Home Ingredients Centaury (Centaurium erythraea)

Centaury (Centaurium erythraea)

Centaurium erythraea
Evidence Level
Preliminary
4 Clinical Trials
5 Documented Benefits
1/5 Evidence Score

Centaury (Centaurium erythraea) is a small plant of the gentian family whose dried flowering tops have long been used in Europe as a bitter herb for appetite and digestion. Its bitterness comes from secoiridoid glycosides, mainly swertiamarin with smaller amounts of gentiopicroside, sweroside and centapicrin. The European Medicines Agency accepts centaury as a traditional herbal medicine for mild digestive complaints and temporary loss of appetite based on long-standing use, and found no clinical studies of centaury. The human trials that do exist tested Canephron, a centaury, lovage and rosemary blend used for urinary complaints, so they cannot show what centaury does alone. Other findings come from rats and lab tests. The EU monograph advises against centaury with a peptic ulcer, in pregnancy and breastfeeding, and under age 18.

Studied Dose No human trial has tested centaury alone. EU traditional use: tea of 1 to 4 g dried herb in 200 ml boiling water up to 4 times daily; powder 0.25 to 2 g, liquid extract 2 to 4 ml or tincture 1.5 to 5 g, each up to 3 times daily; or soft extract 1 to 2 g a day.
Active Compound Bitter secoiridoid glycosides, principally swertiamarin (about 75% of them) with smaller amounts of gentiopicroside (gentiopicrin), sweroside and the very bitter centapicrin; plus methoxylated xanthones such as eustomin, phenolic acids, phytosterols and flavonoids. Swertiamarin is the European Pharmacopoeia marker.

Benefits

Appetite and mild digestive complaints as a traditional bitter

The European Medicines Agency accepts centaury tea, powder and extracts as traditional herbal medicines for mild digestive complaints and temporary loss of appetite, based only on long-standing use in Europe. Its assessment found no clinical studies, and its 2026 review of newer research found nothing that changed this.

Supported by Trial 1, Trial 4

Urinary tract findings for a centaury, lovage and rosemary blend

In a double-blind trial of 659 women with acute bladder infection, a tablet blend with 18 mg each of centaury, lovage and rosemary for 7 days left 83.5% needing no further antibiotics versus 89.8% after a single antibiotic dose, within the preset non-inferiority margin, and 5 women on the blend versus 1 developed kidney infection. The maker sponsored it, and centaury's own share cannot be separated.

Supported by Trial 1, Trial 3

Stomach lining protection in rat studies

In 21 rats given a high dose of aspirin, a water and ethanol centaury extract cut the area of stomach lining damage by 77% versus aspirin alone, with higher glutathione and lower myeloperoxidase, an inflammation enzyme. This was one small animal experiment, and the effect has not been tested in people.

Supported by Trial 4, Trial 1

Blood sugar and blood lipid handling in rat studies

In rats with drug-induced diabetes, 12 days of a centaury extract cut the induced rise in blood sugar by 74%, and 45 days lowered HbA1c; blood cholesterol and triglycerides also fell in diabetic and normal rats. In a 90-day safety study, higher doses lowered blood sugar and triglycerides in normal rats. No human trial has measured these outcomes.

Supported by Trial 4, Trial 2

Liver enzyme levels in a rat acetaminophen study

In rats given a toxic dose of acetaminophen, a centaury leaf extract (300 mg/kg a day for 6 days, or one 900 mg/kg dose) lowered blood liver enzymes and limited liver tissue damage. This is animal work only; in people, suspected liver injury has been reported with two centaury-containing herbal blends.

Supported by Trial 1, Trial 2

Mechanism of action

1

Bitter taste and digestive secretions

The EMA notes that how centaury works is unclear. The usual explanation is that its bitter compounds stimulate taste nerves in the mouth, which reflexively increases stomach juice and bile and so supports appetite and digestion. Older handbooks report more stomach secretion, but no human studies have measured this for centaury.

2

Antioxidant activity of the polyphenols

In lab tests, centaury tea scavenged two reactive oxygen species, hydroxyl radical and hypochlorous acid, though it was weaker than green tea against hypochlorous acid. The EMA report notes that the bitter secoiridoids themselves showed no antioxidant activity, pointing to the flavonoids, xanthones and phenolic acids.

