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PubMed · Epimedium sagittatum Maxim ameliorates adriamycin-induced nephropathy by restraining inflammation and apoptosis via the PI3K/AKT signaling pathway. (2023)
PubMed · [Aqueous extract of Epimedium sagittatum mitigates pulmonary fibrosis in mice]. (2023)
Reviewed by: HerbAlly Editorial Team, Medical herbalists and healthcare professionals
How does Epimedium sagittatum work for erectile dysfunction?
Epimedium sagittatum works primarily through its active compound icariin, which functions as a phosphodiesterase type 5 (PDE5) inhibitor. This mechanism increases levels of cyclic guanosine monophosphate (cGMP), relaxing smooth muscle tissue and increasing blood flow to the genital area. Additionally, the herb exhibits estrogenic effects that may influence hormonal balance. Evidence for this mechanism is rated Level C, derived largely from in vitro and animal studies rather than extensive human clinical trials.
Does Epimedium sagittatum interact with medications?
Yes, Epimedium sagittatum has significant interaction potential. Due to its estrogenic properties, it may interfere with hormone replacement therapies and birth control medications. Because icariin affects blood clotting, it can potentiate the effects of anticoagulants like warfarin, increasing bleeding risk. Furthermore, combining it with prescription PDE5 inhibitors may cause additive effects and hypotension. Patients taking these medications should consult a healthcare provider before use.
What is the recommended dosage for Epimedium sagittatum?
Adult dosages vary depending on the formulation. For standardized extracts, the typical recommendation is 500 to 1000 mg taken twice daily. Traditional preparations using the dried herb generally utilize 6 to 15 grams per day, often decocted in water. Dosage should be adjusted based on the specific icariin concentration of the product. Users should follow manufacturer guidelines or consult a qualified medical herbalist for personalized dosing.
Is Epimedium sagittatum safe during pregnancy?
No, Epimedium sagittatum is contraindicated during pregnancy and is considered unsafe. The herb exerts significant hormonal effects, including estrogenic activity, which can disrupt the delicate hormonal balance required for fetal development and pregnancy maintenance. These properties pose a risk of miscarriage or fetal complications. Breastfeeding women should also avoid this herb. Women with hormone-sensitive conditions, such as breast or ovarian cancer, must strictly avoid this supplement.
Can Epimedium sagittatum improve bone health?
Research suggests potential benefits for bone health, particularly regarding osteoporosis. Preclinical studies indicate that icariin can stimulate osteoblast differentiation and inhibit osteoclast activity, thereby promoting bone formation and reducing bone resorption. While these mechanisms are promising for managing bone loss, current evidence is rated Level C, relying primarily on animal models. Well-designed human clinical trials are necessary to confirm efficacy and establish therapeutic protocols for bone conditions.
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
Epimedium sagittatum is a traditional medicinal plant used primarily in Asia to treat erectile dysfunction and kidney-Yang deficiency [PMID:38593963, PMID:23792897]. Its primary bioactive components are flavonoids, which exhibit various pharmacological activities including anti-inflammatory and PDE5A inhibitory effects [PMID:36863569, PMID:30424767].
Background
Epimedium sagittatum (Sieb. et Zucc.) Maxim is a member of the Berberidaceae family and a perennial traditional Chinese medicinal herb [PMID:33365631, PMID:27733858]. It is characterized by a relatively large haploid genome of approximately 4496 Mbp [PMID:23807511].
Traditional uses
Traditionally used in Asia to dispel wind and cold, tonify the kidney, strengthen bones and tendons [PMID:38593963], and treat erectile dysfunction, impotence, and rheumatism [PMID:23792897, PMID:33691203].
Active compounds
The main active ingredients are flavonoids, specifically icariin, epimedin A, epimedin B, and epimedin C [PMID:36837913, PMID:36471925]. Other identified compounds include 2''-O-rhamnosyl icariside II [PMID:40812555], baohuoside I [PMID:3658722 la, PMID:41380862], and various prenylated flavonoids such as epimesatines A-S [PMID:35810878, PMID:39407639].
Mechanism of action
The herb acts through several pathways: inhibition of phosphodiesterase-5A (PDE5A) to treat erectile dysfunction [PMID:36863569, PMID:41380862], inhibition of the TLR4/MD-2 mediated NF-κB signaling pathway for anti-inflammatory effects [PMID:30424767, PMID:41432450], and modulation of the PI3K/AKT signaling pathway to restrain inflammation and apoptosis [PMID:37382268].
