Internal and Emergency Medicine

, Volume 13, Issue 5, pp 811–813 | Cite as

Aristolochia, a nephrotoxic herb, still surfs on the Web, 15 years later

  • Valentina MagginiEmail author
  • Francesca Menniti-Ippolito
  • Fabio Firenzuoli

Plants in the family Aristolochiaceae contain aristolochic acid, recognized worldwide as cause of serious nephropathy and cancer [1, 2]. In 2001, the Food and Drug Administration (FDA) issued warnings and an important alert on the risks associated with herbal products containing aristolochic acid [3]. In 2002, The International Agency classified products containing Aristolochia species as human carcinogens for Research on Cancer [3]. Despite this, in 2003 Gold and Slone highlighted the sale on the Web of many products containing aristolochic acid [3].

Fifteen years later we conducted a new preliminary Web search with alarming results: there were not only sale sites, but also cooking sites recommending herbal teas containing Aristolochia spp. for arthritis or other symptoms (e.g., uterine fibroids, pancreatitis, and polycystic ovary syndrome). Several representative sites ( n = 40) are listed in Table  1 with the plant part to be used and proposed use.
Table 1

Web pages reporting products...


Compliance with ethical standards

Conflict of interest

The authors declare that they have no conflict of interest.

Statement of human and animal rights

This article does not contain any studies with human participants or animals performed by any of the authors.

Informed consent



  1. 1.
    Jadot I, Declèves AE, Nortier J, Caron N (2017) An integrated view of aristolochic acid nephropathy: update of the literature. Int J MolSci 18(2):e297CrossRefGoogle Scholar
  2. 2.
    Grollman AP, Marcus DM (2016) Global hazards of herbal remedies: lessons from Aristolochia: the lesson from the health hazards of Aristolochia should lead to more research into the safety and efficacy of medicinal plants. EMBO Rep 17(5):619–625CrossRefPubMedPubMedCentralGoogle Scholar
  3. 3.
    Gold LS, Slone TH (2003) Aristolochic acid, an herbal carcinogen, sold on the Web after FDA alert. N Engl J Med 349(16):1576–1577CrossRefPubMedGoogle Scholar
  4. 4.
    Cousyn G, Dalfrà S, Scarpa B (2013) Project BELFRIT. Eur Food Feed Law Rev 8(3):3187–3196Google Scholar
  5. 5.
    Maggini V, Gallo E, Vannacci A, Gori L, Mugelli A, Firenzuoli F (2013) e-Phytovigilance for misleading herbal information. Trends Pharmacol Sci 34(11):594–595CrossRefPubMedGoogle Scholar

Copyright information

© SIMI 2018

Authors and Affiliations

  1. 1.Department of Experimental and Clinical MedicineUniversity of FlorenceFlorenceItaly
  2. 2.National Centre for Drug Research and EvaluationNational Institute of HealthRomeItaly
  3. 3.Referring Center for Phytotherapy, Tuscany RegionCareggi University HospitalFlorenceItaly

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