Herbs & Botanicals · Traditional kidney stone herb

Chanca piedra

Q: What is chanca piedra?

A small tropical herb, Phyllanthus niruri, called stone breaker. It is used as a tea or capsule, mostly for kidney stones.

Q: Does chanca piedra break up kidney stones?

Not proven. A 2020 review pooled only two small controlled studies and found a modest drop in stone size and number. The authors call the evidence limited. Lab work suggests it affects crystals; that has not shown dissolving of stones in people.

Q: Can I use it instead of seeing a doctor for stones?

No. A stone can block urine flow and cause infection or kidney damage. Severe pain, fever, vomiting or blood in the urine needs medical care. Ask your doctor before using any herb alongside stone treatment.

Q: Does it help after lithotripsy?

Maybe for lower-pole stones. In a 150-person trial the overall stone-free rate was not significantly different (93.5% versus 83.3%), but for lower-pole stones it was 93.7% versus 70.8%. There was no placebo, and it was one product.

Q: Does it work for hepatitis B?

Cochrane found no convincing evidence against placebo (one trial, 42 people). Fifteen trials suggested virus-marker clearance when added to antiviral drugs, but all had bias and uncertain results. It is not a replacement for antiviral treatment.

Q: Does it help the liver or fatty liver?

Not shown. In a 36-week trial of 146 people, a capsule with chanca piedra and milk thistle lowered enzymes in the treated groups, but not more than placebo. It was a combination product.

Q: Can it lower blood sugar or blood pressure?

Possibly, but it is not proven. Evidence is a nine-person study of a related species and animal work. If you take diabetes or blood pressure medicines, ask your pharmacist first.

Q: Is it a diuretic?

Traditionally yes. In a nine-person study of a related species urine volume and sodium rose. Diuretics, magnesium and potassium supplements are listed to discuss with a provider.

Q: Is it safe for the liver?

No liver injury cases were found in the sources read, and trials up to 36 weeks (one combination product) reported no safety problems. A rat pregnancy study saw changes in liver markers in mothers. LiverTox could not be checked. People with hepatitis should ask their provider.

Q: Is it safe in pregnancy or breastfeeding?

Avoid it. There is no human data. A related species caused abortion in rats, P. niruri leaf extract altered maternal kidneys and fetal size at a high dose, and traditional sources warn against use. WebMD says it is not known if it passes into breast milk.

Phyllanthus niruri, aerial parts · also called Stone breaker, quebra-pedra, gale of the wind, seed under leaf

Chanca piedra, or stone breaker, is a small tropical plant used for generations to help with kidney stones. Its stems and leaves are made into teas and capsules. Studies are small: two controlled studies suggest a modest drop in stone size, but it has not been shown to dissolve stones. Hepatitis B results are weak. If you have stones, see a doctor; avoid it in pregnancy.

General information, not medical advice. Last substantive update October 25, 2026 · Not medically reviewed. A named clinician has not signed off on this page. How this page is made

About Chanca piedra

Chanca piedra is a small tropical herb best known for kidney stones. Human research is limited to small studies. Hepatitis B and metabolic uses are unproven. Safety questions matter: pregnancy, water pills, blood pressure and diabetes medicines, and stones that need medical care.

What it is

Chanca piedra, or stone breaker, is the plant Phyllanthus niruri. Its name comes from Brazilian use for kidney stones (quebra-pedra). The parts used are the stems and leaves, and sometimes seeds, as teas, capsules and extracts. Several close relatives are sold under similar names; P. amarus and P. urinaria are separate species and are often the plants in hepatitis B studies.

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What the research shows

The best human evidence is for kidney stones, and it is small. A 2020 meta-analysis pooled two controlled studies and found a modest drop in stone size and number. A 2006 trial of 150 people found no significant overall gain after shock-wave lithotripsy, but more lower-pole stones cleared. A placebo trial of 69 people found lower urinary calcium only in a subgroup. For chronic hepatitis B, Cochrane found no convincing benefit against placebo, and add-on results were uncertain. A 36-week trial of a chanca piedra and milk thistle capsule showed no difference from placebo. Blood sugar and blood pressure claims rest on a nine-person study of a related species and on animal work.

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How it may work

The plant holds lignans such as phyllanthin and hypophyllanthin. Lab and animal work suggests it reduces calcium oxalate crystals clumping together and changes crystal structure. Relaxing the ureter is an unproven idea. In rats, extracts relaxed blood vessels. In rats the lignans were poorly absorbed by mouth (under 5%). None of this has been shown to explain a benefit in people.

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At a glance

Traditional uses history, not proof

Brazilian folk use for kidney stones, hence 'stone breaker' (quebra-pedra)
Southeast Asian traditional use for diabetes and related problems
Folk use for liver complaints and as a diuretic (water pill)

Studied for research

Kidney stone size and number, low
Help after shock-wave lithotripsy, low
Urine chemistry and stone prevention, low
Chronic hepatitis B, very low
Fatty liver enzymes (combination capsule), insufficient
Blood sugar and blood pressure, insufficient
Diuretic effect, very low
Cancer, infection and inflammation (lab only), insufficient

Main compounds

Lignans: phyllanthin, hypophyllanthin, niranthin
Flavonoids and tannins (not verified from a source read)

Common forms

Tea (infusion or decoction of stems and leaves)
Capsules of dried herb powder
Liquid and dry extracts
Combination capsules, for example with milk thistle
Not the same as other Phyllanthus plants such as P. amarus or P. urinaria

Research links: Stone breaker meta-analysis, Canadian Journal of Urology (2020) · Trial after shock-wave lithotripsy, J Urol (2006) · Urinary calcium trial in stone formers (2004) · Cochrane: Phyllanthus for chronic hepatitis B (2011) · Fatty liver trial of a combination capsule (2025) · Chanca piedra overview, WebMD · Research Library · Genes & Biomarkers Library

The plant and its history

Accepted scientific name: Phyllanthus niruri L.
Naming authority: ACCEPTED in the GBIF backbone (species key 5381945, family Phyllanthaceae, checked 2026-10-25).
Common names: Chanca piedra (Spanish / trade); Stone breaker (English); Quebra-pedra (Portuguese (Brazil)); Gale of the wind (English); Seed under leaf (English); Dukung anak (Malay (product name in the fatty liver trial))
Botanical family: Phyllanthaceae (older papers place the genus in Euphorbiaceae).
Classification: Plantae > Tracheophyta > Magnoliopsida > Malpighiales > Phyllanthaceae > Phyllanthus > Phyllanthus niruri
Native range: A tropical and subtropical plant; the 2017 review describes it as found throughout the tropics of both hemispheres. Exact native range not verified.
Habitat: Not verified.
What the plant looks like: Roots: Not verified.; Stems: Not verified.; Leaves: The 2017 review calls it a small annual herb. Details not verified.; Flowers: Not verified.; Fruit: Not verified. The common name 'seed under leaf' refers to small seed capsules under the leaves; this was not checked in a botanical source.; Note: Aerial parts (above-ground stems and leaves) are the part used in products and in the fatty-liver trial.
Cultivation: Not verified.
Harvest and processing: Not verified. WebMD says growing area, weather, harvest time and processing change the chemical content.
Look-alikes and adulterants: Name: Phyllanthus amarus Schumach. & Thonn.; Note: A separate accepted species (GBIF key 5382589). Many hepatitis B and older Indian studies used it; some authors call it a synonym of P. niruri.; Name: Phyllanthus urinaria L.; Note: A separate accepted species (GBIF key 5382780), common in Asian hepatitis B trials.; Name: Phyllanthus emblica L. (amla); Note: A different accepted species (GBIF key 5381660), a fruit tree; do not mix with chanca piedra.
Sustainability and conservation: Not verified.

Traditional use and history history, not clinical proof

Tradition or era	Documented use	Source
Brazil (quebra-pedra)	Long used in Brazilian medicine for kidney stones; the name 'stone breaker' comes from this use.	s-webmd-chanca
Southeast Asia (Malay Peninsula)	Traditional use of P. niruri, P. urinaria and P. acidus for diabetes and related disorders.	p41539677
Ayurvedic and West African folk medicine (Phyllanthus amarus)	A rat paper says P. amarus has a long tradition in Ayurveda and, among the Yoruba of western Nigeria, is used for sterility and difficult childbirth. This is a related species.	p22314905
Modern herbal use	A broad list of traditional uses (antimicrobial, antioxidant, diuretic, liver and others) is summarised in a 2017 review.	p28512988
EMA / HMPC	No monograph found; the agency page could not be read.	s-ema-chanca

Traditional use shows how a plant was used. It does not show that a supplement works or is safe today.

What is inside, and how it may work

What the plant contains and how those compounds act in cells and animals. Laboratory and animal mechanisms are not proven effects in people.

Main compounds

Compound	Family	Where it is concentrated	Activity studied	Level of evidence
Phyllanthin PubChem 358901	Lignan	Aerial parts (assumed from plant extracts)	Measured in rat blood after a plant extract; oral bioavailability in rats 0.62%. ¹⁴	Animal research
Hypophyllanthin PubChem 182140	Lignan	Aerial parts (assumed)	Oral bioavailability in rats 1.52%; half-life about 3.9 hours after injection. ¹⁴	Animal research
Niranthin PubChem 11575632	Lignan	Aerial parts (assumed)	Oral bioavailability in rats 2.66%. ¹⁴	Animal research
Phyltetralin	Lignan	Aerial parts (assumed)	Oral bioavailability in rats 4.01%. PubChem ID not looked up. ¹⁴	Animal research
Rutin PubChem 5280805	Flavonoid glycoside	Not verified	A computer docking paper names rutin among plant compounds with predicted drug-target binding. Presence in P. niruri was NOT verified from a source read. ^{7 20}	In silico
Quercetin PubChem 5280343	Flavonoid	Not verified	A common plant flavonoid sometimes listed for the genus. Presence in P. niruri NOT verified from a source read. ²⁰	Unverified

Mechanisms, receptors and pathways

Target or pathway	Gene or receptor	What was found	Level
Calcium oxalate crystal clumping and growth		Lab and animal work: reduces crystals clumping together, changes crystal structure and reduces crystal uptake by kidney cells. Review by authors who ran some of the studies. ^{3 10}	Laboratory research
Glycosaminoglycan clumping, nucleation		A 2025 systematic review (people and rats) lists promoting glycosaminoglycan aggregation, inhibiting nucleation and changing stone density. ¹⁰	Mixed human and animal
Ureter relaxation		Proposed as a reason it may help stones pass; not confirmed in people. ³	Hypothesis
Nitric oxide / cGMP and beta-adrenoceptor vessel relaxation	NOS / sGC / beta-adrenoceptor	Extracts relaxed rat aorta rings and lowered blood pressure in hypertensive rats. ²	Animal research
Blood-sugar pathways		A 2026 review describes anti-hyperglycaemic activity in lab and animal studies of Phyllanthus species. ²⁴	Animal research

Absorption, metabolism and elimination

Absorption: No human data. In rats, four P. niruri lignans were poorly absorbed by mouth: absolute oral bioavailability 0.62% (phyllanthin), 1.52% (hypophyllanthin), 4.01% (phyltetralin), 2.66% (niranthin).
Distribution: Not found.
Metabolism: Not found.
Elimination: After injection in rats the half-lives were 3.35 to 4.40 hours; peak blood levels after oral dosing came at about 1 hour.
Bioavailability: Low for the isolated lignans in rats. Not measured in people or for other compounds.