3

Increased urine output in rats

Daily oral water extracts of centaury raised urine volume and sodium, potassium and chloride excretion in rats from the fifth day of a one-week study, while creatinine clearance fell at the lower dose. This fits its traditional use in urinary blends but has not been measured in people.

Clinical trials

1
Centaury, Lovage and Rosemary Blend vs Fosfomycin: Phase III RCT
PubMed

Double-blind, double-dummy, randomized, multicenter non-inferiority trial: Canephron N (BNO 1045) coated tablets with centaury herb, lovage root and rosemary leaf powder (18 mg each), 2 tablets 3 times daily for 7 days, versus a single dose of the antibiotic fosfomycin trometamol; sponsored by Bionorica SE, the blend's maker, which employs three authors (Wagenlehner et al. 2018, Urol Int)

659 women aged 18 to 70 with newly diagnosed acute lower uncomplicated urinary tract infection (325 blend, 334 fosfomycin).

From day 1 to day 38, 83.5% on the blend and 89.8% on fosfomycin needed no additional antibiotics, which met the 15% non-inferiority margin. Pyelonephritis was reported in 5 women on the blend and 1 on fosfomycin, and gastrointestinal events were more common with fosfomycin. A three-herb blend; nothing can be credited to centaury alone.

2
Urine Inflammation Markers in the Centaury, Lovage and Rosemary Blend Trial
PubMed

Predefined sub-analysis of the randomized, double-blind phase III trial above of Canephron N (BNO 1045; centaury, lovage and rosemary, 18 mg each per tablet) versus fosfomycin, measuring urine IL-6 and IL-8 (corrected for creatinine); sponsored by Bionorica SE, with Bionorica employees involved in design and analysis (Butler et al. 2023, Urol Int)

127 women with acute lower uncomplicated urinary tract infection (58 on the blend, 69 on fosfomycin).

Urine IL-8 fell significantly with the blend (p = 0.0142) and IL-6 showed a trend (p = 0.0551); fosfomycin lowered both significantly. Levels fell in all patients regardless of treatment. Biomarkers only, from a subset, for a three-herb blend.

3
Centaury, Lovage and Rosemary Blend vs Ciprofloxacin After Sling Surgery
PubMed

Randomized comparison (1:1) of Canephron N oral solution (centaury herb, lovage root and rosemary leaf), 5 mL three times daily for 3 weeks, versus ciprofloxacin 500 mg three times daily for 3 days after midurethral sling surgery; funded by the Medical University of Lublin; two authors report speaker fees from Bionorica, the blend's maker (Rechberger et al. 2020, J Clin Med)

562 women having midurethral sling surgery for stress urinary incontinence.

Within 6 months, urinary tract infection occurred in 13.64% (36) of women on the blend and 10.98% (29) on ciprofloxacin, with no statistically significant difference. There was no placebo group, and the blend's effect cannot be assigned to centaury.

4
Centaury, Lovage and Rosemary Blend Added to Standard Care: Open Cohort
PubMed

Open comparative study: Canephron N (lovage root, rosemary leaves and centaury herb) for 6 months added to standard diabetes treatment and an ACE inhibitor, versus standard treatment and ACE inhibitor alone (Martynyuk et al. 2014, J Altern Complement Med)

59 patients with diabetes and diabetic nephropathy.

After 6 months, urine albumin (microalbuminuria) fell significantly more in the blend group than in controls, oxidative stress markers improved, and liver enzymes did not change. Open label, small, and a three-herb blend, so it says nothing about centaury alone.

