She Chuang Zi
StarCnidium monnieri (L.) Cuss.
Traditionally used for
- Menstrual & women's health
- Fertility & vitality
- Energy & fatigue
- Skin
Cautions & contraindications
- Pregnancy
- Liver conditions
- Toxic — professional use only
☯ TCM Properties
Tonifies Kidney Yang; Drains Dampness and Expels Wind; Kills Parasites and Stops Itching; Disperses Cold; Dispels Wind-Dampness and Alleviates Pain
Traditional Chinese Uses
She Chuang Zi (cnidium seed) is a warm herb used both internally and externally in Chinese medicine. Taken internally, it warms Kidney Yang to address impotence, infertility, and vaginal discharge from Kidney deficiency with cold. Applied externally as a wash, decoction, or powder, it relieves itching from damp skin conditions, fungal infections, and vaginal itching. Its traditional applications span both tonic and antiparasitic roles.
Western Herbalism Properties
Relationships
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Botanical Description
Cnidium monnieri is an erect annual herb in the carrot family Apiaceae, native to East Asia and widespread as a weed of riverbanks, ditches, and waste places across China, Korea, Japan, and parts of Europe. It grows 30–80 cm tall with finely 2–3-pinnately divided leaves whose ultimate segments are linear, and bears compound umbels of small white five-petaled flowers 2–7 cm across in summer. The schizocarp fruit splits into two oblong-ovoid mericarps about 2–4 mm long with five prominent winged ridges and a strong aromatic odor due to coumarins (osthole, imperatorin) and a volatile oil. The dried ripe fruit (She Chuang Zi) is collected in autumn. In TCM it is acrid, bitter, and warm, drying dampness, expelling wind, killing parasites, and warming kidney-yang; it is applied externally as a wash for itchy skin, eczema, and trichomonal infection, and taken internally for impotence and infertility from kidney-yang deficiency.
Active Constituents
Osthole (7-methoxy-8-isopentenylcoumarin)
Simple prenylated coumarinConcentration: the assay marker of the Chinese Pharmacopoeia monograph, which requires not less than 1.0% in the dried fruit
The dominant constituent and by far the best-studied molecule in this herb. It accounts for most of the reported anti-inflammatory, anti-pruritic, antifungal, vasorelaxant, neuroactive and bone-anabolic activity. It inhibits osteoclastic bone resorption and promotes osteoblast activity in animal models, relaxes vascular smooth muscle, and reverses P-glycoprotein-mediated multidrug resistance in leukaemia cell lines. It is also the constituent that carries the herb's hepatic liability, being bioactivated by CYP3A4 and CYP1A2 to reactive intermediates.
Imperatorin
Linear furanocoumarinThe second most abundant coumarin of the fruit. It is vasorelaxant in a concentration-dependent manner and, with osthole, facilitates glutamate release from rat hippocampal nerve terminals by positively modulating N- and P/Q-type calcium channels through a PKC-dependent cascade. Imperatorin belongs to the furanocoumarin class implicated in mechanism-based CYP3A4 inhibition.
Bergapten (5-methoxypsoralen)
Linear furanocoumarin (psoralen)A documented constituent of the fruit and a potent photosensitiser. Bergapten is 5-MOP, the same molecule used clinically in PUVA photochemotherapy: on UVA exposure it forms DNA photoadducts. Its presence is the main reason topical Cnidium preparations carry a phototoxicity risk.
Xanthotoxin (8-methoxypsoralen, methoxsalen)
Linear furanocoumarin (psoralen)Another photosensitising furanocoumarin of the fruit. Xanthotoxin is methoxsalen, a licensed photochemotherapy drug in its own right. Together with bergapten it makes phytophotodermatitis a realistic adverse event after topical use and sun exposure.
Xanthotoxol
FuranocoumarinA minor furanocoumarin reported among the active coumarin constituents of the fruit.
Columbianetin and columbianetin acetate
Angular dihydrofuranocoumarinAngular coumarins of the fruit that are routinely measured alongside osthole and imperatorin in pharmacokinetic profiling of Cnidium preparations.
Isopimpinellin
Linear furanocoumarinA further furanocoumarin of the fruit, part of the photosensitising coumarin pool of the drug.
