Traditionally used for
- Urinary & fluids
- Pain & joints
Cautions & contraindications
- Pregnancy
- Heart conditions
- Toxic — professional use only
☯ TCM Properties
Expels Wind, Eliminates Dampness, warms channels to alleviate pain and strengthens the tendons and bones; Promotes urination and alleviates edema
Traditional Chinese Uses
Xiang Jia Pi is the root bark of Periploca sepium (Chinese silkvine), a pungent, bitter, warm substance of the Liver, Kidney and Heart channels. It dispels Wind, eliminates Dampness, warms the channels to relieve pain and strengthens the sinews and bones, being used for Wind-Damp bi syndrome, rheumatic joint pain, and weak, aching low back and knees; it also promotes urination to reduce edema. It is sometimes taken as a medicinal wine for chronic musculoskeletal complaints.
Importantly, this drug contains cardiac glycosides (periplocin) and is toxic — it is a distinct medicine from Wu Jia Pi (Acanthopanax), for which it was historically and dangerously confused, causing fatal poisonings; the Chinese Pharmacopoeia gave it a separate monograph. Dose it precisely under professional guidance; overdose is cardiotoxic. Contraindicated in pregnancy.
Western Herbalism Properties
Relationships
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Botanical Description
Xiang Jia Pi is the dried root bark of Periploca sepium Bunge (Apocynaceae, subfamily Asclepiadoideae), a deciduous twining woody vine to small shrub 1-3 m tall, native to northern and central China. The plant bears opposite, lanceolate to ovate-lanceolate leaves 5-9 cm long with acute tips, and produces small star-shaped flowers in lateral cymes with five purplish-brown corolla lobes that are fragrant and recurved. Slender paired follicles 7-12 cm long contain plumed seeds. The root bark is harvested in spring or autumn, dried, and appears as curled quills 3-10 cm long, with a corky, grayish-brown outer surface and yellowish inner surface, with a characteristic aromatic odor. It contains cardenolide glycosides (periplocin, periplocymarin) and is cardiotoxic; modern Pharmacopoeia limits dose strictly and warns against substitution with the safer Wu Jia Pi (Eleutherococcus).
Active Constituents
Periplocin
Cardenolide (cardiac glycoside)Concentration: not fixed by the Chinese Pharmacopoeia content assay, but its level correlates well with the acute toxicity of the crude drug
Periplocin is simultaneously the main active and the main toxic principle of Periplocae Cortex. It inhibits Na+/K+-ATPase in the manner of digitalis and produces cardiotonic action at unsuitable doses. Its intraperitoneal LD50 in mice is 15.20 mg/kg. This constituent, and not any adaptogenic or tonic action, is what makes this herb dangerous.
Periplocymarin
Cardenolide (cardiac glycoside)The monodesglucosyl secondary glycoside of periplocin. It binds the Na+/K+-ATPase alpha-1 subunit with a binding energy of -9.28 kcal/mol, against -10.48 kcal/mol for digoxin, and produces the same downstream effect: reduced sodium extrusion, raised intracellular calcium and increased myocardial contractility. Functionally it is a digitalis-like drug.
Periplogenin
Cardenolide aglycone (steroid)The genin liberated from the periploca cardenolides. It retains the steroid nucleus and unsaturated five-membered lactone ring that define cardiac-glycoside activity.
Periplocosides A-O
C21 pregnane steroidal glycosidesMore than 30 C21-steroidal glycosides have been characterised from the root bark. They carry immunosuppressive and anti-inflammatory activity in laboratory models and are chemically distinct from the cardenolides, though they occur alongside them.
4-Methoxysalicylaldehyde
Phenolic aldehyde (volatile oil constituent)Concentration: the sole content-determination marker for Periplocae Cortex in the 2020 Chinese Pharmacopoeia
The aromatic principle responsible for the herb's characteristic smell, which is one of the ways Periplocae Cortex is told apart from Acanthopanacis Cortex organoleptically. It is a poor quality marker in practice: it does not track either the efficacy or the toxicity of the drug, and analysts have argued for adding periplocin to the assay for exactly that reason.
