Cinidium

Other Names

Athamanta daucifolia HostAthamanta daucifolia Lag.Cicuta monnieri (L.) CrantzCicuta sinensis ZuccagniCnidii FructusCnidii Monnieri FructusCnidii RhizomaCnidium confertum MoenchCnidium formosanum Y.YabeCnidium FruitCnidium microcarpum TurczaninowCnidium mongolicum H.WolffCnidium monnieri (L.) CussonCnidium monnieri (L.) Cusson ex Juss.Cnidium monnieri var. formosanum (Y.Yabe) Kitag.Cnidium monnieri var. monnieriCnidium officinale MakinoCnidium seedConioselinum officinaleExtrait de CnidiumExtrait de Fruit de CnidiumFruit de CnidiumGraines de CnidiumJashoshiLigusticopsis mongolica (H.Wolff) LeuteLigusticum mongolicum (H.Wolff) LeuteLigusticum monnieri (L.) Calest.Ligusticum monnieri (L.) CalestaniMonnier's CnidiumMonnier's SnowparsleyPinasgelon monnieri (L.) Raf.SasangiaSelinum densiflorum Salisb.Selinum monnieri L.Seseli daucifolium C.B.ClarkeSeseli daucifolium Lag.She ChuangShe Chuang DzeShe Chuang ZiShechuangziXa sang tu蛇床子

Synopsis

Cnidium (Cnidium monnieri): A Comprehensive Reference

1. Identity and Botanical Overview

Scientific Classification and Nomenclature

Cnidium monnieri (L.) Cuss. is the accepted botanical name for the plant commonly known in the supplement and natural-products trade as Cinidium (an alternate commercial spelling of Cnidium). Its common English name is Monnier's snowparsley. The species was first described and validly published by Carl Linnaeus, but it was Pierre Cusson who reclassified it into today's valid botanical systematics in 1787.

Cnidium monnieri is a species in the genus Cnidium, which contains approximately 11 to 35 species and belongs to the family Apiaceae (the carrot family). The dried, ripe fruit — referred to in pharmacopeial and TCM literature as Cnidii Fructus or Fructus Cnidii — is the primary medicinal part. It is also known as Shechuangzi (Pinyin) in Chinese, and is usually harvested in summer and autumn when the fruits are ripe.

The plant is a traditional Chinese herbal medicine widely grown and used in Asia. It is also known as "She chuang zi" (蛇床子) in China, "Jashoshi" in Japan, "Sasangia" in Korea, and "Xa sang tu" in Vietnam.

Botanical Description and Distribution

Cnidium monnieri is an annual plant producing a single, usually erect stem from a thin taproot; the plant usually grows 10–60 cm tall, occasionally to 80 cm. It is characterized by pinnately divided leaves, compound umbel inflorescences with white flowers, and small schizocarps — typical diagnostic features within the Apiaceae family.

The plant grows in most parts of mainland China and is also found in Russia, Korea, Vietnam, North America, and some European countries. It is native to China but has also been found in the US in Oregon.

Common Forms and Preparations

The fruit, seed, and other plant parts are used as medicine. In commerce and in traditional practice, the ingredient appears in several forms:

Dried whole fruit / seed powder: The traditional whole-seed decoction or powdered form for internal use.
Standardized extract: Concentrated extracts often standardized to a defined percentage of osthole, the principal coumarin.
Topical preparations: Cnidium has been used in TCM for thousands of years, often for skin conditions, and is a common ingredient in Chinese lotions, creams, and ointments.
Decoction / topical wash: Whole powder is traditionally boiled into a strong decoction and applied as a wash or sitz bath.

The ingredient appears in trade literature under numerous synonyms, including Cnidii Monnieri Fructus, Cnidii Rhizoma, Cnidium Fruit Extract, Monnier's Snowparsley, Selinum monnieri, She Chuang, and She Chuang Zi.

