Herbs & Botanicals · Chinese root with a pregnancy warning
Trichosanthes
Trichosanthes kirilowii · also called Tian hua fen (root), gua lou (fruit), gua lou ren (seed), Chinese snake gourd
Trichosanthes is a Chinese climbing gourd whose root, fruit and seed are used in traditional medicine for thirst, cough and chest pain. Do not use the root if you are or could be pregnant: its protein, trichosanthin, was used to end pregnancies and can cause severe allergic reactions. Human research is limited to purified injections and hospital formulas, so no health benefit of the root is proven.
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 Trichosanthes
Trichosanthes (Trichosanthes kirilowii and T. rosthornii) is a Chinese climbing gourd. The root (tian hua fen), fruit (gua lou) and seed (gua lou ren) are different products. The root contains trichosanthin, a protein that is toxic and was used to end pregnancies. The evidence for health benefits is weak.
Safety first
Do not use the root if you are pregnant, could be pregnant or are breastfeeding. Trichosanthin was injected in China to end pregnancies at around 12 to 24 weeks, can cause heavy bleeding, and harmed and killed mouse fetuses.
The purified protein can cause severe allergic reactions, including anaphylaxis, and in HIV trials caused flu-like illness, muscle damage and, in some people, nerve reactions. The crude herb is not the same as the purified injection and no safety data on the dried root by mouth were found, so it cannot be assumed safer.
Traditional Chinese texts also list Trichosanthes as clashing with aconite; this rests on tradition and was not verified. Ask a doctor or pharmacist about any amounts or products.
What it is
Two species supply the herb: Trichosanthes kirilowii and T. rosthornii, both in the gourd family. Do not confuse them with the food snake gourds (T. cucumerina). The root, fruit and seed are used for different purposes.
Traditional use
In Chinese medicine the root is used to quench thirst, clear heat and reduce swelling, and the fruit for chest blockage and cough. These uses rest on tradition and lab work.
What research exists
The best-documented human use is ending pregnancy, which is a harm. The HIV work in the early 1990s was Phase I and showed side effects without proven benefit. A 2024 meta-analysis of Chinese trials found a comfrey and trichosanthin decoction shortened bleeding as an add-on in medical abortion. A review of a fruit-based formula for angina found the trials too weak to conclude.
We did not find a trial for molar or ectopic pregnancy use, though Chinese clinical use for these is described.
At a glance
Traditional uses history, not proof
- Root (tian hua fen): thirst, heat, swelling and sores (Chinese medicine)
- Fruit (gua lou): chest blockage and cough
- Root powder to end pregnancy (historical, China)
Studied for research
- Ending pregnancy: purified injection, one trial; a harm for wanted pregnancies
- Medical abortion add-on formula: meta-analysis of Chinese trials; low certainty
- HIV: Phase I studies of the purified protein; very low certainty, serious side effects
- Angina: fruit-based formula, 17 weak trials; low certainty
Main compounds
- Trichosanthin (a ribosome-inactivating protein)
- Cucurbitacins and other triterpenes
- Flavonoids and lignans (fruit)
Common forms
- Dried root slices (traditional decoctions)
- Fruit and seed (different parts)
- Purified injected protein (hospital only)
Research links: Trichosanthin review (Toxins 2022) · Trichosanthis Radix review (Fitoterapia 2025) · Phase I study in HIV (AIDS 1990) · Research Library · Genes & Biomarkers Library
The plant and its history
- Accepted scientific name
- Trichosanthes kirilowii Maxim.
- Naming authority
- Maxim.
- Common names
- Trichosanthes (English); Chinese snake gourd (English); Tian hua fen (root) (Chinese); Gua lou (fruit) (Chinese); Gua lou ren (seed) (Chinese)
- Botanical family
- Cucurbitaceae (gourd family)
- Classification
- Plantae > Cucurbitales > Cucurbitaceae > Trichosanthes > Trichosanthes kirilowii
- Native range
- Used in China, Japan and Korea (review); exact native range not read.
- Habitat
- Not described in the sources read.
- What the plant looks like
- Roots: Large tubers (the tian hua fen).; Stems: Climbing vine (not described in sources read).; Leaves: Not described.; Flowers: Not described.; Fruit: Gourd fruit (gua lou); seeds are gua lou ren.
- Cultivation
- Not verified.
- Harvest and processing
- Not verified. A review mentions processing methods but the abstract gives no detail.
- Look-alikes and adulterants
- Name: Other gua lou species (T. cavaleriei, T. hupehensis and others); Note: Reported to cause more nausea and vomiting; not the trichosanthin source (summary-only).; Name: Trichosanthes cucumerina / dioica (snake gourd, pointed gourd); Note: Different species used as food and in Ayurveda; their results do not apply here.
- Sustainability and conservation
- Not assessed.