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Isolated compounds versus whole extracts

The stone trials used extracts or capsules of P. niruri; the fatty-liver trial used a combination of P. niruri aerial-part extract and milk thistle. Pharmacokinetic work is on isolated lignans in rats. No study compares isolated compounds with the whole plant.

Nutritional composition

Not covered: no nutrition data were found in the sources read. It is sold as a supplement or tea, not a food.

11benefits and uses looked at

26studies and sources checked

Low certaintybest evidence rating found

10lab markers tracked in trials

3 low certainty3 very low certainty5 not enough evidence

What is Chanca piedra good for?

The main studied and promoted uses and how strong the human evidence is. Where a result comes from a combination product or from a related Phyllanthus species, it is said so.

Kidney stone size and numberLow certaintyA 2020 meta-analysis pooled two small controlled studies and found a modest drop in stone size and number. The authors call the evidence limited. It has not been shown to dissolve stones. Help after shock-wave lithotripsyLow certaintyIn a trial of 150 people, stone-free rates after lithotripsy were not significantly different overall (93.5% with an extract versus 83.3% with none). For lower-pole stones it was 93.7% versus 70.8%. No placebo was used. Urine chemistry and preventing stonesLow certaintyIn a placebo trial of 69 calcium-stone formers there was no overall change, but urinary calcium fell in the high-calcium subgroup. A 2025 review lists it among therapies that reduced stone risk factors. No long recurrence trial was found. Chronic hepatitis BVery low certaintyCochrane found no convincing evidence of benefit against placebo (one trial, 42 people). Fifteen trials suggest more virus-marker clearance when added to antiviral drugs, but all were at risk of bias and results are uncertain. These trials used Phyllanthus species in general, not only P. niruri. Liver enzymes in people at risk of fatty liverNot enough evidenceA 36-week trial of 146 people tested a capsule with chanca piedra and milk thistle. Enzymes fell in treated groups, but not more than with placebo. It was a combination, and the maker employs one author. Blood sugarNot enough evidenceA 2026 review says lab and animal studies suggest blood-sugar lowering, while clinical trials are limited. One 10-day study of nine people with a related species reported lower glucose. Blood pressureNot enough evidenceExtracts lowered blood pressure in hypertensive rats. In people, a nine-person study of a related species reported a fall in some groups. No proper trial exists. Diuretic effect (more urine)Very low certaintyOften called a natural water pill. Urine volume and sodium rose in the nine-person study. This is also why diuretics are listed to discuss with a provider. Cancer, infection, inflammation (lab only)Not enough evidenceReviews list antimicrobial, antioxidant, anticancer and other activity in test tubes and animals. No human evidence was found.

Benefits, one by one

Each card is a research question, not a promise. Tap a goal to filter. Open a card to see the studies, doses and limits.

Kidney stone size and number

Low certainty

This is what chanca piedra is best known for. Two small controlled studies, pooled in one 2020 review, found a modest drop in stone size and number. The reviewers call the evidence limited.

3 studiesNot covered. Products differ in plant part, species and extract.

Studies, doses and limits

What the trials found

A systematic review and meta-analysis (Dhawan 2020) found only two controlled human studies with stone size and number data. A 2025 narrative review of herbal treatments said most studies reported smaller stones or easier passing but that doses, treatment length and which stone types respond are unanswered.

Results

Pooled: stone size SMD -0.39 cm (95% CI -0.68 to -0.09); stone number SMD -0.38 (95% CI -0.68 to -0.09).

Effect sizes as reported

Standardised mean difference about -0.4 for both size and number, fixed-effects model, two studies.

Why this rating

Only two controlled studies were pooled and the authors call the evidence limited; study quality is not described in the abstract.

Form and dose studied

Not covered. Products differ in plant part, species and extract.

Who was studied

Adults with kidney stones (details not given in the abstract).

Limits

Very few studies. Stone types and products are not described. A narrow confidence interval in a pooled analysis of two studies does not make the result firm. It has not been shown to dissolve stones or replace medical stone care.

Why researchers looked

The name 'stone breaker' (quebra-pedra in Brazil) comes from its long use for kidney stones.

Traditional use

A long history of use in Brazilian medicine for kidney stones. Teas and capsules are made from the stems, leaves and seeds.

Proposed mechanism Preliminary mechanism

Lab and animal work suggests it reduces calcium oxalate crystals clumping together, changes crystal structure and reduces crystal uptake by kidney cells. A relaxing effect on the ureter (the tube from kidney to bladder) is a hypothesis that has not been confirmed.

A proposed mechanism does not show that the effect happens in people.

Anyone with kidney stones, blood in urine or severe pain should see a doctor. A stone can block the urine flow and needs medical care (see the safety file).

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Help after shock-wave lithotripsy

Low certainty

One randomised trial of 150 people found stone-free rates were not significantly different overall after shock-wave lithotripsy. For lower-pole stones, more people were stone-free with the herb. This is one trial with no placebo.

2 studiesNot covered. One commercial extract was studied.

Studies, doses and limits

What the trials found

Micali 2006: 150 adults with calcium oxalate stones had 1 to 3 lithotripsy sessions; 78 then took a P. niruri extract (Uriston) for at least 3 months and 72 had no treatment. A 2025 systematic review of 16 studies in people and rats (Iregui-Parra) says it may improve stone-free rates, especially for lower-pole stones.

Results

Stone-free at 180 days: 93.5% with the herb versus 83.3% without (p = 0.48, not significant). Lower-calyx stones (56 people): 93.7% versus 70.8% (p = 0.01). Re-treatment 39.7% versus 43.3% (p = 0.2).

Effect sizes as reported

Overall difference 10.2 percentage points (not significant); lower-calyx subgroup difference 22.9 percentage points.

Why this rating

One open-label randomised trial with a significant result only in a subgroup, plus a mixed human-and-rat systematic review.

Form and dose studied

Not covered. One commercial extract was studied.

Who was studied

Adults with calcium oxalate stones up to 25 mm.

Limits

No placebo, so patients knew their group. Subgroup finding. One product. The review mixes human and rat studies and gives no numbers in its abstract.

Why researchers looked

After stones are broken up by shock waves, fragments can stay in the kidney. An add-on that helps clear them would be useful.

Traditional use

Used by people in Brazil to help pass stones.

Proposed mechanism Pharmacological theory

Proposed: relaxing the ureter and altering crystals so fragments pass more easily. Not shown directly in people.

A proposed mechanism does not show that the effect happens in people.

The trial recorded no side effects. See a doctor for stone care.

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Urine chemistry linked to stones (urinary calcium)

Low certainty

A placebo-controlled trial of 69 people who form calcium stones found no overall change in urine chemistry. In the group with high urine calcium, calcium fell. No difference was seen in stones passed or pain.

2 studiesNot covered.

Studies, doses and limits

What the trials found

Nishiura 2004: 69 calcium-stone formers took P. niruri capsules or placebo for 3 months. The authors say larger trials in primary hypercalciuric stone formers are needed.

Results

No significant overall differences in 24-hour urine measures except a slight fall in urinary magnesium that stayed in the normal range. In people with high urine calcium, calcium fell from 4.8 to 3.4 mg/kg/24 h (p < 0.05). No significant difference in stones passed or pain relief.

Effect sizes as reported

Urinary calcium in the high-calcium subset: 4.8 to 3.4 mg/kg/24 h.

Why this rating

A small placebo-controlled trial whose positive result is a subset analysis.

Form and dose studied

Not covered.

Who was studied

Adults who form calcium stones, about 38 years old.

Limits

Subset analysis. 3 months only. The product and plant part are not described in the abstract.

Why researchers looked

High calcium in the urine raises the chance of calcium stones.

Traditional use

Same traditional use as for stones.

Proposed mechanism Preliminary mechanism

The reduction in urinary calcium is observed in a subset; the mechanism is not known.

A proposed mechanism does not show that the effect happens in people.

Urinary magnesium fell slightly (within the normal range). People who take magnesium or potassium supplements are advised to discuss them with a provider.

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Preventing calcium oxalate stones coming back

Very low certainty

A 2025 systematic review listed chanca piedra among therapies that reduced both urinary risk factors and stone formation. We found no long, large trial of stone recurrence, so this is only a lead.

2 studiesNot covered.

Studies, doses and limits

What the trials found

Lo 2025 systematic review (38 studies of many treatments) grouped P. niruri, rice bran and magnesium hydroxide as reducing both urinary risk factors and stone formation. The 2025 narrative review says dose, treatment length, drug interactions and stone types remain unanswered.

Results

No chanca piedra-specific numbers in the abstract.

Effect sizes as reported

None given.

Why this rating

Abstract-level support only; no stone-recurrence trial was read.

Form and dose studied

Not covered.

Who was studied

Adults with or without calcium oxalate stones.

Limits

The review pools many treatments and the abstract does not say how many chanca piedra studies there were.

Why researchers looked

About half of people with a stone have another one, so prevention matters.

Traditional use

Used traditionally both to treat and to prevent stones.

Proposed mechanism Preliminary mechanism

See the kidney stone entries: lab effects on crystals and some effect on urinary calcium in a subset.

A proposed mechanism does not show that the effect happens in people.

Prevention advice (fluids, diet, medicines) should come from a doctor who knows the stone type.

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Chronic hepatitis B (compared with placebo)

Not enough evidence

Cochrane found no convincing evidence that Phyllanthus species help people with chronic hepatitis B, compared with placebo. Only one small trial of 42 people made that comparison.

1 studiesNot covered. The reviewers ask future trials to report the species.

Studies, doses and limits

What the trials found

Cochrane review (Xia 2011) of 16 randomised trials in 1,326 people. One trial of 42 people compared Phyllanthus with placebo or no treatment.

Results

HBeAg seroconversion: RR 0.9 (95% CI 0.73 to 1.25) at end of treatment and RR 1.00 (95% CI 0.63 to 1.60) at follow-up. No other outcomes could be assessed.

Effect sizes as reported

No difference versus placebo in the single trial.

Why this rating

One small trial; the reviewers found no convincing evidence of benefit.

Form and dose studied

Not covered. The reviewers ask future trials to report the species.

Who was studied

Adults with chronic hepatitis B.

Limits

Trials often did not name the Phyllanthus species, so results cannot be assigned to P. niruri.

Why researchers looked

Phyllanthus species, especially P. amarus and P. urinaria, were tested in many hepatitis B trials, partly because of lab signs of activity against the virus.

Traditional use

Phyllanthus plants are used in traditional medicine in Asia and the Americas for liver problems and jaundice.

Proposed mechanism Laboratory research

Antiviral and liver-protecting activity is described in lab and animal studies. This was not tested in the abstracts we read.

A proposed mechanism does not show that the effect happens in people.

Hepatitis B is a serious infection. It needs medical care and monitoring; chanca piedra is not a treatment.

