Alisma Oriental (Alisma orientale): Benefits, Dosage, Safety & Evidence

Frequently asked questions

How does Alisma orientale work as a diuretic?

Alisma orientale works primarily through its triterpenoid compounds, particularly alisol A and alisol B, which inhibit renal tubular sodium reabsorption. This action increases urine output and promotes fluid excretion. The herb also contains polysaccharides that may support kidney function. In Traditional Chinese Medicine, it is classified as promoting urination and leaching out dampness. Evidence level: C (preclinical and traditional use support).

Does Alisma orientale interact with diuretic medications?

Alisma orientale may interact with prescription diuretic medications, potentially enhancing their effects and increasing the risk of electrolyte imbalances, particularly hypokalemia. Due to its effects on kidney function, it should be used cautiously with nephrotoxic medications. Limited clinical interaction data exists (Evidence level: C), so patients taking prescription diuretics, lithium, or kidney-affecting drugs should consult a healthcare provider before use.

What is the recommended dosage for Alisma orientale?

The typical adult dosage for Alisma orientale is 9-15 grams of dried rhizome daily, usually prepared as a decoction in water. Standardized extracts are commonly taken at 500mg twice daily. In Traditional Chinese Medicine, it is often combined with other herbs in classical formulas rather than used alone. Dosage should be adjusted based on individual condition and under guidance from a qualified practitioner. Evidence level: C/Traditional.

Is Alisma orientale safe during pregnancy and breastfeeding?

Alisma orientale is contraindicated during pregnancy and should be avoided. Traditional Chinese Medicine classifies it as unsafe for pregnant women due to its strong diuretic properties and potential effects on fluid balance. There is insufficient safety data for breastfeeding. Women who are pregnant, planning pregnancy, or nursing should not use this herb without explicit guidance from a qualified healthcare provider. Evidence level: Traditional/C.

What conditions is Alisma orientale used to treat?

Alisma orientale is used in Traditional Chinese Medicine and Kampo primarily for urinary disorders, edema, and kidney conditions. It promotes diuresis and helps eliminate excess fluids from the body. The herb is also traditionally used for lipid regulation and metabolic support. Key classical formulas containing Alisma include Wu Ling San and Ze Xie Tang. Modern research suggests potential benefits for hyperlipidemia, though clinical evidence remains limited (Evidence level: C).

What are the side effects of taking Alisma orientale?

The primary side effect of Alisma orientale is electrolyte imbalance, particularly with prolonged use, due to its diuretic action. This may include low potassium levels (hypokalemia). Traditional Chinese Medicine cautions against use in kidney deficiency patterns. Gastrointestinal discomfort may occur in some individuals. Long-term use without medical supervision is not recommended. Patients should monitor electrolyte levels during extended treatment. Evidence level: C/Traditional.

PubMed-compiled information sheet

This sheet was compiled from PubMed (NIH) abstracts using AI assistance. Every factual claim is cited to a real PubMed article (see the source list). It has not yet been human-reviewed — confirm with a healthcare provider before use.

Compiled from 30 PubMed articles · model: gemma4:31b

Summary

Alisma orientale is a traditional Chinese medicinal herb used for its diuretic, hepatoprotective, and anti-inflammatory properties [PMID:27080939, PMID:38562439].

Background

Alisma orientale (Sam.) Juzep, also known as Ze Xie in Chinese and Takusha in Japanese, is a member of the Alismataceae family [PMID:32426329]. Its medicinal properties are primarily derived from its dried rhizomes or tubers [PMID:27080939, PMID:38535196].

Traditional uses

It is traditionally used to treat oliguria, edema, gonorrhea with turbid urine, leukorrhea, diarrhea, dizziness, diabetes, hepatitis, and inflammation [PMID:27080939, PMID:38562439].

Active compounds

The herb contains approximately 120 compounds, with terpenoids being characteristic constituents, specifically protostane triterpenoids (e.g., Alisol A 24-acetate, Alisol B, Alisol B 23-acetate, Alisol F, and Alismol) and guaiane sesquiterpenoids [PMID:27080939, PMID:31275407, PMID:29139211].

Mechanism of action

Alisol B targets soluble epoxide hydrolase (sEH) to attenuate apoptosis, inflammation, and oxidative stress via NF-κB and Nrf2 pathways [PMID:36594097]. It also regulates the AMPK/mTOR/SREBPs pathway by targeting VDAC1 to inhibit lipid synthesis [PMID:38520833]. Alisol A 24-acetate suppresses the Kupffer cell-derived SPHK1/S1P axis to protect against fibrosis [PMID:40992063].

Clinical evidence

Evidence DAcute Kidney Injury (AKI)

Alisol B significantly attenuated cisplatin-induced renal tubular apoptosis and inflammatory response [PMID:36594097]

Evidence DHyperlipidemia

Alisol B regulates AMPK/mTOR/SREBPs to alleviate hyperlipidemia in mice and cells [PMID:38520833]

Evidence DNon-alcoholic Fatty Liver Disease (NAFLD/NASH)

A. orientale prevents hepatic triglyceride accumulation and controls oxidative stress and inflammatory mediators [PMID:31275407]; Alisol A 24-acetate protects against NASH-associated fibrosis [PMID:40992063]

Evidence DHyperuricemia-induced nephropathy

Fuling-Zexie formula (containing A. orientale) attenuated renal inflammation and dysfunction in mice [PMID:37788785]

Evidence DDiuresis

Salt-made A. orientale increased rat urine volume and concentrations of Na+, K+, and Cl- [PMID:35515416]

Safety & adverse effects

Reviews suggest minimal adverse effects [PMID:36961296], although network pharmacology studies have been used to explore potential hepato-nephrotoxicity [PMID:36457705].

Pregnancy & lactation

Alisma orientale has a long history of use in traditional Chinese medicine for pregnancy-induced hypertension (PIH) [PMID:36457705].

Evidence summary

The evidence consists primarily of preclinical laboratory studies (in vitro and animal models) and literature reviews, indicating strong potential for renal and hepatic protection, though high-level human clinical trial data is lacking in the provided set.

PubMed sources

1.PMID: 36457705 (2022) — Exploring the mechanism of Alisma orientale for the treatment of pregnancy induced hypertension and potential hepato-nephrotoxicity by using network pharmacology, network toxicology, molecular docking and molecular dynamics simulation. · Frontiers in pharmacology
2.PMID: 39303509 (2024) — Shenqi Pill alleviates acetaminophen-induced liver injury: a comprehensive strategy of network pharmacology and spectrum-effect relationship reveals mechanisms and active components. · Phytomedicine : international journal of phytotherapy and phytopharmacology
3.PMID: 37788785 (2024) — Fuling-Zexie formula attenuates hyperuricemia-induced nephropathy and inhibits JAK2/STAT3 signaling and NLRP3 inflammasome activation in mice. · Journal of ethnopharmacology
4.PMID: 36594097 (2023) — Direct targeting of sEH with alisol B alleviated the apoptosis, inflammation, and oxidative stress in cisplatin-induced acute kidney injury. · International journal of biological sciences
5.PMID: 27080939

Alisma Oriental

Sources & Citations

Calculate a safe dose of Alisma Oriental