2. Traditional and Historical Use

China

Cnidium monnieri history in medicinal practice begins with the Shen Nong Ben Cao Jing, the foundational text of Chinese herbal medicine compiled over 2,000 years ago, and She Chuang Zi has remained a staple in TCM formulas for centuries. It was recognized as a "top-quality" herb in that foundational document.

In ancient herbal books, Cnidii Fructus was recorded as an herb that functions in tonifying kidney fires (enhancing the physiological function of the kidney) and dispelling rheumatism. In the TCM paradigm, C. monnieri warms the kidneys, strengthens yang, reduces dampness, and dispels wind — meaning it replenishes yang qi in the kidneys and removes the dampness and wind pathogenic qi that causes diseases in the human body.

Ancient Chinese texts document its use as a natural aphrodisiac, remedying male and female sexual dysfunction, and tonifying the kidneys — a key concept in TCM associated with vitality and reproductive health. Applications regarding aphrodisiac use tend to focus on male impotence, while female applications range from broad TCM diagnoses such as a "cold uterus," to vulvar pain and itching, to menopausal tonics.

C. monnieri, a traditional Chinese native medicine, has been frequently used in China for over 2,000 years to treat eczema and pruritus, and its ethanol extract from the fructus has shown inhibitory effects on atopic dermatitis, attributed to its coumarin compounds.

Japan, Korea, and Vietnam

Its fruits have been used to treat a variety of diseases in China, Vietnam, and Japan. Known as She Chuang Zi or Monnier's Snowparsley, it is native to regions including China, Korea, and Mongolia; its seeds and fruits have been a part of traditional Chinese medicine and traditional Korean medicine for thousands of years, valued for various properties. In Japan, the dried fruit is known as Jashoshi and is one of the most frequently used classic remedies for treatment of osteopenia and bone fractures.

Preparations in Traditional Practice

Traditional preparations include oral decoctions, topical washes, and, in some traditions, fumigation of affected skin areas. It was frequently prescribed as a remedy for conditions such as impotence, infertility, and low libido owing to its purported ability to promote blood circulation and stimulate sexual function; additionally, it was applied topically to alleviate skin issues like eczema, itching, and fungal infections, taking advantage of its natural anti-inflammatory and antimicrobial properties.

3. Phytochemistry: Key Constituents and Active Compounds

Overall Chemical Complexity

Cnidium monnieri contains 429 chemical constituents, including coumarins, volatile constituents, liposoluble compounds, chromones, monoterpenoid glucosides, terpenoids, glycosides, and glucides. Of these, coumarins are the best-characterized pharmacologically active class.

Coumarins — Primary Active Class

Coumarins are the major chemical compounds in C. monnieri, among which osthole is the dominant bioactive constituent, with antitumor, anti-inflammatory, neuroprotective, osteogenic, cardiovascular protective, antimicrobial, and antiparasitic activities.

According to a comprehensive review, 364 components have been identified, which mainly include coumarins such as osthole, imperatorin, bergapten, isopimpinellin, xanthotoxol, xanthotoxin, cnidimonal, cnidimarin, and glucosides.

Osthole — The Principal Compound

Osthole, chemically 7-methoxy-8-(3-methyl-2-butenyl)-2H-1-benzopyran-2-one, is a natural product found in several medicinal plants, most prominently Cnidium monnieri and Angelica pubescens. Hydrated berries of Cnidii have concentrations around 1.67–2.88% osthole. Osthole is commonly seen as the primary active ingredient due to it being the most prominent coumarin derivative in Cnidium monnieri.

Furanocoumarins and Other Coumarins

Eight nematicidal coumarins have been isolated and identified from C. monnieri fruits, including osthol (osthole), xanthotoxin, cindimine, isopimpinellin, marmesin, isoimperatorin, imperatorin, and bergapten. Bergapten and xanthotoxin belong to the furanocoumarin subclass, which carries photosensitizing properties (discussed under Safety).