⚠ Drug Interactions
Digoxin and other cardiac glycosides
Periplocin and periplocymarin are true cardenolides that inhibit Na+/K+-ATPase with affinity approaching digoxin's. A 2023 review of Chinese medicine-digoxin interactions classifies Periploca sepium (xiangjiapi) explicitly as a synergistic effect that increases the risk of digoxin toxicity. There is no separate therapeutic window: the same Na+/K+-ATPase inhibition provides both the inotropic effect and the toxicity, and serum digoxin assays may also cross-react with plant cardenolides, obscuring the true glycoside burden.
Clinical note: Do not co-prescribe. Treat concurrent use as a digitalis overdose risk and manage accordingly, with ECG and electrolytes. This herb is NOT Wu Jia Pi (Acanthopanax gracilistylus / Eleutherococcus), which contains no cardiac glycosides; verify which drug is actually in the dispensary before assuming the patient is on the safe one.
Potassium-wasting diuretics (furosemide, thiazides) and other causes of hypokalaemia
Cardiac glycosides compete with potassium for the Na+/K+-ATPase binding site, so a fall in serum potassium increases glycoside binding and toxicity. Periplocin's toxicity is dose-correlated and its margin is narrow, with a mouse intraperitoneal LD50 of 15.20 mg/kg, so any potassium-lowering co-medication meaningfully narrows an already narrow window. The same applies to corticosteroids, amphotericin B and stimulant laxatives.
Clinical note: Avoid the combination. If the herb is unavoidable, check potassium and magnesium before and during treatment.
Beta-blockers, non-dihydropyridine calcium channel blockers and other AV-nodal blocking drugs
Cardiac glycosides slow AV nodal conduction through vagal and direct effects. Combining a cardenolide-containing herb with verapamil, diltiazem or a beta-blocker is expected to compound bradyarrhythmia. This is a class-based inference from the confirmed cardenolide content of Periploca sepium rather than a reported clinical series.
Clinical note: Avoid in patients with existing conduction disease or on rate-limiting agents.
Dosage
| Form | Amount | Frequency | Duration | Population | Notes |
|---|---|---|---|---|---|
| decoction | 3–6 g | Daily | — | — | 中国药典 2020 monograph 【香加皮】【用法与用量】3～6g。 【注意】不宜过量服用。 【性味与归经】辛、苦，温；有毒。归肝、肾、心经。 — Matched to ChP by romanised drug name (pinyin 'Xiang Jia Pi' → 香加皮); the romanisation is unique across all 649 ChP monographs, and the match was cross-checked against this record's own TCM temperature. Quoted verbatim. |
Evidence Tier
Limited evidence · 1 studyRecorded 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
1
0 verified · 1 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
Plasma metabolic profiling analysis of Cortex Periplocae-induced cardiotoxicity based on UPLC/Q-TOF-MS
Thirty-six male Wistar rats received distilled water or Cortex Periplocae ethanol extract at 3, 6 or 9 g/kg/day by gavage for 7 consecutive days. The mid- and high-dose groups showed histological heart tissue injury with muscle fibre degeneration and cellular infiltration; the low-dose group showed none. Twelve plasma metabolites shifted, 11 with AUC above 0.7, implicating phenylalanine metabolism, branched-chain amino acid biosynthesis, glycerophospholipid metabolism and pantothenate/CoA biosynthesis. Cardiotoxicity was reproducible within a week at moderate doses.
⚠ Safety & Contraindications
- Pregnancy
- Heart conditions
- Toxic — professional use only
Contraindications
Contraindicated in pregnancy and in cardiac disease, particularly in patients taking digoxin.
Safety Warnings
- Cardiac-glycoside toxicity: additive with digoxin and with other cardiac glycosides.
- Frequently confused with Wu Jia Pi (Acanthopanax), which is not cardioactive — confirm which drug is being dispensed.
⚠ Toxicity Information
Nausea, vomiting, bradycardia and arrhythmia — digitalis-like cardiotoxicity — with visual disturbance and hyperkalaemia in serious poisoning.
References
- Li Y, Li J, Zhou K, et al.. A Review on Phytochemistry and Pharmacology of Cortex Periplocae . Molecules (2016) [DOI]
- Huang M, Shen S, Luo C, Ren Y. Genus Periploca (Apocynaceae): A Review of Its Classification, Phytochemistry, Biological Activities and Toxicology . Molecules (2019) [DOI]
- Zhuang W, He T, Jia BB, et al.. Interaction between Chinese medicine and digoxin: Clinical and research update . Frontiers in Pharmacology (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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