Che Qian Cao
StarPlantago asiatica L.
Traditionally used for
- Cough & breathing
- Urinary & fluids
- Skin
Cautions & contraindications
- Kidney conditions
☯ TCM Properties
Clears Heat and Promotes Urination to Relieve Stranguria; Expels Phlegm; Cools the Blood; Resolves Toxicity; Stops Bleeding
Traditional Chinese Uses
Che Qian Cao (plantain herb, the whole plant) is a cool herb that clears Heat and promotes urination, making it useful for urinary tract infections, difficult or painful urination, and edema from Damp-Heat. Its Blood-cooling properties stop minor bleeding from Heat, and topically it is applied for inflammatory skin conditions, insect bites, and boils. It is similar in action to the seed (Che Qian Zi) but slightly broader in its range of effects, including mild anti-inflammatory action for skin conditions.
Western Herbalism Properties
Pharmacological Effects
- Expectorant and antitussive: Oral decoction increased tracheal secretion in anesthetized cats, peaking 3-6 h and lasting 6-7 h; plantagin increased bronchial mucus and depressed the respiratory center.
- Antimicrobial: 1:4 aqueous extract inhibited Trichophyton concentricum, Microsporum lanosum and Nocardia asteroides; S. aureus highly, Shigella sonnei moderately and E. coli, P. aeruginosa, S. typhi slightly sensitive; ethanolic extract killed leptospira at 15 mg/ml.
Source: Zhu YP. Chinese Materia Medica: Chemistry, Pharmacology and Applications. Harwood Academic, 1998, p. 323.
Relationships
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Botanical Description
Plantago asiatica is a low-growing perennial rosette herb in the Plantaginaceae family, native to East Asia and widespread across China, Japan, Korea, and the Russian Far East in moist grasslands, roadsides, and disturbed ground. From a short fibrous-rooted crown emerges a basal rosette of ovate to broadly elliptic, long-petioled leaves 4-15 cm long, with 5-7 prominent parallel veins and an entire to slightly wavy margin. Slender erect leafless flowering scapes 10-30 cm tall bear narrow cylindrical spikes of tiny inconspicuous greenish-white wind-pollinated flowers from late spring through autumn. The fruit is a small two-celled pyxis (a capsule that opens by a lid) containing 4-9 minute dark-brown seeds that become mucilaginous when wet. It closely resembles, and is often confused with, the European Plantago major.
Active Constituents
Plantamajoside
Phenylethanoid glycosideConcentration: The most abundant of at least eight compounds detected by RP-HPLC and Q-TOF-MS in an ethanol extract of the aerial parts
The characteristic phenylethanoid of the aerial parts and the compound most often used to distinguish the herb chemically from other Plantago material. It is anti-inflammatory and antioxidant in cell and rodent models, and is extensively metabolised by gut microbiota, which complicates any attempt to read plasma levels off the dose given.
Acteoside (verbascoside)
Phenylethanoid glycosideConcentration: Second most abundant constituent of the ethanol extract of the aerial parts
A widely distributed phenylethanoid that contributes to the herb's anti-inflammatory and renoprotective effects. In transporter-transfected cell work it is a substrate of MATE1 and inhibited MATE1-mediated transport by about 47% at 30 micromolar, which is the most concrete mechanistic basis for a renal drug interaction with this plant.
Cymaroside (luteolin 7-O-glucoside)
Flavone glycosideConcentration: Third most abundant constituent of the ethanol extract of the aerial parts
The main flavonoid carrier of luteolin in the herb. Luteolin released from it bound HIF-1alpha with good affinity in the adriamycin nephropathy work and was identified there as a principal active ingredient, so this glycoside is a plausible source of the herb's kidney-protective activity in animals.
Geniposidic acid
Iridoid glycosideConcentration: A routine marker compound for Plantago material; the herb and the seed both contain it
One of the iridoid markers used in quality control of Plantago drugs. In transporter-transfected cells it was not a substrate of the transporters tested but did inhibit MATE1-mediated transport by about 31% at 30 micromolar.
Aucubin
Iridoid glycosideConcentration: Present throughout the aerial parts; content varies with growth stage and site
The classical iridoid of the genus, associated with hepatoprotective and anti-inflammatory activity in preclinical work across Plantago species. Aucubin is unstable and readily hydrolysed, so its content depends heavily on how the herb was dried and stored.
⚠ Drug Interactions
Digoxin and digitoxin (through Digitalis lanata contamination of plantain material)
This is a contamination hazard specific to Plantago leaf, not a pharmacological property of the plant. In 1997 the US FDA traced digitalis toxicity in a young woman to bulk raw material labelled plantain leaf that was in fact Digitalis lanata; the mislabelled material had been distributed into dietary supplements for roughly two years, and the investigation was published by Slifman and colleagues in 1998. Cardiac glycosides were confirmed in the raw material by chromatography and mass spectrometry and the species by microscopy. Plantago itself contains no cardiac glycosides.