Volatile Compounds

The main active components in C. monnieri are coumarins (mainly osthole) and volatile compounds, exhibiting multiple pharmacological effects including anti-inflammatory, antibacterial, antioxidant, anti-tumor, and immune-regulating effects.

4. Established and Proposed Mechanisms of Action

PDE5 Inhibition and Nitric Oxide Modulation

Osthole has been demonstrated to increase smooth muscle relaxation by releasing nitric oxide (NO) from the endothelium or inhibiting phosphodiesterase-5 (PDE5). An assessment of osthole on the relaxation of rabbit corpus cavernosum tissue in vitro showed that osthole relaxed the smooth muscle of the corpus cavernosum; tetrodotoxin did not alter this relaxation, indicating the effect was not nerve-mediated but rather through vascular endothelial mechanisms, with the main mechanism being increased NO release from endothelial blood vessels.

Virtual screening analysis of bioactive compounds from Cnidium monnieri against PDE-5 identified eight potent antagonists, among which Monnieriside A possesses the best binding affinity comparable with sildenafil (the standard ligand). This research is computational (in silico) only and has not yet been confirmed in clinical trials.

Anti-inflammatory Pathways

The in vitro and in vivo anti-inflammatory effect of osthole operates via the blocking of the activation of the NF-κB and MAPK/p38 pathways. Results from carrageenan-induced hind paw edema in rats suggested that osthole suppressed production of prostaglandin, nitric oxide, and malondialdehyde, as well as downregulated activity of NOS.

Osteogenic and Anti-resorptive Mechanisms

Mechanistically, osthole promotes osteogenic differentiation by activating the Wnt/β-catenin and BMP-2/Smad1/5/8 signaling pathways and suppresses RANKL-induced osteoclastogenesis and osteoclast activity. At the molecular level, osthole can regulate the JNK pathway by inhibiting the expression of related proteins to stimulate osteoclast apoptosis and restrain bone resorption.

Anticancer Mechanisms

Recent studies have elucidated that osthole's anticancer mechanism of action mainly involves inhibiting cancer cell proliferation, inducing cancer cell apoptosis, inhibiting invasion and migration of cancer cells, inhibiting cancer angiogenesis, increasing sensitivity to chemotherapy drugs, and reversing multidrug resistance of cancer cells.

Neuroprotective Mechanisms

Learning and memory impairment was ameliorated by osthole (12.5 and 25 mg/kg) after cerebral ischemia-reperfusion injury in animal models; osthole lifted hippocampal long-term potentiation level in model rats via attenuating glutamic acid and γ-aminobutyric acid levels.

Androgenic Effects

Osthole has also been reported to raise serum testosterone levels and the expression of androgens in reproductive-decline rat testes. This finding is from animal models and has not been verified in human clinical trials.

Pharmacokinetics

In vitro and in vivo experimental results have revealed that osthole demonstrates multiple pharmacological actions, and pharmacokinetic studies showed osthole uptake and utilization are fast and efficient in the body.

5. Scientific Evidence by Area of Use

Important note on evidence quality: The overwhelming majority of mechanistic and pharmacological evidence for Cnidium monnieri and its principal compound osthole derives from in vitro (cell culture) and in vivo (animal model) studies. Robust, well-controlled human clinical trials are generally lacking, and this is stated plainly throughout each section below.

5.1 Sexual Function / Erectile Dysfunction

Traditional claim: C. monnieri has been used for a long time according to traditional experience and documentation in order to treat male sexual disorders.

Preclinical (animal) evidence: A study published in Clinical Phytoscience (Springer, 2020) evaluated the effect of Cnidium monnieri fruit extract (with 35% osthole content, determined by HPLC) on sexual behaviors in adult male rats; the extract was administered orally at 150 mg/kg body weight, and after 30 minutes male rats were coupled with receptive adult female rats to evaluate sexual behaviors including mounting and intromission. The study found improvements in these parameters, but — as an animal study — does not constitute clinical evidence in humans.