Traditional use and history history, not clinical proof
| Tradition or era | Documented use | Source |
|---|---|---|
| Traditional Chinese medicine | Root (tian hua fen): clear heat, generate fluids, reduce swelling, expel pus, regulate menstruation; used for thirst and diabetes-like conditions. Fruit (gua lou): chest blockage, angina, cough. Seed (gua lou ren): used in related formulas. | p40334818 |
| Modern China, 1970s | Root powder as abortifacient; protein purified in 1972 to reduce side effects. | p35324675 |
| 1989 to early 1990s | Anti-HIV research after laboratory activity. | p1892592 |
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 |
|---|---|---|---|---|
| Trichosanthin (TCS) | ribosome-inactivating protein (type I) | root tuber Not stated here. | Removes a base from 28S ribosomal RNA, halting protein synthesis; abortifacient, immune-provoking, anti-HIV in cells. 9 3 | Human data |
| Cucurbitacin B PubChem 5281316 | triterpenoid (cucurbitane) | not established for this species here Not stated here. | Bitter, cytotoxic in lab work; cucurbitacins are a class of the gourd family. 11 | Lab |
| Cucurbitacin D PubChem 5281318 | triterpenoid (cucurbitane) | T. kirilowii (title of a 2025 paper only) Not stated here. | Studied in cell and animal models. 11 | Lab |
| Terpenoids, sterols, flavonoids, lignans | mixed | fruit (about 162 compounds isolated) Not stated here. | Heart-protective, expectorant and anti-inflammatory in lab and animal work. 13 | Lab |
Mechanisms, receptors and pathways
| Target or pathway | Gene or receptor | What was found | Level |
|---|---|---|---|
| Ribosome (rRNA N-glycosylase) | 28S rRNA A-4324 (alpha-sarcin/ricin loop); ribosomal stalk proteins | Trichosanthin depurinates 28S rRNA and interacts with acidic ribosomal stalk proteins, stopping protein synthesis. 9 | Lab |
| Embryo development | Fetal loss and malformations in pregnant mice and cultured embryos. 1 | Animal research | |
| HIV replication | Blocked HIV in some infected cell lines but toxic to another. 3 | Lab | |
| Heart protection (fruit) | Protection against low-oxygen heart injury, calcium channel blocking and reduced clotting in lab and animal studies. 13 | Animal research |
Absorption, metabolism and elimination
- Absorption
- Injected protein only; plain root by mouth not studied.
- Distribution
- Not studied here.
- Metabolism
- Not studied here.
- Elimination
- The 2022 review notes a short plasma half-life.
- Bioavailability
- Not established for the root.
Isolated compounds versus whole extracts
Nearly all human data are for purified, injected trichosanthin, not the dried root. Fruit-based formula trials are a third thing again. Results do not transfer between these forms.
Nutritional composition
Not a food in the sources read.
1 moderate certainty2 low certainty1 very low certainty2 not enough evidence
What is Trichosanthes good for?
What trichosanthes has been studied for and how strong the evidence is. The first two items are about ending pregnancy, which is a harm if you want to stay pregnant.
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.
Ending pregnancy (purified trichosanthin injection; a harm, not a health benefit)
Moderate certaintyThe root powder was used in China to end pregnancy. In 1972 the protein trichosanthin was purified and injected in hospitals for this. One randomised trial of 200 women at 10 to 14 weeks found high rates of complete abortion. This is the reason the root must be avoided in pregnancy.
3 studiesOnly the hospital-injected purified protein was studied. Nothing here…
Studies, doses and limits
What the trials found
One randomised comparison of two injection routes (200 women, China, 1990) and a review. The protein was injected in hospital. No use of the plain dried root as a safe or tested way to do this exists.
Results
The 1990 abstract reports complete abortion in 85% (muscle injection) and 97% (cervical injection) of women at 10 to 14 weeks, with fever and other general side effects; dexamethasone was used to reduce them. A 2022 review calls the root powder a traditional abortifacient and describes immune reactions and serious bleeding (summary-only for the bleeding detail). Mouse work shows fetal loss and malformations at high injected doses.
Effect sizes as reported
85% vs 97% complete abortion by route (200 women)
Why this rating
It reliably ends pregnancy in the studied injection setting, but the evidence is old, from one country, with no placebo, and it is a harm for anyone who wants to stay pregnant.
Form and dose studied
Only the hospital-injected purified protein was studied. Nothing here supports any home use. Ask a doctor about any herb in pregnancy.
Who was studied
Women in China at 10 to 14 weeks in the trial; mouse pregnancy models.
Limits
Not a health benefit. Not a safe or recommended use of the dried root.
Why researchers looked
Traditional Chinese medicine used the root to end pregnancy; the purified protein was developed to reduce the side effects of the raw powder.
Traditional use
Tian Hua Fen powder as an abortifacient in traditional Chinese medicine.
Proposed mechanism Animal / cell
Trichosanthin is a ribosome-inactivating protein: it damages the cell machinery that makes proteins, and placenta cells appear sensitive to it. Mouse studies show fetal death and malformations.
A proposed mechanism does not show that the effect happens in people.
Serious: allergic reactions, fever, bleeding. See the safety tab.
Add-on in early medical abortion (a named formula that contains trichosanthin)
Low certaintyA big review of 73 Chinese trials found that some herbal formulas added to standard abortion drugs may raise complete abortion or shorten bleeding. One of them is a comfrey and trichosanthin decoction. It is not shown that the herb itself is the active part.
1 studiesA hospital-prescribed formula in China; not a product to self-treat w…
Studies, doses and limits
What the trials found
One network meta-analysis of 73 randomised trials (11,683 patients) covering nine formulas.
Results
Eight of nine formulas improved the complete abortion rate. The comfrey and trichosanthin decoction was named best for shortening vaginal bleeding (effect value -8.75, 95% CI -10.86 to -6.64). The abstract does not give a trichosanthin-specific abortion rate.
Effect sizes as reported
-8.75 (bleeding duration, comfrey and trichosanthin decoction)
Why this rating
Many Chinese trials of uncertain quality; indirect comparisons; formulas contain several herbs and the form of trichosanthin is not stated.
Form and dose studied
A hospital-prescribed formula in China; not a product to self-treat with. Ask a doctor.
Who was studied
Women having early medical abortion in China.
Limits
Not trichosanthin alone; quality unclear; applies only to ending pregnancy.
Why researchers looked
Chinese hospitals added herbs to mifepristone and misoprostol to help the abortion finish and reduce bleeding.
Traditional use
Not a traditional wellness use; a modern hospital add-on.
Proposed mechanism Pharmacological theory
Not established. The formulas contain several herbs.
A proposed mechanism does not show that the effect happens in people.
This use is about ending pregnancy. Do not use if pregnant and wishing to continue.
HIV (purified trichosanthin, Phase I and early trials; not a treatment)
Very low certaintyIn 1989 trichosanthin blocked HIV in cells. In the early 1990s it was given by drip to people with HIV in Phase I studies. T-cell counts rose in one study, but another saw no lasting change, side effects were real, and no benefit for health was shown. It is not an HIV treatment.
