Herbs & Botanicals · Traditional bile and wart herb
Greater celandine
Chelidonium majus · also called Swallow-wort, rock poppy, tetterwort, bai qu cai
Greater celandine is a yellow-flowered poppy-family plant with orange sap. It is used traditionally for indigestion and bile complaints, and the sap is dabbed on warts. Two small trials exist and Europe's herbal medicines committee found the evidence lacking. The key caution is the liver: swallowing it has been linked to hepatitis and jaundice, and EMA judged the benefit-risk for oral use negative.
General information, not medical advice. Last substantive update · Not medically reviewed. A named clinician has not signed off on this page. How this page is made
About Greater celandine
Greater celandine (Chelidonium majus) is a poppy-family plant with yellow flowers and orange sap. The dried herb is used as tea, tincture or extract for indigestion and bile complaints, and the fresh sap is dabbed on warts. Evidence is thin: two small trials for indigestion, cell studies for warts and viruses. The main concern is the liver. Hepatitis and jaundice have been reported after tea, capsules and tinctures, and Europe's herbal committee judged the benefit-risk of oral use negative. It should not be used in pregnancy, breastfeeding, childhood, or with liver disease. Ask a doctor or pharmacist before any use.
What it is
Greater celandine is Chelidonium majus, a plant of the poppy family (Papaveraceae). Cut stems release a yellow-orange sap called latex. The aerial parts (the herb) and the sap are used.
It is not lesser celandine (Ficaria verna), a buttercup-family spring flower, and it is not celandine poppy (Stylophorum diphyllum), a North American plant in another genus. Everything on this page is about greater celandine only.
What makes it distinctive
The herb contains over 20 isoquinoline alkaloids, 0.01 to 1% of the plant, including chelidonine, sanguinarine, chelerythrine, berberine and coptisine. Most of its lab activity, and most of its toxicity in lab tests, comes from these alkaloids. They are poorly absorbed from the gut.
Historical and current uses
Since the Middle Ages the herb has been used for bile and liver complaints and the fresh sap on warts, corns and other skin problems. EMA considered a traditional-use monograph for indigestion and for warts, but decided against it in 2011.
What the research shows
Two small trials suggest some relief of upper-belly complaints, but we only know them through EMA's summary, and one tested a two-herb product. EMA concluded efficacy was lacking for the single herb. Wart, virus and cancer findings are from cells. One uncontrolled COVID-19 series reported improvement with no comparison group.
At a glance
Traditional uses history, not proof
- Dried herb as tea, tincture or extract for indigestion, bile and gallbladder-area complaints
- Fresh orange sap dabbed on warts and corns
- Used in medieval European folk medicine for liver and bile disorders and for skin complaints
- Used in Chinese medicine (bai qu cai) for cough, asthma, spasm and pain
Studied for research
- Indigestion and upper-belly discomfort: two small trials, very low certainty
- Warts: cell tests only
- Gallstones and liver: no supporting trial; liver injury reports instead
- Virus and germ activity: lab only
- COVID-19: one uncontrolled 20-patient series
- Cancer: cell studies only
Main compounds
- Isoquinoline alkaloids: chelidonine, sanguinarine, chelerythrine
- Protoberberines: berberine, coptisine
- Protopine and over 20 alkaloids in all (0.01-1% of the herb)
Common forms
- Dried herb tea
- Tincture or fluid extract
- Dry extract tablets and capsules
- Mother tincture (homeopathic-style liquid)
- Fresh latex on the skin
- Ointment
- Ingredient in some multi-herb digestive products
Research links: EMA public statement on greater celandine herb (2011) · EMA assessment report (2011) · Causality assessment of 22 reports of liver injury (2011) · Clinical review of greater celandine liver injury (2012) · Research Library · Genes & Biomarkers Library
The plant and its history
- Accepted scientific name
- Chelidonium majus L.
- Naming authority
- L.
- Common names
- Greater celandine (English); Swallow-wort (English); Rock poppy (English); Tetterwort (English); Bai qu cai (Chinese)
- Botanical family
- Papaveraceae (the poppy family).
- Classification
- Plantae > not checked > not checked > not checked > Papaveraceae > Chelidonium > Chelidonium majus
- Native range
- Not verified from a primary source here.
- Habitat
- Not verified here.
- What the plant looks like
- Roots: Roots contain alkaloids (not examined here).; Stems: Break to release a yellow-orange latex (p36012505).; Leaves: Aerial parts are the traditional herb (s-ema-statement).; Flowers: Not verified here.; Fruit: Not verified here.
- Cultivation
- Not verified here.
- Harvest and processing
- Fresh plant is more toxic; drying lowers the toxicity (s-ema-ar).
- Look-alikes and adulterants
- Name: Lesser celandine (Ficaria verna); Note: Different family (Ranunculaceae, buttercup family) and a different plant despite the shared name (GBIF, s-gbif-ficaria). Not covered by this page's safety data. A 1998 case report abstract says 'common (or lesser) celandine', so older reports can be ambiguous (p9856112).; Name: Celandine poppy (Stylophorum diphyllum); Note: Same family (Papaveraceae) but a different genus (GBIF, s-gbif-stylophorum); not the plant studied here.
- Sustainability and conservation
- Not assessed.
Traditional use and history history, not clinical proof
| Tradition or era | Documented use | Source |
|---|---|---|
| Medieval and European folk medicine | Used since the Middle Ages for bile and liver disorders; fresh latex dabbed on warts, corns, ringworm-type infections, eczema and skin tumours (s-ema-ar). | s-ema-ar |
| 1896 Russian report | An extract was injected into a skin tumour; the EMA report says later research showed this painful method did not shrink tumours. | s-ema-ar |
| Traditional Chinese medicine ('Bai Qu Cai') | Used for coughs, asthma, spasms and pain (p39239653). Not verified beyond the review abstract. | p39239653 |
| EU regulatory review 2009-2011 | HMPC considered an EU monograph for digestive disorders (oral) and warts/corns (skin) and concluded oral benefit-risk was negative (s-ema-statement). | s-ema-statement |
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 |
|---|---|---|---|---|
| Chelidonine PubChem 197810 | benzophenanthridine alkaloid | herb (aerial parts) and latex Total alkaloids 0.01-1% of the herb (EMA) | Major alkaloid; cell-toxic in lab tests; turned into reactive metabolites by liver enzymes in vitro; reported to inhibit CYP enzymes (p31102647). 12 3 18 | Laboratory research |
| Sanguinarine PubChem 5154 | benzophenanthridine alkaloid | herb and latex not reported | Among the most cell-toxic alkaloids to rat liver cells; depleted glutathione in culture (p31054355). 8 18 | Laboratory research |
| Berberine PubChem 2353 | protoberberine alkaloid | herb not reported | Named by EMA among the alkaloids; also the main compound of other plants (berberine, goldenseal, barberry); the safety profiles of those plants should not be assumed alike. 3 18 | Authoritative guidance |
| Coptisine PubChem 72322 | protoberberine alkaloid | herb not reported | The most toxic of six alkaloids tested on rat liver cells in culture (p31054355). EMA gives a low oral bioavailability from animal work (s-ema-ar). 8 4 18 | Laboratory research |
| Chelerythrine, protopine and others | benzophenanthridine and protopine alkaloids | herb over 20 alkaloids in the herb; 94 isolated in all | Chelerythrine is cell-toxic in liver cell tests; protopine less so (p31054355). PubChem CIDs not looked up. 8 11 3 | Laboratory research |
Mechanisms, receptors and pathways
| Target or pathway | Gene or receptor | What was found | Level |
|---|---|---|---|
| Liver cell toxicity | not established | Several alkaloids (coptisine, chelerythrine, sanguinarine) were toxic to rat liver cells in culture; the authors say very low oral absorption may explain why animals fed the extract showed no injury. In human liver preparations chelidonine forms reactive metabolites. How human injury happens remains unsettled (idiosyncratic metabolic vs dose-related). 8 12 13 22 4 | Laboratory research |
| HPV (wart virus) replication in cells | viral E6 and E7 | Latex alkaloid and protein fractions reduced infectivity and E6/E7 activity in cell systems. 14 | Laboratory research |
| DNA binding and cytotoxicity | DNA (sanguinarine, chelerythrine) | Sanguinarine binds DNA in lab tests and several alkaloids kill tumour cell lines; this is the reason for the cytotoxicity caution in pregnancy. 4 11 | Laboratory research |
Absorption, metabolism and elimination
- Absorption
- EMA's report says the alkaloids are poorly absorbed from the gut and heavily metabolised; coptisine's oral bioavailability in an animal study was 7.8% (s-ema-ar).
