Home Ingredients Rupturewort (Herniaria glabra)

Rupturewort (Herniaria glabra)

Herniaria glabra L., H. hirsuta L., H. incana Lam., herba
Evidence Level
Preliminary
5 Clinical Trials
6 Documented Benefits
1/5 Evidence Score

Rupturewort is a low-growing plant of the carnation family whose dried flowering aerial parts (Herniaria glabra, H. hirsuta or H. incana) are brewed as a tea to flush the urinary tract, often in European diuretic tea blends. In the EU it is covered only by a traditional use monograph: regulators accept its use to increase the amount of urine as an add-on in minor urinary complaints, based on long-standing use alone, and found no clinical data on the herb. The only published human study tested a multi-ingredient product with boldo in 32 children after stone-removal procedures, with no placebo. The herb is rich in saponins; its effects on urine output, crystals and bacteria come from rat and lab work, and rat results on urine output conflict. People told to limit fluids because of serious heart or kidney disease, pregnant or breastfeeding women and anyone under 18 should not use it.

Studied Dose No human dose of rupturewort alone has been tested. EU traditional use: 1.5 to 3 g dried herb in 150 ml water as an infusion or decoction 3 to 5 times daily, at most 10 g a day, with ample fluid. The one blend trial in children gave its product 12 days a month for 3 months.
Active Compound Dried flowering aerial parts of Herniaria glabra L., H. hirsuta L., H. incana Lam. or a mixture of them (Austrian Pharmacopoeia; there is no European Pharmacopoeia monograph). Contains 3% to 9% triterpene saponins built on medicagenic acid, 0.2% to 1.2% flavonoids (mainly quercetin and isorhamnetin derivatives such as rutin and narcissin), 0.1% to 0.4% coumarins such as herniarin and umbelliferone, caffeic and chlorogenic acids, small amounts of tannins and traces of essential oil. The EMA recognizes no constituent with known therapeutic activity.

Benefits

Traditional use to increase urine flow

The European Medicines Agency accepts rupturewort tea as a traditional herbal medicine to increase the amount of urine and flush the urinary tract as an add-on in minor urinary complaints, with adequate fluid intake. That acceptance rests on documented use alone: its reviewers found no clinical or pharmacology data in people, so a well-established use could not be supported.

Supported by Trial 3, Trial 1

Rupturewort and boldo product studied in children after urology procedures

In a small randomized study of 32 children and teenagers aged 6 to 18 who had stones broken up by endoscopic procedures, a three-component product with Herniaria hirsuta and boldo, taken 12 days a month for 3 months, was followed by fewer remaining stone fragments than no added treatment. There was no placebo, and rupturewort's own share is unknown.

Supported by Trial 1

Urine output in rats given rupturewort extracts (animal studies)

In rats, ethanol and saponin-rich Herniaria glabra extracts raised urine volume by 81% and 114% at the highest dose (200 mg/kg), along with sodium, potassium and chloride excretion. Results are not uniform: in one rat study a Herniaria hirsuta decoction lowered water intake and urine output. No study has measured urine output in people taking rupturewort.

Supported by Trial 3, Trial 2

Calcium oxalate crystal deposits in rats and crystal binding in lab tests

In rats fed a chemical that forms calcium oxalate crystals in the kidney, a Herniaria hirsuta decoction was followed by smaller urinary crystals and few or no kidney deposits. In cultured kidney cells, the extract coated crystals and blocked their attachment. These are rat and lab findings and say nothing about stones in people.

Supported by Trial 4, Trial 2

Growth of urinary E. coli in lab tests (in vitro)

In a lab comparison of six folk herbs, a hot water Herniaria glabra extract was, with lingonberry, the strongest inhibitor of a urinary E. coli strain, stopping its growth at 1 to 20 mg per ml, and it reduced biofilm in the dish. Lab concentrations like these do not show that drinking the tea affects bacteria in the bladder.

Supported by Trial 4, Trial 3

Blood pressure in rats given rupturewort saponins (animal study)

In rats bred to have high blood pressure, 200 mg/kg a day of Herniaria glabra saponins by mouth for 30 days lowered systolic pressure from about 188 to 142 mmHg and raised urine flow and sodium excretion. Blood pressure effects have never been tested in people, and this is a concentrated saponin fraction, not the tea.

Supported by Trial 3, Trial 5

Mechanism of action

1

Medicagenic acid saponins as the main constituent group

The herb holds 3% to 9% triterpene saponins, mostly mono- and bisdesmosidic glycosides of medicagenic acid, and its water infusion contains these saponins plus flavonoids such as rutin and narcissin. In rats, a saponin-rich extract raised urine output more than a crude extract, so the authors suspect the saponins drive the effect.