⚠ Drug Interactions
Photosensitising drugs and UV/PUVA phototherapy (e.g. methoxsalen, tetracyclines, thiazide diuretics, amiodarone, fluoroquinolones, St John's wort)
The fruit contains bergapten (5-methoxypsoralen) and xanthotoxin (8-methoxypsoralen), which are not merely psoralen-like but are the actual licensed PUVA photosensitisers. On absorbing UVA these furanocoumarins form cyclobutane photoadducts with DNA and generate reactive oxygen species. Adding a second photosensitising agent, or deliberate UV therapy, is straightforwardly additive. This matters most for She Chuang Zi because the herb is used chiefly as a topical wash or ointment, applied directly to skin at 15-30 g or more.
Clinical note: Advise patients using topical She Chuang Zi to keep treated skin out of direct sun and off sunbeds, and to wash the area before sun exposure. Avoid concurrent use with deliberate phototherapy unless that is the intended treatment and the dose is being managed accordingly.
CYP3A4 substrates (e.g. midazolam, statins, calcium-channel blockers, ciclosporin)
Osthole coordinates directly to the CYP3A4 heme iron through its carbonyl group, a binding mode confirmed by X-ray crystallography and DFT and compared explicitly with the grapefruit furanocoumarin bergamottin. Osthole is additionally a substrate of CYP3A4 and CYP1A2. The fruit's furanocoumarin fraction (imperatorin, bergapten, xanthotoxin) is the same chemical class responsible for the grapefruit-juice effect. No human interaction study of the whole herb has been published, so the magnitude in practice is unknown.
Clinical note: Reasonable to avoid high-dose oral Cnidium extracts in patients stabilised on a narrow-therapeutic-index CYP3A4 substrate. Topical use is unlikely to matter.
Hepatotoxic drugs and CYP inducers (e.g. paracetamol/acetaminophen, methotrexate, isoniazid, rifampicin, carbamazepine)
Osthole undergoes metabolic activation by CYP3A4 and CYP1A2 to reactive quinone-type intermediates, and that bioactivation correlates with hepatocyte cytotoxicity in vitro. Inducing those isoforms would be expected to increase reactive metabolite formation rather than reduce exposure, which inverts the usual assumption about enzyme induction. This is an in-vitro mechanism; clinical hepatotoxicity from Cnidium fruit has not been well characterised.
Clinical note: Do not use high-dose concentrated osthole extracts long-term in patients with existing liver disease or on established hepatotoxic drugs. Standard decoction doses in short courses have no reported hepatic signal.
Antihypertensive drugs
An ethanol extract of the fruit produced concentration-dependent vasorelaxation ex vivo and significantly lowered blood pressure in spontaneously hypertensive rats when given orally; imperatorin (3-300 microM) and osthole (1-100 microM) each relaxed vessels directly. The effect is documented in rats only.
Clinical note: No routine action needed. If a hypotension-prone patient begins high-dose internal Cnidium, check blood pressure at the next visit.
Antiepileptic drugs and other agents that lower seizure threshold
Osthole and imperatorin each facilitated 4-aminopyridine-evoked glutamate release from rat hippocampal nerve terminals in a concentration-dependent way, acting through positive modulation of N- and P/Q-type calcium channels via a PKC cascade. Enhanced presynaptic glutamate release is in principle pro-excitatory, but this is an isolated synaptosome preparation and no seizure events have been reported in people taking this herb.
Clinical note: Flag only as a reason not to use concentrated osthole supplements in a patient with poorly controlled epilepsy. Not a concern at ordinary decoction or topical doses.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction, or powder/pills | 3–10 g | Daily | — | — | 中国药典 2020 【用法与用量】3～10g。外用适量，多煎汤熏洗，或研末调敷。 【性味与归经】辛、苦，温；有小毒。归肾经。 — 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
0
In vitro / animal
6
4 verified · 2 unverified
Show 6 studies
- New Coumarins and Anti-Inflammatory Constituents from the Fruits of Cnidium monnieri
- Vasorelaxant and Blood Pressure-Lowering Effects of Cnidium monnieri Fruit Ethanol Extract in Sprague Dawley and Spontaneously Hypertensive Rats
- Effects of osthole on osteoporotic rats: a systematic review and meta-analysis
- Metabolic activation and hepatic cytotoxicity of osthole mediated by cytochrome P450 enzymes
- The Grapefruit Effect: Interaction between Cytochrome P450 and Coumarin Food Components, Bergamottin, Fraxidin and Osthole. X-ray Crystal Structure and DFT Studies
- Osthole and imperatorin, the active constituents of Cnidium monnieri (L.) Cusson, facilitate glutamate release from rat hippocampal nerve terminals
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
New Coumarins and Anti-Inflammatory Constituents from the Fruits of Cnidium monnieri
Isolated previously undescribed coumarins from the fruit and screened the constituents against human neutrophil superoxide anion generation and elastase release, identifying several coumarins with meaningful anti-inflammatory activity in that assay.
