Pansit-pansitan

Pansit-pansitan (Peperomia pellucida (L.) Kunth)

1. Identity and Botanical Description

Scientific Classification and Nomenclature

Pansit-pansitan (Peperomia pellucida (L.) Kunth) is an annual, shallow-rooted herb, usually growing to a height of about 15 to 45 cm (6 to 18 inches), characterized by succulent stems, shiny, heart-shaped, fleshy leaves, and tiny, dot-like seeds attached to several fruiting spikes. It has a mustard-like odor when crushed, flowers year-round, and is found in various shaded, damp habitats all over Asia and the Americas, growing in clumps and thriving in loose, humid soils and a tropical to subtropical climate.

Peperomia pellucida (L.) Kunth belongs to the Piperaceae family and has long been used empirically as a traditional medicine by the communities of Indonesia, the Philippines, India, Nigeria, Brazil, and other countries. The genus Peperomia is the second genus with the highest biological and chemical diversity in the family Piperaceae, with a pantropical distribution that includes about 1,500–1,700 species. The species Peperomia pellucida is the most chemically studied Peperomia species due to its worldwide distribution and various applications in traditional medicine.

Common Names

The plant carries a large number of vernacular names across its pantropical range. In the different dialects of the Philippines, it is called pansit-pansitan or ulasimang-bato (Tagalog), olasiman ihalas (Bisaya), sinaw-sinaw or tangon-tangon (Bikol), lin-linnaaw (Ilocano), and clavo-clavo (Chavacano). Elsewhere it is known as pepper elder, silverbush, rat-ear, man-to-man, clearweed (North America); prenetaria (Puerto Rico); konsaka wiwiri (Suriname); coraçãozinho or "little heart," língua-de-sapo, erva-de-vidro, or erva-de-jabuti (Brazil); and ewe rinrin (Yoruba, Nigeria). In other parts of the world, it is known as pak-krasang (Thailand), càng cua (Vietnam), silverbush or rat ear (North America), kaca-kaca or surukan (Indonesia), and usuba sunakosho (Japan).

Natural Source and Habitat

Peperomia pellucida L. (Piperaceae) is a common annual weed native to tropical North and South America, and is now pantropic in distribution. It is a herbaceous plant that develops during the rainy season and thrives in humid soil under shady trees. The plant has been considered a weed by local farmers, particularly in oil palm plantations in Indonesia.

Common Preparations and Dosage Forms

The plant is used in several physical forms, both as food and as medicine. It has been used as a food item as well as a medicinal herb, and the entire plant is edible both cooked or raw. Medicinally, preparations include decoctions, aqueous extracts, infusions, and topical applications. The wine infusion or decoction of the whole plant is taken orally for gout and kidney problems and applied externally as a rinse against complexion problems. Warmed leaves are applied topically to sores and boils. Infusion and decoction of leaves and stems of fresh plant are eaten as salad for the treatment of gout and arthritis. Research-grade preparations have included spray-dried extracts, ethanol extracts, aqueous extracts, and isolated pure compounds. One Brazilian research group optimized the process of obtaining dried extracts of P. pellucida by spray drying, and subsequently developed capsules for antimicrobial treatment.

2. Traditional and Historical Use

Philippines

Peperomia pellucida, locally known as "ulasimang-bato" or "pansit-pansitan," has long been used in Philippine traditional medicine for its analgesic, anti-inflammatory, and anti-hyperuricemic properties. In the Philippines, the decoction of this plant is used to reduce uric acid levels and kidney disorders. In the Philippines, it is one of the 10 medicinal plants endorsed by the Department of Health. In the Philippines, it belongs to the "preferred list" of medicinal plants, being studied for its use in the treatment of arthritis and gout.

Indonesia

In Indonesian traditional medicine, P. pellucida is used in the treatment of wounds, boils, abscesses, pimples, abdominal pain, colic, gout, rheumatic pain, fatigue, kidney disease, furuncles, eye inflammation (conjunctivitis), dengue, and as an alternative antihypertensive medicine.

India and Ayurvedic Medicine

Peperomia pellucida is also used in traditional Ayurvedic medicine; it is described in Ayurveda as possessing specific qualities (Rasa – Katu and Madhur; Guna – Lakhu, rooksha, Teekshna; Virya – Ushna) and is described as able to pacify vitiated cough, pitta, constipation, kidney diseases, urinary retention, dysuria, urinary tract infections, emaciation, edema, and general weakness. The anti-inflammatory, antihemorrhagic, and wound healing properties of this plant have also been mentioned in Ayurveda records.