Clinical evidence
Evidence BGulf War Illness (GWI)
Symptom severity was unchanged from placebo in a pseudo-randomized crossover trial [PMID:33915962]
Evidence DPulmonary Fibrosis
Aqueous extract and the compound 2''-O-rhamnosyl icariside II ameliorated pulmonary fibrosis in mouse models [PMID:40812555, PMID:38114154]
Evidence DAdriamycin-induced nephropathy
Ameliorated nephropathy by restraining inflammation and apoptosis via the PI3K/AKT pathway in rats [PMID:37382268]
Exosome-like nanovesicles (ENVs) from E. sagittatum ameliorated renal injury in murine models by reshaping gut microbiota and suppressing the TLR4/NF-κB pathway [PMID:41432450]
Evidence DBreast Cancer (MCF-7 cells)
Epimesatines P-S exhibited significant inhibitory effects on the viability of MCF-7 human breast cancer cells in vitro [PMID:39407639]
Evidence DNon-small cell lung cancer (A549 cells)
Safety & adverse effects
Aqueous extracts have been shown to induce liver injury in mice via pyroptosis [PMID:38593963]. Sub-chronic toxicity studies in rats indicated potential injury to the liver, pancreas, and adrenal glands, as well as dysregulation of amino acid biosynthesis [PMID:35287533].
Drug interactions
Significant herb-drug interactions were observed in rats; E. sagittatum extract significantly decreased the area under the concentration-time curve (AUC) of sildenafil [PMID:23792897].
Evidence summary
The evidence consists primarily of in vitro studies and animal models (Level D), with one pseudo-randomized clinical trial (Level B) showing no significant effect on Gulf War Illness symptoms. While pharmacological potential is noted for kidney and lung conditions, safety concerns regarding liver toxicity in animals have been reported.
PubMed sources
1.PMID: 36837913 (2023) — A Comprehensive Analysis to Elucidate the Effects of Spraying Mineral Elements on the Accumulation of Flavonoids in Epimedium sagittatum during the Harvesting Period. · Metabolites
2.PMID: 38593963 (2024) — Aqueous extract of Epimedium sagittatum (Sieb. et Zucc.) Maxim. induces liver injury in mice via pyroptosis. · Journal of ethnopharmacology
3.PMID: 23792897 (2013) — Herb-drug interaction of Epimedium sagittatum (Sieb. et Zucc.) maxim extract on the pharmacokinetics of sildenafil in rats. · Molecules (Basel, Switzerland)
4.PMID: 36863569 (2023) — Flavonoids and prenylhydroquinones from the prepared folium of Epimedium sagittatum Maxim. and their inhibition against phosphodiesterase5A. · Fitoterapia
5.PMID: 40812555 (2025) — 2″-O-rhamnosyl icariside Ⅱ from Epimedium sagittatum maxim ameliorates pulmonary fibrosis by modulating the E-cadherin-mediated oxidative-epithelial mesenchymal transition axis.
Government sources
No direct government monograph is available for this herb. The content below is AI-generated and has not been verified against an authoritative government source. Use the search links to check official sources before relying on this information.