Vasorelaxant and Blood Pressure-Lowering Effects of Cnidium monnieri Fruit Ethanol Extract in Sprague Dawley and Spontaneously Hypertensive Rats
The fruit ethanol extract relaxed isolated rat aortic rings concentration-dependently and significantly reduced blood pressure in spontaneously hypertensive rats after oral dosing. Imperatorin (3-300 microM) and osthole (1-100 microM) reproduced the vasorelaxation individually, identifying them as the active principles.
Effects of osthole on osteoporotic rats: a systematic review and meta-analysis
Pooled the preclinical literature on osthole in rodent osteoporosis models and found consistent improvements in bone mineral density and bone microarchitecture. Note that this is a systematic review of animal experiments, not of human trials - there is no equivalent clinical evidence base in people.
Metabolic activation and hepatic cytotoxicity of osthole mediated by cytochrome P450 enzymes
Showed that CYP3A4 and CYP1A2 oxidise osthole to reactive electrophilic intermediates and that the extent of this bioactivation tracks hepatocyte cytotoxicity, giving a concrete mechanism for the hepatic liability of concentrated osthole preparations.
The Grapefruit Effect: Interaction between Cytochrome P450 and Coumarin Food Components, Bergamottin, Fraxidin and Osthole. X-ray Crystal Structure and DFT Studies
Crystallographic and computational study of how coumarin food constituents engage CYP3A4. Osthole was found to coordinate to the heme iron through its carbonyl oxygen, a binding mode distinct from the pi-stacking of the grapefruit furanocoumarin bergamottin, placing osthole squarely in the grapefruit-effect family of CYP3A4 interactors.
Osthole and imperatorin, the active constituents of Cnidium monnieri (L.) Cusson, facilitate glutamate release from rat hippocampal nerve terminals
Both coumarins concentration-dependently increased 4-aminopyridine-evoked glutamate release from rat hippocampal synaptosomes. The effect was traced to positive modulation of N- and P/Q-type voltage-dependent calcium channels through a protein kinase C signalling cascade.
⚠ Safety & Contraindications
- Pregnancy
- Liver conditions
- Toxic — professional use only
Contraindications
Use with caution in pregnancy. Not for use in damp-heat of the lower burner with yin deficiency.
Safety Warnings
- Chiefly used externally, where the risk is low.
- Furanocoumarins can photosensitise — avoid strong sun on treated skin.
⚠ Toxicity Information
Mild gastrointestinal upset internally; photosensitivity is possible from the furanocoumarin content.
Historical Texts
Shen Nong Ben Cao Jing
Han dynasty (c. 1st-2nd century CE)Pharmacopoeia of the People's Republic of China
Modern (current edition)References
- Sun Y, Yang AWH, Lenon GB. Phytochemistry, Ethnopharmacology, Pharmacokinetics and Toxicology of Cnidium monnieri (L.) Cusson . International Journal of Molecular Sciences (2020) [DOI]
- Li YM, Jia M, Li HQ, Zhang ND, Wen X, Rahman K, Zhang QY, Qin LP. Cnidium monnieri: A Review of Traditional Uses, Phytochemical and Ethnopharmacological Properties . The American Journal of Chinese Medicine (2015) [DOI]
- Lin H, You Q, Wei X, Chen Z, Wang X. Osthole, a Coumarin from Cnidium monnieri: A Review on Its Pharmacology, Pharmacokinetics, Safety, and Innovative Drug Delivery Platforms . The American Journal of Chinese Medicine (2024) [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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