- Distribution
- In rats fed sanguinarine and chelerythrine, liver levels were low (EMA).
- Metabolism
- Chelidonine is oxidised by CYP3A4, 1A2, 2C19 and 2D6 to reactive catechol/quinone-type metabolites that are trapped by glutathione (p31102647).
- Elimination
- Very little alkaloid in urine after oral dosing in animal studies (s-ema-ar).
- Bioavailability
- Low for the alkaloids studied, from animal data; not measured for whole herb products in people.
Isolated compounds versus whole extracts
Most toxicity and anti-virus data use isolated alkaloids or fractions; human liver injury occurs with whole-plant products (tea, capsules, tinctures, combination products). Rat feeding with extract did not reproduce the human injury (p19761826), and isolated alkaloids are toxic to cells in the dish (p31054355). These do not map neatly onto each other, and it is not known which compound causes injury in people.
Nutritional composition
Not a food. No nutrient content was found in the sources read.
1 very low certainty4 not enough evidence1 evidence against
What is Greater celandine good for?
What greater celandine is used for and how strong the evidence is. Where the evidence is thin we say so. Several rows below carry a safety warning, and nothing here is advice to use it.
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.
Upper abdominal discomfort and indigestion
Very low certaintyGreater celandine herb is traditionally taken for stomach-area cramps, fullness and indigestion. Two small placebo-controlled trials exist, one of the herb alone and one of a celandine plus turmeric capsule. Europe's herbal medicines committee found the evidence too weak and the liver risk too high to endorse it.
4 studiesHerb extract tablets in one trial; celandine plus turmeric capsules i…
Studies, doses and limits
What the trials found
Two small randomised trials summarised in the EMA report (60 and 76 people). No systematic review or meta-analysis of the herb for indigestion was found.
Results
In the 60-person trial of the herb extract, symptom scores fell more than with placebo after 6 weeks (p=0.003) and the physician rated 18 of 30 improved or symptom-free versus 8 of 30 on placebo (s-ritter-1993, EMA summary). In the 76-person celandine plus turmeric trial, the main outcome (frequency of cramp-like pain) was only slightly better than placebo and not statistically clear (p=0.069), though some secondary pain measures favoured the capsule (p=0.009 and 0.011) (s-niederau-1999, EMA summary). EMA concluded efficacy was lacking for the single herb (s-ema-statement).
Effect sizes as reported
Trial 1: p=0.003 on symptom score; 18/30 vs 8/30 rated improved. Trial 2: probability-of-superiority 0.62 on the main outcome, p=0.069; 0.67 on dull complaints, p=0.009.
Why this rating
Two small short trials known only through a regulator's summary, one of them a two-herb product with a non-significant main outcome; no independent confirmation; the regulator judged efficacy lacking.
Form and dose studied
Herb extract tablets in one trial; celandine plus turmeric capsules in the other. No amounts are given here.
Who was studied
Adults with functional upper-abdominal complaints; people with bile duct disease, severe colic, cholestasis or prior stomach surgery were excluded from the second trial.
Limits
We did not read the original trial papers, only the EMA summary. 3 and 6 weeks only, so nothing about liver safety over longer use.
Why researchers looked
Used since the Middle Ages for bile and digestive complaints, and sold in Europe as a single herb and inside combination digestive products.
Traditional use
The EMA assessment report says it has been used since the Middle Ages for bile and liver disorders, and lists tea, tincture, dry extract and a mother tincture as the forms assessed (s-ema-ar).
Proposed mechanism Laboratory research
Lab work suggests the alkaloids have spasm-relaxing and anti-inflammatory activity, but human absorption of the alkaloids is very low, and no mechanism for benefit in people has been shown.
A proposed mechanism does not show that the effect happens in people.
Liver injury has been reported with oral greater celandine. See the Safety tab before considering it.
Bile, gallbladder and liver folk use
Evidence againstThe plant is traditionally taken for bile and gallstone complaints and as a so-called liver tonic. No trial supports this, and the documented human liver data point the other way: injury reports, including in people taking it for gallstones.
4 studiesCapsules, tea and tincture appear in the liver injury reports.
Studies, doses and limits
What the trials found
No trial of greater celandine for gallstones, bile flow or liver health was found. The human reports are of liver injury.
Results
None as a benefit. The reviewers call the risk-to-benefit ratio negative (p28379595) and EMA judged the oral benefit-risk negative (s-ema-statement).
Effect sizes as reported
Not applicable.
Why this rating
No supporting trial, and regulators and reviewers find the safety signal outweighs any benefit.
Form and dose studied
Capsules, tea and tincture appear in the liver injury reports.
Who was studied
Not applicable.
Limits
Folk use is not evidence. We did not find any gallstone trial.
Why researchers looked
Traditional use for bile and liver disorders is why it was assessed by regulators.
Traditional use
Used since the Middle Ages for bile and liver disorders (s-ema-ar). A 2024 case report describes a woman who took capsules for gallstones and developed jaundice (p38820341).
Proposed mechanism Laboratory research
No protective liver mechanism has been shown in people. Lab work shows some of the alkaloids are toxic to liver cells.
A proposed mechanism does not show that the effect happens in people.
Gallstones and jaundice need medical assessment, not self-treatment with this herb.
Warts and corns (fresh latex on the skin)
Not enough evidenceThe orange sap from broken stems is an old folk remedy dabbed on warts and corns. There is no controlled trial in people. Cell experiments show the latex can reduce a wart virus's infectivity, but that does not show it clears warts, and the sap can irritate skin.
3 studiesFresh latex and ointments; one Hungarian single-herb product for exte…
Studies, doses and limits
What the trials found
No controlled human trial of greater celandine on warts was found.
Results
Cell study only (p36012505). EMA found the skin indication not sufficiently supported by market information on single-herb products (s-ema-statement).
Effect sizes as reported
No numbers in the abstract.
Why this rating
Lab experiments and folk use only; no trial.
Form and dose studied
Fresh latex and ointments; one Hungarian single-herb product for external use is listed in the EMA report. No amounts here.
Who was studied
None studied.
Limits
Cell results do not predict wart clearance. Fresh latex is irritating and varies between plants.
Why researchers looked
Long folk use against warts, caused by human papillomavirus (HPV).
Traditional use
EMA says the fresh latex was dabbed on warts, corns and other skin complaints (s-ema-ar). A skin-use indication was considered for an EU monograph but not accepted (s-ema-statement).
Proposed mechanism Laboratory research
In cell tests the alkaloid-rich and protein-rich parts of the latex lowered HPV infectivity and viral cancer-gene (E6, E7) activity, though they did not stop the virus attaching to cells. The protein part also raised an inflammation signal (TNF-alpha).
A proposed mechanism does not show that the effect happens in people.
Contact dermatitis (severe itching, redness, papules) was reported in a woman using it on warts. Keep it away from eyes and broken skin and ask a pharmacist or doctor about wart treatments with better evidence.
Antiviral, antimicrobial and anti-inflammatory activity (laboratory)
Not enough evidenceExtracts and isolated alkaloids kill or slow some germs and calm inflammation in lab and animal tests. These are lab findings, and the alkaloids are poorly absorbed when swallowed.
3 studiesIsolated alkaloids and extracts in the lab.
Studies, doses and limits
What the trials found
None.
Results
Narrative review of lab and animal work (p39239653); EMA lists activity against herpes simplex, polio and some adenoviruses in cell tests (s-ema-ar).
Effect sizes as reported
Not applicable.
Why this rating
Lab and animal findings, often with isolated compounds, at concentrations not shown to be reachable in people.
