This product is not intended to diagnose, treat, cure, or prevent any disease. These statements have not been evaluated by the Food and Drug Administration.
This information is for educational purposes only and is not a substitute for professional medical advice, diagnosis, or treatment. Always consult your healthcare provider before using herbs, especially if you are pregnant, nursing, taking medications, or have a medical condition.
Ma Dou Ling contains aristolochic acid, which historically demonstrated anti-inflammatory and antitussive effects by inhibiting phospholipase A2 and reducing inflammatory mediators. However, this same compound causes severe nephrotoxicity by forming DNA adducts in renal tubular cells, leading to irreversible kidney damage and potential carcinogenesis. The herb also contains magnoflorine and allantoin, which may contribute mild anti-inflammatory effects. Due to the dangerous toxicity mechanism, this herb is now rarely used in clinical practice (Evidence Level: C).
Does Ma Dou Ling interact with any medications?
Ma Dou Ling poses significant interaction risks due to its nephrotoxic aristolochic acid content. Concurrent use with other nephrotoxic medications, including NSAIDs, aminoglycoside antibiotics, ACE inhibitors, and certain diuretics, may compound kidney damage. The herb should never be combined with drugs that affect renal function. Due to documented carcinogenicity and limited modern interaction studies, professional guidance is essential. This herb is contraindicated for patients taking any renal-affecting medications (Evidence Level: C/Traditional).
What is the safe dosage for Ma Dou Ling?
Due to documented aristolochic acid nephrotoxicity, there is no established safe dosage for self-administration of Ma Dou Ling. Traditional texts historically recommended 3-9 grams of processed herb, but modern practice strongly discourages unsupervised use. If prescribed by a qualified TCM practitioner, the herb undergoes special processing to reduce toxicity, and dosage is strictly individualized with renal function monitoring. This herb should only be used under professional supervision (Evidence Level: C/Traditional).
Is Ma Dou Ling safe to take during pregnancy?
Ma Dou Ling is absolutely contraindicated during pregnancy. The aristolochic acid content is teratogenic and can cause severe fetal developmental abnormalities. Additionally, the herb's nephrotoxic properties pose serious risks to both maternal and fetal kidney function. Traditional Chinese Medicine classifies this herb as pregnancy-contraindicated, and modern toxicological evidence strongly supports this restriction. Women who are pregnant, planning pregnancy, or breastfeeding must avoid all products containing Ma Dou Ling or any Aristolochia species (Evidence Level: C).
What are the serious side effects of Ma Dou Ling?
Ma Dou Ling carries severe, potentially irreversible side effects. The primary concern is aristolochic acid nephropathy, a progressive kidney disease that can lead to end-stage renal failure requiring dialysis or transplantation. Long-term exposure is strongly associated with urothelial carcinoma of the bladder and urinary tract. Acute symptoms may include nausea, vomiting, and abdominal discomfort. The kidney damage is often irreversible even after discontinuation. Many countries have banned Aristolochia-containing products due to these documented risks (Evidence Level: C).
What is Ma Dou Ling traditionally used for in TCM?
Historically, Ma Dou Ling was used in Traditional Chinese Medicine to clear lung heat, suppress cough, and treat hemorrhoids. It was prescribed for lung heat cough characterized by dry cough, sore throat, and yellow sputum. The herb was also applied externally for hemorrhoids and occasionally used for hypertension. However, since the discovery of aristolochic acid nephrotoxicity in the 1990s, modern TCM practitioners rarely prescribe this herb, and safer alternatives are now preferred for all traditional indications (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
Ma Dou Ling (Aristolochia contorta) is a traditional Chinese medicine material containing aristolochic acids, which are associated with significant nephrotoxicity and carcinogenicity [PMID:38892231, PMID:35147168].
Background
Aristolochia contorta Bunge, also known as Northern pipevine, is a perennial herbaceous vine occurring in East Asia [PMID:37810400, PMID:22567996]. It is a member of the Aristolochiaceae family and is used as a traditional Chinese medicine material [PMID:32089237, PMID:40362550].
Traditional uses
It has been used as a traditional Chinese medicine material [PMID:40362550, PMID:38892231].