2

Saponins may work as prodrugs after gut breakdown (lab work)

Saponins of this type are thought to be stripped of their sugars in the colon, with the medicagenic acid core absorbed and further changed in the liver. In lab tests, liver metabolites of medicagenic acid, mainly its glucuronide, reduced calcium oxalate crystal binding to injured kidney cells. No human pharmacokinetic data exist for the herb.

3

Coating of crystal surfaces in cell experiments

In cultured kidney cells, a Herniaria hirsuta extract blocked crystal attachment only when the crystals, not the cells, were pretreated, which suggests plant molecules coat the crystal surface. It also loosened some crystals already bound, without harming the cells. Whether this happens in the human urinary tract is unknown.

Clinical trials

1
Herniaria hirsuta and Boldo Product After Endoscopic Stone Procedures in Children: Small RCT (combination product, no placebo)
PubMed

Randomized trial over a 5-year enrollment period comparing a three-component herbal product with Herniaria hirsuta and Peumus boldus (the third component is not named in the abstract), plus water intake, taken 12 days a month for 3 months, with no added treatment after endoscopic stone procedures; children were checked after the procedure, at 3 months and after 3 more months of follow-up. (Caione et al. 2022, Ann Ital Chir)

34 patients aged 6 to 18 enrolled after endoscopic stone procedures (15 product, 19 no added treatment); 2 were excluded.

The share of children with small leftover fragments fell from 53.8% (7 of 13 analyzed) to 15.4% (2) with the product and from 57.9% (11 of 19) to 36.8% (7) without it, and the 6 product children who were fragment free at the start stayed so; the authors report a significant difference at 3 and 6 months (p = 0.006 and 0.009). No adverse effects were reported. The control group got no placebo, the product dose is not given in the abstract, and rupturewort's own share cannot be separated from boldo's.

2
Herniaria hirsuta Decoction in Rats With Induced Calcium Oxalate Crystals (animal study)
PubMed

Controlled rat experiment: two groups of six rats made to form calcium oxalate crystals with ethylene glycol, given 1 ml a day of a Herniaria hirsuta decoction or water for 2 weeks, with urine checks and kidney microscopy. (Atmani et al. 2003, BJU Int)

12 rats; no human participants.

Untreated rats passed large calcium oxalate crystals and had large kidney deposits, while treated rats passed smaller crystals and had almost no deposits. Water intake and urine output fell in the treated rats, and urine chemistry was unchanged apart from higher magnesium, so the authors concluded the effect was not due to diuresis. A rat model only.

3
Herniaria glabra Ethanol and Saponin-Rich Extracts and Urine Output in Rats (animal study)
PubMed

Controlled rat experiment comparing a crude ethanol extract and a saponin-rich extract of Herniaria glabra at 10, 50 and 200 mg/kg by mouth with saline and the diuretic drug furosemide 10 mg/kg, measuring urine volume over 5 and 24 hours and urinary electrolytes. (Hakim et al. 2021, J Ethnopharmacol)

Male Wistar rats; no human participants.

The crude extract raised urine output at 50 and 200 mg/kg (by 81% at the top dose) and the saponin-rich extract at every dose (by 114% at 200 mg/kg, its largest effect), with more sodium, potassium and chloride excreted. The extracts contained medicagenic and oleanolic acid saponins. These are alcohol extracts given to rats, not tea in people.

4
Herniaria hirsuta Extract and Crystal Attachment to Kidney Cells (in vitro)
PubMed

Cell-culture study of a water extract of Herniaria hirsuta on the binding of radioactive calcium oxalate monohydrate crystals to Madin Darby canine kidney cells. (Atmani et al. 2004, J Urol)

Cultured dog kidney cells; no human or animal participants.

The extract reduced crystal binding in a concentration-dependent way. Pretreating the crystals, but not the cells, blocked binding, which points to the extract coating the crystal surface, and it displaced part of the crystals already bound. The cells grew normally even at high extract concentrations. Results in a dish do not show an effect in people.

5
Acute and 90-Day Toxicity of a Herniaria glabra Water Extract in Rodents (animal study)
PubMed

Toxicity study of a freeze-dried water extract of Herniaria glabra: single doses of 5 to 14.5 g/kg by gavage in mice, and 1, 2 or 4 g/kg daily by mouth for 90 days in Wistar rats. (Rhiouani et al. 2008, J Ethnopharmacol)

Mice and rats; no human participants.