Form and dose studied
Isolated alkaloids and extracts in the lab.
Who was studied
None.
Limits
Abstract-level reading of a review; mostly isolated compounds.
Why researchers looked
The plant is rich in isoquinoline alkaloids with strong activity against cells in the lab.
Traditional use
Traditional skin and infection uses.
Proposed mechanism Laboratory research
A 2024 review lists 94 alkaloids of several types with reported anti-microbial, anti-inflammatory, anti-viral and anti-tumour effects. EMA notes low oral absorption and heavy metabolism of the main alkaloids.
A proposed mechanism does not show that the effect happens in people.
The same alkaloids are toxic to liver cells in culture (p31054355).
COVID-19 (small case series)
Not enough evidenceA Brazilian doctor reported 20 mild COVID-19 patients treated with a celandine mother tincture; most improved within days and no side effects were reported. With no comparison group, this cannot show the herb did anything, as mild COVID usually improves by itself.
1 studies10% mother tincture for 3-12 days (median 5).
Studies, doses and limits
What the trials found
One uncontrolled 20-patient case series.
Results
Complete or almost complete improvement within 1-9 days (median 3); no adverse events reported (p33778996).
Effect sizes as reported
Descriptive only.
Why this rating
Tiny, uncontrolled, short follow-up; liver effects could not show up in about a week.
Form and dose studied
10% mother tincture for 3-12 days (median 5).
Who was studied
Mild outpatients aged 14-71, Brazil.
Limits
No control group; authors say only that it may inspire further research.
Why researchers looked
Reported antiviral lab activity.
Traditional use
Mother tincture is a homeopathic-style liquid.
Proposed mechanism Other
Not examined in the report.
A proposed mechanism does not show that the effect happens in people.
Do not use it instead of medical care for COVID-19; liver injury has been reported with oral use.
Cancer and tumours
Not enough evidenceIsolated alkaloids kill cancer cells in the lab. That is not a treatment. An 1896 report of injecting an extract into skin tumours was later judged not to shrink tumours. No human trial of the herb for cancer was found.
2 studiesIsolated alkaloids in the lab.
Studies, doses and limits
What the trials found
None found. Injectable derivatives are outside this page and were not reviewed.
Results
Review-level lab findings only (p39239653, s-ema-ar).
Effect sizes as reported
Not applicable.
Why this rating
Cell studies only.
Form and dose studied
Isolated alkaloids in the lab.
Who was studied
None.
Limits
Abstract-level; lab concentrations are not human exposures.
Why researchers looked
The alkaloids are strongly cytotoxic (cell-killing), which is also a toxicity concern.
Traditional use
EMA cites the 1896 injection report; it says the painful method did not affect the tumour (s-ema-ar).
Proposed mechanism Laboratory research
Sanguinarine and chelerythrine can bind DNA in the lab; EMA lists cytotoxicity in cell lines.
A proposed mechanism does not show that the effect happens in people.
Never replace cancer treatment with a herb. The same cell toxicity underlies the liver and pregnancy cautions.
Connections to the rest of health
How Greater celandine 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
A. Wellness goals
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Digestive Support | Very low certainty | Upper abdominal discomfort and indigestion: Greater celandine herb is traditionally taken for stomach-area cramps, fullness and indigestion. Two small placebo-controlled trials exist, one of the herb alone and one of a celandine plus turmeric capsule. Europe's herbal medicines committee found the evidence too weak and the liver risk too high to endorse it. | 19 15 3 4 | |
| Liver Support | Adverse effect or risk | Evidence against | Bile, gallbladder and liver folk use: The plant is traditionally taken for bile and gallstone complaints and as a so-called liver tonic. No trial supports this, and the documented human liver data point the other way: injury reports, including in people taking it for gallstones. | 4 3 16 2 |
| Healthy Skin | Not enough evidence | Warts and corns (fresh latex on the skin): The orange sap from broken stems is an old folk remedy dabbed on warts and corns. There is no controlled trial in people. Cell experiments show the latex can reduce a wart virus's infectivity, but that does not show it clears warts, and the sap can irritate skin. | 14 4 3 | |
| Immune Support | Not enough evidence | Antiviral, antimicrobial and anti-inflammatory activity (laboratory): Extracts and isolated alkaloids kill or slow some germs and calm inflammation in lab and animal tests. These are lab findings, and the alkaloids are poorly absorbed when swallowed. | 11 4 8 | |
| Immune Support | Not enough evidence | COVID-19 (small case series): A Brazilian doctor reported 20 mild COVID-19 patients treated with a celandine mother tincture; most improved within days and no side effects were reported. With no comparison group, this cannot show the herb did anything, as mild COVID usually improves by itself. | 9 | |
| Preventive Wellness | Not enough evidence | Cancer and tumours: Isolated alkaloids kill cancer cells in the lab. That is not a treatment. An 1896 report of injecting an extract into skin tumours was later judged not to shrink tumours. No human trial of the herb for cancer was found. | 11 4 |
B. Body systems
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Digestive System | Biological association | Very low certainty | Studied for: Upper abdominal discomfort and indigestion | 19 15 3 4 |
| Hepatic System | Biological association | Evidence against | Studied for: Bile, gallbladder and liver folk use | 4 3 16 2 |
| Integumentary System | Biological association | Not enough evidence | Studied for: Warts and corns (fresh latex on the skin) | 14 4 3 |
| Immune System | Biological association | Not enough evidence | Studied for: Antiviral, antimicrobial and anti-inflammatory activity (laboratory) Studied for: COVID-19 (small case series) | 11 4 8 9 |
| Respiratory System | Biological association | Not enough evidence | Studied for: COVID-19 (small case series) | 9 |
| Cellular | Biological association | Not enough evidence | Studied for: Cancer and tumours | 11 4 |
E. Health conditions
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Herb-induced liver injury | Adverse effect or risk | Low certainty | Many case reports; EMA negative benefit-risk for oral use. Preparation or compound: Oral herb, tea, capsules, tinctures |
3 22 21 |
| Pregnancy | Contraindication | Not enough evidence | EMA does not recommend; German rules contraindicate. Preparation or compound: Herb |
4 |
| Warts | Traditional use | Not enough evidence | Folk use; cell data only; contact dermatitis reported. Folk use of fresh latex; cell data only. Preparation or compound: Fresh latex |
14 4 |
| Indigestion and upper abdominal complaints | Very low certainty | Two small trials; EMA found efficacy lacking for the single herb. Preparation or compound: Extract tablets; celandine plus turmeric capsules |
19 15 3 |
I. Biomarkers
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Upper abdominal symptom score | Biological association | Very low certainty | Measured in trials: fell more than placebo in trial 1; mixed in trial 2. A lab change is not the same as a health benefit. | |
| Liver enzymes (ALT, AST) and bilirubin | Biological association | Low certainty | Measured in trials: raised in the reported injury cases. A lab change is not the same as a health benefit. | |
| HPV infectivity and viral E6/E7 gene activity (cells) | Biological association | Very low certainty | Measured in trials: lowered by latex fractions in cells. A lab change is not the same as a health benefit. | |
| Time to COVID-19 symptom improvement | Biological association | Not enough evidence | Measured in trials: improved within 1-9 days (no control). A lab change is not the same as a health benefit. |
J. Genes, receptors and enzymes
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| CYP3A4, CYP1A2, CYP2C19, CYP2D6 | Preliminary mechanism | In vitro | Involved in the activation of chelidonine in human liver microsomes; chelidonine reported to inhibit CYP enzymes. | 12 |
| HPV E6 and E7 oncogenes | Preliminary mechanism | In vitro | Expression lowered in cell systems by latex fractions. | 14 |
L. Active compounds
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Chelidonine | Biological association | In vitro | Major alkaloid; cell-toxic in lab tests; turned into reactive metabolites by liver enzymes in vitro; reported to inhibit CYP enzymes (p31102647). Preparation or compound: herb (aerial parts) and latex |
12 3 18 |
| Sanguinarine | Biological association | In vitro | Among the most cell-toxic alkaloids to rat liver cells; depleted glutathione in culture (p31054355). Preparation or compound: herb and latex |
8 18 |
| Berberine | Biological association | Authoritative guidance | Named by EMA among the alkaloids; also the main compound of other plants (berberine, goldenseal, barberry); the safety profiles of those plants should not be assumed alike. Preparation or compound: herb |
3 18 |
| Coptisine | Biological association | In vitro | The most toxic of six alkaloids tested on rat liver cells in culture (p31054355). EMA gives a low oral bioavailability from animal work (s-ema-ar). Preparation or compound: herb |
8 4 18 |
| Chelerythrine, protopine and others | Biological association | In vitro | Chelerythrine is cell-toxic in liver cell tests; protopine less so (p31054355). PubChem CIDs not looked up. Preparation or compound: herb |
8 11 3 |
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).
