing mitotic arrest. As a purified drug given intravenously it is a mainstay of leukaemia and lymphoma treatment; in the plant it is a trace constituent, far less abundant than the monomeric precursors, which is why the commercial drug is semisynthesised from catharanthine and vindoline rather than extracted directly. Its dose-limiting toxicity is peripheral neuropathy, and intrathecal administration is uniformly fatal.
Vinblastine
Bisindole (dimeric terpenoid indole) alkaloidThe second dimeric alkaloid of the plant and, like vincristine, a tubulin-binding antimitotic given intravenously under oncology supervision. Also a trace constituent of field-grown material; the shortages that periodically affect both drugs are a direct consequence of how little the plant makes.
Catharanthine
Monoterpenoid indole alkaloid (iboga type)One of the two most abundant alkaloids in leaf and cell culture. It is the coupling partner with vindoline in the semisynthesis of vinblastine and vincristine, so its abundance, not that of the dimers, is what makes the plant a commercial drug source.
Vindoline
Monoterpenoid indole alkaloid (aspidosperma type)Consistently the other most abundant alkaloid alongside catharanthine, and the second half of the semisynthetic route to the dimeric anticancer drugs.
Ajmalicine (raubasine)
Monoterpenoid indole alkaloid (heteroyohimbine type)An antihypertensive alkaloid produced by the plant and by its cell cultures. It is the most plausible chemical basis for the traditional claim that the herb lowers blood pressure, though no controlled human study of the whole herb supports that use.
Tabersonine
Monoterpenoid indole alkaloidOne of the six alkaloids routinely quantified in C. roseus shoot material along with vindoline, vincristine, vinblastine, catharanthine and ajmalicine; a biosynthetic precursor in the vindoline branch of the pathway.
Akuammicine, perivine, vindorosine and 19R-vindolinine
Monoterpenoid indole alkaloidFour of the major concentrated indole alkaloids isolated from C. roseus leaves by countercurrent chromatography and fully elucidated by NMR. The plant makes on the order of 130 terpenoid indole alkaloids in total, so a crude preparation is a complex and poorly characterised alkaloid mixture rather than a defined drug.
⚠ Drug Interactions
Azole antifungals (itraconazole, voriconazole, posaconazole, ketoconazole, fluconazole) with vincristine or vinblastine
All vinca alkaloids are cleared by CYP3A and are P-glycoprotein substrates. Azoles inhibit both, so vinca exposure rises. In adults with acute lymphoblastic leukaemia receiving itraconazole prophylaxis, unusually severe and unusually early vincristine neurotoxicity appeared after only the first or second injection, including paraesthesia, limb weakness and paralytic ileus.
Clinical note: This is an interaction of the purified intravenous drugs, managed by the oncology team, not of the herb. Azole prophylaxis should be avoided or substituted while vincristine is being given.
Purified vincristine and vinblastine given intravenously (substitution hazard)
The clinical literature on this species is about isolated alkaloids given intravenously at measured doses under oncology supervision, not about the herb. A crude decoction delivers around 130 uncharacterised terpenoid indole alkaloids in unknown proportion, and drinking it has caused documented harm: a woman who boiled about 14 g daily for eight days developed fever, abdominal pain, jaundice with bilirubin 3.8 mg/dL, AST 237 and ALT 519, two active gastric ulcers and lower-limb numbness, recovering only after she stopped the plant. There is no dose of the herb that reproduces a chemotherapy regimen, and no evidence it treats cancer.
Clinical note: Do not offer this herb as a natural version of vinca chemotherapy, and ask oncology patients whether they are taking it. Numbness, jaundice or transaminase rise in someone drinking the plant should prompt stopping it.
Insulin, sulfonylureas and other antidiabetic drugs
An extract of C. roseus altered enzyme activity and lowered glucose in streptozotocin-diabetic rats, which is the pharmacological basis for the plant's widespread folk use in diabetes. This has not been reproduced in a controlled human study, so the size of any effect in a patient on hypoglycaemic drugs is unknown.
Clinical note: If a patient is already taking the herb for diabetes, monitor glucose rather than assuming no effect, and remember the hepatotoxicity risk of prolonged self-dosing.
Hepatotoxic drugs and alcohol
In the only well-documented human case, eight days of home-prepared C. roseus juice produced jaundice, hyperbilirubinaemia and transaminases in the hundreds, with imaging excluding common bile duct stones and blood cultures negative; the Naranjo score was 6, probable. Liver function normalised a week after discharge. Adding another hepatotoxin to that picture has an obvious direction of effect even though it has not been formally studied.
Clinical note: Check liver function if the herb is being taken internally at all, and stop it at the first sign of jaundice or transaminase rise.
Evidence Tier
Strong evidence · 4 studiesRecorded studies by study design, strongest design at the top. This is a study-design tier only, not a GRADE rating: it does not weigh risk of bias, consistency or precision.
Systematic review / meta-analysis
1
1 verified · 0 unverified
Randomized controlled trial
0
Other clinical trial
0
Observational / case report
2
2 verified · 0 unverified
In vitro / animal
1
1 verified · 0 unverified
Other / unclassified
0
Verified: design read from PubMed for a DOI that resolves to the cited paper Unverified: taken from the study's recorded description
Clinical Studies
Catharanthus roseus intoxication mimicking acute cholangitis
A 65-year-old woman drank C. roseus juice as a home remedy for neck pain, boiling about 14 g daily for eight consecutive days. She presented with abdominal pain, fever, anorexia, lower-limb numbness and icteric sclera, with leukocytosis, AST 237, ALT 519 and total bilirubin 3.8 mg/dL, and two active gastric ulcers on endoscopy. CT and MRCP excluded choledocholithiasis and blood cultures were sterile. She recovered within eight days of stopping the plant, with liver function normal a week after discharge; Naranjo score 6 (probable). A single case report, but the only reasonably worked-up human account of whole-plant toxicity.
Aggravation of vincristine-induced neurotoxicity by itraconazole in the treatment of adult ALL
Adults with acute lymphoblastic leukaemia receiving itraconazole antifungal prophylaxis alongside vincristine developed unusually severe and unusually early neurotoxicity, with paraesthesia and muscle weakness of the extremities and paralytic ileus after the first or second vincristine injection. The report concerns the purified drug in a hospital setting, not the plant.
Aspects of vincristine-induced neuropathy in hematologic malignancies: a systematic review
A systematic review of vincristine-induced peripheral neuropathy in haematological malignancy, covering incidence, risk factors including CYP3A-mediated interactions, and management. It is the best summary of the dose-limiting toxicity of the isolated alkaloid, and applies to the intravenous drug rather than to any preparation of the herb.
Effect of an antidiabetic extract of Catharanthus roseus on enzymic activities in streptozotocin induced diabetic rats
An extract of C. roseus was given to streptozotocin-diabetic rats and changes in metabolic enzyme activity accompanying its glucose-lowering effect were measured. This rodent study is the usual citation behind the plant's folk use in diabetes; it is not a human trial and gives no guidance on dose or safety in people.
References
- M. Yahyazadeh; D. Selmar; G. Jerz. Electrospray-Mass Spectrometry-Guided Targeted Isolation of Indole Alkaloids from Leaves of Catharanthus roseus by Using High-Performance Countercurrent Chromatography . Molecules (2025) [DOI]
This information is for educational purposes only and is not intended to replace professional medical advice. Always consult a qualified healthcare provider before using any herbal remedy, especially if you are pregnant, nursing, or taking medications.
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