South and Central America

The plant has a long history of medicinal use in South America, and this use has spread with the plant to other countries in the tropics. In Bolivia, Alteños Indians use the whole plant to stop hemorrhages; the roots are used to treat fevers and the aerial parts are used as dressing for wounds. In northeastern Brazil, this herb is used for blood pressure and lowering cholesterol levels, and the plant is also used in religious activities. In Guyana and the Amazon, it acts as a cough medicine, emollient, and diuretic and can be used to treat proteinuria. In South America, the fresh juice of the stems and leaves can be used as a treatment for inflammation of the eyes.

Africa

In the western parts of Nigeria, it is used as a water extract in the treatment of high blood pressure, urinary tract infections, and insomnia. The plant is also traditionally used in Cameroon for bone fracture management, a use that has since been investigated in animal studies.

Bangladesh

In various areas of Bangladesh, the leaves of this plant are used by local people as a treatment for mental illness. Specifically, local people of Lakshmipur district in Bangladesh use leaves of Peperomia pellucida in the treatment of excited mental disorder.

Broader Ethnomedicinal Summary

P. pellucida has been used for treating abdominal pain, abscesses, acne, boils, colic, fatigue, gout, headache, renal disorders, and rheumatic joint pain across a variety of traditional medical systems. The plant is used ethnobotanically as medicine, food, and flavoring agent in various parts of the world.

3. Phytochemistry: Key Constituents and Active Compounds

General Phytochemical Classes

Phytochemical screening of P. pellucida has repeatedly demonstrated a rich and diverse secondary metabolite profile. Studies revealed the presence of saponins, tannins, flavonoids, essential oils, pellucidin, steroids, alkaloids, cardiac glycosides, inulins, phenolic compounds, resins, and carbohydrates. The methanolic extract indicated the presence of alkaloids, flavonoids, saponins, sterols, tannins, and triterpenoids.

Essential Oil Composition

Initial studies on the chemical composition of essential oil from leaves of P. pellucida revealed the presence of the phenylpropanoids dillapiole and apiol as major constituents, in addition to mono- and sesquiterpenes. The most predominant chemotype is characterized by the presence of dillapiole, with amounts ranging from 20.7–55.3%. The chemical composition of specimens collected in the Brazilian Amazon is marked by dillapiole (39.7–55.3%), β-caryophyllene (10.7–14.3%), and carotol (0–8.1%).

Key Isolated Compounds

Isolation studies have identified three phenylpropanoids and two lignan derivatives from P. pellucida, namely 6-allyl-5-methoxy-1,3-benzodioxol-4-ol, pachypostaudin B, pellucidin A, dillapiole, and apiol. Additional compounds identified include phytol, stigmasterol, sitosterol, secolignans, tetrahydrofuran lignans, highly methoxylated dihydronaphthalenone, peperomins, sesamin, and isoswertisin.

Among the most conspicuous classes of compounds in the Peperomia genus are phenylpropanoids, tetrahydrofuran lignans, secolignans, furofuran lignans, flavonoids, and amides. Some compounds have been annotated for the first time in the Peperomia genus in recent studies, such as 2′,4′,5′-trihydroxybutyrophenonevelutin, dehydroretrofractamide C, and retrofractamide B.

Pharmacologically Relevant Compounds

Among the various phytochemicals identified from P. pellucida, β-caryophyllene, carotol, dillapiole, ellagic acid, pellucidin A, phytol, and vitexin exhibit strong pharmacological activities within the mitogen-activated protein kinase and NF-κB signalling pathways in inflammatory eye diseases. Peperochromen-A compounds have anti-diabetic activity, and flavonoids are associated with anti-hypertensive and anti-microbial effects.

Nutritional Composition

P. pellucida is rich in crude protein, carbohydrate, and total ash contents; its high amount of total ash (31.22%) suggests a high-value mineral composition comprising potassium, calcium, and iron as the main elements. The plant would serve as a good source of protein and energy as well as micronutrients in the form of a leafy vegetable for human consumption. The moisture content of the fresh whole plant was found to be 93.14%, contributed by the bulk tissue weight of the fleshy and succulent stem. The total phenolic content (TPC) and total flavonoid content (TFC) of the plant extract have been reported at 273.33 ± 4.91 mg gallic acid equivalents/g extract and 199.8 ± 0.346 mg quercetin equivalents/g extract, respectively.