In mice, the no-observed-adverse-effect level was 5 g/kg and the median lethal dose 8.5 g/kg. In rats, weight gain slowed, and only the 4 g/kg dose raised liver enzymes and creatinine, with liver and kidney damage on microscopy; the extract also lowered blood sugar. The EMA noted that the toxic signs appeared above the limit doses its test guidelines treat as relevant (5 g/kg single, 2 g/kg repeated) and accepted the authors' reading of low toxicity.

Side effects and drug interactions

Common Potential side effects

No undesirable effects are known, according to the EU monograph, and the EMA found no published reports of side effects from rupturewort tea; no human safety study has been done.
Not recommended for people told to limit fluids, for example with severe heart or kidney disease, because the traditional use depends on drinking enough liquid.
Do not use if hypersensitive to rupturewort.
Not recommended during pregnancy or breastfeeding or for anyone under 18 because safety data are lacking; reproductive toxicity and cancer tests have not been done.
Genetic safety is not established: the only bacterial mutation (Ames) test of the tea was judged inadequate by the EMA, which read one strain's result as positive, so rupturewort could not be placed on the EU list of herbal substances.
In rats given a water extract for 90 days, only the highest dose (4 g/kg) damaged the liver and kidneys; the extract also lowered blood sugar and slowed weight gain. The EMA noted these effects appeared above the limit doses used in toxicity test guidelines.
A 32-year-old man developed acute liver injury after taking a 14-herb tonic that included Herniaria glabra for about two years; it improved after stopping. Causality was rated probable for the tonic as a whole, and rupturewort's own role cannot be separated.
See a doctor if symptoms last longer than 2 weeks or if fever, painful urination, cramping or blood in the urine appears.

Important Drug interactions

The EU monograph lists no reported interactions, and none have been studied in people; no pharmacokinetic data exist for rupturewort.
Prescription diuretics (water pills): any added effect on urine flow is theoretical and unstudied in people; tell your prescriber before combining them.
Lithium: EU assessors, in the EMA assessment report on dandelion leaf, note as a general point about herbal preparations with a diuretic action that people on lithium could, in theory, become dehydrated and develop lithium toxicity. This has not been studied with rupturewort; ask the prescriber before combining them.
Diabetes medicines: a water extract given at 1 to 4 g/kg a day for 90 days lowered blood sugar in rats; this has not been studied in people, but monitor blood sugar if you combine them.
Blood pressure medicines: a saponin fraction lowered blood pressure in rats; whether the tea does this in people is unknown, so ask your prescriber.

Frequently asked questions about Rupturewort (Herniaria glabra)

Has rupturewort on its own been tested in people?

No. The European Medicines Agency's 2020 review found no clinical, pharmacodynamic or pharmacokinetic data on the herb in people, and no product with rupturewort as its only active ingredient on the EU market. The one published human study gave children a multi-ingredient product with boldo, and a maker-sponsored, placebo-controlled trial of a four-herb tablet was still recruiting at its last registry update in 2026.

Which plants are sold as rupturewort?

The EU monograph covers the dried flowering aerial parts of three species, Herniaria glabra, H. hirsuta and H. incana, alone or combined, following the Austrian Pharmacopoeia; there is no European Pharmacopoeia monograph. When the Austrian monograph was updated, commercial samples turned out to be mainly H. glabra and H. incana; older pharmacopoeia tests could not tell H. hirsuta from H. incana, so historical use of H. incana is likely too.

Is the herniarin in rupturewort the same compound as coumarin?

No. Herniarin is 7-methoxycoumarin, a methoxy derivative of coumarin with a different chemical formula, and the herb's coumarin-family compounds (0.1% to 0.4%, for example herniarin and umbelliferone) are minor constituents next to its saponins. The EMA lists no constituent of concern for rupturewort, though cancer, reproductive and adequate genetic safety tests have not been done.

Is there a placebo-controlled trial of a rupturewort blend under way?

Yes. A trial registered in 2024 (NCT06651294) and sponsored by the product's maker plans to give 120 adults tablets of birch leaf extract, Herniaria glabra, guelder rose and couch grass, or a matching placebo, for 90 days after ureteroscopy, and to measure clearance of leftover stone fragments. It was still recruiting at its last update in 2026, with no results posted, and it tests a blend rather than rupturewort alone.

Why is rupturewort called a stonebreaker in Morocco?