Computational (in silico) evidence: A computational study predicted the inhibitory efficacy of eight bioactive compounds from C. monnieri against PDE-5 using molecular docking models, and MD simulation revealed better stability of the Monnieriside A-PDE-5 complex compared with the Sildenafil-PDE-5 complex.

Evidence strength: Preliminary. Mechanistic plausibility (PDE5 inhibition, NO release) is supported by in vitro and animal work. No peer-reviewed human randomized controlled trials (RCTs) investigating Cnidium monnieri specifically for erectile dysfunction in men have been identified in the published literature.

5.2 Bone Health and Osteoporosis

Preclinical evidence: Experiments conducted in vitro and in vivo have shown that osthole inhibits bone resorption, promotes bone formation, and increases bone mass. Total coumarins extract from C. monnieri fruit was reported to be effective for prevention of bone loss in both ovariectomy and glucocorticoid-induced osteoporosis rat models, and osthole was suggested to be as effective as 17β-estradiol in suppressing bone loss in ovariectomized (OVX) rats.

Osthole treatment promoted osteogenesis in osteoblasts by enhancing alkaline phosphatase activity and mineralization, and upregulated osterix expression and promoted bone regeneration during mice femoral fracture repair.

Systematic review and meta-analysis (animal studies): A meta-analysis evaluated the effects of osthole on osteoporotic rats, searching Chinese and English language databases from their establishment to February 2021, to provide a basis for future clinical studies. Recent studies showed osthole had a good effect on osteoporosis, but there was no comprehensive analysis until that point.

Clinical evidence: Cnidii Fructus has been tested in clinical trials of traditional Chinese medicine for the management of osteoporosis, and accumulating preclinical studies indicate that it may be used against osteoporosis. However, the clinical data base remains limited, and the authors of the ScienceDirect review (2024) note the need for further well-designed human trials.

Evidence strength: Moderate for preclinical (animal and in vitro) effects on bone formation and resorption. Weak-to-preliminary for human clinical outcomes; current human trial data are sparse and largely based on TCM compound formulas, making it difficult to isolate effects attributable to Cnidium monnieri alone.

5.3 Dermatological Conditions (Eczema, Pruritus, Fungal Infections)

Antipruritic and anti-allergic effects: Coumarin compounds from C. monnieri have been confirmed to exert beneficial effects on allergic asthma and contact dermatitis. Ethyl acetate extracts rich in osthole alleviate atopic dermatitis in animal models by reducing scratching behavior, epidermal thickness, mast cell infiltration, and levels of the inflammatory cytokines TSLP and IL-31.

Antifungal evidence: In vitro studies demonstrated antifungal activity of Cnidium monnieri aqueous extract against Trichophyton rubrum — the dermatophyte responsible for ringworm (tinea corporis). Documented antifungal activity against multiple Malassezia species responsible for pityrosporum folliculitis, seborrheic dermatitis, and tinea infections has also been reported.

Evidence strength: In vitro and animal studies indicate that extracts of Cnidium exhibit certain antifungal and antibacterial activity that could theoretically be beneficial for skin infections; however, robust clinical trials in humans are lacking, and most of the available evidence comes from traditional use and preliminary laboratory research rather than high-quality clinical data.

5.4 Anticancer Activity

In vitro and in vivo evidence: C. monnieri possesses multi-aspect and comprehensive anti-tumor functions, involving directly tumor-inhibitory activity, anti-mutagenicity, reversing multi-drug tolerance of tumor, as well as improving immune functions. Osthole has been shown to have antiproliferative, anti-invasion, antimigration, antiangiogenetic, anti-multidrug-resistance, chemosensitizing, and proapoptotic effects.