Clinical note: Buy Che Qian Cao only from suppliers who perform botanical identity testing on leaf material, and treat unverified bulk plantain leaf as unsafe. In any patient on digoxin, contaminated material would be additive to a drug with a narrow therapeutic index. New nausea, visual disturbance, bradycardia or arrhythmia after starting a plantain-containing product warrants a digoxin level and stopping the herb.
Metformin, cimetidine and other OCT2/MATE1 substrates
In transporter gene-transfected MDCK cells, plantagoamidinic acid A from Plantago asiatica was a substrate of OCT1, OCT2 and MATE1 and inhibited OCT2 and MATE1; against berberine as substrate, 10 micromolar plantagoamidinic acid A inhibited OCT2 by 53.6% and MATE1 by 31.5%, while 30 micromolar acteoside and geniposidic acid inhibited MATE1 by 47.0% and 31.0% (Zhang et al. 2023). OCT2 and MATE1 are the main route of renal secretion for metformin. Note the study used the seed, Che Qian Zi; acteoside and geniposidic acid are shared with the aerial parts but the quantitative profile of the herb differs.
Clinical note: Reasonable to co-prescribe, but if a patient on metformin starts a substantial daily dose of this herb, check renal function and watch for gastrointestinal intolerance or, rarely, lactic acidosis risk factors. The same caution applies to the traditional Che Qian Cao plus Huang Lian pairing, where the interaction was actually characterised.
Plantago depressa or Plantago major substituted for Plantago asiatica
The Chinese Pharmacopoeia accepts the dried whole plant of both Plantago asiatica L. and Plantago depressa Willd. as Plantaginis Herba, and the two are not chemically identical: HPLC fingerprinting with chemometrics is needed to separate them (Liu et al. 2025). Plantago major, the European plantain, shares many constituents and much of the folk indication set but is not an official source of this drug and is the species implicated in the Digitalis contamination incident.
Clinical note: Either official species is acceptable for practice, but the record should say which was supplied. Do not substitute European Plantago major leaf, sold as plantain, for pharmacopoeial Che Qian Cao without identity testing.
Urate-lowering therapy (allopurinol, febuxostat, benzbromarone, probenecid)
Plantago asiatica extract lowered serum uric acid by roughly 70% versus model animals in a hypoxanthine and potassium oxonate mouse model, by enriching Lachnospiraceae, promoting intestinal urate catabolism, altering intestinal and renal urate transporter expression and suppressing renal NLRP3 activation (Ou et al. 2026, animal). Separately, an ethanol extract reduced joint swelling and inflammatory cytokines in a rat monosodium urate gout model with effects comparable to colchicine. Transporter-level effects overlap with the mechanism of uricosuric drugs, but no human study exists.
Clinical note: Do not stop urate-lowering drugs in favour of the herb. If both are used, monitor serum urate as usual and be aware that mobilising urate can precipitate an acute flare early in treatment.
Doxorubicin (adriamycin)
Plantaginis Herba reduced BUN, serum creatinine, albuminuria and KIM-1 and limited podocyte injury in rats with adriamycin-induced nephropathy, acting through HIF-1alpha-linked mitochondrial apoptosis pathways, with luteolin identified as an active constituent (Zhang et al. 2025, animal). Whether the same antiapoptotic activity would blunt doxorubicin's cytotoxicity against tumour tissue has not been tested.
Clinical note: Do not add this herb during anthracycline chemotherapy on the strength of a nephroprotection model. Any concurrent use should be discussed with the treating oncologist.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction | 9–30 g | Daily | — | — | 中国药典 2020 【用法与用量】9～30g。 【性味与归经】甘，寒。归肝、肾、肺、小肠经。 — Chinese Pharmacopoeia 2020, quoted verbatim; route and cautions preserved. Replaces a cleared category-filler value. |
Evidence Tier
Moderate evidence · 6 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
0
Randomized controlled trial
0
Other clinical trial
0
Observational / case report
1
1 verified · 0 unverified
In vitro / animal
5
3 verified · 2 unverified
Show 5 studies
- Plantaginis Herba attenuates adriamycin-induced nephropathy: Molecular mechanism insights by integrated transcriptomic and experimental validation
- Plantago asiatica L. extract alleviates hyperuricemia-associated renal injury by modulating gut microbiota to inhibit NLRP3 inflammasome activation
- Anti-inflammatory effect of Plantago asiatica crude extract in rat gout arthritis model
- Study on herb-herb interaction between active components of Plantago asiatica L. seed and Coptis chinensis Franch. rhizoma based on transporters using UHPLC-MS/MS
- Chemical Fingerprints Combined with Chemometric Analysis to Evaluate and Distinguish Between Plantago Asiatica L. and Plantago Depressa Willd
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
Contamination of Botanical Dietary Supplements by Digitalis lanata
The US FDA investigation of a case of digitalis toxicity traced to a botanical supplement, in which bulk material sold as plantain leaf was found to be Digitalis lanata. Analytical work confirmed cardiac glycosides in the raw material and identified the species; the mislabelled lot had been in distribution for about two years. This is the reference case for why leaf material of Plantago must be identity-tested rather than accepted on the label.
