IngredientsDidymocarpus (from Ancient Greek dÃdumos, meaning "twin," and karpós, meaning "fruit") is a genus of flowering plants in the family Gesneriaceae, typical of the tribe Didymocarpeae. The family Gesneriaceae (the African Violet family) consists of approximately 150 genera and around 3,400 species, mainly tropical herbs and shrubs. The genus Didymocarpus comprises over 100 species, widely distributed from the Himalayas to the Malay Peninsula.
There are about 100 known species distributed in India, Nepal, Bhutan, Myanmar, southern China, Vietnam, Laos, Cambodia, Thailand, and the Malay Peninsula, with one species extending up to northern Sumatra. The members of the genus are typically small perennial, deciduous herbs with annual flowering stems.
Among the many species, Didymocarpus pedicellatus R. Br. is the most popular, widely utilized, and highly investigated species in the genus, despite the relatively high number of other species within the genus that are more or less underexplored. The accepted scientific name, as recorded in the Plants of the World Online (Kew Science) database, is Didymocarpus pedicellatus R. Br., first published in Bennett & Brown, Pl. Jav. Rar.: 118 (1840). The native range of this species is the Himalaya.
A botanical synonym recognized in the literature is Roettlera pedicellata (R. Br.) Kuntze (Revisio Generum Plantarum 2: 476, 1891). In Ayurvedic practice, the plant carries several Sanskrit designations: Didymocarpus pedicellata is popularly known as "stone flower." In Ayurveda it is known as shilapushpa, shantapushpi, and sometimes pasanbheda. It is highly valuable, though a lesser-known medicinal plant, and popularly known as "stone flower." Pashanbheda is an Ayurvedic drug used in the treatment of urinary calculi, polyuria, dysuria, fever, piles, dysentery, and uterine disorders. It is also referred to in common vernacular as charela, pathar phori, and in Unani medicine as pathar phori. A closely related and medicinally comparable species is Didymocarpus albicalyx C. B. Clarke, which occurs in the sub-tropical western Himalayas from Chamba to Kumaon at altitudes of 2,500–5,500 ft; the dry leaves have a characteristic spicy odour and are used in indigenous medicine as a cure for stones in the kidney and bladder.
Didymocarpus pedicellata is a small herb with a reduced stem, bearing 2–3 pairs of opposite, roundly ovate, glabrous, glandular-punctate leaves, 3–6 inches in diameter. It is an annual herb growing on rocky surfaces in shady and moist localities of the temperate zone. Didymocarpous pedicellata R. Br. (Gesneriaceae), also known as stone flower, is a valuable medicinal plant growing in the subtropical Himalayas (India). The native range of this species is the Himalaya, and it grows primarily in the wet tropical biome.
The taxonomic distribution of D. pedicellatus is recorded for northwest and northeast India and Nepal. Didymocarpous pedicellata is an endangered important medicinal plant and a major ingredient in several commercial lithotriptic formulations. The endangerment status is attributed, in part, to overexploitation from wild harvesting to supply pharmaceutical manufacturing.
The genus Didymocarpus has been used in traditional medicine as single herbs or in polyherbal formulations to treat renal diseases, chronic wounds, traumatic injuries, dysentery, chronic asthma, and others. Common preparations include:
Didymocarpus pedicellata, also known as stone flower, is a traditional medicinal plant extensively used in Ayurveda for treating renal diseases, particularly kidney stones. The Sanskrit Ayurvedic category pashanbheda (literally, "stone-breaker" or "stone-splitting") encompasses multiple plant species collected and used interchangeably across different regions of India, and D. pedicellata is one of the principal botanical sources assigned to this category in the Himalayan region. In Ayurveda, pasanbheda is a drug of controversial origin, and further work on proper botanical identification of pasanbheda has been warranted by researchers.
Traditionally, Didymocarpus pedicellata is used in the treatment of renal diseases, particularly kidney stones. According to a hypothesis, the plant is supposed to regulate calcium absorption in the body. The plant is also known for its diuretic effect and in maintaining healthy urinary function.
Seventeen Didymocarpus species have documented applications in traditional medicine in different Asian countries. Species in the genus Didymocarpus are traditionally used for the treatment of various diseases, including kidney stones, fever, skin allergy, inflammation, chronic asthma, flu, wounds, dysentery, diarrhea, urticaria, psoriasis, bone fracture, and traumatic injuries.
