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Scientific Name(s): Aristolochia serpentaria L.
Common Name(s): Aristolochiae Radix, Birthwort, Caulis Aristolochiae Manshuriensis, Herba Aristolochiae Mollissima, mǎdōu líng, Pelican flower, Red River snakeroot, Sangree root, Sangrel, Snakeroot, Snakeweed, Texas snakeroot, Virginia snakeroot

Medically reviewed by Last updated on Jan 12, 2022.

Clinical Overview


Despite traditional claims of efficacy for snakebite, among other uses, toxicity of Aristolochia extracts precludes their use.


Toxicity of Aristolochia extracts precludes their use.


Avoid use. Aristolochia extracts are toxic. Avoid use in pregnancy.


Avoid use. Aristolochia extracts are known to be toxic. Abortifacient effects of aristolochic acids have been documented in animal studies.


None well documented.

Adverse Reactions

Extracts of Aristolochia are known to be toxic (carcinogenic and nephrotoxic). Safety concerns regarding use of products containing aristolochic acids exist.


Aristolochia extracts are carcinogenic and nephrotoxic.

Scientific Family

  • Aristolochiaceae (birthwort)


The genus Aristolochia (Dutchman's pipe) comprises more than 500 species of herbs and vines, including A. serpentaria (also known as Virginia snakeroot). Synonyms include Aristolochia convolvulacea, Aristolochia hastate, Aristolochia nashi, and Endodeca serpentaria. "Snakeroot" is a term also applied to the unrelated white snakeroot (Ageratina altissima), rattlesnake root (genus Prenanthes), Canadian blacksnakeroot (Sanicula canadensis), black snakeroot (Actaea racemose), and Sampson’s snakeroot (Orbexilum pedunculatum).(Krell 2013, USDA 2021)

A. serpentaria is a low-growing (up to 0.6 m in height) perennial found primarily in the forests of the central and southern United States. The leaves of the plant are heart-shaped. Its exotic, brownish-purple, tube-like flowers are lined with hairs and possess a foul, fruit-like odor that attracts insects. Insects become caught in the hairs of the flowers, then become covered with pollen while struggling to escape; upon escape, the insect carries the pollen to other flowers, resulting in cross-pollination. The dried rhizome of the plant has been traditionally used as an herbal tonic for its gastric stimulant and diuretic effects.(Sharp 2014)

Several species of butterfly larvae feed on A. serpentaria, transferring the toxic aristolochic acids of the plant to the adult butterflies for use as a defense mechanism against predators.(Pinto 2009, Wu 2000)


Aristolochia spp. have been widely and extensively used in traditional Chinese medicine, as well as in England and the Americas. Chewed snakeroot was traditionally applied to wounds and used as a cure for snakebite by American Indians. Colonial and European physicians sometimes used snakeroot for infectious fevers, malaria, and rabies. Use in obstetrics, arthritis, eczema, cancer, and weight loss, and as an aphrodisiac, antiviral, and antibacterial agent has been recorded.(Heinrich 2009, Krell 2013, Kuo 2012, Luciano 2015, Tang 1992)

Toxicity of A. serpentaria was reported as early as 1825; in 2000, the US Food and Drug Administration (FDA) issued a warning regarding preparations containing aristolochic acids.(FDA 2001, Stegelmeier 2015) In 2004, the European Union ceased approving herbal preparations containing aristolochic acids. The compound has also been removed from the Pharmacopoeia of the People's Republic of China.(Kuo 2012) However, products containing toxic substances such as aristolochic acids are still available, either on unregulated websites or as adulterants in other preparations.(Luciano 2015)


A. serpentaria and other members of the genus contain aristolochic acids and associated aristolactams and aporphines; protoberberine-, isoquinoline-, and benzylisoquinoline-type alkaloids; and amides, flavonoids, lignans, coumarins, terpenoids, benzenoids, and steroids. Research has focused on identifying aristolochic acids and associated chemicals because of their toxicity.(Kuo 2012, Michl 2014, Tang 1992, USDA 2021)

Uses and Pharmacology

Toxicity of Aristolochia preparations precludes their use.(FDA 2001)


Animal data

Ethanolic root extracts of Aristolochia ringens showed inhibition of solid tumor growth (in vivo in rodents) and were significantly active in leukemia models.(Akindele 2015) In vitro, activity against leukemia has been demonstrated with aristolochic acids extracted from other plants.(Goun 2002)

Other uses

Limited studies in rodents suggest Aristolochia extracts may exert neutralizing effects against certain snake venom.(Otero 2000, Shabbir 2014)

Potential use of Aristolochia extracts as an insecticide, particularly against the malarial vector Anopheles stephensi, has been investigated.(Pradeepa 2015)


Toxicity of Aristolochia extracts precludes their use.(FDA 2001)

Pregnancy / Lactation

Avoid use. Aristolochia extracts are known to be toxic. Abortifacient effects of aristolochic acids have been documented in dogs and rodents(Wang 1984); the plant has been traditionally used for this purpose.(Che 1984, Ganguly 1986, Krell 2013)


None well documented. Aristolochic acids have been shown to have antithrombin activity.Goun 2002 In vitro evidence suggests that use with Panax ginseng may increase the renal toxicity of Aristolochia.Bunel 2015

Adverse Reactions

Aristolochia extracts are carcinogenic and nephrotoxic (see Toxicology section).


Based on case reports of nephrotoxicity, including end-stage renal disease and aristolochic acid–related DNA adducts in the renal tissue of some patients, the FDA issued a warning in 2000 regarding the nephrotoxicity and carcinogenicity of herbal products containing aristolochic acids.(Duke 2002, FDA 2001, Tomlinson 2020) Aristolactams and 4,5-dioxoaporphine derivatives are related chemical constituents also reported to be toxic.(Michl 2014)

The proposed mechanism for carcinogenicity is that the aristolochic acid component undergoes a reaction to form an electrophilic cyclic N-acylnitrenium ion that binds to DNA, making a DNA adduct. These adducts have been detected in patients exposed to aristolochic acids who have nephropathy or upper urinary tract cancer. They are responsible for causing DNA mutations, which leads to the production of RAS and other cancer-promoting proteins. It is classified by the World Health Organization as a type 1 carcinogen and is in the same classification as asbestos and solar radiation.(Krell 2013, Poon 2015, Sidorenko 2020, Yang 2014)

Index Terms

  • Aristolochia convolvulacea
  • Aristolochia hastate
  • Aristolochia nashi
  • Endodeca serpentaria



This information relates to an herbal, vitamin, mineral or other dietary supplement. This product has not been reviewed by the FDA to determine whether it is safe or effective and is not subject to the quality standards and safety information collection standards that are applicable to most prescription drugs. This information should not be used to decide whether or not to take this product. This information does not endorse this product as safe, effective, or approved for treating any patient or health condition. This is only a brief summary of general information about this product. It does NOT include all information about the possible uses, directions, warnings, precautions, interactions, adverse effects, or risks that may apply to this product. This information is not specific medical advice and does not replace information you receive from your health care provider. You should talk with your health care provider for complete information about the risks and benefits of using this product.

This product may adversely interact with certain health and medical conditions, other prescription and over-the-counter drugs, foods, or other dietary supplements. This product may be unsafe when used before surgery or other medical procedures. It is important to fully inform your doctor about the herbal, vitamins, mineral or any other supplements you are taking before any kind of surgery or medical procedure. With the exception of certain products that are generally recognized as safe in normal quantities, including use of folic acid and prenatal vitamins during pregnancy, this product has not been sufficiently studied to determine whether it is safe to use during pregnancy or nursing or by persons younger than 2 years of age.

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