4 studiesOnly the purified injected protein was studied, never the dried root.
Studies, doses and limits
What the trials found
Two Phase I human studies of the purified protein GLQ223 (18 and 22 people), one dish study, and a review.
Results
Phase I (1990, 18 people): no notable toxicity except one severe neurological reaction; no consistent or sustained CD4+ or HIV antigen change. Multiple-dose study (1994, 22 people): all had a flu-like illness with muscle aches and raised creatine kinase; CD4+ and CD8+ counts rose at the two highest dose levels and stayed up for at least 28 days; no clinical benefit shown. Our earlier summary of a 2022 review also records confusion and coma in some trial participants and one death (summary-only).
Effect sizes as reported
CD4+/CD8+ counts rose in one small study; no clinical outcome measured
Why this rating
Small, uncontrolled, early-phase studies from 1990 to 1994 on immune counts only, with serious side effects.
Form and dose studied
Only the purified injected protein was studied, never the dried root.
Who was studied
Adults with AIDS or AIDS-related complex, CD4+ 100 to 350/mm3.
Limits
No placebo, no illness or survival outcome, nerve and muscle toxicity.
Why researchers looked
Blocking HIV in infected immune cells in the dish.
Traditional use
Not a traditional use; a modern drug-development effort on the purified protein.
Proposed mechanism Laboratory research
The protein damages ribosomes in infected cells, which may explain activity in dishes and its toxicity.
A proposed mechanism does not show that the effect happens in people.
Serious nerve and muscle effects. Do not use the root for HIV.
Angina and chest blockage (Gualou Xiebai Banxia formula, fruit-based; combination product)
Low certaintyThe ripe fruit (gua lou) is a main herb of a classic Chinese formula for chest pain. A review of 17 trials in 1,676 people found hints of help for angina, but the trials were too weak to reach a conclusion. The formula contains other herbs, including pinellia.
2 studiesA multi-herb formula, not the root, not a supplement tested here. Ask…
Studies, doses and limits
What the trials found
One systematic review of 17 randomised trials (1,676 patients) of the formula with or without usual drugs.
Results
The authors say the formula might help angina, ECG and blood lipids to a certain extent, but the trials had poor method quality and a high risk of bias, so no definite conclusion and no meta-analysis.
Effect sizes as reported
Not pooled
Why this rating
Trials too biased to pool; combination formula; mostly Chinese trials.
Form and dose studied
A multi-herb formula, not the root, not a supplement tested here. Ask a doctor; angina needs medical care.
Who was studied
Adults with stable angina in China.
Limits
Cannot tell which herb does what. Not tested against modern gold-standard care alone.
Why researchers looked
Traditional texts use the fruit for chest blockage and angina; the formula is widely prescribed in China.
Traditional use
Fruit (gua lou) for "chest blockage" in Chinese medicine.
Proposed mechanism Animal and lab
Lab and animal work suggests the fruit protects heart muscle from low oxygen, blocks calcium channels and reduces clotting.
A proposed mechanism does not show that the effect happens in people.
Chest pain can be an emergency. This formula must not replace medical care. See the safety tab for incompatibilities.
Thirst, cough, swelling and sores (root, traditional use)
Not enough evidenceIn Chinese medicine the root (tian hua fen) is used to "generate fluids" and quench thirst, clear heat in the lungs and reduce swelling and pus. These uses rest on tradition and lab work, not on human trials.
1 studiesNo dose or form to state.
Studies, doses and limits
What the trials found
No human trial of the root for these uses was found.
Results
Traditional use only (a 2025 review).
Effect sizes as reported
Not applicable
Why this rating
Only historical use and lab or animal work.
Form and dose studied
No dose or form to state.
Who was studied
No human data.
Limits
Tradition is not proof; the same root is dangerous in pregnancy.
Why researchers looked
Traditional use across China, Japan and Korea.
Traditional use
Pharmacopoeias list clearing heat, reducing swelling, expelling pus, generating fluids and regulating menstruation, and uses for diabetes, inflammation and respiratory conditions.
Proposed mechanism Lab and animal
Lab studies report anti-inflammatory and blood-sugar-lowering effects of root extracts; none established in people.
A proposed mechanism does not show that the effect happens in people.
See the safety tab. Regular use of the root is not supported.
Cancer (laboratory and animal work only)
Not enough evidenceTrichosanthin and root extracts have been tested on cancer cells and animals, including stomach and bowel cancer. No human trial showing benefit was found.
2 studiesNo form studied in people.
Studies, doses and limits
What the trials found
No human trial found.
Results
Review-level statement of anticancer lab effects.
Effect sizes as reported
Not applicable
Why this rating
Lab and animal only.
Form and dose studied
No form studied in people.
Who was studied
No human data.
Limits
Same protein is toxic to normal cells and the immune system.
Why researchers looked
The protein damages ribosomes in rapidly dividing cells, so it was tried on cancer cells.
Traditional use
Traditional lists for the root include cancer.
Proposed mechanism Laboratory research
Trichosanthin removes a base from ribosomal RNA, shutting protein production in a cell.
A proposed mechanism does not show that the effect happens in people.
Serious side effects seen with the injected protein in people.