Active compounds
The plant contains aristolochic acids (AAs) including AA-I, AA-II, AA-III, AA-IIIa, AA-IVa, and AA-VIIa [PMID:21322947, PMID:28558875]. Other identified compounds include aristololactams (e.g., aristololactam I, II, IIIa, and derivatives W-Y), aporphine alkaloids (e.g., corytuberine, glaziovine), biflavonoids (e.g., 3"-hydroxyamentoflavone), phenolic acids (syringic, vanillic, and p-coumaric acid), and various glycosides [PMID:29313366, PMID:38379355, PMID:16259130, PMID:21322947, PMID:1431939].
Mechanism of action
Aristolochic acids are linked to nephrotoxicity and carcinogenicity [PMID:35147168]. Specific interactions between certain aristolochic acid analogues and the target protein organic anionic transporter 1 (OAT1) have been evaluated as a key mediator of aristolochic acid nephropathy [PMID:33374869].
Safety & adverse effects
Ma Dou Ling is classified as a toxic traditional Chinese medicine [PMID:32089237]. It contains aristolochic acids (AAs) which are known to cause nephrotoxicity and carcinogenicity [PMID:35147168, PMID:38892231]. In vitro studies using human proximal tubular epithelial cells (HK-2) demonstrated that AA-I, 7-methoxy-aristololactam IV, and aristololactam IVa exhibit cytotoxic activity [PMID:16554666].
Evidence summary
The evidence is primarily based on pharmacological reviews and in vitro toxicological studies (Level C and D), highlighting severe renal toxicity and carcinogenicity associated with the plant's aristolochic acid content.
PubMed sources
1.PMID: 32089237 (2020) — Toxicity of traditional Chinese medicine herbal and mineral products. · Advances in pharmacology (San Diego, Calif.)
2.PMID: 37810400 (2023) — Mechanistic understanding of perianth traits hindering pollination in Aristolochia contorta Bunge. · Frontiers in plant science
3.PMID: 38379355 (2024) — Characterization of two CYP80 enzymes provides insights into aporphine alkaloid skeleton formation in Aristolochia contorta. · The Plant journal : for cell and molecular biology
4.PMID: 26670420 (2016) — Renal toxic ingredients and their toxicology from traditional Chinese medicine. · Expert opinion on drug metabolism & toxicology
5.PMID: 29313366 (2018) — Aristololactam derivatives from the fruits of Aristolochia contorta Bunge. · Natural product research
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.
6.PMID: 35147168 (2022) — Chromosome-level genome assembly of Aristolochia contorta provides insights into the biosynthesis of benzylisoquinoline alkaloids and aristolochic acids. · Horticulture research
7.PMID: 40362550 (2025) — Genome-Wide Identification and Functional Analysis of the Norcoclaurine Synthase Gene Family in Aristolochia contorta. · International journal of molecular sciences
8.PMID: 38892231 (2024) — Genome-Wide Identification and Characterization of miRNAs and Natural Antisense Transcripts Show the Complexity of Gene Regulatory Networks for Secondary Metabolism in Aristolochia contorta. · International journal of molecular sciences
9.PMID: 21322947 (2010) — [Chemical constituent from fruit of Aristolochia contorta]. · Zhongguo Zhong yao za zhi = Zhongguo zhongyao zazhi = China journal of Chinese materia medica
10.PMID: 28558875 (2017) — Characterization and quantitation of aristolochic acid analogs in different parts of Aristolochiae Fructus, using UHPLC-Q/TOF-MS and UHPLC-QqQ-MS. · Chinese journal of natural medicines
11.PMID: 33374869 (2020) — Two New Aristolochic Acid Analogues from the Roots of Aristolochia contorta with Significant Cytotoxic Activity. · Molecules (Basel, Switzerland)
12.PMID: 22567996 (2012) — [Genetic diversity of a rare species Aristolochia contorta bungae (aristolochiaceae) in Primorsky Krai]. · Genetika
13.PMID: 16554666 (2006) — Cytotoxicity of phenanthrenes extracted from Aristolochia contorta in human proximal tubular epithelial cell line. · Nephron. Experimental nephrology
14.PMID: 1431939 (1992) — A new acylated N-glycosyl lactam from Aristolochia contorta. · Journal of natural products
15.PMID: 16259130 (2005) — A new biflavonoid from Aristolochia contorta. · Die Pharmazie