Some species have applications as weight loss agents, laxatives, and protective medication after childbirth. Didymocarpus pedicellata R. Br. (Gesneriaceae) is a small herb growing in the subtropical Himalayas, and it is used to treat kidney diseases, diabetes, diarrhoea, chest pain, cough, epilepsy, heart diseases, stomachache, splenitis, syphilis, wound, and ulcer in traditional systems of herbal medicine.
The herb has been cherished for centuries in Ayurveda and other indigenous healing systems, primarily for its potential to support renal and urinary health. Healers have long used the leaves and aerial parts of this plant in remedies designed to alleviate kidney stones, urinary tract infections, and inflammation of the urinary system. Decoctions and extracts were often administered to promote diuresis, thereby aiding the natural elimination of toxins and preventing the recurrence of calculi (kidney stones).
It is traditionally used for treating kidney and bladder stones and is the main ingredient of herbal formulations used to treat kidney stones, such as Cystone and Safoof-e-Pathr Phori (SPP). The Unani Pharmacopoeia of India includes Safoof-e-Pathar Phori as a polyherbal formulation with documented antiurolithiatic indication.
Different botanical sources used in the name of pashanbheda in different parts of the country include Aerva lanata, A. persica (both of family Amaranthaceae), Ammania baccifera (Lythraceae), Bauhinia racemosa (Caesalpiniaceae), and Berginia ciliata, among others. This botanical heterogeneity complicates the attribution of therapeutic activity to any single species and is noted as a limitation in interpreting the ethnobotanical record.
A total of 166 compounds have been isolated from the genus Didymocarpus, including terpenoids, flavonoids, phenolic compounds, fatty acids, chalcones, steroids, and others. Among these constituents, terpenoids, flavonoids, chalcones, and phenolics are the significant contributors to pharmacological activities of the genus Didymocarpus, possessing wide-reaching biological activities both in vivo and in vitro.
Thirteen chalcones have been identified from the genus Didymocarpus. The most prominent and earliest isolated chalcone is pashanone, isolated from the roots of D. pedicellata (Agarwal, Bhaskar & Seshadri, 1973). A previous study reported the antifungal potential of the chalcone pashanone, due to its inhibitory action against several human pathogenic fungi with minimum inhibitory concentration values as low as 4.0 μg/mL. An additional chalcone, isodidymyocarpin, was isolated by Bose and Chaudhary (1978). Chalcone compounds isolated from D. pedicellata have been shown to inhibit α-glucosidase, indicating relevance to glycaemic modulation. Flavokawin B has also been reported to possess a significant antinociception effect against both chemical and thermal models of pain in mice, exhibiting peripheral and central analgesic activity.
Didymyocarpin is a flavanone isolated from D. pedicellata (Bose & Chaudhary, 1978). Subsequent structural revision confirmed its identity as 7-hydroxy-5,6,8-trimethoxyflavone (Garg, Gupta & Sharma, 1979). A new flavone, pediflavone, was isolated from the immature leaves and identified as 5,8-dihydroxy-7-methoxyflavone. Another chalcone and flavone combination was reported by Rathore, Garg, and Gupta (1981).
A dicarboxylic acid known as pedicellic acid (Rao et al., 1966) is considered to be the active principle of Didymocarpus pedicellata extracts. This compound is also valued for anticancer activity.
The essential oil of D. pedicellata contains the main compound didymocarpene (Singh, Sinha & Pathak, 1978), and the essential oil has demonstrated antimicrobial activity. In an analysis of the essential oil via hydrodistillation, a total of thirty-five compounds were identified, constituting 94.86% of the total oil.
The chemical composition of Didymocarpous pedicellata comprises chalcones, flavones, didymocarpene, aromatic monoterpenic esters, and new fatty acids. Polyphenolic compounds, including phenolic acids and tannins, are present and have been linked to the plant's antioxidant and nephroprotective properties. The extract of D. pedicellata was found to possess a high content of total polyphenolics, exhibit potent reducing power, and significantly scavenge free radicals including several reactive oxygen species (ROS) and reactive nitrogen species (RNS).
The most extensively studied pharmacological property of D. pedicellata is its antiurolithiatic (anti-kidney stone) activity. Traditionally, Didymocarpus pedicellata is used in the treatment of renal diseases, particularly kidney stones. According to one hypothesis, the plant is supposed to regulate calcium absorption in the body.