Side effects and drug interactions

Common Potential side effects

The EU monograph lists no known side effects at traditional doses; stomach upset and nausea have been reported after high doses.
Peptic ulcer: the EU monograph lists it as a reason not to use centaury, because bitter compounds are thought to reflexively increase stomach acid secretion. Allergy to centaury is the other listed contraindication.
Not recommended under 18 or during pregnancy and breastfeeding, because data are lacking; tests for reproductive toxicity, genotoxicity and carcinogenicity have not been done.
Liver: a case of suspected liver injury with the centaury, lovage and rosemary blend Canephron N has been published, and the EMA notes a case of acute hepatitis possibly linked to a blend of Coutarea latiflora and centaury (50 mg each). Neither case shows that centaury alone was the cause.
Kidneys: a 17-year-old who drank a wormwood, white horehound and centaury mixture for about 6 months to lose weight developed acute kidney injury (interstitial nephritis) and recovered after stopping it and taking steroids. The mixture was not analyzed.
In a trial of the three-herb blend for bladder infection, 5 women on the blend and 1 on an antibiotic developed kidney infection; a herbal blend is not a substitute for medical care of a urinary infection.
In rodents, single oral doses of a centaury water extract up to 15 g/kg caused no deaths or signs of toxicity, and 90 days at up to 1,200 mg/kg a day caused no liver or kidney damage.
Plants collected in polluted industrial areas of Poland had high cadmium, cobalt and zinc levels, so the EMA advises careful choice of collection sites; buy from tested sources.
A 2026 EMA safety review found only a handful of reports in EU and WHO adverse-event databases, all involving other medicines or herbs taken at the same time.

Important Drug interactions

The EU monograph reports no interactions, but no interaction studies have been done.
Stomach acid: bitters such as centaury are thought to increase stomach secretions, which works against acid-reducing treatment; anyone using acid-reducing medicine for a stomach problem should ask a clinician first.
Diuretics (water pills): centaury water extracts increased urine output and salt excretion in rats; whether this matters in people is unknown, so ask a clinician before combining.
Tinctures and liquid extracts contain alcohol (70% and 25% ethanol in the EU-listed forms); choose a tea or powder if alcohol must be avoided.

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Frequently asked questions about Centaury (Centaurium erythraea)

When is centaury tea usually taken?

Centaury is used as a bitter, and one older handbook cited by the EMA describes a cup of the tea before meals, though the EU monograph itself gives no timing. The usual explanation is that tasting bitter compounds reflexively increases stomach juice and bile, which is meant to help appetite and digestion. The EMA calls this mechanism unclear, and no human study has measured it for centaury.

What is Canephron, and what does it show about centaury itself?

Canephron N is a European herbal medicine for urinary complaints that combines centaury herb with lovage root and rosemary leaf (18 mg of each per tablet). It has been tested in several trials, often sponsored by its maker, against antibiotics. Because three herbs are combined, these trials cannot show any effect of centaury on its own.

How does centaury compare with gentian root as a bitter?

Both are gentian-family bitters accepted in the EU as traditional remedies for poor appetite and mild digestive complaints. Centaury's main bitter compound is swertiamarin, while gentian root's is gentiopicroside. Gentian has a few small human studies of bitters around meals; for centaury the EMA found no clinical studies at all.

Why should people with a sensitive stomach be careful with bitters like centaury?

Bitter compounds are thought to increase stomach acid secretion, so the EU monograph says not to use centaury with a peptic ulcer, and high doses have caused stomach upset and nausea. Anyone with ongoing stomach pain, or symptoms lasting more than 2 weeks, should see a clinician rather than self-treat.

Has centaury been tested in people for blood sugar?

No. Centaury is used as a folk remedy for blood sugar in Morocco and the Balkans, and rat studies found lower blood sugar and blood lipids with centaury extracts, but no human trial has measured these effects. People taking glucose-lowering medicine should not add it without asking a clinician.

What is Centaury?

Centaury (Centaurium erythraea) is a small plant of the gentian family whose dried flowering tops have long been used in Europe as a bitter herb for appetite and digestion. Its bitterness comes from secoiridoid glycosides, mainly swertiamarin with smaller amounts of gentiopicroside, sweroside and centapicrin.

What is Centaury used for?

NutraSmarts does not list Centaury under a health category. What the research covers: The European Medicines Agency accepts centaury tea, powder and extracts as traditional herbal medicines for mild digestive complaints and temporary loss of appetite, based only on long-standing use in Europe.

What is the recommended dosage of Centaury?

No human trial has tested centaury alone. EU traditional use: tea of 1 to 4 g dried herb in 200 ml boiling water up to 4 times daily; powder 0.25 to 2 g, liquid extract 2 to 4 ml or tincture 1.5 to 5 g, each up to 3 times daily; or soft extract 1 to 2 g a day. Always follow the product label and check with a healthcare provider for personal advice.