Epimesatines A and I inhibited the expression of SPHK1 and reduced cell viability in vitro [PMID:35810878]
· Journal of ethnopharmacology
6.PMID: 38744386 (2024) — Comparing the pharmacological effects of the prepared folium of Epimedium brevicornu Maxim. and Epimedium sagittatum Maxim. on kidney-Yang deficiency syndrome and liver injury complications. · Fitoterapia
7.PMID: 37382268 (2023) — Epimedium sagittatum Maxim ameliorates adriamycin-induced nephropathy by restraining inflammation and apoptosis via the PI3K/AKT signaling pathway. · Immunity, inflammation and disease
8.PMID: 39722017 (2024) — Spraying methyl jasmonate before harvesting can significantly increase the content of icariin in an important leaf medicinal herb, Epimedium sagittatum, by activating the expression of genes involved in flavonoid synthesis pathways. · BMC plant biology
9.PMID: 38114154 (2023) — [Aqueous extract of Epimedium sagittatum mitigates pulmonary fibrosis in mice]. · Zhongguo Zhong yao za zhi = Zhongguo zhongyao zazhi = China journal of Chinese materia medica
10.PMID: 38462913 (2024) — Integration of Network Pharmacology and Experimental Validation to Explore Jixueteng - Yinyanghuo Herb Pair Alleviate Cisplatin-Induced Myelosuppression. · Integrative cancer therapies
11.PMID: 41432450 (2026) — Epimedium-Derived Exosome-like Nanovesicles Regulate Lipid Metabolism via the "Gut-Kidney Axis" for Multitargeted Inhibition of Sepsis-Associated Acute Kidney Injury. · ACS applied materials & interfaces
12.PMID: 39407639 (2024) — Epimesatines P-S: Four Undescribed Flavonoids from Epimedium sagittatum Maxim. and Their Cytotoxicity Activities. · Molecules (Basel, Switzerland)
13.PMID: 39657052 (2025) — Boosting transcriptional activities by employing repeated activation domains in transcription factors. · The Plant cell
14.PMID: 39122793 (2024) — Biological characteristics of flowers and examination of pollen viability at different developmental stages of Epimedium sagittatum (Sieb. et Zucc.) Maxim. · Scientific reports
15.PMID: 33365631 (2019) — The complete chloroplast genome of Epimedium sagittatum (Sieb. Et Zucc.) Maxim. (Berberidaceae), a traditional Chinese herb. · Mitochondrial DNA. Part B, Resources
16.PMID: 36471925 (2022) — [Rapid prediction of flavonoid content in Epimedium sagittatum by infrared spectroscopy]. · Zhongguo Zhong yao za zhi = Zhongguo zhongyao zazhi = China journal of Chinese materia medica
17.PMID: 36587222 (2022) — Isolation, bioassay and 3D-QSAR analysis of 8-isopentenyl flavonoids from Epimedium sagittatum maxim. as PDE5A inhibitors. · Chinese medicine
18.PMID: 35810878 (2022) — Epimesatines A-I, nine undescribed prenylated flavonoids with SPHK1 inhibitory activities from Epimedium sagittatum maxim. · Phytochemistry
19.PMID: 33915962 (2021) — A Placebo-Controlled, Pseudo-Randomized, Crossover Trial of Botanical Agents for Gulf War Illness: Reishi Mushroom (Ganoderma lucidum), Stinging Nettle (Urtica dioica), and Epimedium (Epimedium sagittatum). · International journal of environmental research and public health
20.PMID: 27733858 (2016) — Leaf-Like Sepals Induced by Ectopic Expression of a SHORT VEGETATIVE PHASE (SVP)-Like MADS-Box Gene from the Basal Eudicot Epimedium sagittatum. · Frontiers in plant science
21.PMID: 26874879 (2016) — Herb-drug interaction of Epimedium extract on the pharmacokinetic of dapoxetine in rats. · Journal of chromatography. B, Analytical technologies in the biomedical and life sciences
22.PMID: 23936468 (2013) — A R2R3-MYB transcription factor from Epimedium sagittatum regulates the flavonoid biosynthetic pathway. · PloS one
23.PMID: 23807511 (2013) — First insights into the large genome of Epimedium sagittatum (Sieb. et Zucc) Maxim, a Chinese Ttaditional medicinal plant. · International journal of molecular sciences
24.PMID: 30424767 (2018) — Epimedium sagittatum inhibits TLR4/MD-2 mediated NF-κB signaling pathway with anti-inflammatory activity. · BMC complementary and alternative medicine
25.PMID: 37231361 (2023) — Construction of the first high-density genetic linkage map and QTL mapping of flavonoid and leaf-size related traits in Epimedium. · BMC plant biology
26.PMID: 25936868 (2015) — Chemotypic and genetic diversity in Epimedium sagittatum from different geographical regions of China. · Phytochemistry
27.PMID: 33691203 (2021) — Comparative analysis of chemical components in different parts of Epimedium Herb. · Journal of pharmaceutical and biomedical analysis
28.PMID: 35287533 (2023) — Sub-chronic toxicity of an aqueous extract of Epimedium sagittatum (Sieb. Et Zucc.) Maxim. in rats. · Drug and chemical toxicology
29.PMID: 26388888 (2015) — Elucidating the biosynthetic and regulatory mechanisms of flavonoid-derived bioactive components in Epimedium sagittatum. · Frontiers in plant science
30.PMID: 41380862 (2026) — Mechanistic study of PDE5A inhibitors from the prepared folium of Epimedium sagittatum maxim. · Journal of structural biology