Animal model evidence: One study explored the antiurolithiatic effect of Didymocarpous pedicellata leaves (DPL) in urolithiasis caused by ethylene glycol in Wistar male rats. The ethylene glycol-induced urolithiasis group exhibited significantly higher (P < 0.001) serum creatinine, blood urea nitrogen, tissue lipid peroxidation, and urinary calcium levels, and significantly lower (P < 0.001) urinary potassium and sodium levels than the standard control group. DPL treatment at doses of 200 and 300 mg/kg exhibited significantly (P < 0.001) lower urine and serum markers than toxicant rats.
Histological investigation demonstrated refractile crystals and extensive damage to proximal tubules causing dilation in ethylene glycol-induced urolithiasis rats. However, Didymocarpous pedicellata treatment of 300 mg/kg exhibited the absence of crystals and reduced kidney tissue damage, thus protecting against urolithiasis and nephrotoxicity. Therefore, DPL at 300 mg/kg is indicated as useful in the management of urolithiasis in this animal model.
Oxidative stress is a key driver of inflammatory injury that predisposes renal cells to nephrolithiatic damage. Recurrent stone formation is associated with cellular dysfunction, oxidative stress, inflammation, and renal epithelial cell death. Didymocarpus pedicellata is an important medicinal herb in the Ayurvedic system for the treatment of renal afflictions, and the phytochemicals present in D. pedicellata show potential in mitigating these series of cellular responses.
However, the antiurolithiatic effect of Didymocarpus pedicellata has not been proven clinically. All robust efficacy data are derived from in vitro assays and rodent (rat) models.
Ethanolic extract of the aerial parts of Didymocarpus pedicellata demonstrated significant antioxidant and protective activity against ferric nitriloacetate-induced renal oxidative stress, nephrotoxicity, and tumor promotion response. Further, the extract provided significant protection against ferric nitriloacetate-mediated damage to lipids and DNA in a dose-dependent manner.
The nephroprotective activity of the plant is attributed to its polyphenolic compounds. This study further supported the ancient use of the plant in the treatment of kidney diseases.
Ethanolic extract of the aerial parts of D. pedicellata has been found to possess significant antioxidant activity and to protect against ferric nitrilotriacetate (Fe-NTA)-mediated renal oxidative stress, nephrotoxicity, and tumor promotion response. The extract possesses a high content of total polyphenolics, exhibits potent reducing power, and significantly scavenges free radicals including several reactive oxygen species (ROS) and reactive nitrogen species (RNS). The extract also significantly and dose-dependently protected against Fe-NTA plus Hâ‚‚Oâ‚‚-mediated damage to lipids and DNA. Protective efficacy of the extract was also tested in vivo against Fe-NTA-mediated nephrotoxicity and tumor promotion response.
Evidence has been demonstrated for the antidiabetic effect of various extracts of Didymocarpus pedicellata as well as its chemical constituents, including various flavonoid-like chalcones, which are major bioactive constituents chiefly present in the plant. The chalcones present in this plant have various therapeutic targets for the management of type 2 diabetes, including PPARγ, DPP-4, α-glucosidase, PTP1B, and aldose reductase, and they stimulate insulin secretion and tissue sensitivity. This evidence is, however, preclinical (in vitro and animal studies); no human clinical trials for antidiabetic activity have been identified in the literature.
The essential oil of Didymocarpus pedicellata, the main compound of which is didymocarpene, has antimicrobial activity. The chalcone pashanone has been reported for its antifungal potential, showing inhibitory action against several human pathogenic fungi with minimum inhibitory concentration (MIC) values as low as 4.0 μg/mL. These findings are from in vitro studies only.
Spasmolytic (smooth muscle relaxant) activity of a hydroalcoholic extract of D. pedicellata and its chalcone was investigated in 1970 (Bertolini & Greggia, 1970). The Didymocarpus pedicellata plant has also been reported to exhibit antispasmolytic activity. This property may be relevant to its traditional use in relieving ureteral spasm and facilitating the passage of kidney stones.
Pedicellic acid is considered to be the active principle of Didymocarpus pedicellata extracts and is also valued for anticancer activity. The crude extracts and isolated phytochemical compounds from this genus have been shown to exhibit cytotoxic activities, though all evidence at this stage is in vitro or preclinical. No clinical evidence for anticancer benefit exists.