Is Centaury safe, and does it have side effects?

Side effects and cautions reported for Centaury include: The EU monograph lists no known side effects at traditional doses; stomach upset and nausea have been reported after high doses. Peptic ulcer: the EU monograph lists it as a reason not to use centaury, because bitter compounds are thought to reflexively increase stomach acid secr… It may also interact with some medications. Centaury is not right for everyone, so check with a healthcare provider first if you are pregnant or breastfeeding, have a medical condition, or take prescription medication.

Does Centaury interact with any medications?

Possible interactions include: The EU monograph reports no interactions, but no interaction studies have been done. Stomach acid: bitters such as centaury are thought to increase stomach secretions, which works against acid-reducing treatment; anyone using acid-reducing medicine for a stomach problem should as… If you take prescription medication, check with a pharmacist or doctor before using it.

How strong is the scientific evidence for Centaury?

NutraSmarts rates the evidence for Centaury as Preliminary (1 out of 5). It is backed by 4 study summaries and 15 cited references summarized on this page. A higher rating reflects more, larger, and better-designed human studies.

References(15 citations)

Evidence ratings on NutraSmarts are based on the totality of human clinical research, with emphasis on randomized controlled trials, meta-analyses, and systematic reviews. The references below directly support claims made throughout this page.

  1. Committee on Herbal Medicinal Products (HMPC), European Medicines Agency. European Union herbal monograph on Centaurium erythraea Rafn. s.l., herba (EMA/HMPC/277493/2015). European Medicines Agency. 2015;Final monograph adopted 24 November 2015, published January 2016 (not PubMed-indexed)..SourceUsed to support: Not PubMed-indexed: EU regulatory monograph. Traditional herbal medicinal product for mild dyspeptic or gastrointestinal disorders and temporary loss of appetite, exclusively on long-standing use. Posology: tea 1 to 4 g in 200 ml boiling water up to 4 times daily; powder 0.25 to 2 g up to 3 times daily; liquid extract (1:1, 25% ethanol) 2 to 4 ml up to 3 times daily; tincture (1:5, 70% ethanol) 1.5 to 5 g up to 3 times daily; soft extract 0.2 g per dose, 1 to 2 g a day; see a doctor if symptoms last over 2 weeks. Contraindications: hypersensitivity and peptic ulcer. Not recommended under 18 or in pregnancy and lactation. Interactions: none reported. Undesirable effects: none known. Overdose: stomach disturbances and nausea reported. Reproductive toxicity, genotoxicity and carcinogenicity tests not performed.
  2. Committee on Herbal Medicinal Products (HMPC), European Medicines Agency. Assessment report on Centaurium erythraea Rafn. s.l., herba (EMA/HMPC/277491/2015). European Medicines Agency. 2015;Final assessment report dated 24 November 2015, published January 2016 (not PubMed-indexed)..SourceUsed to support: Not PubMed-indexed: EU regulatory assessment. Constituents: bitter secoiridoid glucosides, principally (75%) swertiamarin with smaller amounts of gentiopicroside, sweroside and centapicrin; methoxylated xanthones, phenolic acids, phytosterols; swertiamarin is the Ph. Eur. marker. Mechanism unclear; bitter constituents assumed to stimulate gustatory nerves and increase gastric juice and bile. Secoiridoids showed no antioxidant activity in one study. Clinical studies of centaury could not be found; only blend studies (centaury, lovage, rosemary, 18 mg each) exist. Peptic ulcer contraindication because bitters reflexively stimulate gastric secretion. One case of acute cytolytic hepatitis with a Coutarea latiflora and centaury (50 mg each) combination; no conclusion on centaury. Polish plants from polluted industrial regions had the highest cadmium, cobalt and zinc levels. Rodent toxicity: no deaths up to 15 g/kg oral; no organ damage at 1,200 mg/kg for 90 days. No pharmacodynamic interaction data.