4. Mechanisms of Action

Anti-Inflammatory and Antinociceptive Pathways

In vitro studies have reported that the extracts and essential oils of this plant exerted their pharmacological effects through multiple pathways, such as inhibiting COX, NF-κB, and NOS, and scavenging free radicals, which are driven by terpenoids, phenolics, and flavonoids.

Antinociceptive, anti-inflammatory, and wound healing activity of P. pellucida or its metabolite pellucidin A have been confirmed, which were in agreement with the results of in silico studies describing the molecular interaction of P. pellucida metabolites with iNOS, eNOS, COX-2, NF-κB p65, and PPAR-γ, and in vitro studies delineating significant downregulation of pro-inflammatory cytokines, angiogenic markers, and alteration of the Janus kinase (JAK)-STAT3 pathway.

In one rodent study specifically examining pellucidin A, the antinociceptive effect of the novel dimeric ArC2 compound pellucidin A was evaluated using in vivo and in silico models. Animals were subjected to chemical, biphasic, and thermal models of pain.

Antihypertensive: ACE Inhibition

Peperomia pellucida has activity as an antihypertensive, mainly as an ACE inhibitor; the ethyl acetate fraction of the herb extract has activity as an ACE inhibitor (in vitro method) with an IC₅₀ value of 7.17 μg/ml, and at a dose of 50 mg/kg body weight it has demonstrated ACE inhibitory effects in an in vivo assay. Under optimized microwave-assisted extraction conditions, an ACE inhibitory activity of 54.73% at a concentration of 100 μg/mL was obtained.

Antidiabetic Mechanism

Peperochromen-A compounds in the plant have been associated with anti-diabetic activity. Multiple studies have reported antihyperglycemic effects in animal models. The overall consensus from reviews is that the plant exhibited antidiabetic activities in keeping with its traditional use, though the precise cellular mechanisms in human systems remain to be fully elucidated.

Gastroprotective Mechanism

A gastroprotective effect was observed when hexane and dichloromethane extracts were tested in an ethanol-induced gastric ulcer rat model, with dillapiole identified as the most active compound. Rats treated with dillapiole at 3, 10, 30, and 100 mg/kg showed 23.1%, 56.1%, 73.2%, and 85.5% gastroprotection, respectively. The effect of dillapiole at 100 mg/kg was not attenuated by pretreatment with indomethacin, N^G^-nitro-l-arginine methyl ester (a nitric oxide synthase inhibitor), or N-ethylmaleimide (a blocker of sulfhydryl groups), suggesting that the gastroprotective mechanism of action of dillapiole does not involve prostaglandins, nitric oxide, or sulfhydryl groups.

Estrogenic and Bone-Related Mechanisms

Activity assays clearly showed that the ethyl acetate extract and its fractions, subfractions, and isolated compounds exerted estrogenic activity; the methanol fraction of the ethyl acetate extract produced the highest estrogenic activity, while some compounds (derivatives of dillapiole and pellucidin A) also had anti-estrogenic activity. In docking studies, estrogenic activities appeared to be mediated by a classical ligand-dependent mechanism via binding interactions between the compounds and estrogen receptors, with binding occurring on Arg 394 and His 524 of the alpha receptor and Arg 346 and His 475 of the beta receptor. This establishes P. pellucida as a promising anti-osteoporotic agent due to its estrogenic activity, with lignan and phenylpropanoid derivatives identified as the responsible compounds.

5. Scientific Evidence by Area of Use

5.1 Anti-Inflammatory and Analgesic Activity

A frequently cited rodent study tested an aqueous extract of the aerial part of P. pellucida for anti-inflammatory and analgesic activity. An aqueous extract of the aerial part was tested for anti-inflammatory (paw edema induced by carrageenin and arachidonic acid) and analgesic activity (abdominal writhes and hot plate) in rats and mice, respectively. Oral administration of 200 and 400 mg/kg of the aqueous extract exhibited anti-inflammatory activity in the carrageenin test, which was based on interference with prostaglandin synthesis, as confirmed by the arachidonic acid test. In the abdominal writhing test induced by acetic acid, 400 mg/kg of the plant extract had the highest analgesic activity, whereas in the hot-plate test the best dose was 100 mg/kg. Evidence level: Preclinical (animal model). No human clinical trials on analgesic use have been identified.