Herniaria species are used in Moroccan folk medicine for urinary and kidney complaints, and one Moroccan name for Herniaria glabra translates as stonebreaker. That name reflects traditional use. The supporting research is rat and lab work on calcium oxalate crystals, and the only human study tested a multi-ingredient product.

What is Rupturewort?

Rupturewort is a low-growing plant of the carnation family whose dried flowering aerial parts (Herniaria glabra, H. hirsuta or H. incana) are brewed as a tea to flush the urinary tract, often in European diuretic tea blends.

What is Rupturewort used for?

NutraSmarts does not list Rupturewort under a health category. What the research covers: The European Medicines Agency accepts rupturewort tea as a traditional herbal medicine to increase the amount of urine and flush the urinary tract as an add-on in minor urinary complaints, with adequate fluid intake.

What is the recommended dosage of Rupturewort?

No human dose of rupturewort alone has been tested. EU traditional use: 1.5 to 3 g dried herb in 150 ml water as an infusion or decoction 3 to 5 times daily, at most 10 g a day, with ample fluid. Always follow the product label and check with a healthcare provider for personal advice.

Is Rupturewort safe, and does it have side effects?

Side effects and cautions reported for Rupturewort include: No undesirable effects are known, according to the EU monograph, and the EMA found no published reports of side effects from rupturewort tea; no human safety study has been done. It may also interact with some medications. Rupturewort 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 Rupturewort interact with any medications?

Possible interactions include: The EU monograph lists no reported interactions, and none have been studied in people; no pharmacokinetic data exist for rupturewort. Prescription diuretics (water pills): any added effect on urine flow is theoretical and unstudied in people; tell your prescriber before combining… If you take prescription medication, check with a pharmacist or doctor before using it.

How strong is the scientific evidence for Rupturewort?

NutraSmarts rates the evidence for Rupturewort as Preliminary (1 out of 5). It is backed by 5 study summaries and 16 cited references summarized on this page. A higher rating reflects more, larger, and better-designed human studies.