Connections to the rest of health
How Trichosanthes 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 |
|---|---|---|---|---|
| Immune Support | Very low certainty | HIV (purified trichosanthin, Phase I and early trials; not a treatment): In 1989 trichosanthin blocked HIV in cells. In the early 1990s it was given by drip to people with HIV in Phase I studies. T-cell counts rose in one study, but another saw no lasting change, side effects were real, and no benefit for health was shown. It is not an HIV treatment. | 6 7 3 9 | |
| Heart Health | Low certainty | Angina and chest blockage (Gualou Xiebai Banxia formula, fruit-based; combination product): The ripe fruit (gua lou) is a main herb of a classic Chinese formula for chest pain. A review of 17 trials in 1,676 people found hints of help for angina, but the trials were too weak to reach a conclusion. The formula contains other herbs, including pinellia. | 2 13 | |
| Lung Support | Traditional use | Not enough evidence | Thirst, cough, swelling and sores (root, traditional use): In Chinese medicine the root (tian hua fen) is used to "generate fluids" and quench thirst, clear heat in the lungs and reduce swelling and pus. These uses rest on tradition and lab work, not on human trials. | 10 |
B. Body systems
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Reproductive System | Biological association | Moderate certainty | Studied for: Ending pregnancy (purified trichosanthin injection; a harm, not a health benefit) Studied for: Add-on in early medical abortion (a named formula that contains trichosanthin) | 5 9 1 8 |
| Immune System | Biological association | Very low certainty | Studied for: HIV (purified trichosanthin, Phase I and early trials; not a treatment) Studied for: Cancer (laboratory and animal work only) | 6 7 3 9 10 |
| Cardiovascular System | Biological association | Low certainty | Studied for: Angina and chest blockage (Gualou Xiebai Banxia formula, fruit-based; combination product) | 2 13 |
| Respiratory System | Biological association | Not enough evidence | Studied for: Thirst, cough, swelling and sores (root, traditional use) | 10 |
I. Biomarkers
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Complete abortion rate | Biological association | Low certainty | Measured in trials: raised. A lab change is not the same as a health benefit. | 5 8 |
| Duration of vaginal bleeding | Biological association | Low certainty | Measured in trials: shortened. A lab change is not the same as a health benefit. | 8 |
| CD4+ T-cell count | Biological association | Very low certainty | Measured in trials: raised. A lab change is not the same as a health benefit. | 7 6 |
| Creatine kinase (CK) | Biological association | Low certainty | Measured in trials: raised. A lab change is not the same as a health benefit. | 7 |
| Angina symptoms, ECG and blood lipids | Biological association | Low certainty | Measured in trials: improved. A lab change is not the same as a health benefit. | 2 |
J. Genes, receptors and enzymes
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Ribosomal RNA 28S | Preliminary mechanism | Lab | The molecular target of trichosanthin. | 9 |
L. Active compounds
| Connected to | Kind of connection | Evidence status | Context | Studies |
|---|---|---|---|---|
| Trichosanthin | Documented | The ribosome-inactivating protein that explains pregnancy loss, immune reactions and the HIV research. The protein behind pregnancy loss, immune reactions and the HIV research. Preparation or compound: root |
9 | |
| Trichosanthin (TCS) | Biological association | Human | Removes a base from 28S ribosomal RNA, halting protein synthesis; abortifacient, immune-provoking, anti-HIV in cells. Preparation or compound: root tuber |
9 3 |
| Cucurbitacin B | Biological association | Lab | Bitter, cytotoxic in lab work; cucurbitacins are a class of the gourd family. Preparation or compound: not established for this species here |
11 |
| Cucurbitacin D | Biological association | Lab | Studied in cell and animal models. Preparation or compound: T. kirilowii (title of a 2025 paper only) |
11 |
| Terpenoids, sterols, flavonoids, lignans | Biological association | Lab | Heart-protective, expectorant and anti-inflammatory in lab and animal work. Preparation or compound: fruit (about 162 compounds isolated) |
13 |
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 3 lab markers
Tap a number to show only those markers. Counts are markers, not people.
The evidence
The research centre for Trichosanthes. 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 built on our existing summary, re-read PubMed abstracts and checked GBIF and PubChem. Details beyond abstracts from the 2022 review are marked summary-only.
Study library: every study we checked 13
| Study | Design | People | Product, dose, length | Result |
|---|---|---|---|---|
| Chan 1993 Developmental toxicity and teratogenicity of trichosanthin, a ribosome-inactivating protein, in mice Teratog Carcinog Mutagen · PMID 8102209 · DOI |
Animal research animal |
Pregnant mice and cultured mouse embryos | Trichosanthin protein from Trichosanthes kirilowii tubers, injected into the abdomen root tuber protein not given here single dose on day 8 of pregnancy · vs saline |
At the highest dose fetal viability fell to 70.2% (saline control 96.5%), more fetuses were reabsorbed and survivors were smaller. At the two higher doses 2.3% and 9.0% of survivors were abnormal (exencephaly, short limbs, short tail). Cultured embryos were also harmed. not applicable Methods, limits and fundingOutcomes: Fetal survival and malformations Limitations: Mice, injected protein; shows harm to development, not a human dose. Funding and conflicts: Not stated in the abstract. Read: abstract |
| Chen 2019 A systematic review of the effectiveness and safety of Chinese herbal medicine formula Gualou Xiebai Banxia (GLXBBX) decoction for the treatment of stable angina pectoris Medicine (Baltimore) · PMID 31860998 · DOI |
Systematic review |
1676 17 randomised trials (1,676 patients) with stable angina in China |
Gualou Xiebai Banxia decoction (a multi-herb formula built on the fruit, gua lou; also contains pinellia), alone or with usual drugs fruit (Trichosanthis Fructus) plus other herbs not given here varies by trial · vs usual angina drugs |