5.2 Anti-Gout and Anti-Hyperuricemic Activity

Pansit-pansitan has long been used in Philippine traditional medicine for its analgesic, anti-inflammatory, and anti-hyperuricemic properties, and the Philippine Department of Health's research arm (NIRPROMP, Institute of Herbal Medicine, University of the Philippines Manila) has developed a drug formulation from ulasimang-bato extracts targeted to cure hyperuricemia and gout. Plants such as P. pellucida contain xanthine oxidase inhibitory (XOI) activity that helps reduce gout symptoms due to their anti-inflammatory activity.

A 2025 clinical trial investigated the plant in a pharmaceutical tablet form. The study was conducted from February to April 2025; a clinical trial was conducted with 300 participants (consisting of 150 people taking Ulasimang Bato tablets and 150 people taking allopurinol) from rural areas of the Philippines, seeking to assess the conversion of Ulasimang Bato into a contemporary pharmaceutical tablet for the treatment of gout by examining its efficacy, safety, and use alongside allopurinol. Laboratory tests validated the presence of active constituents including flavonoids, tannins, and phenolic acids, which are thought to play a role in the anti-inflammatory, analgesic, and antioxidant properties. Evidence level: One comparative clinical trial published in 2025 (ResearchGate preprint); this study's methodological quality and peer-review status require independent verification. Broader human clinical evidence remains limited.

5.3 Antihypertensive Activity

Hypotensive activity has been documented among the pharmacological activities of P. pellucida in the form of pure compound isolates, fractions, or extracts. Animal studies have confirmed ACE inhibitory effects in hypertensive rat models. The in silico and in vitro studies are in agreement with in vivo studies, which have delineated antihypertensive activity among others. Evidence level: In vitro and animal (in vivo) studies confirmed; no independent human clinical trials identified.

5.4 Antidiabetic / Antihyperglycemic Activity

Studies have shown that P. pellucida exhibited antidiabetic activities among several pharmacological effects. Peperochromen-A compounds have been associated with anti-diabetic activity. Multiple in vitro and rodent studies have investigated alpha-glucosidase inhibition and hypoglycemic effects. Evidence level: Preclinical only (in vitro and animal). No registered human clinical trials on glycemic control have been identified in the reviewed literature.

5.5 Bone and Fracture Healing Activity

Two independent animal studies have investigated the plant's effect on bone healing. In a rat femur drill-hole model using an ethanol extract: ethanol extract from P. pellucida dose-dependently induced bone regeneration at the fracture site, and at 200 mg/kg dose the extract significantly increased mineral deposition compared to controls; the extract also improved microarchitecture of the regenerating bone evident from increased bone volume fraction, trabecular thickness, trabecular number, and decreased trabecular separation and structure model index. Furthermore, the extract induced the expression of osteogenic genes in the femur, including type 1 collagen, osteocalcin, and BMP-2, compared to control.

A second study using an aqueous extract at oral doses of 100, 200, and 400 mg/kg found that: aqueous extract from P. pellucida increased bone calcium at the lowest dose and maintained this parameter at normal range at the high dose in fractured rats; alkaline phosphatase and phosphorus concentrations reduced significantly (p < 0.01) at 400 mg/kg; and radiological tests revealed a dose-dependent formation of callus at the level of the fracture gap, confirmed by the formation of a highly dense and compact fibrocartilaginous callus. The mineral content of the plant extract revealed the presence of calcium, phosphorus, magnesium, sodium, and potassium.

A further animal study showed that oral administration of P. pellucida extracts promotes the healing process in the tooth socket after extraction to proceed more rapidly, particularly by increasing fibroblast proliferation and trabecular thickness. Its effect on bone is promoted by its estrogenic effect, its ability to induce calcium homeostasis, anabolic effects on osteoblasts, inhibition of osteoclastogenesis, antioxidant effects, and bone-related nutritional content. Evidence level: Preclinical (animal models). No human trials on bone healing have been identified.

5.6 Antimicrobial Activity

Antibacterial, antifungal, and antiplasmodial activities of P. pellucida were reported in multiple articles, inhibiting Escherichia coli, Enterobacter cloacae, Enterococcus faecalis, Lactobacillus casei, Listeria ivanovii, Mycobacterium smegmatis, and Proteus mirabilis. P. pellucida has also shown antibacterial activity against Staphylococcus aureus, Bacillus subtilis, Pseudomonas aeruginosa, and Escherichia coli. Chloroform extracts from dried leaves, particularly apiol and pachypophyllin, have antifungal activity against Trichophyton mentagrophytes. A whole plant extract inhibited growth of the chloroquine-resistant Plasmodium falciparum Indo strain by 95% in vitro at 100 mg/mL, and the rodent malaria Plasmodium vinckei petteri by 78% in vivo at 1,000 mg/kg. Research reveals no clinical data regarding the use of P. pellucida for antimicrobial activity in humans. Evidence level: In vitro and some in vivo (animal) data only.