The evidence
The research centre for Greater celandine. Every record here was checked against PubMed or the publisher's page; we never list a study we have not verified.
Evidence by outcome
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, read the abstracts, read the two EMA documents on greater celandine, and checked GBIF and PubChem. No study is cited that we could not verify. Trial results come from EMA's summaries.
Study library: every study we checked 23
| Study | Design | People | Product, dose, length | Result |
|---|---|---|---|---|
| Adamidis 2026 Chelidonium majus-Induced Hepatitis: A Case Report of Herb-Induced Liver Injury. Cureus · PMID 42359199 · DOI |
Case report |
1 60-year-old woman presenting with jaundice |
Herbal preparation identified as Chelidonium majus not stated not extracted not stated · vs none |
Jaundice, nausea and tiredness after starting the herb; very high liver enzymes and bilirubin; viral hepatitis excluded; autoimmune tests did not confirm autoimmune hepatitis; scans showed no bile duct blockage; biopsy showed acute hepatitis-like injury with cell death around central veins. After stopping the herb and supportive care she improved step by step. single case (not applicable) Methods, limits and fundingOutcomes: Liver tests, imaging, biopsy Limitations: Abstract only; one case; product type not described in the abstract. Funding and conflicts: Not stated in the abstract. Read: abstract |
| Ciornolutchii 2024 A Hidden Cause of Hypertransaminasemia: Liver Toxicity Caused by Chelidonium Majus L.: Report of Two Cases of Herb-Induced Liver Injury and Literature Review. Am J Ther · PMID 38820341 · DOI |
Case report plus systematic review |
2 Two women (64 and 66) plus 38 literature cases, mostly adult women aged 27-77, mainly reported from Germany |
Greater celandine capsules (gallstone use) and tea capsules; tea not extracted use from 1 week to 1 year in the reviewed cases · vs none |
Case 1: jaundice after about 1 month of capsules taken for gallstones; liver enzymes above 1000 IU/L; gallstones and a bile duct stone were also found; improved after stopping and treatment. Case 2: raised liver tests found by chance in a woman drinking the tea for general health; normalised. The literature search (to March 2023) found 38 cases; stopping the herb generally led to recovery. narrative; no pooled effect (not applicable) Methods, limits and fundingOutcomes: Liver enzymes, jaundice, recovery after stopping Limitations: Abstract only. Case reports cannot show how common injury is. Case 1 also had gallstone disease, which can itself cause jaundice. Funding and conflicts: Not stated in the abstract. Read: abstract |
| EMA Committee on Herbal Medicinal Products (HMPC) 2011 Public statement on Chelidonium majus L., herba (EMA/HMPC/743927/2010), final, 13 September 2011 European Medicines Agency · Source |
Regulator document not applicable |
not applicable | Read in full (3 pages). Lists over 20 alkaloids (0.01-1%). WHO Vigisearch: 124 liver-bile adverse reactions from 56 spontaneous reports to 4 May 2011, mostly Germany with single cases from Austria and Belgium. Some countries withdrew licences for products giving more than 2.5 mg alkaloid a day. HMPC was not reassured by the scientific rationale for that limit, found clinical efficacy lacking for the single herb, and judged the benefit-risk of oral use negative for establishing an EU monograph. Safer herbal products exist. Skin use not sufficiently supported by market information. May be re-assessed if new data appear. Methods, limits and fundingOutcomes: Benefit-risk of oral and skin use; liver reports Read: full text | |
| EMA Committee on Herbal Medicinal Products (HMPC); rapporteur G. Laekeman 2011 Assessment report on Chelidonium majus L., herba (EMA/HMPC/369801/2009), final, 13 September 2011 European Medicines Agency · Source |
Regulator document not applicable |
not applicable | Text extracted and searched (not read page by page). Contains: traditional use since the Middle Ages for bile and liver disorders, latex on warts; two small placebo-controlled trials in upper abdominal complaints; case reports of liver injury with recovery usually in 2-3 months and worsening on re-exposure in 2 patients; Germany's 2008 graduated plan (withdrawal above 2.5 mg alkaloids a day; liver disease, other liver-damaging medicines, pregnancy and lactation contraindicated; liver tests if used over 4 weeks); EMA text says use in pregnancy is not recommended because of some cytotoxicity; acute toxicity of fresh plant due to latex; contact dermatitis in a woman using it on warts; deaths in children who ate the plant cited from a 1992 source; low oral absorption of the alkaloids. Methods, limits and fundingOutcomes: Traditional use, clinical studies, non-clinical and safety data Read: full text (searched) | |
| GBIF Secretariat 2026 GBIF species match: Chelidonium majus L. GBIF API · Source |
Database record not applicable |
not applicable | Chelidonium majus L. is ACCEPTED (key 5334186), family Papaveraceae, exact match (checked 2026-10-25). Methods, limits and fundingOutcomes: Accepted name and family Read: database record | |
| GBIF Secretariat 2026 GBIF species match: Ficaria verna Huds. (lesser celandine) GBIF API · Source |
Database record not applicable |
not applicable | Ficaria verna Huds. is ACCEPTED (key 9094061), family Ranunculaceae (the buttercup family), a different family from greater celandine. Methods, limits and fundingOutcomes: Accepted name and family Read: database record | |
| GBIF Secretariat 2026 GBIF species match: Stylophorum diphyllum (celandine poppy) GBIF API · Source |
Database record not applicable |
not applicable | Stylophorum diphyllum (Michx.) Nutt. is ACCEPTED (key 2888466), family Papaveraceae; a different genus from Chelidonium. Methods, limits and fundingOutcomes: Accepted name and family Read: database record | |
| Gao 2019 Characterization of the cytotoxicity of selected Chelidonium alkaloids in rat hepatocytes. Toxicol Lett · PMID 31054355 · DOI |
Laboratory research in-vitro |
Rat liver cells in culture | Chelidonium alkaloids (chelerythrine, coptisine, sanguinarine, chelidonine, protopine, dihydrosanguinarine) isolated alkaloids not extracted not applicable · vs not applicable |
Coptisine, chelerythrine and sanguinarine were the most toxic to liver cells (EC20 at or below 2 micromolar); chelidonine, protopine and dihydrosanguinarine less so. Sanguinarine depleted glutathione. The authors say the extracts and alkaloids did not cause similar effects when given by mouth to pigs or rats, likely because very little is absorbed, and note that a daily alkaloid limit was set in the EU. rank order only (not applicable) Methods, limits and fundingOutcomes: Cell toxicity ranking Limitations: Abstract only. Isolated alkaloids on rat cells. Funding and conflicts: Not stated in the abstract. Read: abstract |
| Gardin 2021 Greater celandine (Chelidonium majus L.) for COVID-19: A twenty-case series. Phytother Res · PMID 33778996 · DOI |
Case series |
20 20 consecutive mild COVID-19 outpatients aged 14-71 in Brazil (private offices) |
Chelidonium majus 10% mother tincture mother tincture not extracted 3-12 days (median 5) · vs none |
Most symptoms eased within 1-9 days (median 3); no adverse events were reported. The authors say the small series may inspire further research. descriptive only (not applicable) Methods, limits and fundingOutcomes: Clinical symptoms Limitations: Abstract only. No comparison group, so natural recovery from mild COVID-19 cannot be separated from any effect. Short follow-up for liver effects (about 1 week after treatment). Funding and conflicts: Not stated in the abstract. Read: abstract |
| Leroy 2022 Iberogast-Induced Acute Liver Injury-A Case Report. Gastro Hep Adv · PMID 39132058 · DOI |
Case report |
1 32-year-old woman with abdominal pain, jaundice and itching |
