Phyllanthus niruri (Chanca Piedra)

Phyllanthus niruri
Evidence Level
Limited
2 Clinical Trials
4 Documented Benefits
2/5 Evidence Score

Phyllanthus niruri — known as Chanca Piedra ('stone breaker') in South America — is a small tropical herb with a long folk-medicine tradition for urinary tract stones, liver complaints, and viral infections. Its active compounds include lignans (phyllanthin, hypophyllanthin), flavonoids, and ellagitannins. The human evidence here is a single randomized, placebo-controlled trial in 69 calcium-stone-forming patients (33 Phyllanthus, 36 placebo) over 3 months. Urinary calcium fell only in the subset who began with hypercalciuria. Overall urinary parameters showed no significant differences between groups, and stone passage and pain relief were measured and showed no difference. The other two references on this page are reviews, not trials. Liver and antiviral activity comes from laboratory and animal work; systematic reviews of hepatitis B trials in people have found that evidence equivocal and not sufficient to recommend the herb as hepatitis treatment. Nothing cited here measured a liver outcome in a person. Generally well-tolerated for short-term use.

Studied Dose 500-2,000 mg/day dried herb or aqueous extract, divided; urolithiasis trial used 450 mg three times daily.
Active Compound Lignans (phyllanthin, hypophyllanthin, niranthin, nirtetralin); ellagitannins (corilagin, geraniin); flavonoids (quercetin, rutin); alkaloids.

Benefits

Urinary Calcium Modulation

In the single placebo-controlled trial cited here (69 calcium-stone-forming patients, 3 months), urinary calcium fell only in the subset who started with hypercalciuria. Overall urinary parameters did not differ significantly between groups, and the trial's stone passage and pain relief endpoints showed no difference. A lower urinary calcium in that subgroup is a laboratory measurement, not a demonstrated reduction in stones.

Kidney Stone Support Tradition

Used for centuries in South American traditional medicine for 'stone breaking,' Phyllanthus niruri remains a widely recommended botanical for urolithiasis support. Modern data amount to one placebo-controlled trial, which found lower urinary calcium in the hypercalciuric subset but no difference in stone passage or pain relief. It does not directly dissolve existing stones.

Liver Activity in Laboratory and Animal Models

The liver work cited here is preclinical: cell and animal models, summarized in two narrative reviews. No study cited on this page measured any liver outcome in a person, and systematic reviews of Phyllanthus for chronic hepatitis B have judged that evidence weak, citing low trial quality and variation in the herb itself. Treat this as laboratory background, not a reason to expect a liver benefit, and not a treatment for any liver condition.

Antioxidant Support

The polyphenol and ellagitannin fraction of Phyllanthus niruri shows free-radical scavenging activity in vitro. Scavenging in a test tube is not an antioxidant effect in a person. No study cited here measured any antioxidant, oxidative stress, or detoxification marker in humans.

Mechanism of action

1

Crystallization Inhibition

Aqueous extracts of Phyllanthus niruri interfere with calcium oxalate crystal nucleation and aggregation in laboratory models. Whether this translates into fewer stones in people is not established. The one human trial cited here measured stone passage and found no difference against placebo.

2

Urinary Calcium Normalization

One placebo-controlled trial found lower urinary calcium in its hypercalciuric subset only, with no significant difference in overall urinary parameters between groups. The mechanism is not defined and may involve renal calcium handling or intestinal absorption.

3

Antioxidant and Anti-Inflammatory Activity

Phyllanthin, hypophyllanthin, and ellagitannins scavenge reactive oxygen species and suppress inflammatory cytokine production in cell models. These are cell-model observations. Nothing cited here measured an antioxidant or liver effect in a person.

4

Hepatic Enzyme Modulation

Animal studies report lower liver enzymes (ALT, AST) in chemically induced liver injury models. This is animal work. No cited study measured a liver enzyme or any other liver outcome in a person, and an effect in a chemically injured animal liver does not predict a benefit in a healthy one.

Clinical trials

1
Phyllanthus niruri for Calcium-Stone-Forming Patients

Randomized, placebo-controlled trial of Phyllanthus niruri (450 mg three times daily) for 3 months in 69 calcium-stone-forming patients randomized to Phyllanthus (33) or placebo (36), including patients with hypercalciuria. Urinary biochemistry, stone passage and pain relief were all assessed. (Nishiura et al, Urol Res)

69 calcium-stone-forming patients randomized, 33 to Phyllanthus and 36 to placebo, including a hypercalciuric subgroup.

Urinary calcium fell in the hypercalciuric subset only (4.8±1.0 to 3.4±1.1 mg/kg/24 h, p<0.05), with no significant adverse effects. The clinical endpoints were measured and were null: there were no significant differences in overall urinary parameters between groups, and stone passage and pain relief showed no difference between Phyllanthus and placebo. For a herb whose folk name means stone breaker, the absence of any effect on stone passage is the central result of this trial.

2
Phyllanthus niruri Phytochemistry and Pharmacology — Review

Comprehensive review of Phyllanthus niruri phytochemistry and pharmacology, including hepatoprotective, antiviral, antioxidant, and antilithic activity from preclinical and clinical studies. (Kaur et al, Phytother Res)

Narrative review of preclinical and human literature.

