Question 1

How does Keishi-bukuryo-gan work for blood stasis?

Accepted Answer

Keishi-bukuryo-gan works through multiple mechanisms to address blood stasis. Cinnamaldehyde from cinnamon improves microcirculation and produces antiplatelet effects. Paeoniflorin from peony root modulates blood flow and reduces inflammation. Pachymic acid from Poria supports fluid metabolism. Together, these compounds promote blood circulation in the lower abdomen, helping disperse stagnation. Traditional use and limited clinical evidence (Level C) support these mechanisms for gynecological conditions involving blood stasis patterns.

Question 2

Can I take Keishi-bukuryo-gan with blood thinners?

Accepted Answer

No, Keishi-bukuryo-gan should not be combined with anticoagulant or antiplatelet medications. The formula contains cinnamaldehyde and other compounds with blood-thinning properties that increase bleeding risk when taken with warfarin, aspirin, clopidogrel, or similar drugs. This interaction is well-documented in Kampo literature and poses serious health risks. Patients on blood thinners must avoid this formula entirely and should consult a qualified practitioner for safer alternatives.

Question 3

What is the typical dosage for Keishi-bukuryo-gan?

Accepted Answer

Standard Keishi-bukuryo-gan dosage varies by preparation. Commercial Kampo extracts typically provide 2.5-7.5 grams of dried extract daily, divided into 2-3 doses. Traditional decoctions use higher amounts of raw herbs. Dosage should be individualized based on the patient's condition, age, and constitution. This formula requires professional guidance—consult a qualified Kampo or TCM practitioner rather than self-prescribing to ensure appropriate dosing.

Question 4

Is Keishi-bukuryo-gan safe during pregnancy?

Accepted Answer

No, Keishi-bukuryo-gan is contraindicated during pregnancy. The formula stimulates uterine contractions and promotes blood circulation in the pelvic region, increasing miscarriage risk. Cinnamon bark and peach kernel are specifically contraindicated in pregnancy in both TCM and Kampo traditions. Pregnant women should avoid this formula entirely. Women trying to conceive should discontinue use immediately if pregnancy is suspected and consult their healthcare provider.

Question 5

What conditions is Keishi-bukuryo-gan used for?

Accepted Answer

Keishi-bukuryo-gan is primarily used for gynecological conditions involving blood stasis in TCM and Kampo medicine. Common applications include menstrual pain with clots, endometriosis, uterine fibroids, and pelvic congestion syndrome. It is one of the most frequently prescribed Kampo formulas in Japanese gynecology. The formula addresses lower abdominal pain, menstrual irregularities, and palpable masses. Evidence level C supports its traditional use, indicating benefits are suggested but more rigorous trials are needed.

Question 6

What are the side effects of Keishi-bukuryo-gan?

Accepted Answer

Common side effects include gastrointestinal upset, such as nausea or loose stools, primarily from peach kernel content. The formula's blood-thinning effects may cause increased bruising or prolonged bleeding from minor cuts. Uterine stimulation can occur, which is why it is unsafe during pregnancy. Some patients experience mild allergic reactions to cinnamon components. Side effects are generally mild when properly prescribed. Report any unusual symptoms to your practitioner promptly.

Keishi-bukuryo-gan

Sources & Citations

Summary

Background

Traditional uses

Mechanism of action

Clinical evidence

Safety & adverse effects

Drug interactions

Evidence summary

PubMed sources

Government sources