5.7 Anti-Inflammatory Use in Periodontitis (Animal)

A laboratory experimental study used 24 Wistar rats divided into four groups (non-periodontitis, no treatment, chlorhexidine-treated, and extract-treated) all induced with periodontitis. The extract group received a topical application of 2.5 µL of P. pellucida leaf extract, with observations on days 0, 3, 5, and 7, and histological changes assessed on day 7 by evaluating the cell counts of osteoclasts, osteoblasts, fibroblasts, macrophages, and PMNs. Phytochemical analysis confirmed the presence of alkaloids, polyphenols, tannins, flavonoids, quinones, monoterpenoids, and sesquiterpenoids; the extract demonstrated antibacterial activity against Porphyromonas gingivalis; and clinical and histological assessments showed significant improvements in the extract-treated group, with outcomes comparable to the chlorhexidine-treated group after 7 days. Evidence level: Animal study only.

5.8 Neuropharmacological / CNS Depressant Activity

Petroleum ether and ethyl acetate soluble fractions of ethanol extract of P. pellucida leaves were administered to mice intraperitoneally; the duration of diazepam-induced sleep was extended by administration of these fractions, and nikethamide at high doses caused death of mice while administration of these fractions delayed the time nikethamide caused death. These results provide some pharmacological basis for the traditional use of the plant in Bangladesh for mental disorders. Evidence level: Animal study only.

5.9 Antioxidant Activity

Results revealed that P. pellucida contains volatile substances and is rich in antioxidant compounds such as polyphenols, tannins, flavonoids, saponins, alkaloids, and terpenoids; the total phenolic content and total flavonoid content of the plant extract were measured at 273.33 ± 4.91 mg gallic acid equivalents/g extract and 199.8 ± 0.346 mg quercetin equivalents/g extract, respectively; and the remarkable antioxidative properties of the plant extract were demonstrated by nearly doubling the lifespan of Drosophila against oxidative stress. Evidence level: Primarily in vitro and invertebrate model; human antioxidant efficacy not established.

Overall Evidence Summary

Despite substantial pharmacological evidence, most studies have been limited to preclinical stages, and clinical data remain scarce, posing a significant challenge for confirming the efficacy and safety of the plant for human use. Despite promising pharmacological evidence, the clinical applications of P. pellucida remain limited owing to a lack of human studies and open challenges in determining its safety, dosage, and long-term effects.

6. Body Systems and Health Areas

The following body systems and health areas have been associated with P. pellucida in the scientific literature:

• Musculoskeletal system: Anti-inflammatory and analgesic activities, along with fracture healing activity, have been reported. Anti-gout and anti-hyperuricemic effects are among the most extensively studied traditional applications.
• Cardiovascular system: Antihypertensive activity, mainly as an ACE inhibitor, has been reported based on several studies.
• Metabolic / endocrine: The plant has activity as antidiabetic mellitus, with multiple preclinical studies confirming antihyperglycemic effects.
• Gastrointestinal system: The plant is used in traditional medicine to treat gastric ulcers, and dillapiole has been confirmed as the main gastroprotective compound in animal models.
• Integumentary system / skin: Warmed leaves are applied topically for boils, acne, and wound management across multiple traditional cultures.
• Renal and urinary system: The plant is described in traditional medicine to address kidney diseases, urinary retention, dysuria, and urinary tract infections.
• Skeletal / bone system: Ethanolic extract of P. pellucida accelerates fracture repair in rats via stimulatory effects on osteoblast differentiation and mineralization.
• Ophthalmic: The antihypertensive, anti-inflammatory, antioxidant, antihyperglycemic, and anti-angiogenic activities displayed by P. pellucida extracts suggest its potential role in the management of inflammatory eye diseases.
• Central nervous system: Animal studies indicate CNS depressant activity, corroborating ethnomedicinal use in Bangladesh for mental disorders.
• Immune / antimicrobial: Antimicrobial and immunostimulatory activities have been documented in preclinical studies.