The review synthesizes evidence for hepatoprotective and antilithic activity, with stronger support for the urolithiasis indication than for antiviral hepatitis claims. Authors note Cochrane analyses of hepatitis B trials have been equivocal, supporting cautious framing of liver-disease claims while affirming the herb's traditional and pharmacologic profile.

Side effects and drug interactions

Common Potential side effects

Generally well-tolerated; mild stomach upset or diarrhea possible.
Increased urination — drink adequate water throughout the day.
May modestly lower blood sugar; monitor in diabetic patients.
Avoid in pregnancy due to limited safety data and traditional emmenagogue reports.
Long-term safety beyond 12 weeks of continuous use is not well established.

Important Drug interactions

Antidiabetic medications (metformin, sulfonylureas, insulin) — possible additive blood glucose lowering; monitor
Antihypertensive medications — may have modest diuretic effects that lower blood pressure; monitor
Lithium — diuretic activity may affect lithium clearance; discuss with prescriber
Anticoagulants — limited interaction data; discuss with prescriber if on warfarin or DOACs

Frequently asked questions about Phyllanthus niruri (Chanca Piedra)

What is Phyllanthus niruri used for?

Phyllanthus niruri, known as stonebreaker (chanca piedra), is a herb used traditionally for kidney and gallstones, urinary health, and liver support. Its nickname reflects its traditional use against stones.

Does Phyllanthus niruri help with kidney stones?

It has been studied for that, and the result was mostly negative. In the one placebo-controlled trial cited here, 69 stone-forming patients took Phyllanthus or placebo for 3 months. Urinary calcium fell in the subset who started with hypercalciuria, but stone passage and pain relief were measured and showed no difference between groups. Crystal inhibition has only been seen in laboratory models. Kidney stones need a doctor's care.

How much Phyllanthus niruri should I take?

It is used as a tea, tincture, or extract; follow product labeling. It is often used in courses for urinary and kidney goals.

Is Phyllanthus niruri safe?

It is generally well tolerated. It may lower blood sugar and blood pressure, so those on related medications should monitor. Pregnant women should avoid it. For diagnosed kidney stones, work with a doctor.

What is Phyllanthus niruri?

Phyllanthus niruri — known as Chanca Piedra ('stone breaker') in South America — is a small tropical herb with a long folk-medicine tradition for urinary tract stones, liver complaints, and viral infections. Its active compounds include lignans (phyllanthin, hypophyllanthin), flavonoids, and ellagitannins.

What is the recommended dosage of Phyllanthus niruri?

The clinically studied dose is 500-2,000 mg/day dried herb or aqueous extract, divided; urolithiasis trial used 450 mg three times daily. Always follow the product label and check with a healthcare provider for personal advice.

Is Phyllanthus niruri safe, and does it have side effects?

For most healthy adults, Phyllanthus niruri is well tolerated at studied doses. Reported effects can include: Generally well-tolerated; mild stomach upset or diarrhea possible. Increased urination — drink adequate water throughout the day. It may also interact with some medications. Phyllanthus niruri 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 Phyllanthus niruri interact with any medications?

Possible interactions include: Antidiabetic medications (metformin, sulfonylureas, insulin) — possible additive blood glucose lowering; monitor Antihypertensive medications — may have modest diuretic effects that lower blood pressure; monitor If you take prescription medication, check with a pharmacist or doctor before using it.

How strong is the scientific evidence for Phyllanthus niruri?

NutraSmarts rates the evidence for Phyllanthus niruri as Limited (2 out of 5). It is backed by 2 clinical trials and 3 cited references summarized on this page. A higher rating reflects more, larger, and better-designed human studies.

References(3 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. Nishiura JL, Campos AH, Boim MA, Heilberg IP, Schor N. Phyllanthus niruri normalizes elevated urinary calcium levels in calcium stone forming (CSF) patients. Urol Res. 2004;32(5):362-6. doi: 10.1007/s00240-004-0432-8.PubMedUsed to support: The only human trial cited on this page. Randomized, placebo-controlled, 69 calcium-stone-forming patients (33 Phyllanthus, 36 placebo), 3 months. Urinary calcium fell only in the hypercalciuric subset; overall urinary parameters showed no significant differences, and stone passage and pain relief showed no difference between groups
  2. Kaur N, Kaur B, Sirhindi G. Phytochemistry and Pharmacology of Phyllanthus niruri L.: A Review. Phytother Res. 2017;31(7):980-1004. doi: 10.1002/ptr.5825.PubMedUsed to support: Narrative review, not a clinical trial. Describes phytochemistry and preclinical hepatoprotective and antilithic activity, and notes that hepatitis B antiviral evidence is equivocal
  3. Lee NY, Khoo WK, Adnan MA, Mahalingam TP, Fernandez AR, Jeevaratnam K. The pharmacological potential of Phyllanthus niruri. J Pharm Pharmacol. 2016;68(8):953-69. doi: 10.1111/jphp.12565.PubMedUsed to support: Pharmacological review, not a clinical trial. Surveys preclinical hepatoprotective, antilithic, antioxidant, and antiviral work, and notes the herb is not a substitute for standard hepatitis therapy