Iberogast, a 9-herb liquid product that includes greater celandine liquid combination of 9 plant extracts not extracted symptoms resolved about 5 weeks after stopping · vs none |
Severe acute hepatitis with high direct bilirubin; other causes excluded; labelled drug-induced liver injury linked to Iberogast; resolved by itself about 5 weeks after stopping. Because it is a 9-herb product, the injury cannot be pinned on greater celandine alone. single case (not applicable) Methods, limits and fundingOutcomes: Liver tests Limitations: Abstract only. Combination product, so greater celandine is one of nine ingredients. The authors say the product is generally safe. Funding and conflicts: Not stated in the abstract. Read: abstract |
| Li 2024 Alkaloids in Chelidonium majus L: a review of its phytochemistry, pharmacology and toxicology. Front Pharmacol · PMID 39239653 · DOI |
Narrative review review |
Literature review (mostly lab and animal work) | Chelidonium majus alkaloids whole plant and isolated alkaloids not extracted not applicable · vs not applicable |
94 alkaloids have been isolated, of benzophenanthridine, protoberberine, aporphine and protopine types. Reported lab effects include anti-microbial, anti-inflammatory, anti-viral and anti-tumour effects. Traditionally used for coughs, asthma, spasm and pain in China. narrative; no pooled effect (not applicable) Methods, limits and fundingOutcomes: Alkaloid chemistry, pharmacology, toxicology Limitations: Abstract only. Mostly lab and animal findings. Funding and conflicts: Not stated in the abstract. Read: abstract |
| Liu 2019 In vitro and in vivo studies of the metabolic activation of chelidonine. Chem Biol Interact · PMID 31102647 · DOI |
In vitro animal in-vitro/rat |
Human liver microsomes and rats | Chelidonine (isolated) isolated compound not extracted not applicable · vs not applicable |
Chelidonine was turned into reactive catechol/quinone-type metabolites that bind glutathione, in human liver microsomes and in rat bile. CYP3A4, 1A2, 2C19 and 2D6 were mainly involved. The authors note chelidonine has been reported to inhibit CYP enzymes. mechanistic (not applicable) Methods, limits and fundingOutcomes: Metabolites and enzymes involved Limitations: Abstract only. Lab and rat work with one isolated alkaloid. Funding and conflicts: Not stated in the abstract. Read: abstract |
| Mazzanti 2009 Chelidonium majus is not hepatotoxic in Wistar rats, in a 4 weeks feeding experiment. J Ethnopharmacol · PMID 19761826 · DOI |
Animal research rat |
Wistar rats, 2 or 4 weeks | Extract made from the herb batch tied to one human liver case aerial parts not extracted 2 or 4 weeks · vs control rats |
No significant change in body weight, food intake, liver enzymes or liver tissue. A slight but significant fall in glutathione (GSH) and superoxide dismutase (SOD) activity, mainly at the high dose. The authors say the doses were about 50 and 100 times those generally used in people and suggest caution when liver function is already stressed. no liver enzyme change; small GSH and SOD fall (not applicable) Methods, limits and fundingOutcomes: Liver enzymes, liver tissue, oxidative stress markers Limitations: Abstract only. Rat study; absence of liver injury in rats does not rule out rare human reactions. Funding and conflicts: Not stated in the abstract. Read: abstract |
| Musidlak 2022 The Activity of Chelidonium majus L. Latex and Its Components on HPV Reveal Insights into the Antiviral Molecular Mechanism. Int J Mol Sci · PMID 36012505 · DOI |
Laboratory research in-vitro |
Human papillomavirus (HPV) test systems in cells | Crude latex and its protein-rich and alkaloid-rich fractions latex not extracted not applicable · vs untreated cells |
Alkaloids and proteins in the latex lowered HPV infectivity and lowered E6/E7 gene activity. The latex did not stop the virus from attaching to cells. The protein fraction raised TNF-alpha release, which may mean an inflammatory response. lab result only (not applicable) Methods, limits and fundingOutcomes: HPV infectivity; viral cancer-gene (E6, E7) expression Limitations: Abstract only. Cell experiments; not a trial on warts in people. Funding and conflicts: Not stated in the abstract. Read: abstract |
| Niederau 1999 Niederau and Gopfert 1999, randomised double-blind placebo-controlled pilot trial of celandine plus curcuma root extract capsules in upper abdominal complaints (as summarised in EMA/HMPC/369801/2009) cited in EMA assessment report; original not read · Source |
Controlled trial |
76 76 outpatients (39 active, 37 placebo; 73 analysed for efficacy) with cramp-like and dull upper abdominal complaints |
Per the EMA summary: the main outcome (cramp-like pain frequency) differed from placebo only by a small to moderate amount (p=0.069); some secondary measures were better with the active capsule (dull complaints p=0.009; combined pain p=0.011). No adverse events in the active group; 4 events in 3 placebo patients. It was a combination of celandine and curcuma, so the effect cannot be assigned to celandine alone. We did not read the original paper. Methods, limits and fundingOutcomes: Frequency of cramp-like and dull complaints (0-100 mm scale diary), secondary symptoms, safety Limitations: Secondary source; combination product; pilot trial; 3 weeks. Funding and conflicts: Not stated in the EMA summary. Read: regulator-report summary | |
| Pantano 2017 Hepatotoxicity induced by greater celandine (Chelidonium majus L.): a review of the literature. Eur Rev Med Pharmacol Sci · PMID 28379595 |
Narrative review review |
Literature review | Greater celandine products whole plant products as reported not extracted not applicable · vs not applicable |
Several liver injury cases were rated probable or highly probable with liver-specific causality scales. The authors describe it as a distinct herb-induced liver injury, an idiosyncratic reaction of the metabolic type, and judge the risk-to-benefit ratio of greater celandine products negative given the lack of considerable benefit. narrative; no pooled effect (not applicable) Methods, limits and fundingOutcomes: Liver injury cases, causality, risk-benefit Limitations: Abstract only. Narrative review with its own opinion; other experts see dose-dependence (see EMA report). Funding and conflicts: Not stated in the abstract. Read: abstract |
| Power 2024 A Yellow Flower With Jaundice Power: Liver Injury Attributed to Greater Celandine. ACG Case Rep J · PMID 38682076 · DOI |
Case report |
1 72-year-old man in the United States, taking the supplement for nausea |
Greater celandine herbal supplement not stated not extracted not stated · vs none |
Acute hepatitis attributed to greater celandine in a US patient. The authors say earlier cases were mostly from Europe and none had been identified in the United States. single case; no pooled effect (not applicable) Methods, limits and fundingOutcomes: Acute hepatitis Limitations: Abstract only; one case; no lab values or recovery details in the abstract. Funding and conflicts: Not stated in the abstract. Read: abstract |
| PubChem 2026 PubChem compound records: chelidonine, sanguinarine, berberine, coptisine PubChem PUG REST · Source |
Database record not applicable |
not applicable | CIDs by name lookup: chelidonine 197810 (C20H19NO5); sanguinarine 5154 (C20H14NO4+); berberine 2353 (C20H18NO4+); coptisine 72322 (C19H14NO4+). Methods, limits and fundingOutcomes: Compound identifiers Read: database record | |
| Ritter R et al. 1993 Ritter et al. 1993, randomised double-blind placebo-controlled trial of a Chelidonium majus extract tablet in functional epigastric complaints (as summarised in EMA/HMPC/369801/2009) cited in EMA assessment report; original not read · Source |
Controlled trial |
60 60 patients with functional upper abdominal complaints |