Plantaginis Herba attenuates adriamycin-induced nephropathy: Molecular mechanism insights by integrated transcriptomic and experimental validation
Plantaginis Herba, the whole-plant drug rather than the seed, lowered BUN, serum creatinine, microalbuminuria and KIM-1 in rats with adriamycin nephropathy, reduced podocyte foot-process fusion and basement-membrane thickening, and limited collagen deposition and oxidative stress. Transcriptomic and network analysis implicated HIF-1, TGF-beta and PI3K/AKT signalling, and luteolin from the herb bound HIF-1alpha with good affinity. Rodent and cell work only.
Plantago asiatica L. extract alleviates hyperuricemia-associated renal injury by modulating gut microbiota to inhibit NLRP3 inflammasome activation
In mice made hyperuricaemic with hypoxanthine and potassium oxonate, P. asiatica extract cut serum uric acid by about 70% versus model animals, changed intestinal and renal urate transporter expression, reshaped the gut microbiota and suppressed renal NLRP3 inflammasome activation. Faecal microbiota transplantation and Lachnospiraceae supplementation confirmed the microbiota as the mediating step. An animal model; no human hyperuricaemia trial of this herb.
Anti-inflammatory effect of Plantago asiatica crude extract in rat gout arthritis model
An ethanol extract of P. asiatica, whose most abundant constituents by RP-HPLC were plantamajoside, verbascoside and cymaroside, was given orally at 1 g/kg to Wistar rats with monosodium urate-induced gouty arthritis. It reversed joint-space narrowing and ankle swelling and normalised IL-1beta, IL-17a, TNF-alpha, IFN-gamma and IL-10, with effects broadly comparable to colchicine 0.3 mg/kg. A rat model with nine animals per group; not a clinical trial.
Study on herb-herb interaction between active components of Plantago asiatica L. seed and Coptis chinensis Franch. rhizoma based on transporters using UHPLC-MS/MS
Using transporter-transfected MDCK cells, plantagoamidinic acid A from Plantago was shown to be a substrate of OCT1, OCT2 and MATE1 and to inhibit OCT2 and MATE1, while acteoside was a MATE1 substrate and geniposidic acid was not transported. With berberine as substrate, 10 micromolar plantagoamidinic acid A inhibited OCT2 by 53.6% and MATE1 by 31.5%. The study material was Che Qian Zi, the seed, not the whole-plant drug, although two of the three compounds occur in both.
Chemical Fingerprints Combined with Chemometric Analysis to Evaluate and Distinguish Between Plantago Asiatica L. and Plantago Depressa Willd
HPLC fingerprinting with chemometric analysis separated Plantago asiatica from Plantago depressa, the two species that the Chinese Pharmacopoeia accepts as sources of this drug. The work establishes that the two official sources are chemically distinguishable and that a certificate naming only the pinyin does not identify what was supplied.
⚠ Safety & Contraindications
- Kidney conditions
Contraindications
Its use is prohibited in patients with spontaneous seminal emission due to essential qi insecurity.
Source: Xi S, Gong Y. Essentials of Chinese Materia Medica and Medical Formulas. Academic Press/Elsevier, 2017, p. 151.
Historical Texts
Shi Jing (Book of Songs), poem Fu Yi
Zhou dynasty, verses collected c. 1000-600 BCEShen Nong Ben Cao Jing (Divine Farmer's Classic of Materia Medica)
Han dynasty, compiled c. 200 CEMing Yi Bie Lu (Miscellaneous Records of Famous Physicians)
Attributed to Tao Hongjing, c. 500 CEPharmacopoeia of the People's Republic of China, Plantaginis Herba (Che Qian Cao) monograph
Modern standard, 2020 editionReferences
- Hunter ES; Literman R; Handy SM. Utilizing Big Data to Identify Tiny Toxic Components: Digitalis . Foods (2021) [DOI]
- Xu H; Yu H; Fu J; Zhang ZW; Hu JC; Lu JY; Yang XY; Bu MM; Jiang JD; Wang Y. Metabolites analysis of plantamajoside based on gut microbiota-drug interaction . Phytomedicine (2023) [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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