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Chronic hepatitis B (added to antiviral drugs, or compared with them)

Very low certainty

Fifteen trials suggested more virus-marker clearance when a Phyllanthus product was added to an antiviral drug. The trials were at high risk of bias and the results are uncertain. A second Cochrane review could not say whether Phyllanthus equals or beats antiviral drugs.

2 studiesNot covered. Trials used mostly compound products.

Studies, doses and limits

What the trials found

Cochrane 2011: 15 trials added Phyllanthus to interferon alpha, lamivudine, adefovir, thymosin, vidarabine or conventional treatment. Cochrane 2013: five trials (290 people), all at high risk of bias, compared compound Phyllanthus with lamivudine, interferon alpha or thymosin.

Results

Add-on: HBV DNA RR 0.69 (0.52 to 0.91), HBeAg RR 0.70 (0.60 to 0.81), HBeAg seroconversion RR 0.77 (0.63 to 0.92), with substantial heterogeneity; the HBV DNA result was not supported by trial sequential analysis. Versus antivirals: HBeAg clearance RR 0.76 (0.64 to 0.91) in ordinary analysis but not in trial sequential analysis; no effect on HBsAg (RR 1.00) or HBV DNA (RR 0.83, 0.53 to 1.31). No trial reported deaths, liver disease complications or liver biopsy results.

Effect sizes as reported

Risk ratios 0.69 to 0.77 for add-on outcomes, with heterogeneity (I2 68 to 78%).

Why this rating

All trials at high risk of bias, high heterogeneity and the authors' trial sequential analyses did not confirm the results.

Form and dose studied

Not covered. Trials used mostly compound products.

Who was studied

Adults with chronic hepatitis B.

Limits

Compound products and several species; surrogate lab markers only; no outcomes such as deaths or liver complications.

Why researchers looked

Researchers wanted to know if the herb adds to standard antiviral treatment.

Traditional use

See the previous entry.

Proposed mechanism Laboratory research

Not established in people.

A proposed mechanism does not show that the effect happens in people.

Do not stop prescribed hepatitis B treatment for an herbal product. Only two trials reported side effects, with no significant differences and no serious events.

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Liver enzymes in people at risk of fatty liver (NASH)

Not enough evidence

A 36-week trial of 146 people tested a capsule combining chanca piedra aerial-part extract and milk thistle. Liver enzymes fell in the treated groups, but the change was not different from placebo.

1 studiesNot covered.

Studies, doses and limits

What the trials found

Shaker 2025: phase II, double-blind, placebo-controlled trial in Egypt of Heptex capsules (200 mg P. niruri aerial-part extract plus 100 mg milk thistle fruit extract); placebo, one capsule or two capsules daily.

Results

ALT fell 57 to 40 IU/L (low dose, p = 0.026) and 61 to 47.5 IU/L (high dose, p < 0.0001); AST fell 43.5 to 32 IU/L in the high-dose group (p = 0.001). Between groups: ALT p = 0.465, AST p = 0.632, Fib-4 p = 0.985, so no difference from placebo.

Effect sizes as reported

Within-group changes only; no between-group effect.

Why this rating

A single combination-product trial with no between-group difference.

Form and dose studied

Not covered.

Who was studied

146 adults with risk factors for NASH.

Limits

Combination product, so chanca piedra's own effect is unknown. Registered after the trial. One author works for the product company.

Why researchers looked

Both plants have a reputation for supporting the liver.

Traditional use

Phyllanthus plants are used in folk medicine for liver complaints.

Proposed mechanism Pharmacological theory

Antioxidant and anti-inflammatory effects on liver cells are proposed; not tested here.

A proposed mechanism does not show that the effect happens in people.

The authors report the capsules were safe and well tolerated over 36 weeks.

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Blood sugar

Not enough evidence

A 2026 review says lab and animal studies suggest blood-sugar lowering, while clinical trials are limited. One tiny 10-day study of 9 people with mild high blood pressure reported lower blood glucose.

2 studiesNot covered.

Studies, doses and limits

What the trials found

Srividya 1995: nine people with mild hypertension (four also had diabetes) took a whole-plant Phyllanthus amarus preparation for 10 days. Wong 2026 review: clinical trials with clear antidiabetic effects are limited.

Results

Blood glucose fell significantly in the treated group (no numbers in the abstract).

Effect sizes as reported

None given in the abstract.

Why this rating

Nine people, 10 days, no clear control group; the rest is lab and animal evidence.

Form and dose studied

Not covered.

Who was studied

Nine adults with mild hypertension.

Limits

Tiny and old study, a related species, subgroup reporting. The review mixes three species.

Why researchers looked

Phyllanthus plants are used in Southeast Asian traditional medicine for diabetes.

Traditional use

Traditional use for diabetes in the Malay Peninsula and Southeast Asia is described in a 2026 review.

Proposed mechanism Animal research

The review describes anti-hyperglycaemic activity in lab and animal studies of Phyllanthus species.

A proposed mechanism does not show that the effect happens in people.

People who take diabetes medicines should ask a doctor or pharmacist first, because of a theoretical low-blood-sugar risk.

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Blood pressure

Not enough evidence

Extracts lowered blood pressure in hypertensive rats. In people, one tiny 10-day study reported a drop in systolic pressure in some subgroups. There are no proper trials.

3 studiesNot covered.

Studies, doses and limits

What the trials found

Srividya 1995 (nine people, 10 days). No randomised trial of chanca piedra for blood pressure was found.

Results

Systolic blood pressure fell significantly in non-diabetic hypertensive people and in women. No numbers in the abstract. In rats, all four extracts lowered blood pressure from baseline; the petroleum-ether extract was strongest.

Effect sizes as reported

None given in the abstracts.

Why this rating

A nine-person study and animal work.

Form and dose studied

Not covered.

Who was studied

Nine adults with mild hypertension; spontaneously hypertensive rats.

Limits

Subgroup results, no placebo described, related species. The strongest rat extract was made with a laboratory solvent, unlike home preparations.

Why researchers looked

Traditional use for high blood pressure.

Traditional use

Reported as a traditional treatment for hypertension.

Proposed mechanism Animal research

In rat aorta rings, an extract relaxed the vessel through nitric oxide and beta-adrenoceptor pathways. This is lab and animal work.

A proposed mechanism does not show that the effect happens in people.

If you take blood pressure medicines, ask a doctor or pharmacist first; a combined effect is theoretical.

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Diuretic effect (more urine)

Very low certainty

The herb is traditionally called a diuretic. In the nine-person study urine volume and urine and blood sodium rose. It has not been tested in a proper trial.

2 studiesNot covered.

Studies, doses and limits

What the trials found

Srividya 1995 (nine people).

Results

24-hour urine volume and urine and serum sodium rose significantly (no numbers in the abstract).

Effect sizes as reported

None given in the abstract.

Why this rating

One tiny, old study of a related species.

Form and dose studied

Not covered.

Who was studied

Nine adults with mild hypertension.

Limits

Very small, uncontrolled as far as the abstract says, species Phyllanthus amarus.

Why researchers looked

Traditional use to increase urine flow.

Traditional use

WebMD says it may act as a diuretic.

Proposed mechanism Pharmacological theory

Not established.

A proposed mechanism does not show that the effect happens in people.

A diuretic effect is why diuretics, magnesium and potassium should be discussed with a provider.

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Cancer, infection, inflammation and antioxidant claims (lab only)

Not enough evidence

Reviews describe antimicrobial, antioxidant, anticancer, anti-inflammatory and antiviral activity in the lab. These are test-tube and animal findings, not treatments.

1 studiesNot covered.

Studies, doses and limits

What the trials found

None found for these uses in the sources read.

Results

No outcome data in people.

Effect sizes as reported

None.

Why this rating

Lab-only evidence.

Form and dose studied

Not covered.

Who was studied

None studied.

Limits

Cell and animal results often do not carry over to people.

Why researchers looked

Many plant compounds show activity in cells.

Traditional use

Traditional uses are broad.

Proposed mechanism Laboratory research

Lab and animal findings only.

A proposed mechanism does not show that the effect happens in people.

Do not use it in place of treatment for cancer or infection.

¹¹

Connections to the rest of health

How Chanca piedra connects to the rest of our health knowledge graph. Every link says what kind of connection it is. A safety link (for example to the liver) is a warning, not a benefit. A study that merely mentions a topic never creates a benefit link.

Explore every connection: goals, body systems, organs, symptoms, genes

Kind of connection Connected to Search

A. Wellness goals

Connected to	Kind of connection	Evidence status	Context	Studies
Liver Support	Potential benefit	Not enough evidence	Chronic hepatitis B (compared with placebo): Cochrane found no convincing evidence that Phyllanthus species help people with chronic hepatitis B, compared with placebo. Only one small trial of 42 people made that comparison.	²⁵
Liver Support	Preliminary mechanism	Very low certainty	Chronic hepatitis B (added to antiviral drugs, or compared with them): Fifteen trials suggested more virus-marker clearance when a Phyllanthus product was added to an antiviral drug. The trials were at high risk of bias and the results are uncertain. A second Cochrane review could not say whether Phyllanthus equals or beats antiviral drugs. Liver enzymes in people at risk of fatty liver (NASH): A 36-week trial of 146 people tested a capsule combining chanca piedra aerial-part extract and milk thistle. Liver enzymes fell in the treated groups, but the change was not different from placebo.	^{25 26 21}
Blood Sugar Balance	Preliminary mechanism	Not enough evidence	Blood sugar: A 2026 review says lab and animal studies suggest blood-sugar lowering, while clinical trials are limited. One tiny 10-day study of 9 people with mild high blood pressure reported lower blood glucose.	^{22 24}
Blood Pressure Support	Preliminary mechanism	Not enough evidence	Blood pressure: Extracts lowered blood pressure in hypertensive rats. In people, one tiny 10-day study reported a drop in systolic pressure in some subgroups. There are no proper trials.	^{22 2 7}

B. Body systems

Connected to	Kind of connection	Evidence status	Context	Studies
Kidney and urinary system	Potential benefit	Low certainty	Small studies for stone size and stone-free rate after lithotripsy. Preparation or compound: P. niruri products	^{5 13 18}
Liver	Preliminary mechanism	Very low certainty	Cochrane found no convincing benefit versus placebo; add-on results uncertain. Preparation or compound: Phyllanthus species (hepatitis B); P. niruri plus milk thistle (fatty liver)	^{25 26 21}
Kidney Urinary	Biological association	Low certainty	Studied for: Kidney stone size and number Studied for: Help after shock-wave lithotripsy	^{5 15 3 13 10 18 12 22 23}
Urinary System	Biological association	Low certainty	Studied for: Kidney stone size and number	^{5 15 3}
Liver Detox	Biological association	Not enough evidence	Studied for: Chronic hepatitis B (compared with placebo) Studied for: Chronic hepatitis B (added to antiviral drugs, or compared with them)	^{25 26 21}
Hepatic System	Biological association	Not enough evidence	Studied for: Chronic hepatitis B (compared with placebo) Studied for: Chronic hepatitis B (added to antiviral drugs, or compared with them)	^{25 26 21}
Blood Sugar Support	Biological association	Not enough evidence	Studied for: Blood sugar	^{22 24}
Heart Circulation	Biological association	Not enough evidence	Studied for: Blood pressure	^{22 2 7}
Cardiovascular System	Biological association	Not enough evidence	Studied for: Blood pressure	^{22 2 7}
Immune System	Biological association	Not enough evidence	Studied for: Cancer, infection, inflammation and antioxidant claims (lab only)	¹¹