Per the EMA summary: after 6 weeks symptom score fell significantly more with the extract than with placebo (p=0.003); physician rated 18 of 30 improved or symptom-free with the extract versus 8 of 30 with placebo. Side effects were few in both groups (3 on extract, 5 on placebo). We did not read the original paper. Methods, limits and fundingOutcomes: Symptom score (Zerssen list), physician rating Limitations: Secondary source only. Single small trial; 6 weeks; no long-term liver follow-up described. Funding and conflicts: Not stated in the EMA summary. Read: regulator-report summary | |
| Strahl 1998 [Necrotizing hepatitis after taking herbal remedies]. Dtsch Med Wochenschr · PMID 9856112 · DOI |
Case report |
2 Two women aged 39 and 42, German-language report |
One kava-containing remedy and one celandine-containing remedy (the abstract says "common (or lesser) celandine") herbal remedies not extracted repeated bouts · vs none |
Both women had repeated episodes of acute hepatitis, each after herbal remedies (one with kava, one with celandine). Biopsies showed acute necrotising hepatitis; liver tests quickly became normal after stopping. The wording "common (or lesser)" is the abstract translator's: which celandine species was in the product is not clear. 2 cases (not applicable) Methods, limits and fundingOutcomes: Liver tests, biopsy Limitations: Abstract only (English translation of the abstract). Species of celandine unclear; the two women took different remedies. Funding and conflicts: Not stated in the abstract. Read: abstract |
| Teschke 2011 Herbal hepatotoxicity by Greater Celandine (Chelidonium majus): causality assessment of 22 spontaneous reports. Regul Toxicol Pharmacol · PMID 21893153 · DOI |
Case series review |
22 22 spontaneous reports from Germany (average age 56.4 years, female predominance) |
Greater celandine herb products not extracted average treatment 36.4 days · vs not applicable |
Regulators had rated 16 cases probable and 6 possible. The liver-specific scale found highly probable in 2, probable in 6, possible in 10, unlikely in 1 and excluded in 3. Injury was of the liver-cell type; average time to first symptoms 29.8 days and to jaundice 35.6 days. The authors say the link is real but less strong than first assumed because data quality was poor. 2 highly probable, 6 probable, 10 possible, 1 unlikely, 3 excluded (not applicable) Methods, limits and fundingOutcomes: Causality grading with liver-specific scale Limitations: Abstract only. Spontaneous reports with poor data quality, as the authors say. Funding and conflicts: Not stated in the abstract. Read: abstract |
| Teschke 2012 Greater Celandine hepatotoxicity: a clinical review. Ann Hepatol · PMID 23109446 |
Case series review |
16 16 published patients from several European countries |
Greater celandine extracts herb extracts not extracted not applicable · vs not applicable |
All 16 cases scored probable or highly probable for greater celandine. The injury was usually acute, with a liver-cell pattern, jaundice with high liver enzymes in almost all, and a favourable outcome despite a severe course. The authors say it is an idiosyncratic reaction of the metabolic kind and that the culprit compound(s) are unknown. narrative; no pooled effect (not applicable) Methods, limits and fundingOutcomes: Clinical picture and causality (CIOMS scale) Limitations: Abstract only. Cases were selected from those published, so this cannot give frequency. Funding and conflicts: Not stated in the abstract. Several of these authors also wrote other celandine causality papers. Read: abstract |
| Teschke 2012 Suspected Greater Celandine hepatotoxicity: liver-specific causality evaluation of published case reports from Europe. Eur J Gastroenterol Hepatol · PMID 22189691 · DOI |
Case series review |
21 21 published case reports from Europe |
Greater celandine herb products not extracted not applicable · vs not applicable |
Causality for greater celandine was highly probable in 2 cases and probable in 6; lower in the other 13 (possible in 10, excluded in 3). The authors conclude liver injury from greater celandine is real but data quality and other possible causes lowered many ratings. 2 highly probable + 6 probable of 21 (not applicable) Methods, limits and fundingOutcomes: Causality grading (updated CIOMS scale) Limitations: Abstract only. Reports were published case reports, often with other medicines or poor data. Funding and conflicts: Not stated in the abstract. Read: abstract |
What we do not know yet
- No independent, adequately sized trial of greater celandine alone for any use.
- The original trial papers were not read; only EMA's summary.
- The frequency of liver injury, and which compound or dose causes it, is unknown.
- No human pregnancy, breastfeeding, child or interaction data.
- The NIH LiverTox entry was blocked, and LactMed, NCCIH, FDA and the original German regulator notice were not read.
- Only abstracts of the research papers were read, plus the full EMA documents.
How new research is added
New studies are found by a saved PubMed search and are placed in a review queue. A person reads each one before it changes any evidence rating or safety wording.
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".
Other 4
Upper abdominal symptom score
Fell more than placebo in trial 1; mixed in trial 2 in trials
A questionnaire or diary score of cramp-like pain, fullness and discomfort in the upper belly.
Very low certaintyResults and what it means
Why it was measured
The main outcome in both small trials of functional upper-abdominal complaints.
Statistical vs. clinical meaning
Small regulator-summarised trials only; does not show the herb is worth its liver risk.
| Study | Result | People | Product |
|---|---|---|---|
| 19 | Zerssen symptom score fell more with the extract than placebo (p=0.003) after 6 weeks. | 60 adults with functional epigastric complaints | Greater celandine herb extract tablets versus placebo |
| 15 | Main outcome (frequency of cramp-like pain) p=0.069; dull complaints p=0.009. | 76 adults, upper abdominal complaints | Celandine plus turmeric root extract capsules versus placebo |
Liver enzymes (ALT, AST) and bilirubin
Raised in the reported injury cases in trials
Blood tests that rise when liver cells are damaged or bile flow is blocked.
Low certaintyResults and what it means
Why it was measured
The key safety measure for greater celandine; it is where the harm shows up.
Statistical vs. clinical meaning
Case-based signal, strong enough to prompt regulator action; frequency unknown.
| Study | Result | People | Product |
|---|---|---|---|
| 2 | Enzymes above 1000 IU/L in one gallstone-use case; normalised after stopping in the other. | Two women with herb-induced liver injury | Greater celandine capsules; tea |
| 21 | Hepatocellular pattern; average time to jaundice 35.6 days (22 German spontaneous reports). | 22 reports, average age 56.4 | Greater celandine products |
HPV infectivity and viral E6/E7 gene activity (cells)
Lowered by latex fractions in cells in trials
How well a wart-virus test system infects cells and how active its cancer-related genes are.
Very low certaintyResults and what it means
Why it was measured
A lab stand-in for wart-virus activity.
Statistical vs. clinical meaning
A lab screen; does not show warts clear in people.
| Study | Result | People | Product |
|---|---|---|---|
| 14 | Alkaloid and protein fractions of the latex lowered infectivity and E6/E7 mRNA and protein; no effect on virus attachment. | Human cell test systems | Crude latex and its protein-rich and alkaloid-rich fractions |
Time to COVID-19 symptom improvement
Improved within 1-9 days (no control) in trials
Days until symptoms such as fever, cough and loss of smell eased.
Not enough evidenceResults and what it means
Why it was measured
The only outcome reported in the case series.