The authors judged the trials too biased to pool. They say the formula might help angina, ECG and blood lipids to a certain extent, but reached no definite conclusion because of poor method quality, high risk of bias and weak reporting. not pooled Methods, limits and fundingOutcomes: Angina symptoms, ECG, blood lipids, safety Limitations: Poor-quality trials, no meta-analysis, formula of several herbs so the fruit cannot be separated out. Funding and conflicts: No conflicts declared. Read: abstract |
| Ferrari 1991 Toxicity and activity of purified trichosanthin AIDS · PMID 1892592 · DOI |
Laboratory research cell |
Human cell lines in dishes | Trichosanthin purified from fresh Trichosanthes kirilowii root tubers root tuber not given here not applicable · vs untreated cells |
Trichosanthin blocked cell fusion and HIV replication in some cell lines at about 0.5 to 4 micrograms/ml, but was toxic to one cell line at lower levels. The authors say it confirms anti-HIV activity on some cell lines. not applicable Methods, limits and fundingOutcomes: Anti-HIV activity and cell toxicity Limitations: Dish study only; not tested in people here. Funding and conflicts: Not stated in the abstract. Read: abstract |
| GBIF 2026 GBIF species match: Trichosanthes kirilowii Maxim. (key 3624240), T. rosthornii Harms (key 7317615), genus Trichosanthes L. (key 2874604) GBIF · Source |
Registry or database plant |
not applicable | Trichosanthes species whole plant not given here not applicable · vs none |
GBIF API on 2026-10-25: all three names are ACCEPTED (exact match), family Cucurbitaceae. not applicable Methods, limits and fundingOutcomes: Accepted names Limitations: NCBI Taxonomy not checked. Funding and conflicts: not applicable Read: full-text |
| Jin 1990 [Crystal trichosanthin protein intramuscular or intracervical injection for the termination of pregnancy at 10 to 14 weeks gestation: clinical analysis of 200 cases] Shengzhi Yu Biyun · PMID 12316199 |
Controlled trial |
200 200 women seeking termination at 10 to 14 weeks (China) |
Crystal trichosanthin protein injection (muscle or cervix), with or without dexamethasone root-derived purified protein not given here single treatment · vs other injection route |
The abstract (in English, from a Chinese paper) says both routes were 99% and 100% effective and complete abortion was 85% (muscle) and 97% (cervix). Fever was less common in the cervical group. Dexamethasone was used to reduce general side effects. Dosing details are not repeated here. not given Methods, limits and fundingOutcomes: Completeness of abortion, side effects Limitations: Old Chinese-language paper, abstract only, no placebo group; this is about ending pregnancy, which is a harm to a continuing pregnancy, not a health benefit. Funding and conflicts: Not stated in the abstract. Read: abstract |
| Kahn 1990 The safety and pharmacokinetics of GLQ223 in subjects with AIDS and AIDS-related complex: a phase I study AIDS · PMID 2088398 · DOI |
Clinical trial |
18 18 people (10 AIDS, 8 AIDS-related complex) |
GLQ223 (purified trichosanthin), single intravenous infusion, dose escalation root-derived purified protein not given here single infusion · vs none (dose-escalation) |
No notable toxicity except one person with a severe neurological reaction. No consistent or sustained change in CD4+ counts or HIV antigen. Blood levels like those that worked in cells were reached only briefly. not given in the abstract Methods, limits and fundingOutcomes: Safety, blood levels, immune and virus measures Limitations: Phase I, small, uncontrolled, single dose. The authors said the drug had been imported from China and was already in community-initiated treatment programmes. Funding and conflicts: Not stated in the abstract. Read: abstract |
| Kahn 1994 Safety, activity, and pharmacokinetics of GLQ223 in patients with AIDS and AIDS-related complex Antimicrob Agents Chemother · PMID 7910722 · DOI |
Clinical trial |
22 22 people with AIDS or AIDS-related complex, CD4+ counts 100 to 350/mm3 |
GLQ223 (purified trichosanthin), intravenous infusions root-derived purified protein not given here multiple infusions (see paper) · vs none (dose-escalation) |
All 22 had a flu-like illness with muscle and joint aches and raised creatine kinase, which was easily controlled. At the two highest dose levels target blood levels were reached and CD4+ and CD8+ T-cell counts rose for at least 28 days. The authors call repeat infusions relatively well tolerated and say it may have activity; no clinical benefit (illness or survival) was shown. not given in the abstract Methods, limits and fundingOutcomes: Safety, blood levels, immune counts Limitations: Early phase, small, no control group, immune counts only, 1994. Funding and conflicts: Not stated in the abstract. Read: abstract |
| Li 2024 Effects of medical abortion assisted by traditional Chinese medicine: A network meta-analysis of randomized controlled trials Int J Gynaecol Obstet · PMID 38037875 · DOI |
Meta-analysis |
11683 73 randomised trials in China (11,683 patients) of early medical abortion with mifepristone and misoprostol, with or without a Chinese medicine added |
Nine named Chinese herbal formulas added to mifepristone plus misoprostol (one is a comfrey and trichosanthin decoction) not specified in the abstract not given here early pregnancy medical abortion · vs mifepristone plus misoprostol alone |
Eight of nine formulas improved the complete abortion rate versus the drugs alone (Sancao decoction effect value 5.86, 95% CI 2.53 to 13.58). Seven shortened bleeding. For the comfrey and trichosanthin decoction the effect on bleeding duration was -8.75 (95% CI -10.86 to -6.64), which the authors call the best for shortening bleeding. The abstract does not give trichosanthin-specific abortion-rate results. -8.75 (bleeding duration, comfrey and trichosanthin decoction) Methods, limits and fundingOutcomes: Complete abortion rate; duration of vaginal bleeding Limitations: Add-on formulas, not trichosanthin alone; trial quality and the form of trichosanthin (root, protein) are not stated in the abstract; trials were in China; a network of indirect comparisons. Funding and conflicts: Not stated in the abstract. Read: abstract |
| Lu 2022 A Sixty-Year Research and Development of Trichosanthin, a Ribosome-Inactivating Protein Toxins (Basel) · PMID 35324675 · DOI |
Narrative review review |
Review of 60 years of work on trichosanthin (TCS), the protein from the root | Trichosanthin (purified protein) and the traditional root powder (Tian Hua Fen) root (tuber) not given here not applicable · vs not applicable |