E. Health conditions

Connected to	Kind of connection	Evidence status	Context	Studies
Chronic hepatitis B	Preliminary mechanism	Very low certainty	Cochrane: no convincing benefit versus placebo; add-on results uncertain. Preparation or compound: Phyllanthus species	^{25 26}

I. Biomarkers

Connected to	Kind of connection	Evidence status	Context	Studies
Kidney stone size and number	Biological association	Low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	⁵
Stone-free rate after lithotripsy	Biological association	Low certainty	Measured in trials: mixed. A lab change is not the same as a health benefit.	^{13 10}
24-hour urinary calcium	Biological association	Low certainty	Measured in trials: mixed. A lab change is not the same as a health benefit.	¹⁸
24-hour urinary magnesium	Biological association	Low certainty	Measured in trials: lowered. A lab change is not the same as a health benefit.	¹⁸
HBeAg seroconversion (hepatitis B marker)	Biological association	Very low certainty	Measured in trials: mixed. A lab change is not the same as a health benefit.	^{25 26}
HBV DNA (viral load)	Biological association	Very low certainty	Measured in trials: mixed. A lab change is not the same as a health benefit.	^{25 26}
ALT and AST (liver enzymes)	Biological association	Not enough evidence	Measured in trials: no-change. A lab change is not the same as a health benefit.	²¹
Systolic blood pressure	Biological association	Not enough evidence	Measured in trials: lowered. A lab change is not the same as a health benefit.	²²
Blood glucose	Biological association	Not enough evidence	Measured in trials: lowered. A lab change is not the same as a health benefit.	^{22 24}
24-hour urine volume and sodium	Biological association	Very low certainty	Measured in trials: raised. A lab change is not the same as a health benefit.	²²

K. Biological pathways

Connected to	Kind of connection	Evidence status	Context	Studies
Nitric oxide / cGMP signalling	Preliminary mechanism	Animal	Vessel relaxation in rat aorta; relevance in people unknown.	²
Targets of thiazide-like diuretics, calcium channel blockers, ACE inhibitors, ARBs, CYP enzymes	Preliminary mechanism	In silico	Predicted binding in a computer model.	⁷

L. Active compounds

Connected to	Kind of connection	Evidence status	Context	Studies
Phyllanthin	Biological association	Animal	Measured in rat blood after a plant extract; oral bioavailability in rats 0.62%. Preparation or compound: Aerial parts (assumed from plant extracts)	¹⁴
Hypophyllanthin	Biological association	Animal	Oral bioavailability in rats 1.52%; half-life about 3.9 hours after injection. Preparation or compound: Aerial parts (assumed)	¹⁴
Niranthin	Biological association	Animal	Oral bioavailability in rats 2.66%. Preparation or compound: Aerial parts (assumed)	¹⁴
Phyltetralin	Biological association	Animal	Oral bioavailability in rats 4.01%. PubChem ID not looked up. Preparation or compound: Aerial parts (assumed)	¹⁴
Rutin	Biological association	In silico	A computer docking paper names rutin among plant compounds with predicted drug-target binding. Presence in P. niruri was NOT verified from a source read. Preparation or compound: Not verified	^{7 20}
Quercetin	Biological association	Unverified	A common plant flavonoid sometimes listed for the genus. Presence in P. niruri NOT verified from a source read. Preparation or compound: Not verified	²⁰

Each connection is stored with the ingredient, the connected record, the kind of connection, the evidence status, the supporting studies, the preparation or compound involved, and a review date (last reviewed October 25, 2026).

Evidence at a glance: what changed in 10 lab markers

Tap a number to show only those markers. Counts are markers, not people.

Metabolic1 Other3114

The evidence

The research centre for Chanca piedra. Every record here was checked against PubMed or the publisher's page; we never list a study we have not verified.

Evidence by outcome

Kidney stone size and number 3 studies Low certainty Help after shock-wave lithotripsy 2 studies · 150 people in trials Low certainty Urine chemistry linked to stones (urinary calcium) 2 studies · 69 people in trials Low certainty Preventing calcium oxalate stones coming back 2 studies Very low certainty Chronic hepatitis B (compared with placebo) 1 studies Not enough evidence Chronic hepatitis B (added to antiviral drugs, or compared with them) 2 studies Very low certainty Liver enzymes in people at risk of fatty liver (NASH) 1 studies · 146 people in trials Not enough evidence Blood sugar 2 studies Not enough evidence Blood pressure 3 studies Not enough evidence Diuretic effect (more urine) 2 studies Very low certainty Cancer, infection, inflammation and antioxidant claims (lab only) 1 studies Not enough evidence

Bars show how many studies we found for each outcome, not how well it works. People are added up across trials only (reviews are not added, to avoid double counting).

How we rate evidence

High certainty

Several well-run trials or reviews agree; further research is unlikely to change the picture much.

Moderate certainty

Good trials point the same way, but some doubt remains.

Low certainty

Small, short or inconsistent trials. The finding could change with better research.

Very low certainty

Very little or very weak human data. Treat as a possibility only.

Mixed findings

Trials or reviews disagree with each other.

Not enough evidence

Not enough human research to say either way.

Evidence against

Good research found no benefit, or found harm.

We take the reviewers' own risk-of-bias and GRADE statements where they exist, and otherwise judge from study size, design, consistency, directness and whether a product matches what is sold. Many publications do not make evidence high. Method note: We searched PubMed and read each abstract directly, and checked plant names through GBIF and compound IDs through PubChem. WebMD was read in full. NCCIH has no chanca piedra page; EMA and LiverTox could not be opened; LactMed, Commission E and WHO were not checked. Full texts were mostly not read.