Statistical vs. clinical meaning
Cannot be separated from natural recovery.
| Study | Result | People | Product |
|---|---|---|---|
| 9 | Median 3 days to complete or almost complete improvement; no adverse events reported. | 20 mild outpatients, Brazil | 10% mother tincture of greater celandine |
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 6
- Liver injury is the main risk. Greater celandine taken by mouth has been linked to hepatitis and jaundice in many case reports, mostly from Europe and now also the United States. The injury is usually of the liver-cell type, starts within weeks to a few months, and mostly recovers after the herb is stopped. EMA's herbal committee judged the benefit-risk balance of oral use negative. Case report 3 4 22 17 16
- Experts disagree on how common and why. The WHO database held 124 liver-bile reactions from 56 reports to May 2011. A liver-specific re-analysis of 22 German reports found only 8 rated highly probable or probable, and concluded the link is real but less strong than first assumed. Some reviewers call it an idiosyncratic (unpredictable) reaction; the EMA report suggests it looks dose-dependent and cites an expert who saw no clear link below 9 mg alkaloids a day. Rat feeding and cell studies do not settle it. Narrative review 3 4 21 23 13 8
- Germany restricted products; the EU did not endorse oral use. Germany's 2008 graduated plan, described in the EMA report, withdrew licences for products giving over 2.5 mg of alkaloids a day and required warnings on the rest: not for people with current or past liver disease or taking other liver-damaging medicines, not in pregnancy or breastfeeding, and liver tests if used longer than 4 weeks. EMA's committee was not reassured by the scientific basis for that limit. Authoritative guidance 3 4
- Avoid in pregnancy and breastfeeding. EMA does not recommend it in pregnancy because of some cytotoxicity, and the German rules list pregnancy and breastfeeding as contraindications. There are no human pregnancy studies. Authoritative guidance 4
- The fresh latex can irritate skin and the plant is poisonous in quantity. The fresh plant can be acutely toxic because of the latex; drying reduces this. Contact dermatitis was reported in a woman using it on warts. Large amounts irritate the gut. Deaths in children who ate the plant are cited by EMA from a 1992 source we did not read. Authoritative guidance 4
- Not the same as lesser celandine or celandine poppy. Lesser celandine (Ficaria verna, buttercup family) and celandine poppy (Stylophorum diphyllum, same family but a different genus) are different plants. Safety findings on this page are about Chelidonium majus only. Other 5 6 7
Side effects 5
| Effect | How often | Severity and recovery | Evidence |
|---|---|---|---|
| Hepatitis with jaundice, dark urine, itching, fatigue Capsules, tea and tinctures all feature in reports. Frequency cannot be calculated from case reports. | Not established | serious Usually recovered after stopping, within about 2-3 months in the EMA report (rarely over 5 months). EMA's German label wording also mentions cases of liver failure. | Case series 22 21 2 1 4 |
| Worse liver injury on re-exposure EMA mentions 2 patients who had impaired liver function again after re-exposure; a 1998 German report describes repeated hepatitis episodes after remedies (one celandine-containing, species unclear). | Not established | serious Not stated. | Case report 4 20 |
| Skin irritation and contact dermatitis (itching, redness, papules) Applied to warts. The case is cited from a 2000 report we did not read. | Not established | moderate Settled within a few days without treatment in the one case cited by EMA. | Case report 4 |
| Gut irritation with large amounts EMA notes large doses can irritate the digestive tract. | Not established | unknown Not stated. | Authoritative guidance 4 |
| Restlessness, sleeplessness, dry mouth Short 6-week trial summarised by EMA; too small and brief to show liver risk. | 3 of 30 on extract versus 5 of 30 on placebo (any reaction) | mild Not stated. | Controlled trial 19 |
Liver
Greater celandine is a recognised cause of herb-induced liver injury. EMA counted 124 liver-bile reactions from 56 reports in the WHO database by May 2011, mostly from Germany. Published causality reviews rate a core of cases as probable or highly probable (8 of 22 in one German series; 8 of 21 in another; all 16 in a selected clinical review), with other cases weaker because of poor data or other medicines. Typical pattern: liver-cell injury with jaundice, starting about a month or two after beginning, with recovery after stopping. Case reports from 2024 and 2026 show it still happens, including a US case and cases from gallstone use and tea. Rat feeding at high doses did not change liver enzymes, and isolated alkaloids are toxic to rat liver cells, so the mechanism is unsettled. We did not open the NIH LiverTox page (it was blocked by a bot check), so its rating is not reported here. 3 4 21 23 22 16 17 2 1 10 13 8
How often. Unknown. The WHO count is spontaneous reports, which have no denominator.
Monitoring. The German label wording described by EMA calls for liver tests if used longer than 4 weeks and for stopping at once if liver damage signs appear.
This is a safety connection. It is not evidence that Greater celandine supports liver health.
Medicines and supplements 3
| With | Why it matters | Importance | Evidence | What to do |
|---|---|---|---|---|
| Other medicines, herbs or alcohol that can harm the liver liver-damaging medicines and herbs | Added strain on the liver. The German rules, described by EMA, contraindicate celandine products with other liver-damaging medicines, and most reported patients also took other medicines or herbs. | Potentially serious; no specific interacting drug was named by EMA. | Authoritative guidance Low certainty 4 | Ask a pharmacist before combining with anything that affects the liver. |
| Medicines cleared by the liver enzymes CYP3A4, CYP1A2, CYP2C19 or CYP2D6 prescription | Chelidonine is processed by these enzymes in human liver microsomes and has been reported to inhibit CYP enzymes. This is lab work; no human interaction study exists. | Unknown. | Laboratory research Very low certainty 12 | Tell your pharmacist you are taking it so they can check your medicines. |
| Multi-herb digestive products and turmeric-containing products combination products | Some digestive products have contained greater celandine, so liver injury cannot always be pinned on one ingredient. | Relevant when reading labels and case reports. | Case report Very low certainty 10 4 | Read ingredient lists; ask a pharmacist. |
Who should check first 7
| Situation | Advice | Evidence |
|---|---|---|
| Current or past liver disease, or unexplained raised liver tests | Avoid. German rules described by EMA list liver disease (past or present) as a contraindication. | Authoritative guidance 4 |
| Pregnancy | Avoid. EMA does not recommend it because of some cytotoxicity; German rules list it as a contraindication. No human pregnancy data. | Authoritative guidance 4 |
| Breastfeeding | Avoid. German rules list lactation as a contraindication. We did not find a LactMed entry. | Authoritative guidance 4 |
| Children | Avoid. EMA found no data in children and cites deaths in children who ate the plant (1992 source, not read). | Authoritative guidance 4 |
| Gallstones, bile duct problems or jaundice | Get medical assessment. Jaundice can come from a blocked bile duct and needs a doctor; one reported injury occurred in a person taking it for gallstones. | Case report 2 |
| Open wounds, eyes, and broken skin | Do not apply the fresh latex. It is irritating and the plant is toxic fresh. | Authoritative guidance 4 |
| Taking other liver-damaging medicines | Avoid combining; German rules list this as a contraindication. | Authoritative guidance 4 |
Overdose, product quality and regulators
Summary. The fresh plant and its latex are toxic; drying reduces this. The alkaloids (such as chelerythrine, sanguinarine, coptisine and chelidonine) are cell-toxic in lab tests.
Animal. EMA reports mouse LD50 of 1300 mg/kg and over 2000 mg/kg in rats for the plant (via the ESCOP monograph). A 4-week rat feeding study with extract from a herb batch tied to one human liver case found no liver enzyme or tissue changes, but a slight drop in glutathione and SOD (p19761826).
Human doses studied. None reported here.
High dose or long term signals. EMA advises avoiding excessive long-term use because of risk of severe hepatitis, cholestasis and fibrosis; the mechanism has not been established.
Overdose response. No systematic overdose data. Seek urgent help for jaundice, severe abdominal pain or vomiting after swallowing the plant.
Genotoxicity. EMA lists DNA damage and DNA-adduct findings for sanguinarine and chelerythrine in some lab tests and negative results in others; we did not read the primary reports.
Toxic plant parts. The latex of fresh stems and leaves is the acutely toxic part per EMA. The report lists the herb (aerial parts) as the traditional substance; the root also contains alkaloids but was not assessed here.
We found no contamination or adulteration reports specific to greater celandine. Alkaloid content varies between plants and products. Denmark's entry in the EMA national table records that it is not allowed in food supplements.
