Traditionally used for
- Cough & breathing
- Urinary & fluids
- Pain & joints
Cautions & contraindications
- Toxic — professional use only
☯ TCM Properties
Dispels Wind, unblocks the channels and collaterals and eliminates Dampness; Promotes urination, resolves toxicity and reduces swellings
Traditional Chinese Uses
Mu Fang Ji is anchored here to Cocculus orbiculatus (syn. C. trilobus, Menispermaceae), the 'wood' Fang Ji. Bitter, pungent and cold, entering the Spleen, Bladder, Kidney and Lung channels, it dispels Wind and Dampness, unblocks the channels and collaterals, and promotes urination while resolving toxicity and reducing swelling. It is used for Wind-Damp painful obstruction (bi syndrome) with joint pain and swelling, and for edema and difficult urination.
Critical safety note: the market name 'Fang Ji' has historically been confused with, or adulterated by, Aristolochia species (Guang Fang Ji, Aristolochia fangchi), which contain aristolochic acid, a potent nephrotoxin and carcinogen now banned worldwide. Only correctly identified Cocculus (or Stephania tetrandra, Han Fang Ji) should be used; any Aristolochia-derived Fang Ji must be avoided entirely. Cocculus itself contains bioactive alkaloids, so moderate dosing is warranted.
Relationships
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Botanical Description
Cocculus orbiculatus (syn. C. trilobus) is a deciduous woody climbing vine of the Menispermaceae family widespread across East Asia from China and the Himalayas to Korea and Japan, where it scrambles over fences, shrubs, and forest margins. The slender twining stems are pale brown to greenish when young and become finely longitudinally striate with age. Leaves are alternate, variable in shape from broadly ovate and entire to distinctly three-lobed on the same plant, with cordate to truncate bases and softly pubescent surfaces. The plant is dioecious, producing small inconspicuous yellowish-green unisexual flowers in axillary panicles during summer, followed on female plants by small spherical drupes that ripen blue-black with a whitish bloom and contain a characteristic horseshoe-shaped seed typical of the family.
Active Constituents
Trilobine
Bisbenzylisoquinoline alkaloidConcentration: One of six bisbenzylisoquinoline alkaloids mapped across the cork layer, xylem and ray of the root by AFADESI mass spectrometry imaging; no validated percentage content is published for the crude drug
A dimeric benzylisoquinoline characteristic of Cocculus roots and the scaffold from which hemisynthetic antimalarial leads with sustained activity against multidrug-resistant Plasmodium falciparum have been built. Trilobine itself is reported to interfere with proteins of DNA replication and translation in cultured cells; no human data exist.
Isotrilobine
Bisbenzylisoquinoline alkaloidConcentration: Co-occurs with trilobine as a principal root alkaloid; imaged in cork layer and xylem, content not quantified in the crude drug
Inhibits proliferation of human hepatocellular carcinoma and breast adenocarcinoma cell lines in vitro. A hydroxylated congener, 10-hydroxyisotrilobine, was isolated from Taiwanese Cocculus orbiculatus stems.
Magnoflorine
Quaternary aporphine alkaloidConcentration: One of four constituents selected as pharmacokinetic markers for the root extract; not quantified as a percentage of the drug
After intragastric dosing of Cocculus orbiculatus extract to rats it is absorbed and eliminated rapidly, and is detectable in heart, liver, spleen, lung, kidney, prostate, intestine and stomach, with the highest concentrations in intestine and stomach. Widely distributed across Menispermaceae and not specific to this drug.
Laurifoline
Quaternary benzyltetrahydroisoquinoline alkaloidConcentration: Pharmacokinetic marker constituent of the root extract; content in the crude drug not reported
The slowest-eliminated of the four marker constituents in rats after oral dosing of the root extract, and detectable in all tissues sampled. Its slow clearance is the reason repeated dosing deserves more caution than the rapid clearance of the other markers would suggest.
Oblongine
Quaternary benzyltetrahydroisoquinoline alkaloidConcentration: Pharmacokinetic marker constituent of the root extract
Rapidly eliminated after oral administration of the root extract in rats and distributed to all tissues examined, highest in intestine and stomach.
Sinococuline
Morphinane alkaloidConcentration: Isolated from stems of Taiwanese material; a single morphinane alkaloid was also localised in the root by mass spectrometry imaging
Showed significant cytotoxicity against HepG2, Hep3B, MCF-7 and MDA-MB-231 cancer cell lines in the isolation study. In vitro only.
Syringic acid
Phenolic acidConcentration: Pharmacokinetic marker constituent of the root extract
Unlike the alkaloid markers it distributes narrowly, being detectable only in kidney and stomach after oral dosing of the extract in rats.
Coccuorbiculatine A
Bisbenzylisoquinoline alkaloidConcentration: Isolated as a new compound from stems of Taiwanese Cocculus orbiculatus; not quantified
One of two previously undescribed bisbenzylisoquinolines reported from the stems in 2005, characterised alongside amidic aporphines and a protoberberine. Chemistry only; no pharmacology established.