Study library: every study we checked 26

Design Research type Plant part Year from Search

Study	Design	People	Product, dose, length	Result
Asare 2012 Genotoxicity, cytotoxicity and toxicological evaluation of whole plant extracts of the medicinal plant Phyllanthus niruri (Phyllanthaceae) Genet Mol Res · PMID 22290470 · DOI	Animal research animal	Laboratory rats; human blood cells in the lab	Ethanol extract of the whole P. niruri plant whole plant 30 or 300 mg/kg by gavage Single dose; 90 days for the subchronic test · vs Saline (negative) and a known DNA-damaging chemical (positive)	The extract did not cause DNA damage in rat bone marrow (ratio 63 versus 168 for the positive control), was cytotoxic only at high concentrations (CC50 26.3 mg/mL), and showed no liver or kidney toxicity after 90 days in rats. The authors call it generally non-toxic. CC50 26.3 mg/mL (n/a) Methods, limits and funding Outcomes: Bone-marrow genotoxicity, cell toxicity, 90-day kidney and liver toxicity Limitations: Rats and cells, one ethanol extract of the whole plant. Not a human safety study. Funding and conflicts: Not stated in the abstract. Read: abstract
Bello 2020 Blood pressure lowering effect and vascular activity of Phyllanthus niruri extract: The role of NO/cGMP signaling pathway and beta-adrenoceptor mediated relaxation of isolated aortic rings J Ethnopharmacol · PMID 31830549 · DOI	Animal research animal	Spontaneously hypertensive rats and isolated rat aorta rings	Four solvent extracts of P. niruri (petroleum ether, chloroform, methanol, water) unspecified Daily oral gavage; amounts not given in the abstract 2 weeks · vs Baseline values / untreated	All extracts lowered blood pressure in the hypertensive rats compared with baseline, with the petroleum-ether extract the strongest. The same extract relaxed rat aorta rings through endothelium-dependent pathways (nitric oxide) and beta-adrenoceptor activity. Reduction vs baseline; no numbers in the abstract (n/a) Methods, limits and funding Outcomes: Blood pressure; vessel relaxation Limitations: Rats and isolated tissue only. The strongest extract was a petroleum-ether extract, unlike a tea or capsule. Funding and conflicts: Not stated in the abstract. Read: abstract
Boim 2010 Phyllanthus niruri as a promising alternative treatment for nephrolithiasis Int Braz J Urol · PMID 21176271 · DOI	Narrative review	Lab, animal and clinical data on P. niruri and stones, partly from the authors' own group	P. niruri unspecified not covered not covered · vs Varies	The review says P. niruri interferes with several stages of stone formation in lab and animal work (less crystal clumping, changed crystal structure, less crystal uptake by kidney cells). Clinical benefit may relate to relaxing the ureter or to lowering urinary calcium. It reports no adverse kidney, heart, nerve or toxic effects in the studies reviewed, and says longer randomised trials are needed. Not pooled (n/a) Methods, limits and funding Outcomes: How stones form; clinical effects; safety Limitations: Narrative review by authors who ran some of the studies reviewed. The ureter-relaxing idea is a hypothesis. Funding and conflicts: Not stated in the abstract; the authors review their own group's work. Read: abstract
Costa Alves 2025 Phyllanthus niruri L. Administration during pregnancy and breastfeeding: Maternal evaluation and effects on initial development and adult behavior of male rat offspring Brain Res · PMID 39694168 · DOI	Animal research animal	24 Pregnant rats, three groups of 8, and their male pups	Aqueous extract of P. niruri leaves leaf 75 or 150 mg/kg by gavage Through pregnancy and lactation · vs Vehicle	No significant change in maternal and reproductive measures, but changes in biochemical markers of liver function were seen in the mothers. Pups' growth was not changed, but eyes and ear canal opened early and adult males showed behaviour changes the authors read as anxiolytic. The authors note that use of the plant is contraindicated in pregnancy and breastfeeding in folk medicine, and that earlier reports were scarce and controversial. Liver marker changes in dams; early eye and ear opening in pups (n/a) Methods, limits and funding Outcomes: Maternal toxicity, pup development, adult behaviour Limitations: Rats only. The abstract does not say which liver markers changed or by how much. Funding and conflicts: Not stated in the abstract. Read: abstract
Dhawan 2020 Phyllanthus niruri (stone breaker) herbal therapy for kidney stones; a systematic review and meta-analysis of clinical efficacy, and Google Trends analysis of public interest Can J Urol · PMID 32333735	Meta-analysis	Controlled human studies of P. niruri with stone size and number data; two studies met the criteria	P. niruri products (plant part and product not stated in the abstract) unspecified not stated in abstract not stated in abstract · vs Control groups of the included studies	Two studies met the criteria. Pooled (fixed-effects) change in mean stone size was SMD -0.39 cm and in stone number SMD -0.38, both favouring P. niruri. The authors conclude limited clinical evidence supports a modest effect, pending further study. Stone size SMD -0.39 cm; stone number SMD -0.38 (Size: 95% CI -0.68 to -0.09, p = 0.01; number: 95% CI -0.68 to -0.09, p = 0.01) Methods, limits and funding Outcomes: Change in mean stone size and number Limitations: Only two studies were pooled. The abstract does not describe the products, stone types or study quality. The paper also analyses Google search interest, which is not evidence of benefit. Funding and conflicts: None stated in the abstract. Read: abstract
European Medicines Agency 2026 EMA / HMPC herbal monograph search for Phyllanthus (not confirmed) European Medicines Agency · Source	Regulator record		Chanca piedra (Phyllanthus niruri) unspecified	Checked 2026-10-25. The EMA search page returned a security check ('unusual traffic') to the command-line request, so no result was read. No monograph is known to have been found; this is not confirmed either way. Methods, limits and funding Limitations: Access blocked; absence not verified. Read: full-text
Evadgian 2022 Use of Cheminformatics to Determine Potential Drug Interactions between Popular Barbadian Botanical Medicines and Antihypertensive Drugs ACS Omega · PMID 36530331 · DOI	In silico in-vitro	Computer docking of 30 plant compounds from 11 Barbadian plants against targets of common blood pressure drugs	Compounds from P. niruri among those screened unspecified n/a n/a · vs n/a	Compounds from four plants, including P. niruri, showed strong predicted binding to targets of thiazide-like diuretics, calcium channel blockers, ACE inhibitors and ARBs, and to liver enzymes (CYP) and transporters. The authors say these are likely interactions to study, and that in-vitro and in-vivo work is needed. Computer prediction only (n/a) Methods, limits and funding Outcomes: Predicted binding to drug targets and enzymes Limitations: Computer model, not a measured interaction. Many plants and compounds are grouped together in the abstract. Funding and conflicts: The authors declare no competing financial interest. Read: abstract
GBIF 2026 GBIF Backbone Taxonomy species match: Phyllanthus niruri, P. amarus, P. urinaria, P. emblica GBIF · Source	Database		Chanca piedra (Phyllanthus niruri) unspecified	Checked 2026-10-25. Phyllanthus niruri L. (key 5381945) is ACCEPTED, family Phyllanthaceae, order Malpighiales. Phyllanthus amarus Schumach. & Thonn. (key 5382589), Phyllanthus urinaria L. (key 5382780) and Phyllanthus emblica L. (key 5381660) are each separate ACCEPTED species in the same family. Methods, limits and funding Limitations: Accepted name not cross-checked in Plants of the World Online. Read: full-text
Iranloye 2010 Effect of aqueous extract of Phyllantus amarus leaves on implantation and pregnancy in rats Niger J Physiol Sci · PMID 22314905	Animal research animal	36 Pregnant rats, two groups of 18	Aqueous extract of Phyllanthus amarus leaves (a related species, not P. niruri) leaf 0.2 mg/100 g body weight (as reported) From day 1 of pregnancy; groups checked on days 6, 8 and 19 · vs Distilled water	The extract shortened the time frame for implantation and caused abortion in the pregnant rats. The authors say this abortifacient effect does not support the traditional claim that it treats sterility. Abortion in treated rats; numbers not in the abstract (n/a) Methods, limits and funding Outcomes: Implantation and pregnancy Limitations: Rats; a different species of Phyllanthus. Small groups; no numbers in the abstract. Funding and conflicts: Not stated in the abstract. Read: abstract
Iregui-Parra 2025 Phyllanthus niruri in the management of nephrolithiasis: A systematic review of the literature Actas Urol Esp (Engl Ed) · PMID 40480426 · DOI	Systematic review	16 16 studies in people and rats, 1994 to September 2022 (English and Spanish)	P. niruri (products vary) unspecified not covered not covered · vs Varies	The authors report that P. niruri works through several lab-described mechanisms (it affects crystal clumping and stone formation), that serial blood tests in the studies showed no harm to electrolytes or liver function, and that it may improve stone-free rates after shock-wave lithotripsy, especially for lower-pole stones. They conclude it is safe and may help when used alongside standard treatment. 16 studies; no pooled number in the abstract (n/a) Methods, limits and funding Outcomes: Stone-free rate after shock-wave lithotripsy; safety Limitations: Studies were limited to those the authors could access through their institutions. Human and rat studies are mixed together. The abstract gives no numbers, and the authors themselves describe earlier results as mixed. Funding and conflicts: The authors declare no conflicts. Read: abstract
Kaur 2017 Phytochemistry and Pharmacology of Phyllanthus niruri L.: A Review Phytother Res · PMID 28512988 · DOI	Narrative review in-vitro	Literature on P. niruri chemistry and lab, animal and traditional uses	P. niruri unspecified not covered not covered · vs n/a	The review lists 83 phytochemicals and reports traditional and lab-described activities (antimicrobial, antioxidant, anticancer, anti-inflammatory, antiplasmodial, antiviral, diuretic, hepatoprotective), with emphasis on anticancer mechanisms. It points to inconsistent plant naming as a gap. 83 compounds (n/a) Methods, limits and funding Outcomes: Compounds and pharmacological activities Limitations: A review of mostly lab work; the abstract gives no human findings. It places the plant in Euphorbiaceae, an older family placement. Funding and conflicts: Not stated in the abstract. Read: abstract
Lo 2025 Systematic review of pharmacological, complementary, and alternative therapies for the prevention of calcium oxalate stones Asian J Urol · PMID 40458577 · DOI	Systematic review	38 38 studies of adults with or without calcium oxalate stones, searched to November 2022	Many treatments; P. niruri is one unspecified not covered not covered · vs Varies	P. niruri, rice bran and magnesium hydroxide were grouped as therapies that reduced both urinary risk factors and stone formation. The authors say several therapies may be useful to consider for future prevention guidelines. 38 studies; no chanca piedra numbers in the abstract (n/a) Methods, limits and funding Outcomes: Urinary stone risk factors and stone formation Limitations: The abstract does not say how many chanca piedra studies there were or how strong they were. Other treatments in the review are not herbal. Funding and conflicts: The authors declare no conflicts. Read: abstract
Micali 2006 Can Phyllanthus niruri affect the efficacy of extracorporeal shock wave lithotripsy for renal stones? A randomized, prospective, long-term study J Urol · PMID 16890682 · DOI	Controlled trial	150 150 adults with calcium oxalate kidney stones up to 25 mm who had 1 to 3 shock-wave lithotripsy sessions	Uriston, a P. niruri extract (commercial product) unspecified 2 g daily (as reported) At least 3 months, follow-up 180 days · vs No treatment after lithotripsy (no placebo)	Stone-free rate at 180 days was 93.5% with P. niruri and 83.3% in the control group (p = 0.48, not significant). In the 56 patients with lower-calyx stones it was 93.7% versus 70.8% (p = 0.01). Re-treatment was 39.7% versus 43.3% (p = 0.2). No side effects were recorded. Overall stone-free 93.5% vs 83.3%; lower-calyx subgroup 93.7% vs 70.8% (Not given in the abstract) Methods, limits and funding Outcomes: Stone-free rate at 180 days (no stones or fragments under 3 mm), re-treatment, side effects Limitations: No placebo; patients knew which group they were in. The overall difference was not significant, and the lower-calyx result is a subgroup finding. Only calcium oxalate stones. One product. Funding and conflicts: Not stated in the abstract. Read: abstract
Murugaiyah 2007 Analysis of lignans from Phyllanthus niruri L. in plasma using a simple HPLC method with fluorescence detection and its application in a pharmacokinetic study J Chromatogr B · PMID 17261384 · DOI	Animal research animal	Rats	Four lignans from P. niruri (phyllanthin, hypophyllanthin, phyltetralin, niranthin) unspecified Intravenous and oral (amounts not given in the abstract) Single dose · vs n/a	After an injection the four lignans cleared slowly, with half-lives of 3.35 to 4.40 hours. After oral doses blood levels peaked at about 1 hour, but absorption was incomplete: absolute oral bioavailability was 0.62% (phyllanthin), 1.52% (hypophyllanthin), 4.01% (phyltetralin) and 2.66% (niranthin). Oral bioavailability 0.62 to 4.01% (n/a) Methods, limits and funding Outcomes: Blood levels, half-life, bioavailability Limitations: Rats and isolated lignans, not a whole-herb product. No human data. Funding and conflicts: Not stated in the abstract. Read: abstract
Mutomba 2025 Phytotherapy in Urolithiasis: An Updated Overview of Current Knowledge J Clin Med · PMID 40363917 · DOI	Narrative review	Randomised human studies of herbal medicines for kidney and urinary stones (mixtures and single plants)	Herbal mixtures and single-plant extracts (chanca piedra is one of many) unspecified not covered not covered · vs Varies	Most studies reviewed reported benefit in reducing stone size and helping stones pass. The authors say questions about dosing, mechanisms, drug interactions, treatment length and which stone types respond remain unanswered, and that herbal therapy is mostly used as an add-on to standard care. Not pooled (n/a) Methods, limits and funding Outcomes: Stone size, stone expulsion Limitations: Narrative review, not a systematic one. It covers many herbs; the abstract does not give chanca piedra results separately. It says drug interactions are an open question. Funding and conflicts: The authors declare no commercial or financial conflicts. Read: abstract
NIH LiverTox 2026 NIH LiverTox (access blocked) NIH LiverTox · Source	Regulator record		Chanca piedra (Phyllanthus niruri) unspecified	Checked 2026-10-25. The NCBI Bookshelf returned a reCAPTCHA browser check to the command-line request, so no LiverTox entry for Phyllanthus or chanca piedra could be read. Whether an entry exists is not confirmed. Methods, limits and funding Limitations: Access blocked; absence not verified. The nutrient summary also noted LiverTox was blocked. Read: full-text
NIH NCCIH 2026 NCCIH herb page for chanca piedra (not found) NIH NCCIH · Source	Regulator record		Chanca piedra (Phyllanthus niruri) unspecified	Checked 2026-10-25. The address https://www.nccih.nih.gov/health/chanca-piedra returns 'Page not found'. No NCCIH page for this herb was found. Methods, limits and funding Limitations: Absence of a page, not a statement about safety. Read: full-text
Nishiura 2004 Phyllanthus niruri normalizes elevated urinary calcium levels in calcium stone forming (CSF) patients Urol Res · PMID 15221244 · DOI	Controlled trial	69 69 people who form calcium stones (39 men, 30 women, about 38 years old)	P. niruri capsules unspecified 450 mg capsules three times a day (as reported) 3 months · vs Placebo	Overall there were no significant differences in urine measures, except a slight fall in urinary magnesium that stayed in the normal range. In a subset with high urine calcium, calcium fell from 4.8 to 3.4 mg/kg/24 h (p < 0.05). No significant differences in stones passed or pain relief were found in this short follow-up. The authors say larger trials are needed. Urinary calcium in the high-calcium subset 4.8 to 3.4 mg/kg/24 h (p < 0.05 (subset)) Methods, limits and funding Outcomes: 24-hour urine calcium, oxalate, citrate, uric acid, magnesium, sodium, potassium; stone passing and pain Limitations: The calcium result comes from a subset analysis, not the main comparison. Short (3 months). Plant part and product not stated in the abstract. Funding and conflicts: Not stated in the abstract. Read: abstract
Paula 2020 Maternal-fetal repercussions of Phyllanthus niruri L. treatment during rat pregnancy J Ethnopharmacol · PMID 32145330 · DOI	Animal research animal	Pregnant rats, four groups	Aqueous (water) extract of P. niruri (the authors refer to the leaf extract) leaf 150, 300 or 600 mg/kg by gavage Gestational day 0 to 21 · vs Water	Treatment did not change reproductive performance outcomes and caused no birth defects. At the top dose (600 mg/kg) the mothers' kidney weight and structure changed, and pups showed macrosomia (larger size) and more ossification sites. The authors say the leaf extract can have detrimental effects during pregnancy. Kidney changes in dams at top dose; larger fetuses (n/a) Methods, limits and funding Outcomes: Maternal toxicity, reproductive outcomes, fetal anomalies Limitations: Rats. The dose-to-human conversion is unknown. One extract. Funding and conflicts: No competing interests declared. Read: abstract
PubChem 2026 PubChem compound records (name lookup) PubChem · Source	Database		Chanca piedra (Phyllanthus niruri) unspecified	Checked 2026-10-25 by name: phyllanthin CID 358901 (C24H34O6); hypophyllanthin CID 182140 (C24H30O7); niranthin CID 11575632 (C24H32O7); quercetin CID 5280343 (C15H10O7); rutin CID 5280805 (C27H30O16). Methods, limits and funding Limitations: Checked by name only. This does not show that each compound occurs in the plant. Read: full-text
Shaker 2025 The activity of a herbal medicinal product of Phyllanthus niruri and Silybum marianum powdered extracts (Heptex) in patients with apparent risk factors for nonalcoholic steatohepatitis: a phase II, multicentered, randomized, double-blind, placebo-controlled clinical trial BMC Complement Med Ther · PMID 39789561 · DOI	Controlled trial	146 146 adults with risk factors for NASH (fatty liver with inflammation), Egypt	Capsule with 200 mg powdered P. niruri aerial-part extract plus 100 mg milk thistle fruit extract (combination) aerial parts 1 or 2 capsules a day (low or high dose) 36 weeks · vs Placebo	ALT fell in the low-dose group (57 to 40 IU/L, p = 0.026) and the high-dose group (61 to 47.5 IU/L, p < 0.0001); AST fell in the high-dose group (43.5 to 32 IU/L, p = 0.001). But there was no significant difference between the three groups in the percent change in ALT (p = 0.465) or AST (p = 0.632), or in Fib-4 (p = 0.985). Total cholesterol fell in the low-dose group only. The authors say the capsules were safe and well tolerated over 36 weeks and that the liver effect needs further assessment. No between-group difference in ALT, AST or Fib-4 (ALT between groups p = 0.465; AST p = 0.632) Methods, limits and funding Outcomes: ALT, AST, Fib-4 score, lipids, liver scans Limitations: Combination product, so effects cannot be given to chanca piedra alone. Within-group falls were not different from placebo. Registered after the trial (April 2022). Not a trial of chanca piedra alone. Funding and conflicts: One author is an employee of the product company (Natural Wellness); the others declare no conflicts. Industry-linked. Read: abstract
Srividya 1995 Diuretic, hypotensive and hypoglycaemic effect of Phyllanthus amarus Indian J Exp Biol · PMID 8786163	Controlled clinical trial	9 9 people with mild high blood pressure, 4 of them also with diabetes	Whole-plant preparation of Phyllanthus amarus (the authors call it a synonym of P. niruri; GBIF lists them as separate species) whole plant not given in the abstract 10 days · vs Not described in the abstract (before-and-after comparison)	24-hour urine volume and urine and serum sodium rose significantly. Systolic blood pressure fell significantly in the non-diabetic people and in women. Blood glucose fell significantly in the treated group. No harmful side effects were seen on clinical observation. No numbers in the abstract (Not given) Methods, limits and funding Outcomes: 24-hour urine volume, urine and serum sodium, blood pressure, blood glucose Limitations: Nine people for 10 days, no placebo described, different species name, 1995. Too small to rely on. Results by subgroup. Funding and conflicts: Not stated in the abstract. Read: abstract
WebMD 2025 Chanca Piedra: Overview, Uses, Side Effects, Precautions, Interactions, Dosing and Reviews WebMD (consumer drug reference) · Source	Consumer reference		Chanca piedra (Phyllanthus niruri) unspecified	Reference page: made from stems, leaves and seeds of Phyllanthus niruri; traditionally used for kidney stones; may act as a diuretic; small studies in people with liver problems have not shown benefit; most common side effects nausea and vomiting; serious allergic reaction possible. Tell your provider if you have diabetes, gallstones, kidney problems (including kidney stones), hepatitis, or low potassium or magnesium. Medicines and supplements to discuss: diuretics, magnesium and potassium supplements; interaction research is incomplete. Not known whether it affects pregnancy or passes into breast milk. The FDA has not reviewed it for safety and effectiveness. Products vary by plant part and maker. Methods, limits and funding Limitations: A consumer reference for the public, not primary research. It lists dosing, which this page does not repeat. The page text had no dated clinical citations for the safety statements. Read: full-text
Wong 2026 Unlocking the Potential of Phyllanthus Species From Traditional Knowledge to Clinical Trials: An Updated Review of Metabolomics Approach in Diabetes Intervention Phytother Res · PMID 41539677 · DOI	Narrative review	P. niruri, P. urinaria and P. acidus; mostly in-vitro and animal studies, 2010 to 2025	Phyllanthus species (three species reviewed) unspecified not covered not covered · vs Varies	The review says in-vitro and animal studies show anti-hyperglycaemic activity of Phyllanthus species, while clinical trials with clear antidiabetic effects are limited. It reports toxicity data suggest lower doses are safe without significant adverse effects. It describes Southeast Asian traditional use. Not pooled (n/a) Methods, limits and funding Outcomes: Blood sugar, toxicity Limitations: Mostly lab and animal evidence. Species are mixed. The abstract gives no human numbers. Funding and conflicts: Not stated in the abstract. Read: abstract
Xia 2011 Phyllanthus species for chronic hepatitis B virus infection Cochrane Database Syst Rev · PMID 21491412 · DOI	Systematic review	1326 16 randomised trials, 1,326 people with chronic hepatitis B	Phyllanthus species (trials often did not name the species) unspecified not covered 3 to 12 months · vs Placebo, or the same antiviral drug alone	One trial of 42 people compared Phyllanthus with placebo and found no significant difference in HBeAg seroconversion (RR 0.9, 95% CI 0.73 to 1.25 at end of treatment; RR 1.00, 95% CI 0.63 to 1.60 at follow-up). Fifteen trials added Phyllanthus to an antiviral drug: it improved HBV DNA (RR 0.69), HBeAg (RR 0.70) and HBeAg seroconversion (RR 0.77), but heterogeneity was substantial and the HBV DNA result was not supported by trial sequential analysis. No trial reported deaths, liver disease complications, quality of life or liver biopsy results. Only two reported adverse events, with no significant differences and no serious events. The authors conclude there is no convincing evidence against placebo, and that the add-on result is questionable because of bias and random error. Add-on to antivirals: HBV DNA RR 0.69; HBeAg RR 0.70; seroconversion RR 0.77 (HBV DNA 0.52 to 0.91; HBeAg 0.60 to 0.81; seroconversion 0.63 to 0.92) Methods, limits and funding Outcomes: HBeAg seroconversion, HBV DNA, HBeAg; deaths and liver disease Limitations: Trials covered several Phyllanthus species and were at risk of bias. Heterogeneity was high (I2 68 to 78%). The review is from 2011 (searches to October 2010). Funding and conflicts: Cochrane: none known. Read: abstract
Xia 2013 Phyllanthus species versus antiviral drugs for chronic hepatitis B virus infection Cochrane Database Syst Rev · PMID 23633363 · DOI	Systematic review	290 5 randomised trials, 290 people with chronic hepatitis B	Compound Phyllanthus preparations unspecified not covered 3 to 12 months · vs Lamivudine, interferon alpha or thymosin	All five trials were at high risk of bias. Phyllanthus seemed better for clearing HBeAg at end of treatment in ordinary meta-analysis (RR 0.76, 95% CI 0.64 to 0.91) but not in trial sequential analysis. No significant effect on HBsAg (RR 1.00) or HBV DNA (RR 0.83, 95% CI 0.53 to 1.31). No adverse event data were reported. The authors say evidence is insufficient to support or refute use. HBeAg RR 0.76 (not confirmed by sequential analysis); HBsAg RR 1.00; HBV DNA RR 0.83 (HBeAg 0.64 to 0.91; HBV DNA 0.53 to 1.31) Methods, limits and funding Outcomes: HBeAg and HBsAg clearance, HBV DNA Limitations: Five small trials, all high risk of bias, compound products, no adverse event data. Searches to October 2012. Funding and conflicts: Cochrane: none known. Read: abstract