A group of investigators determined the anticancer properties of osthole on Y79 cells, finding it inhibited cell viability by decreasing PI3K, Akt, and mammalian target of rapamycin (mTOR). In a network pharmacology study, 19 active phytochemicals in Cnidium monnieri, 532 potential targets, and 566 HCC-related genes were identified; GO enrichment results indicated that Cnidium monnieri might affect gene targets involved in multiple biological processes, including protein phosphorylation and negative regulation of the apoptotic process, attributed to its anti-HCC effects.

Xanthotoxol: Xanthotoxol (XTL), a furocoumarin from Cnidium monnieri, has significant anticancer activity against lung, skin, blood, and thyroid cancers in cell-line research; it induces apoptosis by activating pro-apoptotic factors like caspase 3, 7, 8, 9, and Bax while inhibiting proliferation, colony formation, DNA replication, migration, and invasion. However, most studies are limited to in vitro experiments, lacking in vivo and clinical evaluations.

Evidence strength: All anticancer evidence to date is in vitro or from animal models/network pharmacology. No human clinical trials of Cnidium or osthole as a cancer treatment have been identified. This area remains at the stage of laboratory investigation only.

5.5 Neuroprotection and Cognitive Function

In vitro and in vivo experimental results have revealed that osthole demonstrates neuroprotective pharmacological actions. By inhibiting IL-8 and IL-1β, osthole can reduce the infiltration of neutrophils in brain tissue and local tissue inflammation; at 5 and 10 mg/kg it inhibited inducible nitric oxide synthase vitality and NO level in animal models of neuronal injury.

Evidence strength: Preclinical only (animal and cell culture). No human clinical data are available for neuroprotection or cognitive enhancement.

5.6 Cardiovascular Effects

Osthole inhibited the elevation of systolic blood pressure in stroke-prone spontaneously hypertensive rats, and also induced a remarkable increase in hepatic 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase mRNA expression, which induced decreased cholesterol in the liver. For imperatorin, after 10 weeks of intervention (6.25, 12.5, and 25 mg/kg per day), the middle- and high-dose groups demonstrated a significant reduction of mean blood pressure in renal-induced hypertension rat models, and kidney function parameters were also improved.

Evidence strength: Animal models only. No human clinical data on cardiovascular outcomes have been published for this ingredient.

5.7 Sedative and Hypnotic Activity

One study showed that the incubation period of each group of Cnidium was not significantly different from that of diazepam — meaning it could induce sleep rapidly and significantly prolong the duration of sleep — and the hangover response and tolerance in adverse reactions were weaker than those of diazepam. Another study showed the hypnotic active component of C. monnieri (130–520 mg/kg) exerted a hypnotic effect on animal models but had no influence on the animals' learning and memory functions.

Evidence strength: Animal models only. No human data.

5.8 Antimicrobial Activity

Cytotoxic studies revealed significant protective behavior of C. monnieri extract, and the selected herb was found to have antibacterial and antifungal activities. The main active components exhibit antibacterial and antioxidant pharmacological effects.

Evidence strength: In vitro only. No clinical trials of Cnidium as an antimicrobial agent in humans have been published.

6. Body Systems Associated with Cnidium

Reproductive / urogenital system: Male erectile function, libido; female vulvar health, reproductive tonification.
Integumentary system (skin): Eczema, contact dermatitis, pruritus, ringworm, seborrheic dermatitis.
Musculoskeletal system: Bone density maintenance, osteoporosis prevention, fracture healing.
Cardiovascular system: Blood pressure modulation, vasodilation, nitric oxide signaling.
Central nervous system: Neuroprotection (ischemia models), sedation/hypnosis.
Immune system: Anti-inflammatory, anti-allergic, antipruritic.
Oncology (investigational): Antiproliferative and pro-apoptotic effects in cancer cell lines.

7. Dosage Forms and Dosages Reported in Studies

There is not enough scientific information at this time to determine an appropriate range of doses for cnidium from a clinical evidence perspective.