⚠ Drug Interactions
Aristolochia fangchi (Guang Fang Ji)
Three unrelated drugs are sold under the name Fang Ji: Mu Fang Ji is Cocculus orbiculatus (Menispermaceae), Han Fang Ji is Stephania tetrandra (Menispermaceae) and Guang Fang Ji is Aristolochia fangchi (Aristolochiaceae). That three-way name collision is the documented exposure mechanism of the Belgian epidemic: in a Brussels slimming clinic the Stephania tetrandra in the regimen was replaced by Aristolochia fangchi, and Vanherweghem and colleagues reported rapidly progressive interstitial renal fibrosis in the women who took it. Nortier and colleagues later found urothelial carcinoma in 18 of 39 such patients at prophylactic nephroureterectomy and detected aristolochic acid–DNA adducts in the removed tissue. Cocculus orbiculatus contains no aristolochic acid, but it sits inside the same name group, so a batch labelled Mu Fang Ji can be Aristolochia. Aristolochic acid nephropathy is dose-cumulative and irreversible, and there is no antidote or monitoring interval that makes an adulterated batch safe.
Clinical note: Do not accept Mu Fang Ji, Han Fang Ji or any unqualified Fang Ji on a supplier's label alone. Require botanical identification to species — hyperspectral imaging and sequence-specific Aristolochia DNA tests both discriminate the fang ji drugs — and refuse material without it. Aristolochia fangchi has been prohibited in the UK since 2001 and withdrawn from medicinal use in China since 2003 and 2004.
Stephania tetrandra (Han Fang Ji)
Mu Fang Ji and Han Fang Ji are routinely traded and dispensed interchangeably under the shared name Fang Ji, and the two roots differ pharmacologically: Stephania tetrandra is a tetrandrine-bearing drug traditionally directed at water qi, Cocculus orbiculatus at wind qi. Because the Fang Ji group is where Aristolochia fangchi entered the supply chain, any sloppiness about which Fang Ji is in the jar carries the Aristolochia risk with it. The United Kingdom's response makes the point: the Medicines (Aristolochia and Mu Tong etc.) (Prohibition) Order 2001 banned not only every Aristolochia species but the substitute drugs as well, naming Cocculus orbiculatus, Cocculus trilobus, Cocculus laurifolius, Stephania tetrandra, Akebia quinata, Akebia trifoliata, Clematis armandii and Clematis montana. The regulator banned the substitutes as well as the culprit.
Clinical note: Treat the two as different drugs and specify the binomial on every prescription and purchase order. In the UK, supply of a medicinal product containing either Cocculus orbiculatus or Stephania tetrandra is prohibited outside a licence or traditional herbal registration; check the position in your own jurisdiction rather than assuming.
Anamirta cocculus (fish berry, Cocculus indicus)
Anamirta cocculus is a separate Menispermaceae species whose seed, known in trade as Cocculus indicus and used as a homeopathic starting material called simply Cocculus, contains picrotoxin. Picrotoxin is a non-competitive GABA-A receptor channel blocker and a convulsant; it has no pharmacological relationship to the isoquinoline alkaloids of Cocculus orbiculatus. The overlap is purely nominal, but the shared word Cocculus on an invoice or a homeopathic label is enough to cause a mix-up, and the consequence of that particular mix-up is a seizure rather than a therapeutic failure.
Clinical note: Never fill an order reading only Cocculus. Confirm Cocculus orbiculatus (L.) DC., root, and confirm that the material is not Anamirta cocculus seed. Homeopathic Cocculus preparations are a different substance entirely and should not be reconciled against a Mu Fang Ji stock entry.
P-glycoprotein and CYP3A4 substrates
The principal Cocculus orbiculatus root alkaloids are bisbenzylisoquinolines, the structural class to which the well-characterised multidrug-resistance reversal agents tetrandrine and cepharanthine belong. No transporter or cytochrome inhibition study has been published for trilobine, isotrilobine or the crude drug, so this is an inference from chemical class, not a measured effect. Absence of an assay is not evidence of absence.
Clinical note: Where a patient is on a narrow-therapeutic-index P-glycoprotein or CYP3A4 substrate, treat concurrent Mu Fang Ji as an untested variable and monitor for exaggerated drug effect rather than assuming no interaction.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| not established | Not established — see note | — | — | — | No ChP 2020 monograph. This record is anchored to *Cocculus orbiculatus* (Menispermaceae) — the true 木防己, which does NOT contain aristolochic acid. IDENTITY WARNING: material sold as Mu Fang Ji has historically been supplied as Aristolochia species, and the old pharmaceutical name 'Radix Aristolochiae seu Cocculi' encoded that ambiguity in the identity field itself. The latin_name has been corrected to Cocculi Orbiculati Radix so the field identifies rather than hedges; the substitution hazard belongs here, in the note. Confirm any 防己 material against a certificate of analysis — the ChP-listed safe drug is Fang Ji (Stephaniae Tetrandrae Radix, 5–10 g). |
Evidence Tier
Moderate 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
0
Randomized controlled trial
1
1 verified · 0 unverified
Other clinical trial
1
1 verified · 0 unverified
Observational / case report
0
In vitro / animal
2
0 verified · 2 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
Ningmitai capsule in patients with chronic prostatitis/chronic pelvic pain syndrome: a multicenter, prospective, randomized, parallel, positive-controlled study
Multicentre randomised positive-controlled trial of Ningmitai capsule in chronic prostatitis/chronic pelvic pain syndrome. Cocculus orbiculatus root (Dafengteng) is one of seven botanical ingredients and about 15 percent of the formula, so the trial supports the finished product and not the single herb; no dose of Mu Fang Ji alone can be inferred from it.