What we do not know yet

No long trial of stone recurrence; only two controlled studies pooled for stone size.
Hepatitis B trials rarely name the species, so P. niruri results cannot be separated.
The blood sugar, blood pressure and diuretic findings rest on one nine-person study of a related species.
No human pregnancy, breastfeeding or controlled interaction data.
LiverTox, EMA/HMPC and LactMed could not be confirmed.

How new research is added

New studies are found by a saved PubMed search and placed in a review queue. A person checks each one before it is added.

Lab markers

What changed in blood or saliva tests during trials. A changed number is not the same as feeling or being healthier, and we give no "normal ranges".

Metabolic 1

▼

Blood glucose

Lowered in trials

Sugar in the blood.

Not enough evidence

Results and what it means

Why it was measured

Raised in diabetes.

Statistical vs. clinical meaning

A tiny study; unreliable.

Safety implication

Possible additive effect with diabetes medicines (theoretical).

Study	Result	People	Product
²²	Blood glucose fell significantly in the treated group (no numbers in the abstract)	9 people (4 with diabetes)	Whole-plant Phyllanthus amarus preparation for 10 days

^{22 24}

Other 9

▼

Kidney stone size and number

Lowered in trials

How big the stones are and how many are seen on imaging.

Low certainty

Results and what it means

Why it was measured

Smaller and fewer stones are easier to pass.

Statistical vs. clinical meaning

Statistically significant but based on two studies; the clinical size of the change is unclear.

Safety implication

None found, but stones need a doctor's follow-up.

Study	Result	People	Product
⁵	Pooled SMD -0.39 cm for size and -0.38 for number (95% CI -0.68 to -0.09 for each)	Two controlled human studies	P. niruri products

⁵

↕

Stone-free rate after lithotripsy

Mixed results in trials

The share of people with no stone or only fragments under 3 mm at follow-up.

Low certainty

Results and what it means

Why it was measured

It shows whether treatment cleared the stones.

Statistical vs. clinical meaning

Not significant overall; significant only in a subgroup.

Safety implication

No side effects recorded in the trial.

Study	Result	People	Product
¹³	93.5% vs 83.3% at 180 days overall (p = 0.48); lower-calyx stones 93.7% vs 70.8% (p = 0.01)	150 adults with calcium oxalate stones after shock-wave lithotripsy	P. niruri extract (Uriston) after lithotripsy vs no treatment

^{13 10}

↕

24-hour urinary calcium

Mixed results in trials

The amount of calcium passed in urine over a day.

Low certainty

Results and what it means

Why it was measured

High urinary calcium raises the chance of calcium stones.

Statistical vs. clinical meaning

A subset finding; it may or may not lead to fewer stones.

Safety implication

None found.