Antiurolithiatic, nephroprotective, antimicrobial, anticancer, antidiabetic, cytotoxicity, wound healing, and antioxidant activities exhibited by various extracts and compounds isolated from the genus Didymocarpus showed its pharmacological importance. Wound-healing effects have been demonstrated in preclinical studies; clinical evidence is absent.
Evidence level: Preclinical (animal and in vitro studies); very limited clinical data from polyherbal formulations only.
The most extensively investigated application of D. pedicellata is the prevention and treatment of urolithiasis, consistent with its traditional role as a "lithotriptic" (stone-dissolving) herb. The in vivo evidence in animal models demonstrates effects on reducing urinary oxalate crystal deposition and normalizing renal biomarkers.
A 2021 study published in the South African Journal of Botany (ScienceDirect) used an ethylene glycol and ammonium chloride-induced urolithiasis model in Wistar male rats. The study explored the antiurolithiatic effect of DPL in urolithiasis caused by ethylene glycol. The ethylene glycol-induced urolithiasis group exhibited significantly higher serum creatinine, blood urea nitrogen, tissue lipid peroxidation, and urinary calcium levels; DPL treatment at 200 and 300 mg/kg exhibited significantly lower urine and serum markers than toxicant rats.
A 2025 study published in Urolithiasis (Springer) examined bioactivity-guided fractionation, crystallization assays, phytochemical screening, and GC-MS analysis to assess secondary metabolites present in D. pedicellata. The cytoprotective potential of the extract was evaluated by assessing cell viability, reactive oxygen species (ROS) generation, analyzing cell death, and gene expression changes to determine the extent of damage caused by oxalate exposure.
For clinical evidence, D. pedicellata has been studied almost exclusively as a component of the polyherbal tablet Cystone, not as an isolated ingredient. Some in vitro and animal studies suggest possible antiurolithiatic and diuretic effects, but robust human clinical trials are lacking. Most published evidence comes from studies evaluating multi-herb formulations, making it difficult to attribute the effects specifically to Didymocarpus pedicellata.
A two-phase clinical study (6-week, randomized double-blinded; and one-year, open-label) was conducted using Cystone tablets in kidney stone patients. This study was carried out on 10 calcium-containing kidney stone patients and 10 cystine stone patients; patients received two tablets of Cystone twice a day, with each tablet containing Didymocarpus pedicellata 130 mg among other ingredients. There were no significant differences in urinary chemistries or stone burden in both calcium oxalate and cystine stone formers.
An observational follow-up study of Cystone in urolithiasis patients conducted at Madinah Teaching Hospital (Pakistan) reported: there was a significant decrease in stone size from an initial mean stone size of 1.57 ± 0.08 mm to an endpoint stone size of 0.69 ± 0.09 mm after treatment. One hundred and seven (64.84%) patients cleared the stone, 10 (6.06%) had their stone size reduced, 17 (10.3%) had stone size unchanged, and 31 (18.78%) had stone size increased. No significant adverse effects were noted during the study that required patients to stop treatment. This was an observational, uncontrolled study, limiting causal attribution.
A randomized, placebo-controlled double-blind trial of Cystone (of which D. pedicellata is the largest ingredient at 130 mg per tablet) was conducted at the Department of Urology, Safdarjung Hospital, New Delhi, India, between January 2008 and March 2009, in accordance with the ethical guidelines of Helsinki. The sample size of 52 (26 in each arm) was calculated to have a power to detect a 25% reduction with urinary stones at 95% confidence limit. Individual-ingredient attribution from this trial is not possible.
Overall assessment: The preclinical evidence from rodent models is reasonably consistent in demonstrating antiurolithiatic and nephroprotective effects. The clinical evidence from human trials is weak, confounded by the polyherbal nature of the tested formulations, and the studies published to date are small and limited in design quality.
Evidence level: Preclinical in vitro and animal studies only.
Ethanolic extract of the aerial parts of D. pedicellata has been found to possess significant antioxidant activity and to protect against Fe-NTA-mediated renal oxidative stress, nephrotoxicity, and tumor promotion response. The extract has a high content of total polyphenolics, exhibits potent reducing power, and significantly scavenges free radicals including various reactive oxygen and nitrogen species. All evidence supporting this activity is from in vitro assays or animal models; no human trials have been conducted.
Evidence level: Preclinical (in vitro, mechanism-based research); no human clinical trials identified.