References(16 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. European Medicines Agency, Committee on Herbal Medicinal Products (HMPC). European Union herbal monograph on Herniaria glabra L., H. hirsuta L., H. incana Lam., herba (EMA/HMPC/554043/2018). European Medicines Agency. 2020;EMA/HMPC/554043/2018. Final, adopted 8 July 2020..SourceUsed to support: Not PubMed-indexed; official EU monograph, in force. Lists rupturewort only under traditional use: a traditional herbal medicinal product to increase the amount of urine to achieve flushing of the urinary tract as an adjuvant in minor urinary complaints, based exclusively on long-standing use. Herbal tea of 1.5 to 3 g in 150 ml water as infusion or decoction 3 to 5 times daily, maximum 10 g a day; see a doctor if symptoms last more than 2 weeks. Contraindications: hypersensitivity and conditions where reduced fluid intake is recommended (for example severe heart or kidney disease). Not recommended under 18 or in pregnancy and lactation, no reported interactions, no known undesirable effects, and adequate genotoxicity, reproductive toxicity and carcinogenicity tests not performed.
  2. European Medicines Agency, Committee on Herbal Medicinal Products (HMPC). Assessment report on Herniaria glabra L., H. hirsuta L., H. incana Lam., herba (EMA/HMPC/554033/2018). European Medicines Agency. 2020;EMA/HMPC/554033/2018. Final, 8 July 2020..SourceUsed to support: Not PubMed-indexed; the EMA's scientific review. Defines the herb by the Austrian Pharmacopoeia (no European Pharmacopoeia monograph) and notes current commercial samples are mainly H. glabra and H. incana. Lists constituents: 3% to 9% medicagenic acid saponins, 0.2% to 1.2% flavonoids, 0.1% to 0.4% coumarins (for example herniarin and umbelliferone), tannins, phenolic acids and traces of essential oil. Finds no product with rupturewort as the only active ingredient on the EU market (it is used in diuretic tea blends), no clinical, pharmacodynamic or pharmacokinetic data in people, and no literature reports of side effects. Summarizes rat, dog and lab studies, judges single- and repeat-dose toxicity of a water extract as low, rates the only Ames test inadequate (with a positive TA102 result under the 1.5-fold rule), and finds no constituent with known therapeutic activity.
  3. Caione P, Salerno A, Collura G, De Dominicis M, Innocenzi M, Martucci C, Capozza N. Phytotherapy as ancillary treatment after urinary stone lithotripsy in pediatric age. Ann Ital Chir. 2022;92:313-318..PubMedUsed to support: Small randomized trial in patients aged 6 to 18 after endoscopic stone procedures (34 enrolled, 2 excluded): a three-component herbal product with Herniaria hirsuta and boldo, plus water intake, 12 days a month for 3 months, was followed by fewer children with leftover fragments (15.4% vs 36.8% at 6 months) than no added treatment, with no adverse effects reported. No placebo; a combination product.
  4. Atmani F, Slimani Y, Mimouni M, Hacht B. Prophylaxis of calcium oxalate stones by Herniaria hirsuta on experimentally induced nephrolithiasis in rats. BJU Int. 2003;92(1):137-40. doi: 10.1046/j.1464-410x.2003.04289.x.PubMedUsed to support: Animal study: in rats made to form calcium oxalate crystals, 1 ml a day of a Herniaria hirsuta decoction for 2 weeks was followed by smaller urinary crystals and almost no kidney deposits, while water intake and urine output decreased and urine chemistry was unchanged apart from higher magnesium. Not a human study.
  5. Atmani F, Slimani Y, Mimouni M, Aziz M, Hacht B, Ziyyat A. Effect of aqueous extract from Herniaria hirsuta L. on experimentally nephrolithiasic rats. J Ethnopharmacol. 2004;95(1):87-93. doi: 10.1016/j.jep.2004.06.028.PubMedUsed to support: Animal study in normal and crystal-forming rats over 3 weeks: with a Herniaria hirsuta decoction, urinary oxalate and calcium stayed stable, treated rats passed mostly small calcium oxalate dihydrate crystals, and kidney deposits were limited compared with untreated rats; water intake and urine volume increased in the crystal-forming rats. Not a human study.
  6. Atmani F, Farell G, Lieske JC. Extract from Herniaria hirsuta coats calcium oxalate monohydrate crystals and blocks their adhesion to renal epithelial cells. J Urol. 2004;172(4 Pt 1):1510-4. doi: 10.1097/01.ju.0000131004.03795.c5.PubMedUsed to support: Cell study: a water extract of Herniaria hirsuta reduced calcium oxalate monohydrate crystal binding to dog kidney cells in a concentration-dependent way, acted when the crystals rather than the cells were pretreated, displaced part of the crystals already bound and did not harm the cells. Not a human study.
  7. Hakim EM, Sivak KV, Kaukhova IE. Evaluation of the diuretic effect of crude ethanol and saponin-rich extracts of Herniaria glabra L. in rats. J Ethnopharmacol. 2021;273:113942. doi: 10.1016/j.jep.2021.113942.PubMedUsed to support: Animal study: in rats, a crude ethanol extract of Herniaria glabra raised urine output at 50 and 200 mg/kg (by 81% at 200 mg/kg) and a saponin-rich extract at all doses (by 114% at 200 mg/kg, comparable to furosemide 10 mg/kg), with higher sodium, potassium and chloride excretion; the main saponin aglycones were medicagenic and oleanolic acids. Notes the Moroccan name meaning stonebreaker. Not a human study.