Study	Result	People	Product
¹⁸	No overall change; in the high-calcium subset 4.8 to 3.4 mg/kg/24 h (p < 0.05)	69 calcium-stone formers	P. niruri capsules vs placebo for 3 months

¹⁸

▼

24-hour urinary magnesium

Lowered in trials

The amount of magnesium passed in urine over a day.

Low certainty

Results and what it means

Why it was measured

Magnesium in urine helps limit stone crystals.

Statistical vs. clinical meaning

Small; within normal range.

Safety implication

WebMD advises discussing magnesium and potassium supplements with a provider; it does not give a reason.

Study	Result	People	Product
¹⁸	A slight fall in mean urinary magnesium that stayed within the normal range	69 calcium-stone formers	P. niruri capsules vs placebo for 3 months

¹⁸

↕

HBeAg seroconversion (hepatitis B marker)

Mixed results in trials

Loss of the HBeAg protein and appearance of its antibody, which usually means the virus is less active.

Very low certainty

Results and what it means

Why it was measured

Used as a stand-in for controlling hepatitis B.

Statistical vs. clinical meaning

A lab marker, not deaths or liver damage. Not confirmed by trial sequential analysis for related outcomes.

Safety implication

None found.

Study	Result	People	Product
²⁵	Versus placebo: RR 0.9 (0.73 to 1.25) at end of treatment, RR 1.00 (0.63 to 1.60) at follow-up. Added to antivirals: RR 0.77 (0.63 to 0.92) with high heterogeneity	1 placebo trial of 42 people; 15 add-on trials	Phyllanthus species

^{25 26}

↕

HBV DNA (viral load)

Mixed results in trials

The amount of hepatitis B virus genetic material in the blood.

Very low certainty

Results and what it means

Why it was measured

Higher viral load means more active infection.

Statistical vs. clinical meaning

Unreliable because of bias and heterogeneity.

Safety implication

None found.

Study	Result	People	Product
²⁵	Added to antivirals: RR 0.69 (0.52 to 0.91), not supported by trial sequential analysis	15 trials	Phyllanthus plus antiviral vs antiviral alone
²⁶	Versus antivirals: RR 0.83 (0.53 to 1.31), no significant difference	5 trials, 290 people	Compound Phyllanthus vs antiviral drug

^{25 26}

●

ALT and AST (liver enzymes)

No clear change in trials

Enzymes that leak from damaged liver cells into the blood.

Not enough evidence

Results and what it means

Why it was measured

High levels can signal liver injury.

Statistical vs. clinical meaning

No difference from placebo.

Safety implication

No liver safety signal reported in this trial.

Study	Result	People	Product
²¹	ALT fell in both treated groups (57 to 40 and 61 to 47.5 IU/L) but between-group differences were not significant (ALT p = 0.465, AST p = 0.632)	146 adults at risk of NASH	P. niruri plus milk thistle capsules vs placebo, 36 weeks

²¹

▼

Systolic blood pressure

Lowered in trials

The top number in a blood pressure reading.

Not enough evidence

Results and what it means

Why it was measured

High pressure raises heart and stroke risk.

Statistical vs. clinical meaning

Subgroup result in a nine-person study.

Safety implication

Possible additive effect with blood pressure medicines (theoretical).

Study	Result	People	Product
²²	Significant fall in non-diabetic hypertensive people and in women (no numbers in the abstract)	9 people with mild hypertension	Whole-plant Phyllanthus amarus preparation for 10 days

²²

▲

24-hour urine volume and sodium

Raised in trials

How much urine is passed in a day and how much sodium it holds.

Very low certainty

Results and what it means

Why it was measured

Shows a diuretic (water pill) effect.

Statistical vs. clinical meaning

A diuretic effect may change salt and fluid balance.

Safety implication

Relevant to people on diuretics or with low sodium, potassium or magnesium.

Study	Result	People	Product
²²	Significant rises in 24-hour urine volume and in urine and serum sodium (no numbers in the abstract)	9 people with mild hypertension	Whole-plant Phyllanthus amarus preparation for 10 days

²²

Safety

What studies and official sources say about side effects, medicines and who should check first. Each point shows what kind of evidence it comes from.

Main points to know 4

See a doctor if you have kidney stones. Chanca piedra is used for kidney stones, but a stone can block the urine flow and cause infection or kidney damage. Severe pain, fever, vomiting or blood in the urine needs medical care. The herb has not been shown to replace it. Authoritative guidance ^{23 5}
Avoid in pregnancy and breastfeeding. No human pregnancy data were found. In pregnant rats a related species (Phyllanthus amarus leaf extract) caused abortion, and P. niruri leaf extract at the top dose changed the mothers' kidneys and made the pups larger. A 2025 rat paper notes the plant is contraindicated in pregnancy and breastfeeding in folk medicine. WebMD says it is not known if it affects pregnancy or breast milk. Animal research ^{9 19 4 23}
It may add to water pills and to blood pressure or blood sugar medicines. Diuretics, magnesium and potassium supplements are listed to discuss with a provider. A tiny 1995 study of a related species reported more urine, lower blood pressure in some people, and lower blood glucose. These are theoretical overlaps, not documented harms. Pharmacological theory ^{23 22}
Human safety data are limited but reassuring so far. The systematic reviews and trials we read report few or no side effects, including 36 weeks of use in a combination capsule. Most trials were small, short and not designed to detect rare harms. Controlled trial ^{10 21 25}

Side effects 5

Effect	How often	Severity and recovery	Evidence
Nausea and vomiting WebMD lists these as the most common side effects; it gives no rates. The trials we read recorded none.	Not established	mild expected to resolve	Authoritative guidance ²³
Severe allergic reaction Listed by WebMD as the most serious but less common risk. Signs include hives, swelling of the face or throat, wheezing and fainting.	Not established	serious unknown	Authoritative guidance ²³
No side effects recorded in trials Micali 2006 (150 people, with lithotripsy) recorded none; the 36-week combination trial called the capsules well tolerated; Cochrane found only two hepatitis B trials reporting adverse events, with no serious events. Short, small studies.	Not established	none reported n/a	Controlled trial ^{13 21 25}
Slightly lower urinary magnesium The placebo-controlled stone trial saw a slight fall in urinary magnesium that stayed in the normal range.	Not established	mild unknown	Controlled trial ¹⁸
More urine and changes in sodium Urine volume and sodium rose in nine people taking a related species for 10 days.	Not established	unknown unknown	Observational ²²

Liver

No liver injury case reports for chanca piedra were found in the sources we read, and no LiverTox entry could be opened (the page returned a browser check). A 2025 systematic review says serial blood tests in the studies it covered showed no harm to liver function. A 36-week combination capsule trial reported no safety problems. A 90-day rat study of a whole-plant ethanol extract found no liver or kidney toxicity. But a 2025 pregnant-rat study saw changes in liver-function blood markers in the mothers, and WebMD asks people with hepatitis to tell their provider. In chronic hepatitis B, the herb is not a replacement for antiviral treatment. ^{10 21 1 4 23 16}

How often. No frequency data; no case reports found.

Monitoring. No monitoring advice from a regulator was found. People with liver disease, hepatitis or on liver-affecting medicines should ask their clinician first. Yellow skin or eyes, dark urine or pale stools need urgent medical review.

This is a safety connection. It is not evidence that Chanca piedra supports liver health.

Medicines and supplements 6

With	Why it matters	Importance	Evidence	What to do
Diuretics (water pills) drug	Chanca piedra is traditionally a diuretic, and a small study of a related species reported more urine and sodium loss.	Possible extra fluid and salt loss, dizziness or low potassium. No interaction report was found.	Authoritative guidance Not enough evidence ^{23 22}	WebMD lists diuretics to discuss with a provider. Ask your doctor or pharmacist before combining.
Magnesium and potassium supplements supplement	Not explained by the source. A stone trial saw slightly lower urinary magnesium; a diuretic effect could change mineral balance.	Unknown.	Authoritative guidance Not enough evidence ^{23 18}	WebMD lists these supplements to discuss with a provider.
Blood pressure medicines (including thiazide-like diuretics, calcium channel blockers, ACE inhibitors and ARBs) drug	Extracts lowered blood pressure in rats; a 9-person study of a related species reported lower systolic pressure in subgroups. A computer docking study predicts compounds from P. niruri may bind targets of these drugs and some liver enzymes.	Possible extra blood pressure lowering. Predicted interactions are not measured ones.	Pharmacological theory Not enough evidence ^{2 22 7}	If you take blood pressure medicine, ask your doctor or pharmacist before use, and watch for dizziness or fainting.
Diabetes medicines (insulin, metformin, sulfonylureas and others) drug	A 2026 review describes blood-sugar lowering in lab and animal studies, and the 9-person study reported lower blood glucose.	Possible low blood sugar. No human interaction report was found.	Pharmacological theory Not enough evidence ^{24 22}	If you take diabetes medicines, ask your doctor or pharmacist and watch for shakiness, sweating or confusion.
Drugs broken down by liver enzymes (CYP) or moved by transporters drug	Computer docking predicts P. niruri compounds can bind some of these proteins.	Unknown; not tested in people or cells in the source read.	In silico Not enough evidence ⁷	No action beyond telling your pharmacist you take it.
Other herbs for stones or liver (for example milk thistle) herb	Used together in a trial product.	The trial product was well tolerated for 36 weeks; effects of each plant cannot be separated.	Controlled trial Low certainty ²¹	Products with several herbs need each one checked.

Who should check first 8

Situation	Advice	Evidence
Pregnancy	Avoid. A related species caused abortion in pregnant rats, and P. niruri leaf extract altered maternal kidneys and fetal size at a high dose in rats. Traditional sources warn against use. No human data.	Animal research ^{9 19 4 23}
Breastfeeding	Avoid; not known whether it passes into breast milk (WebMD). A rat study of use through lactation found early eye and ear opening in pups.	Authoritative guidance ^{23 4}
Known kidney stones with pain, fever, vomiting or blood in the urine	See a doctor promptly; do not rely on the herb. A blocked stone can damage the kidney.	Authoritative guidance ^{23 5}
Kidney disease or gallstones	Tell your provider first (WebMD lists kidney problems and gallstones). Reason not given.	Authoritative guidance ²³
Liver disease or hepatitis	Tell your provider first (WebMD). Do not replace prescribed hepatitis B treatment.	Authoritative guidance ^{23 25}
Diabetes, high or low blood pressure, or low potassium or magnesium	Ask your provider first: theoretical effects on blood sugar, blood pressure, and mineral balance.	Pharmacological theory ^{23 22 24}
Allergy to the plant	Do not use.	Authoritative guidance ²³
Children	No safety data were found; keep out of reach of children (WebMD).	Authoritative guidance ²³

Overdose, product quality and regulators

Summary. No human toxicity cases were found. Rat studies are mostly reassuring at the doses tested, with exceptions in pregnancy.

Animal. A whole-plant ethanol extract at 30 or 300 mg/kg was not genotoxic to rat bone marrow, and a 90-day rat study showed no liver or kidney toxicity (CC50 26.3 mg/mL in human white blood cells in the lab). Pregnant rats given a leaf aqueous extract had no birth defects, but at 600 mg/kg showed changes in maternal kidneys and larger pups. Pups of mothers given 75 or 150 mg/kg through pregnancy and nursing opened eyes and ears early, and mothers showed liver-marker changes.