Ningmitai capsule promotes calculi expulsion after RIRS for 10–20-mm upper urinary stones: a multicenter, prospective, randomized controlled trial
Multicentre randomised trial of the same seven-herb Ningmitai capsule as an adjunct to retrograde intrarenal surgery for 10 to 20 mm upper urinary tract stones, reporting improved stone clearance. Again a whole-formula result; Cocculus orbiculatus is one constituent herb and the trial attributes nothing to it individually.
Pharmacokinetics and Tissue Distribution of Four Characteristic Constituents from Cocculus orbiculatus in Rats Using UHPLC-Q-trap-MS/MS
Rats given Cocculus orbiculatus extract by gavage. Magnoflorine, oblongine and syringic acid were eliminated rapidly while laurifoline was eliminated slowly; magnoflorine, oblongine and laurifoline reached all eight tissues sampled with highest levels in intestine and stomach, whereas syringic acid appeared only in kidney and stomach. This is the first in vivo disposition dataset for the drug and is the basis for the caution about laurifoline accumulation on repeated dosing.
New Bisbenzylisoquinolines, Fatty Acid Amidic Aporphines, and a Protoberberine from Formosan Cocculus orbiculatus
Isolation from the stems of Taiwanese Cocculus orbiculatus of two new bisbenzylisoquinolines including 10-hydroxyisotrilobine, two amidic aporphines and a protoberberine, with cytotoxicity screening against HepG2, Hep3B, MCF-7 and MDA-MB-231. Sinococuline showed significant inhibitory activity. Note that the material was stems, not the root that is the medicinal drug.
Historical Texts
Shen Nong Ben Cao Jing (Divine Husbandman's Classic of Materia Medica)
Eastern Han dynasty, compiled c. 200 CEYao Xing Lun (Treatise on the Nature of Medicinals), attributed to Zhen Quan
Tang dynasty, 7th century CEBen Cao Gang Mu (Compendium of Materia Medica), Li Shizhen
Ming dynasty, completed 1578, first printed 1596Pharmacopoeia of the People's Republic of China
Modern; Aristolochia fangchi withdrawn from medicinal use by the State Food and Drug Administration in 2003 and 2004 and removed from the pharmacopoeia thereafterReferences
- Vanherweghem JL, Tielemans C, Abramowicz D, Depierreux M, Vanhaelen-Fastre R, Vanhaelen M, Dratwa M, Richard C, Vandervelde D, Verbeelen D, Jadoul M. Rapidly progressive interstitial renal fibrosis in young women: association with slimming regimen including Chinese herbs . The Lancet (1993) [DOI]
- Nortier JL, Martinez MM, Schmeiser HH, Arlt VM, Bieler CA, Petein M, Depierreux MF, De Pauw L, Abramowicz D, Vereerstraeten P, Vanherweghem JL. Urothelial Carcinoma Associated with the Use of a Chinese Herb (Aristolochia fangchi) . New England Journal of Medicine (2000) [DOI]
- Debelle FD, Vanherweghem JL, Nortier JL. Aristolochic acid nephropathy: A worldwide problem . Kidney International (2008) [DOI]
- Zhou Q, Jiang L, Su T, Liu G, Yang L. Overview of aristolochic acid nephropathy: an update . Kidney Research and Clinical Practice (2023) [DOI]
- Tankeu S, Vermaak I, Chen W, Sandasi M, Viljoen A. Differentiation between two "fang ji" herbal medicines, Stephania tetrandra and the nephrotoxic Aristolochia fangchi, using hyperspectral imaging . Phytochemistry (2016) [DOI]
- Sgamma T, Masiero E, Mali P, Mahat M, Slater A. Sequence-Specific Detection of Aristolochia DNA – A Simple Test for Contamination of Herbal Products . Frontiers in Plant Science (2018) [DOI]
- Zhang M, Wang Z, Li K, Li Q, Yu K, Li J, Feng J, Yang B, Liu L, Cai W. The visualization of the spatial distribution of Cocculus orbiculatus based on air flow-assisted desorption electrospray ionization mass spectrometry imaging . Fitoterapia (2024) [DOI]
- Wang XR, Wei MC, Qin L, Tan DP, Wu FM, Xie J, Wu D, Liu AN, Wu JJ, Wu XD, He YQ. Chemical characterization and comparative analysis of different parts of Cocculus orbiculatus through UHPLC-Q-TOF-MS . Analytical Methods (2024) [DOI]
- Secretary of State for Health, United Kingdom. The Medicines (Aristolochia and Mu Tong etc.) (Prohibition) Order 2001 . Statutory Instruments 2001 No. 1841, The Stationery Office, London (2001)
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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