  3. Committee on Herbal Medicinal Products (HMPC), European Medicines Agency. Addendum to Assessment report on Centaurium erythraea Rafn. s.l., herba (EMA/HMPC/8050/2026). European Medicines Agency. 2026;Periodic review adopted 4 March 2026 (not PubMed-indexed)..SourceUsed to support: Not PubMed-indexed: EU periodic review covering 2015 to 2025. PubMed search found 69 new references, none relevant enough to revise the monograph; EudraVigilance gave two case reports and VigiBase three, all with co-medication or other herbs. No revision needed.
  4. Wagenlehner FM, Abramov-Sommariva D, Höller M, Steindl H, Naber KG. Non-Antibiotic Herbal Therapy (BNO 1045) versus Antibiotic Therapy (Fosfomycin Trometamol) for the Treatment of Acute Lower Uncomplicated Urinary Tract Infections in Women: A Double-Blind, Parallel-Group, Randomized, Multicentre, Non-Inferiority Phase III Trial. Urol Int. 2018;101(3):327-336. doi: 10.1159/000493368.PubMedUsed to support: Double-blind randomized non-inferiority trial in 659 women with acute lower uncomplicated urinary tract infection: Canephron N (centaury, lovage root and rosemary leaf powder, 18 mg each per tablet; 2 tablets 3 times daily for 7 days) versus single-dose fosfomycin. 83.5% versus 89.8% needed no additional antibiotics, non-inferior at a 15% margin; pyelonephritis in 5 versus 1 patients; more gastrointestinal events with fosfomycin. Sponsored by Bionorica SE, which employs three authors. A blend; centaury's own effect cannot be isolated.
  5. Butler DSC, Wagenlehner F, Höller M, Abramov-Sommariva D, Steindl H, Naber KG. Phytotherapy (BNO 1045) of Acute Lower Uncomplicated Urinary Tract Infection in Women Normalizes Local Host Responses. Urol Int. 2023;107(8):778-784. doi: 10.1159/000531206.PubMedUsed to support: Sub-analysis of the phase III BNO 1045 versus fosfomycin trial in 127 women: urine IL-8 fell significantly with the blend (p = 0.0142) and IL-6 showed a trend (p = 0.0551); fosfomycin lowered both. Sponsored by Bionorica SE.
  6. Rechberger E, Rechberger T, Wawrysiuk S, Miotla P, Kulik-Rechberger B, Kuszka A, Wróbel A. A Randomized Clinical Trial to Evaluate the Effect of Canephron N in Comparison to Ciprofloxacin in the Prevention of Postoperative Lower Urinary Tract Infections after Midurethral Sling Surgery. J Clin Med. 2020;9(11):3391. doi: 10.3390/jcm9113391.PubMedUsed to support: Randomized trial in 562 women after midurethral sling surgery: Canephron oral solution 5 mL three times daily for 3 weeks versus ciprofloxacin 500 mg three times daily for 3 days; urinary tract infection within 6 months in 13.64% versus 10.98%, not significantly different. Funded by the Medical University of Lublin; two authors report speaker fees from Bionorica. A blend.
  7. Martynyuk L, Martynyuk L, Ruzhitska O, Martynyuk O. Effect of the herbal combination Canephron N on diabetic nephropathy in patients with diabetes mellitus: results of a comparative cohort study. J Altern Complement Med. 2014;20(6):472-8. doi: 10.1089/acm.2013.0400.PubMedUsed to support: Open comparative study in 59 patients with diabetic nephropathy: Canephron N (lovage root, rosemary leaves, centaury herb) added to standard therapy and an ACE inhibitor for 6 months lowered microalbuminuria significantly versus controls, improved antioxidant and lipid peroxidation markers, and did not change liver aminotransferases. A blend, open label.
  8. Tuluce Y, Ozkol H, Koyuncu I, Ine H. Gastroprotective effect of small centaury (Centaurium erythraea L) on aspirin-induced gastric damage in rats. Toxicol Ind Health. 2011;27(8):760-8. doi: 10.1177/0748233710397421.PubMedUsed to support: Animal study in 21 rats (7 per group): a 50% aqueous-ethanolic centaury extract reduced the aspirin-induced ulcer index by 77% versus aspirin alone, measured at the end of a 4-hour drug administration (the EMA report describes the extract as given for 7 days), with higher glutathione and vitamin A and lower myeloperoxidase activity. Not tested in people.