Human doses studied. Not repeated here. Trials ran from 10 days to 36 weeks; the combination capsule trial of 36 weeks reported no safety problems.

High dose or long term signals. None identified in people. Longest human data: 36 weeks (combination product).

Overdose response. WebMD advises calling poison control or a doctor after an overdose; no overdose data were found.

Genotoxicity. Not genotoxic in a rat bone-marrow test of one whole-plant ethanol extract.

Toxic plant parts. WebMD says supplements and teas use stems, leaves and seeds; the trials used aerial parts or leaf extracts. Toxicity of individual parts was not compared.

WebMD says the amount of each chemical varies with growing area, weather, harvest and processing, that products use different plant parts, and that the FDA has not tested products to confirm label contents. No heavy-metal or pesticide testing of chanca piedra products was found.

Plant part and species mix-ups. Several Phyllanthus species are sold under similar names and trials often do not name the species; one 1995 study treated P. amarus as a synonym of P. niruri although GBIF lists them separately. ^{23 8 25}

Content varies. WebMD warns that content varies between products and batches and that switching brands may change effects. ²³

Body	Action	Date
NIH NCCIH (US) (United States)	No chanca piedra page found; the address returns page not found. source	2026-10-25

When to get medical help

Itching, hives, swelling of lips, face or throat, wheezing or fainting after taking it (possible allergy; seek urgent care).
Severe flank pain, fever or chills, vomiting, or being unable to pass urine (a blocked stone or infection needs urgent care, not a herb).
Blood in the urine that does not stop.
Yellow skin or eyes, dark urine or pale stools (liver warning signs; not reported for chanca piedra but worth acting on).
Shakiness, sweating or confusion if you also take diabetes medicines (possible low blood sugar).
Dizziness or fainting if you also take blood pressure medicines or water pills.
Vaginal bleeding or cramps in pregnancy.

Stop the supplement and contact a clinician or emergency service. In the US, Poison Control is 1-800-222-1222.

General information only, not medical advice. Ask a clinician or pharmacist before use, especially with medicines, in pregnancy or with a health condition. See the Natural Remedy Safety guide.

Frequently asked questions

What is chanca piedra?

A small tropical herb, Phyllanthus niruri, called stone breaker. It is used as a tea or capsule, mostly for kidney stones.

^{8 23}

Does chanca piedra break up kidney stones?

Not proven. A 2020 review pooled only two small controlled studies and found a modest drop in stone size and number. The authors call the evidence limited. Lab work suggests it affects crystals; that has not shown dissolving of stones in people.

^{5 3}

Can I use it instead of seeing a doctor for stones?

No. A stone can block urine flow and cause infection or kidney damage. Severe pain, fever, vomiting or blood in the urine needs medical care. Ask your doctor before using any herb alongside stone treatment.

^{23 5}

Does it help after lithotripsy?

Maybe for lower-pole stones. In a 150-person trial the overall stone-free rate was not significantly different (93.5% versus 83.3%), but for lower-pole stones it was 93.7% versus 70.8%. There was no placebo, and it was one product.

^{13 10}

Does it work for hepatitis B?

Cochrane found no convincing evidence against placebo (one trial, 42 people). Fifteen trials suggested virus-marker clearance when added to antiviral drugs, but all had bias and uncertain results. It is not a replacement for antiviral treatment.

^{25 26}

Does it help the liver or fatty liver?

Not shown. In a 36-week trial of 146 people, a capsule with chanca piedra and milk thistle lowered enzymes in the treated groups, but not more than placebo. It was a combination product.

²¹

Can it lower blood sugar or blood pressure?

Possibly, but it is not proven. Evidence is a nine-person study of a related species and animal work. If you take diabetes or blood pressure medicines, ask your pharmacist first.

^{22 24 2}

Is it a diuretic?

Traditionally yes. In a nine-person study of a related species urine volume and sodium rose. Diuretics, magnesium and potassium supplements are listed to discuss with a provider.

^{22 23}

Is it safe for the liver?

No liver injury cases were found in the sources read, and trials up to 36 weeks (one combination product) reported no safety problems. A rat pregnancy study saw changes in liver markers in mothers. LiverTox could not be checked. People with hepatitis should ask their provider.

^{10 21 4 16}

Is it safe in pregnancy or breastfeeding?

Avoid it. There is no human data. A related species caused abortion in rats, P. niruri leaf extract altered maternal kidneys and fetal size at a high dose, and traditional sources warn against use. WebMD says it is not known if it passes into breast milk.

^{9 19 4 23}

Can it interact with medicines?

Possibly. Diuretics, magnesium and potassium are listed to discuss; blood pressure and diabetes medicine overlaps are theoretical; a computer model predicts binding to some drug targets and liver enzymes. No controlled interaction study exists.

^{23 7 22}

Is it the same as other Phyllanthus plants?

No. P. amarus and P. urinaria are separate species, often used in hepatitis B studies, and amla (P. emblica) is a different fruit tree. Check the Latin name and plant part on the label.

^{8 25}

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Editorial transparency

Written by: AlternativeMed editorial team. Research compiled with AI assistance, then checked against the original sources.
Medical review: None. This page has not been reviewed by a physician or pharmacist.
First published: 2026-10-25
Last substantive update: 2026-10-25
How we research: We searched PubMed and read each abstract directly, and checked plant names through GBIF and compound IDs through PubChem. WebMD was read in full. NCCIH has no chanca piedra page; EMA and LiverTox could not be opened; LactMed, Commission E and WHO were not checked. Full texts were mostly not read.
How we rate evidence: See "How we rate evidence" in the Evidence tab.
Independence: No product is promoted on this page. No affiliate links are shown. The fatty-liver trial is linked to the product company, which is flagged.

Sources 26

Each source was opened and checked. Where we read only the abstract, it says so. The small numbers in the text point here.

Asare GA, Bugyei K, Sittie A et al.. Genotoxicity, cytotoxicity and toxicological evaluation of whole plant extracts of the medicinal plant Phyllanthus niruri (Phyllanthaceae). Genet Mol Res. 2012. PMID 22290470. DOI 10.4238/2012.January.13.3. (abstract)
Bello I, Usman NS, Dewa A et al.. Blood pressure lowering effect and vascular activity of Phyllanthus niruri extract: The role of NO/cGMP signaling pathway and beta-adrenoceptor mediated relaxation of isolated aortic rings. J Ethnopharmacol. 2020. PMID 31830549. DOI 10.1016/j.jep.2019.112461. (abstract)
Boim MA, Heilberg IP, Schor N. Phyllanthus niruri as a promising alternative treatment for nephrolithiasis. Int Braz J Urol. 2010. PMID 21176271. DOI 10.1590/s1677-55382010000600002. (abstract)
Costa Alves MD, Pereira DE, Bido RCA et al.. Phyllanthus niruri L. Administration during pregnancy and breastfeeding: Maternal evaluation and effects on initial development and adult behavior of male rat offspring. Brain Res. 2025. PMID 39694168. DOI 10.1016/j.brainres.2024.149402. (abstract)
Dhawan S, Olweny EO. Phyllanthus niruri (stone breaker) herbal therapy for kidney stones; a systematic review and meta-analysis of clinical efficacy, and Google Trends analysis of public interest. Can J Urol. 2020. PMID 32333735. (abstract)
European Medicines Agency. EMA / HMPC herbal monograph search for Phyllanthus (not confirmed). European Medicines Agency. 2026. (full-text)
Evadgian A, Bharatha A, Cohall D. Use of Cheminformatics to Determine Potential Drug Interactions between Popular Barbadian Botanical Medicines and Antihypertensive Drugs. ACS Omega. 2022. PMID 36530331. DOI 10.1021/acsomega.2c02446. (abstract)
GBIF. GBIF Backbone Taxonomy species match: Phyllanthus niruri, P. amarus, P. urinaria, P. emblica. GBIF. 2026. (full-text)
Iranloye B, Oyeusi K, Alada A. Effect of aqueous extract of Phyllantus amarus leaves on implantation and pregnancy in rats. Niger J Physiol Sci. 2010. PMID 22314905. (abstract)
Iregui-Parra J, Rojas Ossa V, Arias Salazar CM et al.. Phyllanthus niruri in the management of nephrolithiasis: A systematic review of the literature. Actas Urol Esp (Engl Ed). 2025. PMID 40480426. DOI 10.1016/j.acuroe.2025.501791. (abstract)
Kaur N, Kaur B, Sirhindi G. Phytochemistry and Pharmacology of Phyllanthus niruri L.: A Review. Phytother Res. 2017. PMID 28512988. DOI 10.1002/ptr.5825. (abstract)
Lo CYZ, Khor QH, Abdullatif VA et al.. Systematic review of pharmacological, complementary, and alternative therapies for the prevention of calcium oxalate stones. Asian J Urol. 2025. PMID 40458577. DOI 10.1016/j.ajur.2024.04.006. (abstract)
Micali S, Sighinolfi MC, Celia A et al.. Can Phyllanthus niruri affect the efficacy of extracorporeal shock wave lithotripsy for renal stones? A randomized, prospective, long-term study. J Urol. 2006. PMID 16890682. DOI 10.1016/j.juro.2006.04.010. (abstract)
Murugaiyah V, Chan KL. Analysis of lignans from Phyllanthus niruri L. in plasma using a simple HPLC method with fluorescence detection and its application in a pharmacokinetic study. J Chromatogr B. 2007. PMID 17261384. DOI 10.1016/j.jchromb.2007.01.014. (abstract)
Mutomba WF, Symeonidis EN, Mykoniatis I et al.. Phytotherapy in Urolithiasis: An Updated Overview of Current Knowledge. J Clin Med. 2025. PMID 40363917. DOI 10.3390/jcm14092885. (abstract)
NIH LiverTox. NIH LiverTox (access blocked). NIH LiverTox. 2026. (full-text)
NIH NCCIH. NCCIH herb page for chanca piedra (not found). NIH NCCIH. 2026. (full-text)
Nishiura JL, Campos AH, Boim MA et al.. Phyllanthus niruri normalizes elevated urinary calcium levels in calcium stone forming (CSF) patients. Urol Res. 2004. PMID 15221244. DOI 10.1007/s00240-004-0432-8. (abstract)
Paula VG, Cruz LL, Sene LB et al.. Maternal-fetal repercussions of Phyllanthus niruri L. treatment during rat pregnancy. J Ethnopharmacol. 2020. PMID 32145330. DOI 10.1016/j.jep.2020.112728. (abstract)
PubChem. PubChem compound records (name lookup). PubChem. 2026. (full-text)
Shaker MK, Hassany M, Eysa B et al.. The activity of a herbal medicinal product of Phyllanthus niruri and Silybum marianum powdered extracts (Heptex) in patients with apparent risk factors for nonalcoholic steatohepatitis: a phase II, multicentered, randomized, double-blind, placebo-controlled clinical trial. BMC Complement Med Ther. 2025. PMID 39789561. DOI 10.1186/s12906-024-04692-y. (abstract)
Srividya N, Periwal S. Diuretic, hypotensive and hypoglycaemic effect of Phyllanthus amarus. Indian J Exp Biol. 1995. PMID 8786163. (abstract)
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