The abstract says the root powder was used in traditional Chinese medicine to end pregnancy; TCS was purified in 1972 to reduce side effects; it blocked HIV replication in cells in 1989 and clinical studies followed; it was also studied for stomach and bowel cancer. Immune reactions, short half-life and lack of specificity limited its use. Details on anaphylaxis, nerve and muscle effects and the raw powder come from our earlier reading of the full text (summary-only here). not applicable Methods, limits and fundingOutcomes: History, clinical uses, mechanism and adverse reactions of TCS Limitations: Narrative review, not systematic. Certainty of individual clinical claims is not graded. Funding and conflicts: No competing interests declared. Read: abstract |
| Mudondo 2025 Trichosanthis Radix: A comprehensive review on botany, ethnomedicine, phytochemistry, pharmacology, quality control and toxicology Fitoterapia · PMID 40334818 · DOI |
Narrative review review |
Review of the dried root of Trichosanthes kirilowii and T. rosthornii | Trichosanthis Radix (dried root) root not given here not applicable · vs not applicable |
The abstract says the root is used in China, Japan and Korea for diabetes, cancer, inflammation, heart and lung conditions; pharmacopoeias list actions such as clearing heat, reducing swelling, expelling pus, generating fluids and regulating menstruation. Reported lab activities include antimicrobial, anti-inflammatory, anticancer, antidiabetic, abortifacient, neuroprotective, immune and antiviral effects. Clinical, pharmacokinetic and toxicity sections exist but the abstract gives no numbers. not applicable Methods, limits and fundingOutcomes: Botany, traditional uses, chemistry, pharmacology, quality control, toxicity Limitations: Narrative review; the abstract gives no trial numbers. Only the abstract was read. Funding and conflicts: No competing interests declared. Read: abstract |
| PubChem 2026 PubChem: cucurbitacin B (CID 5281316, C32H46O8) and cucurbitacin D (CID 5281318, C30H44O7) PubChem · Source |
Registry or database plant |
not applicable | Cucurbitacins not applicable not given here not applicable · vs none |
PubChem API on 2026-10-25 returned CIDs 5281316 and 5281318 for these names. That T. kirilowii holds cucurbitacin D comes from the title of a 2025 paper (PMID 40383960), title only. Trichosanthin is a protein, so has no single small-molecule PubChem CID. not applicable Methods, limits and fundingOutcomes: Identity of compounds Limitations: Registry record; does not show content in the herb. Funding and conflicts: not applicable Read: full-text |
| Search note 2026 Agency monograph check: NCCIH, EMA/HMPC, LiverTox, LactMed search note · Source |
Registry or database plant |
not applicable | Trichosanthes root, fruit, seed not applicable not given here not applicable · vs none |
NCCIH address for trichosanthes returned 404 on 2026-10-25. No EMA/HMPC monograph, LiverTox or LactMed entry was found in a brief search; these are not verified as absent. The Chinese Pharmacopoeia lists the root, fruit and seed (known to us only through the reviews above). not applicable Methods, limits and fundingOutcomes: Whether regulators assessed the herb Limitations: Brief check only. Funding and conflicts: not applicable Read: full-text |
| Yu 2018 Trichosanthis Fructus: botany, traditional uses, phytochemistry and pharmacology J Ethnopharmacol · PMID 29842965 · DOI |
Narrative review review |
Review of the ripe fruit of T. kirilowii and T. rosthornii | Trichosanthis Fructus (fruit) fruit (seed and pericarp discussed) not given here not applicable · vs not applicable |
The abstract says the fruit is used for chest blockage, angina, heart failure and other heart and lung conditions. About 162 compounds (terpenoids, sterols, flavonoids, lignans and others) have been isolated. Lab and animal activities include protection against heart muscle low-oxygen injury, calcium-channel blocking, anti-clotting, expectorant, anti-inflammatory and cytotoxic effects. The authors say fruit, seed and rind uses still need to be separated and quality control improved. not applicable Methods, limits and fundingOutcomes: Traditional uses, chemistry, pharmacology Limitations: Narrative review, mostly lab and animal work; fruit, not root. Funding and conflicts: Not stated in the abstract. Read: abstract |
What we do not know yet
- No human trial of the plain dried root for any use.
- No trial found for molar or ectopic pregnancy use.
- No agency monograph or liver safety record for the root.
- No trial separating the fruit from the other herbs in the angina formula.
How new research is added
New studies are found by a saved PubMed search and placed in a review queue. A person reads each one before it changes any 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 5
Complete abortion rate
Raised in trials
The share of pregnancies fully ended without further procedure.
Low certaintyResults and what it means
Why it was measured
Main outcome in abortion trials.
Statistical vs. clinical meaning
Shows the protein works to end pregnancy; this is a harm to a wanted pregnancy.
Safety implication
Strong reason to avoid in pregnancy.
| Study | Result | People | Product |
|---|---|---|---|
| 5 | 85% (muscle) and 97% (cervical injection) in 200 women at 10 to 14 weeks. | 200 women, China | Purified trichosanthin injection |
| 8 | Eight of nine added formulas improved the rate; trichosanthin-specific rate not in the abstract. | 73 trials, 11,683 patients | Chinese formulas plus mifepristone and misoprostol |
Duration of vaginal bleeding
Shortened in trials
How many days bleeding lasts after the abortion.
Low certaintyResults and what it means
Why it was measured
Secondary outcome in abortion trials.
Statistical vs. clinical meaning
Network estimates of uncertain quality.
Safety implication
None stated.
| Study | Result | People | Product |
|---|---|---|---|
| 8 | Comfrey and trichosanthin decoction effect value -8.75 (95% CI -10.86 to -6.64), named best of seven formulas. | 73 trials, 11,683 patients | Formula plus drugs |
CD4+ T-cell count
Raised in trials
Number of helper T cells, a marker of immune health in HIV.
Very low certaintyResults and what it means
Why it was measured
Main immune outcome in the HIV studies.
Statistical vs. clinical meaning
A count change is not better health.
Safety implication
Raised in a setting with significant side effects.
Creatine kinase (CK)
Raised in trials
A blood enzyme that leaks from damaged muscle.