Evidence has been demonstrated for the antidiabetic effect of various extracts of Didymocarpus pedicellata and its chemical constituents, including chalcones. The chalcones present in the plant have various therapeutic targets for the management of type 2 diabetes, including PPARγ, DPP-4, α-glucosidase, PTP1B, aldose reductase, and stimulate insulin secretion and tissue sensitivity. These remain mechanistic findings without clinical validation.
Evidence level: In vitro studies only.
Antimicrobial activity has been demonstrated in vitro for both the essential oil and isolated chalcones. The chalcone pashanone has been reported for its antifungal potential, showing inhibitory action against several human pathogenic fungi with MIC values as low as 4.0 μg/mL. No clinical antimicrobial trials have been conducted.
Evidence level: Early in vitro and in vivo preclinical data; no recent clinical studies.
Spasmolytic activity was first reported by Bertolini and Greggia (1970) for a hydroalcoholic extract and its isolated chalcone fraction. This finding supports the traditional use of the herb in managing ureteral colic, but no controlled clinical studies have followed.
Evidence level: Preliminary in vitro evidence only.
Pedicellic acid is considered to be the active principle of Didymocarpus pedicellata extracts and is valued for anticancer activity. All anticancer evidence is in vitro and/or mechanistic; no clinical trials have been conducted.
Based on the available literature, the following body systems and health areas are associated with Didymocarpus:
The following dosages appear in published scientific studies and are reproduced here exactly as reported:
No established human dosage for isolated D. pedicellata extract or powder (as a single ingredient) has been confirmed in peer-reviewed clinical literature.
Although substantial progress on the chemical and pharmacological properties of Didymocarpus species has been made, further studies on the pharmacology and toxicology of these species are needed to ensure safety, efficacy, and quality. Formal acute, subacute, or chronic toxicity studies conforming to current OECD guidelines for D. pedicellata in isolation have not been widely published; the available clinical use data relate primarily to the polyherbal Cystone formulation.
In an observational study of Cystone (containing 130 mg D. pedicellata per tablet) administered over four weeks, no significant adverse effects were noted during the study that required patients to stop treatment. Individual-component attribution of tolerability is not possible from these data.
A pharmacokinetic and pharmacodynamic interaction study was conducted in normal and diabetic rats: this study evaluated the possible interaction between the Ayurvedic antiurolithiatic agent hydroalcoholic extract of Didymocarpus pedicellata (HADP) leaves and gliclazide. Dose optimization was performed by measuring serum glucose levels after 200 mg/kg and 400 mg/kg HADP administration to normal rats. Pharmacokinetic interaction was studied in normal rats by administration of gliclazide alone and in combination with HADP at 400 mg/kg. Diabetes was induced by administration of streptozotocin (55 mg/kg), and animals were treated with gliclazide, HADP, and the combination for 28 days. Pharmacokinetic and pharmacodynamic interactions were assessed after single (day 1) and repeated dose (day 28) co-administration. Gliclazide showed biphasic concentration-time data and glucose reduction with maximum reduction at 2 and 8 hours post administration. The findings of this preclinical study suggest potential for a pharmacokinetic or pharmacodynamic interaction with the sulfonylurea class of antidiabetic drugs; the clinical significance of this in humans has not been established.
Further studies on the pharmacology and toxicology of Didymocarpus species are needed to ensure safety, efficacy, and quality. Further research on the structure-activity relationship of some of the isolated phytocompounds may improve their biological potency and scientific exploitation of traditional uses of the Didymocarpus taxa. No systematic reproductive toxicity, genotoxicity, or carcinogenicity data have been published for D. pedicellata as an isolated ingredient. No formal drug interaction studies in humans have been conducted.
Didymocarpous pedicellata is an endangered important medicinal plant and one of the major ingredients of several lithotriptic formulations in the Indian systems of medicine. Its endangered status raises supply-chain concerns for commercial preparations that rely on wild-harvested material.
Health conditions that Didymocarpus may help support.
Didymocarpus (Didymocarpus pedicellata) is a key ingredient in the Ayurvedic polyherbal formulation Cystone, used clinically for kidney stones and urinary tract disorders. Traditional texts and ethnobotanical surveys describe its use for urinary calculi, urinary inflammation, and diuretic support. Scientific validation comes primarily from in vitro, animal, and combination product studies; standalone human RCT data are absent.
Body systems that Didymocarpus may help support.
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