  8. Rhiouani H, Settaf A, Lyoussi B, Cherrah Y, Lacaille-Dubois MA, Hassar M. Effects of saponins from Herniaria glabra on blood pressure and renal function in spontaneously hypertensive rats. Therapie. 1999;54(6):735-9..PubMedUsed to support: Animal study in spontaneously hypertensive rats (10 per group): 200 mg/kg a day of Herniaria glabra saponins by mouth for 30 days lowered systolic and diastolic pressure (from about 188/119 to 142/90 mmHg) and raised glomerular filtration, urine flow and sodium, potassium and chloride excretion. Not a human study.
  9. Rhiouani H, El-Hilaly J, Israili ZH, Lyoussi B. Acute and sub-chronic toxicity of an aqueous extract of the leaves of Herniaria glabra in rodents. J Ethnopharmacol. 2008;118(3):378-86. doi: 10.1016/j.jep.2008.05.009.PubMedUsed to support: Animal toxicity study: in mice, single doses of a Herniaria glabra water extract had a no-observed-adverse-effect level of 5 g/kg and a median lethal dose of 8.5 g/kg; in rats given 1 to 4 g/kg daily for 90 days, weight gain slowed, blood sugar fell, and only the 4 g/kg dose raised liver enzymes and creatinine with liver and kidney damage on microscopy. Not a human study.
  10. van Dooren I, Foubert K, Bijttebier S, Theunis M, Velichkova S, Claeys M, Pieters L, Exarchou V, Apers S. Saponins and Flavonoids from an Infusion of Herniaria hirsuta. Planta Med. 2016;82(18):1576-1583. doi: 10.1055/s-0042-118710.PubMedUsed to support: Chemical analysis of a Herniaria hirsuta infusion: two previously undescribed medicagenic acid saponins and three known flavonoids (a quercetin glucuronide, rutin and narcissin) were isolated as main constituents. No health outcomes were measured.
  11. Peeters L, Foubert K, Breynaert A, Schreurs G, Verhulst A, Pieters L, Hermans N. Effects of medicagenic acid metabolites, originating from biotransformation of an Herniaria hirsuta extract, on calcium oxalate crystallization in vitro. J Ethnopharmacol. 2022;285:114860. doi: 10.1016/j.jep.2021.114860.PubMedUsed to support: Lab study: notes that Herniaria hirsuta saponins are thought to be deglycosylated in the colon, with aglycones such as medicagenic acid absorbed and metabolized in the liver; liver metabolites of medicagenic acid (mainly the glucuronide) significantly inhibited calcium oxalate crystal binding to injured kidney cells and had a tentative effect on crystal aggregation. Not a human study.
  12. Wojnicz D, Kucharska AZ, Sokół-Łętowska A, Kicia M, Tichaczek-Goska D. Medicinal plants extracts affect virulence factors expression and biofilm formation by the uropathogenic Escherichia coli. Urol Res. 2012;40(6):683-97. doi: 10.1007/s00240-012-0499-6.PubMedUsed to support: Lab study of six folk herb extracts (birch, horsetail, rupturewort, sweet woodruff, nettle, lingonberry) against a uropathogenic E. coli strain: the Herniaria glabra extract (a dried hot water extract) and the lingonberry extract showed the strongest growth inhibition, with Herniaria stopping growth at 1 to 20 mg per ml, and like all six extracts it reduced biofilm. Not a human study.
  13. Hussaini H, Waheed A, Fadeyi O, Boostany T, Hashimoto Y, Flint AT. Acute Liver Injury Following Herbal Drink Consumption With Steatosis and Immune Activation: A Case Report. Cureus. 2025;17(2):e79839. doi: 10.7759/cureus.79839.PubMedUsed to support: Case report: a 32-year-old man who had taken 50 ml a day of a 14-herb tonic, including Herniaria glabra, for about two years developed acute liver injury with steatosis and raised IgG; liver tests improved after stopping, and the RUCAM causality score of 6 was read as probable for the tonic. The herbs in the blend cannot be separated.
  14. Neopharm Bulgaria Ltd. (sponsor); ClinicalTrials.gov, U.S. National Library of Medicine. Efficacy of Neorenal Forte for the Complete Elimination of Residual Fragments (NCT06651294). ClinicalTrials.gov. 2024;NCT06651294. First posted 21 October 2024; last updated 10 August 2026; status recruiting. Accessed 2026..SourceUsed to support: Not PubMed-indexed; trial registry record. Describes a randomized, triple-blind, placebo-controlled trial sponsored by the product's maker, Neopharm Bulgaria, planned for 120 adults aged 18 to 65 after flexible ureteroscopy with laser lithotripsy, testing tablets of birch leaf dry extract with Herniaria glabra, guelder rose (Viburnum opulus) and couch grass for 90 days on clearance of residual stone fragments. Recruiting, with no results posted.
  15. National Center for Biotechnology Information. PubChem Compound Summary for CID 10748, Methylumbelliferone (herniarin, 7-methoxycoumarin). PubChem. 2026;PubChem CID 10748. Accessed 2026..SourceUsed to support: Not PubMed-indexed; chemical database record. Identifies herniarin as 7-methoxycoumarin (7-methoxychromen-2-one, C10H8O3), a methoxy derivative distinct from coumarin itself (PubChem CID 323, chromen-2-one, C9H6O2).
  16. European Medicines Agency, Committee on Herbal Medicinal Products (HMPC). Assessment report on Taraxacum officinale Weber ex Wigg., folium (EMA/HMPC/579634/2008). European Medicines Agency. 2009;Final, 12 November 2009. Accessed October 2026..SourceUsed to support: Not PubMed-indexed; official EU assessment report on dandelion leaf, not on rupturewort. Its drug interactions section states that, theoretically, patients on lithium therapy who use herbal preparations with diuretic activity may experience dehydration and resulting lithium toxicity. Cited only for the general lithium caution with diuretic herbs; the interaction has not been studied with rupturewort.