7. Dosage Forms and Dosages Reported in Studies

No standardized human dosage has been formally established for pansit-pansitan. The following dosages are reported only as they appear in the cited studies:

• Anti-inflammatory and analgesic study (rats/mice): aqueous extract of aerial parts administered orally at 100, 200, and 400 mg/kg body weight. Anti-inflammatory activity was observed at 200 and 400 mg/kg; analgesic activity was highest at 400 mg/kg (writhing test) and 100 mg/kg (hot-plate test).
• Gastroprotection study (rats): dillapiole isolated from the plant administered at 3, 10, 30, and 100 mg/kg, yielding 23.1%, 56.1%, 73.2%, and 85.5% gastroprotection, respectively.
• Fracture healing study (Wistar rats): aqueous extract of the whole plant administered orally at doses of 100, 200, and 400 mg/kg.
• Fracture healing study (Sprague-Dawley rats): ethanol extract administered orally at 100 and 200 mg/kg.
• ACE inhibitory activity: ethyl acetate fraction showed IC₅₀ of 7.17 μg/ml in vitro; in vivo antihypertensive effect observed at 50 mg/kg body weight.
• Periodontitis study (rats): topical application of 2.5 µL of P. pellucida leaf extract applied to the gingival sulcus daily for one week.
• Sub-chronic toxicity study (mice): polyherbal infusion containing P. pellucida administered orally at doses of 560, 650, and 1,300 mg/kg body weight daily for 28 days.
• Safety study: animals given P. pellucida aqueous extract 5 g/kg for 14 days showed no adverse reactions or changes in behavior or weight.
• Clinical trial (gout, Philippines, 2025): 150 participants received Ulasimang Bato tablets; dosage specifics as tested against 150 participants taking allopurinol.

8. Safety Considerations

Acute Toxicity

The LD₅₀ of Peperomia pellucida aqueous extract was determined to be 5,000 mg/kg, indicating low acute toxicity. Animals given P. pellucida aqueous extract at 5 g/kg for 14 days showed no adverse reactions or changes in behavior or weight.

Subchronic Toxicity

Clinical monitoring and body weight measurements in a polyherbal sub-chronic toxicity study involving P. pellucida revealed no signs of toxicity or growth impairment at lower doses; however, organ index analysis demonstrated dose-dependent increases in liver and kidney weights, and histopathological examination confirmed hepatocellular degeneration and tubular damage at the highest dose (1,300 mg/kg/day), indicating that the infusion is generally safe at low to moderate doses, but prolonged high-dose consumption may compromise hepatic and renal integrity.

A separate study using two concentrations of P. pellucida aqueous extract (30 and 60 mg/kg) administered in vivo to BALB/c mice for nine weeks found that significant differences were observed between the 60 mg/kg freeze-dried extract and the control in terms of mice weight and micronucleus frequency at 7–8 weeks of treatment, raising a potential concern about mutagenic effects at higher doses with prolonged administration.

Normal Cell and Organism Safety

The extract did not cause any acute or chronic toxicity in mice after being fed the plant, as indicated by normal blood parameters and the absence of hepatic shape damage or impaired function; based on these findings, P. pellucida is deemed safe for consumption.

CNS Effects

According to the Manila Medical Society, it is used to relieve arthritic pains, but it may cause central nervous system (CNS) depression. This is supported by rodent studies demonstrating CNS depressant activity.

Hypersensitivity

The plant has a strong mustard-like odor and may cause asthma-like symptoms in patients with known hypersensitivity reactions to the plant species.

Drug Interactions

No drug interaction data could be found in the medical literature reviewed; however, theoretically, patients taking herbal preparations containing P. pellucida with analgesic or anti-inflammatory drugs should be wary of potential additive and adverse effects such as GI bleeding, constipation, and bruising.

Human Toxicity Data

No clinical data have been reported on human toxicity. The available evidence confirms that P. pellucida was not toxic towards normal cells or animal models, though long-term human safety data are absent.

Knowledge Gaps

Despite promising pharmacological evidence, the clinical applications of P. pellucida remain limited owing to a lack of human studies and open challenges in determining its safety, dosage, and long-term effects. The leaves and aerial parts of P. pellucida were broadly explored and confirmed as the most active components, followed by the stems, entire plants, and seeds, but the precise optimal form, dose, and duration for any therapeutic use in humans remain unestablished by adequately powered clinical trials.

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