Low certaintyResults and what it means
Why it was measured
Safety marker in the HIV infusion study.
Statistical vs. clinical meaning
Shows a muscle side effect of the injected protein.
Safety implication
Muscle injury signal.
| Study | Result | People | Product |
|---|---|---|---|
| 7 | Raised in all 22 people with muscle and joint aches, controlled easily. | 22 people | GLQ223 infusions |
Angina symptoms, ECG and blood lipids
Improved in trials
Chest pain episodes, heart tracing changes and cholesterol or fat in blood.
Low certaintyResults and what it means
Why it was measured
Outcomes in the formula trials.
Statistical vs. clinical meaning
Not pooled; high risk of bias.
Safety implication
No safety findings in the abstract.
| Study | Result | People | Product |
|---|---|---|---|
| 2 | Authors say the formula might benefit angina, ECG and lipids to a certain extent but the evidence is too poor to conclude. | 17 trials, 1,676 patients | Gualou Xiebai Banxia formula |
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
- Do not use if pregnant or trying to be.. The root powder was used in China to end pregnancy, and the purified protein (trichosanthin) was injected for the same purpose at 10 to 14 weeks and later. It can cause heavy bleeding and other serious harm. In mice it killed and deformed fetuses. Avoid the root in any form if you are or could be pregnant. Controlled trial 5 9 1
- Serious allergic reactions are documented with the protein.. The purified protein provokes immune responses. Our earlier summary of the 2022 review records anaphylaxis with injection in abortion use and in HIV trials, and antibody formation. Steroid medicine was given to reduce reactions. Narrative review 9 5
- Injected trichosanthin harmed nerves and muscles in HIV trials.. A Phase I study saw a severe neurological reaction in one person. A later study saw flu-like illness, muscle and joint aches and raised creatine kinase in all 22. Our earlier summary adds confusion, coma and one death in early trials (summary-only). Human trial 6 7 9
- The raw herb and the purified injection are not the same.. The crude root is a mix; its protein content is not standardised, and no safety data on the dried root as taken by mouth were found. Do not assume the root is milder or safer. The raw prescription itself caused fever, rashes and abdominal pain, which is why a purified form was developed (summary-only). Narrative review 9
Side effects 5
| Effect | How often | Severity and recovery | Evidence |
|---|---|---|---|
| Allergic reactions including anaphylaxis (protein injection) Summary-only detail from the 2022 review. | Not given in the sources read. | serious Not stated | Narrative review 9 |
| Heavy bleeding, fever (abortion use) Dexamethasone was used to reduce general side effects. | Fever less common after cervical than muscle injection in one trial. | moderate to serious Not stated | Controlled trial 5 9 |
| Flu-like illness, muscle and joint aches, raised creatine kinase (infusion) | All 22 people in one study. | moderate Controlled easily | Human trial 7 |
| Severe neurological reaction (infusion) Later reports of reversible confusion or coma are summary-only. | One of 18 in the Phase I study. | serious Not stated | Human trial 6 |
| Nausea and vomiting from some look-alike gua lou species Summary-only; species other than the trichosanthin source. | Not given. | mild to moderate Not stated | Narrative review 9 |
Liver
No LiverTox entry and no human liver-injury case for the root were found in a brief search. A paper found in the search was in a different species (Trichosanthes cucumerina) in rats and does not apply. Liver safety of the root is unknown. 12
How often. Unknown.
Monitoring. No official advice found. Seek care for yellow skin or eyes, dark urine or severe tiredness.
This is a safety connection. It is not evidence that Trichosanthes supports liver health.
Medicines and supplements 3
| With | Why it matters | Importance | Evidence | What to do |
|---|---|---|---|---|
| Aconite (fu zi, chuan wu, cao wu; Aconitum) traditional-incompatibility | Traditional Chinese texts list Trichosanthes among herbs said to clash with aconite (the 'eighteen incompatibilities'). No mechanism or human study was found. | Unknown. Aconite is itself a serious poison, so combining the two is a concern on tradition alone. | Traditional use (not verified) Not enough evidence | Do not combine without a qualified practitioner; see the aconite page. |
| Prescription medicines prescription | None studied for the root. Injected trichosanthin was given with steroid medicine in trials. | Unknown. | None found Not enough evidence 5 | Tell your doctor or pharmacist about any root, fruit or seed product, especially before surgery or with immune-suppressing medicines. |
| Mifepristone and misoprostol prescription | Formulas with trichosanthin were added to these drugs in trials in China. | Shortened bleeding in a network meta-analysis; harms not described in the abstract. | Meta-analysis Low certainty 8 | Only under a doctor's care. |
Who should check first 5
| Situation | Advice | Evidence |
|---|---|---|
| Pregnancy | Avoid. Abortifacient use in China; fetal loss and malformations in mice. | Controlled trial 5 1 9 |
| Breastfeeding | No data found. Avoid unless a doctor says otherwise. | None found 12 |
| Children | No data found. Avoid. | None found 12 |
| History of allergic reactions or anaphylaxis, or use of other protein drugs | Avoid; the protein is strongly immunogenic. | Narrative review 9 |
| Seizure, nerve or muscle disease | Avoid; nerve and muscle effects were seen with the injected protein. | Human trial 6 7 |
Overdose, product quality and regulators
Summary. Trichosanthin is a ribosome-inactivating protein: it shuts down protein making in cells. It is toxic to the fetus and, at injected doses, to nerves and muscle.
Animal. In pregnant mice, injected trichosanthin lowered fetal survival to 70.2% versus 96.5% in controls at the highest dose and caused exencephaly, short limbs and short tail in survivors; cultured embryos were harmed.
Human doses studied. Not stated here.
High dose or long term signals. Nerve and muscle toxicity, antibodies and immune reactions with repeat injections.
Overdose response. Unknown for the root.
Genotoxicity. Not checked.