The following dosages appear in the published sources consulted:

Animal study (sexual behavior): Fruit extract was administered orally at the dose of 150 mg/kg body weight in rats.
Animal study (neuroprotection): Osthole at 12.5 and 25 mg/kg ameliorated learning and memory impairment after cerebral ischemia-reperfusion injury.
Animal study (fracture healing): Adult mice were administered orally with 20 mg/kg osthole and vehicle solvent daily from week 1 post-operation.
Animal study (blood pressure): For imperatorin, after 10 weeks of intervention at 6.25, 12.5, and 25 mg/kg per day, significant reductions of mean blood pressure were observed.
Osthole concentration in fruit: Hydrated berries of Cnidii have concentrations around 1.67–2.88% osthole.

No standardized human clinical dosage has been established through controlled trials for any indication. Traditional Chinese medicine practice does not translate directly to milligram-equivalent Western supplement dosing without clinical validation.

8. Safety Considerations and Drug Interactions

General Safety Profile

When taken by mouth, there is not enough reliable information to know if cnidium is definitively safe; it might cause side effects such as a bitter mouth, stomach discomfort, and drowsiness. According to its traditional properties, Cnidium monnieri is described as acrid, bitter, warm, and slightly toxic.

Photosensitivity

The furocoumarin constituents may induce photosensitivity, increasing the risk of skin reactions upon exposure to sunlight, particularly at higher doses. Specifically, this product contains naturally occurring xanthotoxin (also known as methoxsalen), a furanocoumarin found in the Apiaceae family; xanthotoxin is photosensitizing, and while it contributes to the herb's traditional topical activity, it also requires responsible sun exposure management.

Anticoagulant and Bleeding Risk

Cnidium might slow blood clotting and could cause extra bleeding during and after surgery. Individuals with bleeding disorders should avoid it, as its antiplatelet activity may exacerbate bleeding tendencies; concurrent use with anticoagulant medications such as warfarin or aspirin is not recommended due to increased risk of bruising and hemorrhage.

Potential Interaction with PDE5 Inhibitors

Caution is advised with concurrent use of phosphodiesterase-5 (PDE5) inhibitors like sildenafil, as Cnidium monnieri's PDE5 inhibitory effects may potentiate hypotension or other cardiovascular side effects.

Hepatic and Renal Considerations

Preclinical studies suggest potential hepatotoxicity and nephrotoxicity at higher doses, including elevated liver enzymes and renal function markers in animal models. High doses of coumarins over extended periods may stress the liver.

Pregnancy and Breastfeeding

There is not enough reliable information to know if cnidium is safe to use when pregnant or breastfeeding; it is advisable to avoid use in these periods.

Adulteration Risk

Adulteration risks exist, particularly substitution with morphologically similar species from the Apiaceae family, which can compromise efficacy and introduce contaminants; authentication often relies on macroscopic, microscopic, and chemical analyses to mitigate these issues in commercial products.

Traditional Contraindications

Contraindications in traditional practice include avoiding use during pregnancy and breastfeeding, and TCM texts caution against combining Cnidium monnieri with croton seed, peony root, or fritillaria.

9. Regulatory Status and Nomenclature Notes

The spelling "Cinidium" used in commercial supplement labeling is a variant rendering of the genus name Cnidium. In all scientific and pharmacopeial literature, the correct genus and species name is Cnidium monnieri (L.) Cusson (family Apiaceae, formerly Umbelliferae). It is an annual plant of the Umbelliferae species and one of the most widely used traditional herbal medicines, with its fruits used to treat a variety of diseases in China, Vietnam, and Japan.

Globally, Cnidium monnieri is predominantly exported from China as dried ripe fruits, with production centered in regions like Sichuan and Gansu; in the European Union, it is not authorized as a novel food ingredient due to limited regulatory review.

References

Health Conditions

Health conditions that Cinidium may help support.

No conditions available.

Body Systems

Body systems that Cinidium may help support.

No body systems available.