  9. Stefkov G, Miova B, Dinevska-Kjovkarovska S, Stanoeva JP, Stefova M, Petrusevska G, Kulevanova S. Chemical characterization of Centaurium erythrea L. and its effects on carbohydrate and lipid metabolism in experimental diabetes. J Ethnopharmacol. 2014;152(1):71-7. doi: 10.1016/j.jep.2013.11.047.PubMedUsed to support: Rat study: a methanol extract of the aerial parts contained secoiridoids (53% of identified compounds), flavonoid glycosides (25%) and xanthones (22%). In streptozotocin-diabetic rats, 12 days of treatment reduced the induced hyperglycemia by 74%; 45 days lowered HbA1c; total cholesterol, triglycerides, HDL and LDL fell in normal and diabetic rats. Not tested in people.
  10. Mroueh M, Saab Y, Rizkallah R. Hepatoprotective activity of Centaurium erythraea on acetaminophen-induced hepatotoxicity in rats. Phytother Res. 2004;18(5):431-3. doi: 10.1002/ptr.1498.PubMedUsed to support: Rat study: a methanol extract of centaury leaves, 300 mg/kg a day for 6 days or a single 900 mg/kg dose, lowered serum SGOT, SGPT and LDH after acetaminophen and protected liver tissue on histology. Not tested in people.
  11. Tahraoui A, Israili ZH, Lyoussi B. Acute and sub-chronic toxicity of a lyophilised aqueous extract of Centaurium erythraea in rodents. J Ethnopharmacol. 2010;132(1):48-55. doi: 10.1016/j.jep.2010.07.038.PubMedUsed to support: Rodent toxicity study of a whole-plant water extract: no deaths or signs of toxicity in mice after single oral doses up to 15 g/kg; in rats given 100, 600 or 1,200 mg/kg a day for 90 days, no changes in blood tests except a small fall in mean corpuscular volume and lower serum glucose and triglycerides at higher doses, with normal liver and kidney histology.
  12. Valentão P, Fernandes E, Carvalho F, Andrade PB, Seabra RM, Bastos ML. Hydroxyl radical and hypochlorous acid scavenging activity of small centaury (Centaurium erythraea) infusion. A comparative study with green tea (Camellia sinensis). Phytomedicine. 2003;10(6-7):517-22. doi: 10.1078/094471103322331485.PubMedUsed to support: Lab study: centaury infusion, rich in xanthones and phenolic acids, scavenged hydroxyl radical and hypochlorous acid, with lower activity than green tea against hypochlorous acid. No human intake tested.
  13. Haloui M, Louedec L, Michel JB, Lyoussi B. Experimental diuretic effects of Rosmarinus officinalis and Centaurium erythraea. J Ethnopharmacol. 2000;71(3):465-72. doi: 10.1016/s0378-8741(00)00184-7.PubMedUsed to support: Rat study: daily oral water extracts of centaury (8% or 16%, 10 ml/kg) for one week increased urine volume and sodium, potassium and chloride excretion from the fifth day; creatinine clearance fell with the 8% extract. Not tested in people.
  14. Sychev DA, Semenov AV, Polyakova IP. A case of hepatic injury suspected to be caused by Canephron N, a Centaurium Hill containing phytotherapeutics. Int J Risk Saf Med. 2011;23(1):5-6. doi: 10.3233/JRS-2011-0514.PubMedUsed to support: Case report of suspected liver injury with the centaury-containing blend Canephron N (PubMed lists no abstract; cited for what its title states). A published letter commented on the report.
  15. Selles A, Afir Y, Rahou Y, Debchi L, Rafa-Debbah H, Bahriz MR, Benziane A. Acute Kidney Injury Following the Ingestion of a Medicinal Plants' Mixture: A Case Report. Case Rep Nephrol. 2024;2024:8207758. doi: 10.1155/crin/8207758.PubMedUsed to support: Case report: a 17-year-old who took a mixture of Artemisia absinthium, Marrubium vulgare and Centaurium erythraea for about 6 months for weight loss developed severe acute kidney injury with interstitial nephritis on biopsy, plus erosive gastritis; kidney function recovered after stopping the mixture and a course of prednisone. Dose unknown and the mixture was not analyzed; the authors call the link likely.