Toxic plant parts. The root (tuber) is the protein-rich part. Fruit and seed are different parts with other compounds, including cucurbitacins (bitter, toxic in large amounts; amounts here not established).
No contamination or adulteration report for tian hua fen was found in a brief search.
Look-alike species. A review says other gua lou species cause more nausea and vomiting than the species that makes trichosanthin (summary-only). Pharmacopoeia species are T. kirilowii and T. rosthornii. 9 4
Root, fruit and seed mix-ups. Root (tian hua fen), fruit (gua lou) and seed (gua lou ren) are different products with different uses and risks. 13 10
| Body | Action | Date |
|---|---|---|
| NCCIH (US) (United States) | No trichosanthes page (address returned 404). source | 2026-10-25 |
When to get medical help
- Swelling of lips, face or tongue, wheezing, hives or fainting after any dose: emergency help now.
- Heavy vaginal bleeding or severe belly pain in pregnancy.
- Confusion, severe muscle pain or dark urine.
- Fever with rash or severe stomach pain.
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 trichosanthes?
A Chinese climbing gourd. Its root is called tian hua fen, its fruit gua lou and its seed gua lou ren.
Is trichosanthes safe in pregnancy?
What is trichosanthin?
A protein in the root that stops cells making proteins. It was purified in 1972 and injected in hospitals.
Can it cause allergic reactions?
Yes. The purified protein caused severe reactions, including anaphylaxis, in clinical use. Seek emergency help for swelling or trouble breathing.
Does it treat HIV?
Does it help angina or chest pain?
A fruit-based multi-herb formula showed hints of help, but the trials were too weak to conclude. Chest pain needs a doctor.
Is the root the same as the purified injection?
No. The dried root is a mix; no safety data for it by mouth were found, so do not assume it is milder.
What about aconite?
Traditional Chinese texts list Trichosanthes as clashing with aconite. This is traditional only and was not verified. See the aconite page.
What is the difference between root, fruit and seed?
Do regulators approve it?
We found no agency monograph (NCCIH page not found; others not verified). Ask a doctor or pharmacist before using any product.
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Editorial transparency
- Written by
- 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 built on our existing summary, re-read PubMed abstracts and checked GBIF and PubChem. Details beyond abstracts from the 2022 review are marked summary-only.
- 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.
Sources 13
Each source was opened and checked. Where we read only the abstract, it says so. The small numbers in the text point here.
- Chan WY, Ng TB, Wu PJ, Yeung HW. Developmental toxicity and teratogenicity of trichosanthin, a ribosome-inactivating protein, in mice. Teratog Carcinog Mutagen. 1993. PMID 8102209. DOI 10.1002/tcm.1770130202. (abstract)
- Chen M, Men L, Wu H, Zhong G, Ou L, Li T, et al.. A systematic review of the effectiveness and safety of Chinese herbal medicine formula Gualou Xiebai Banxia (GLXBBX) decoction for the treatment of stable angina pectoris. Medicine (Baltimore). 2019. PMID 31860998. DOI 10.1097/MD.0000000000018375. (abstract)
- Ferrari P, Trabaud MA, Rommain M, Mandine E, Zalisz R, Desgranges C, Smets P. Toxicity and activity of purified trichosanthin. AIDS. 1991. PMID 1892592. DOI 10.1097/00002030-199107000-00011. (abstract)
- GBIF. GBIF species match: Trichosanthes kirilowii Maxim. (key 3624240), T. rosthornii Harms (key 7317615), genus Trichosanthes L. (key 2874604). GBIF. 2026. (full-text)
- Jin YC. [Crystal trichosanthin protein intramuscular or intracervical injection for the termination of pregnancy at 10 to 14 weeks gestation: clinical analysis of 200 cases]. Shengzhi Yu Biyun. 1990. PMID 12316199. (abstract)
- Kahn JO, Kaplan LD, Gambertoglio JG, Bredesen D, Arri CJ, Turin L, et al.. The safety and pharmacokinetics of GLQ223 in subjects with AIDS and AIDS-related complex: a phase I study. AIDS. 1990. PMID 2088398. DOI 10.1097/00002030-199012000-00003. (abstract)
- Kahn JO, Gorelick KJ, Gatti G, Arri CJ, Lifson JD, Gambertoglio JG, et al.. Safety, activity, and pharmacokinetics of GLQ223 in patients with AIDS and AIDS-related complex. Antimicrob Agents Chemother. 1994. PMID 7910722. DOI 10.1128/AAC.38.2.260. (abstract)
- Li F, Han M, Zhang J, Ji J, Wu Y, Wei J. Effects of medical abortion assisted by traditional Chinese medicine: A network meta-analysis of randomized controlled trials. Int J Gynaecol Obstet. 2024. PMID 38037875. DOI 10.1002/ijgo.15272. (abstract)
- Lu JQ, Wong KB, Shaw PC. A Sixty-Year Research and Development of Trichosanthin, a Ribosome-Inactivating Protein. Toxins (Basel). 2022. PMID 35324675. DOI 10.3390/toxins14030178. (abstract)
- Mudondo J, Happy K, Okello D, Kang Y. Trichosanthis Radix: A comprehensive review on botany, ethnomedicine, phytochemistry, pharmacology, quality control and toxicology. Fitoterapia. 2025. PMID 40334818. DOI 10.1016/j.fitote.2025.106597. (abstract)
- PubChem. PubChem: cucurbitacin B (CID 5281316, C32H46O8) and cucurbitacin D (CID 5281318, C30H44O7). PubChem. 2026. (full-text)
- Search note. Agency monograph check: NCCIH, EMA/HMPC, LiverTox, LactMed. search note. 2026. (full-text)
- Yu X, Tang L, Wu H, Zhang X, Luo H, Guo R, et al.. Trichosanthis Fructus: botany, traditional uses, phytochemistry and pharmacology. J Ethnopharmacol. 2018. PMID 29842965. DOI 10.1016/j.jep.2018.05.034. (abstract)