Species mix-ups. Lesser celandine (Ficaria verna) and celandine poppy (Stylophorum diphyllum) are different plants. A 1998 case report's abstract refers to 'common (or lesser) celandine', so labelling is not always clear. 6 7 20
Variable alkaloid content. EMA reports alkaloids of 0.01-1% in the herb, and different extracts differ widely in alkaloids. 3
| Body | Action | Date |
|---|---|---|
| EMA / HMPC (European Union) (EU) | Final public statement 13 September 2011: no EU herbal monograph; benefit-risk of oral use considered negative because of many liver-bile reports and national withdrawals; efficacy lacking for the single herb; skin use not sufficiently supported. May be re-assessed if new data are submitted. source | 2011-09-13 |
| Germany (graduated plan, as described in the EMA assessment report) (Germany) | From 9 April 2008: licences withdrawn for oral products giving more than 2.5 mg alkaloids a day; others must state contraindications (liver disease past or present, other liver-damaging medicines, pregnancy, lactation) and advise liver tests after 4 weeks. We did not read the original German regulator (BfArM) notice. source | 2008-04-09 |
| EMA national market table (Denmark, Ireland, Hungary) | In the 2011 assessment report: Denmark - no authorised products and not allowed in food supplements; Ireland - voluntary withdrawal of oral products; Hungary - one single-herb product for external use on warts and corns. The current position may have changed. source | 2011-09-13 |
When to get medical help
- Yellow skin or eyes (jaundice), dark urine or pale stools
- Severe or lasting nausea, vomiting, belly pain or unusual tiredness after taking it
- Itching all over with yellowing
- Confusion or drowsiness with jaundice (possible liver failure) - call emergency services
- A child or pet has eaten the fresh plant
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 greater celandine?
Is it the same as lesser celandine?
Can greater celandine harm the liver?
What do European regulators say?
Is the liver risk certain or exaggerated?
Both views exist. A liver-specific re-analysis found only about a third of 22 German reports were highly probable or probable, so the link is real but weaker than first assumed. Others call it unpredictable, and EMA's report points to possible dose-dependence. Rat feeding studies did not show liver injury.
Does it help indigestion?
Does it work for warts?
Is it safe in pregnancy or breastfeeding?
No. EMA does not recommend it in pregnancy because of some cytotoxicity, and German rules contraindicate pregnancy and breastfeeding. There are no human pregnancy studies.
Can children take it?
It should be avoided. EMA found no data in children and cites deaths in children who ate the plant, from a 1992 source we did not read.
Does it interact with medicines?
Is it used for gallstones or as a liver tonic?
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- AlternativeMed editorial team. Research compiled with AI assistance, then checked against PubMed records.
- 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, read the abstracts, read the two EMA documents on greater celandine, and checked GBIF and PubChem. No study is cited that we could not verify. Trial results come from EMA's summaries.
- 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. If one is added later it will be labelled and kept apart from the evidence.
Sources 23
Each source was opened and checked. Where we read only the abstract, it says so. The small numbers in the text point here.
- Adamidis N, Adamidi S, Georgakopoulou VE, Miliou S, Karampela A, Stratopoulos E. Chelidonium majus-Induced Hepatitis: A Case Report of Herb-Induced Liver Injury.. Cureus. 2026. PMID 42359199. DOI 10.7759/cureus.109572. (abstract)
- Ciornolutchii V, Ismaiel A, Sabo CM, Al Hajjar N, Seicean A, Dumitrascu DL. A Hidden Cause of Hypertransaminasemia: Liver Toxicity Caused by Chelidonium Majus L.: Report of Two Cases of Herb-Induced Liver Injury and Literature Review.. Am J Ther. 2024. PMID 38820341. DOI 10.1097/MJT.0000000000001708. (abstract)
- EMA Committee on Herbal Medicinal Products (HMPC). Public statement on Chelidonium majus L., herba (EMA/HMPC/743927/2010), final, 13 September 2011. European Medicines Agency. 2011. (full text)
- EMA Committee on Herbal Medicinal Products (HMPC); rapporteur G. Laekeman. Assessment report on Chelidonium majus L., herba (EMA/HMPC/369801/2009), final, 13 September 2011. European Medicines Agency. 2011. (full text (searched))
- GBIF Secretariat. GBIF species match: Chelidonium majus L.. GBIF API. 2026. (database record)
- GBIF Secretariat. GBIF species match: Ficaria verna Huds. (lesser celandine). GBIF API. 2026. (database record)
- GBIF Secretariat. GBIF species match: Stylophorum diphyllum (celandine poppy). GBIF API. 2026. (database record)
- Gao L, Schmitz HJ, Merz KH, Schrenk D. Characterization of the cytotoxicity of selected Chelidonium alkaloids in rat hepatocytes.. Toxicol Lett. 2019. PMID 31054355. DOI 10.1016/j.toxlet.2019.04.031. (abstract)
- Gardin NE, Braga AJ. Greater celandine (Chelidonium majus L.) for COVID-19: A twenty-case series.. Phytother Res. 2021. PMID 33778996. DOI 10.1002/ptr.7085. (abstract)
- Leroy A, Perrin H, Porret R, Sempoux C, Chtioui H, Fraga M. Iberogast-Induced Acute Liver Injury-A Case Report.. Gastro Hep Adv. 2022. PMID 39132058. DOI 10.1016/j.gastha.2022.02.020. (abstract)
- Li XL, Sun YP, Wang M, Wang ZB, Kuang HX. Alkaloids in Chelidonium majus L: a review of its phytochemistry, pharmacology and toxicology.. Front Pharmacol. 2024. PMID 39239653. DOI 10.3389/fphar.2024.1440979. (abstract)
- Liu Y, Peng Y, Zhang Z, Guo X, Ji M. In vitro and in vivo studies of the metabolic activation of chelidonine.. Chem Biol Interact. 2019. PMID 31102647. DOI 10.1016/j.cbi.2019.05.012. (abstract)
- Mazzanti G, Di Sotto A, Franchitto A, Mammola CL, Mariani P. Chelidonium majus is not hepatotoxic in Wistar rats, in a 4 weeks feeding experiment.. J Ethnopharmacol. 2009. PMID 19761826. DOI 10.1016/j.jep.2009.09.004. (abstract)
- Musidlak O, Warowicka A, Broniarczyk J, Adamczyk D, Gozdzicka-Jozefiak A. The Activity of Chelidonium majus L. Latex and Its Components on HPV Reveal Insights into the Antiviral Molecular Mechanism.. Int J Mol Sci. 2022. PMID 36012505. DOI 10.3390/ijms23169241. (abstract)
- Niederau C, Gopfert E. Niederau and Gopfert 1999, randomised double-blind placebo-controlled pilot trial of celandine plus curcuma root extract capsules in upper abdominal complaints (as summarised in EMA/HMPC/369801/2009). cited in EMA assessment report; original not read. 1999. (regulator-report summary)
- Pantano F, Mannocchi G, Marinelli E, Gentili S, Graziano S, Busardo FP. Hepatotoxicity induced by greater celandine (Chelidonium majus L.): a review of the literature.. Eur Rev Med Pharmacol Sci. 2017. PMID 28379595. (abstract)
- Power S, Barritt AS. A Yellow Flower With Jaundice Power: Liver Injury Attributed to Greater Celandine.. ACG Case Rep J. 2024. PMID 38682076. DOI 10.14309/crj.0000000000001347. (abstract)
- PubChem, NCBI. PubChem compound records: chelidonine, sanguinarine, berberine, coptisine. PubChem PUG REST. 2026. (database record)
- Ritter R et al.. Ritter et al. 1993, randomised double-blind placebo-controlled trial of a Chelidonium majus extract tablet in functional epigastric complaints (as summarised in EMA/HMPC/369801/2009). cited in EMA assessment report; original not read. 1993. (regulator-report summary)
- Strahl S, Ehret V, Dahm HH, Maier KP. [Necrotizing hepatitis after taking herbal remedies].. Dtsch Med Wochenschr. 1998. PMID 9856112. DOI 10.1055/s-2007-1024196. (abstract)
- Teschke R, Glass X, Schulze J. Herbal hepatotoxicity by Greater Celandine (Chelidonium majus): causality assessment of 22 spontaneous reports.. Regul Toxicol Pharmacol. 2011. PMID 21893153. DOI 10.1016/j.yrtph.2011.08.008. (abstract)
- Teschke R, Frenzel C, Glass X, Schulze J, Eickhoff A. Greater Celandine hepatotoxicity: a clinical review.. Ann Hepatol. 2012. PMID 23109446. (abstract)
- Teschke R, Glass X, Schulze J, Eickhoff A. Suspected Greater Celandine hepatotoxicity: liver-specific causality evaluation of published case reports from Europe.. Eur J Gastroenterol Hepatol. 2012. PMID 22189691. DOI 10.1097/MEG.0b013e32834f993f. (abstract)