Capillary Wormwood
AsteraceaeArtemisia capillaris
Also known as: Yin Chen Hao, 茵陈蒿, Yin Chen
clinical_notes Clinical Summary
Capillary Wormwood (Artemisia capillaris / Yin Chen Hao) is the principal TCM herb for jaundice and cholestatic liver disease, documented in Shang Han Lun over 2000 years ago.
Its coumarins (scoparone) activate the nuclear receptor CAR to enhance bilirubin clearance, underlying use in Yin Zhi Huang and Inchin-ko-to for neonatal jaundice.
Avoid in pregnancy and biliary obstruction.
Pregnancy Safety
Contraindicated in pregnancy. Traditional and modern sources agree.
Lactation Safety
Avoid during lactation due to insufficient safety data.
warning Contraindications
- Pregnancy (avoid)Theoretical
- Breastfeeding (avoid)Theoretical
- Children <12 years (unsupervised) (caution)Clinically Proven
- Biliary obstruction (contraindicated)Theoretical
vital_signs Clinical Profile
Primary Indications
- check_circle jaundice (damp-heat)
- check_circle cholestatic liver disease
- check_circle hepatitis
- check_circle neonatal hyperbilirubinemia
- check_circle NAFLD
- check_circle skin itching with damp-heat
- check_circle urinary dysfunction
Therapeutic Actions
System Affinities
- check_circle hepatic/biliary
- check_circle spleen
- check_circle stomach
labs Active Constituents
scoparone
capillarisin
capillin
scopoletin
chlorogenic acid
β-pinene
cirsilineol
arcapillin
history_edu Traditional Use
Traditional Chinese Medicine (TCM)
茵陈蒿 (Yin Chen Hao)
Nature: cool
- Damp-heat jaundice (yang and yin patterns)
- cholestatic hepatitis
- damp-heat skin itching
- heat with dysuria
- cirrhosis
Harvested early spring ('Yin Chen in March; wormwood in May'). Specific herb for jaundice.
Traditional Uses Across Healing Systems
While many herbs lack controlled clinical trials, centuries of traditional practice across cultures provide valuable insight into their therapeutic applications.
Primary TCM herb for jaundice and cholestatic liver disease.
Yin Chen Hao Tang is foundational formula in Shang Han Lun (~200 CE).
Inchin-ko-to — Japanese Kampo formula for neonatal jaundice and liver disease.
Used alongside phototherapy.
Used by Western herbalists for liver/gallbladder congestion and jaundice.
spa Parts Used
aerial
- jaundice
- hepatitis
- NAFLD
Harvested early spring when plants tender; older parts inferior.
shield Safety
Contraindications — Evidence Basis
Pregnancy
Classical TCM and modern sources list Yin Chen as unsafe in pregnancy.
Breastfeeding
Insufficient data; essential oils may transfer to milk.
Children <12 years (unsupervised)
Only under supervision; exception: specific formulas for neonatal jaundice under medical care.
Biliary obstruction
Strong cholagogue; contraindicated in gallstones with duct obstruction.
Monitoring Parameters
Monitor during use, especially with prolonged or high-dose therapy.
Liver enzymes (ALT, AST, total/direct bilirubin)
Baseline and every 4 weeksEfficacy marker for cholestasis; rare hepatic dysfunction at high doses.
flagThreshold: ALT/AST >3× ULN: discontinue
Toxicity
Generally low toxicity. Can cause nausea, bloating, dizziness, rare cardiac symptoms at high doses. Capillin potentially cytotoxic isolated.
Nausea, bloating, dizziness, palpitations; rare hepatic dysfunction at very high doses.
Discontinue; supportive care.
Adverse Effects
CYP Metabolism
Scoparone induces CYP2A5 and activates CAR (constitutive androstane receptor), enhancing bilirubin clearance. Yin-Chen-Hao-Tang alters spironolactone PK.
swap_horiz Interactions
Spironolactone
Class: Potassium-sparing diuretic / aldosterone antagonist
Yin-Chen-Hao-Tang (Artemisia capillaris + Gardenia jasminoides + Rheum palmatum) significantly altered the pharmacokinetics of spironolactone in rats, with documented herb-drug interactions in preclinical pharmacokinetic/pharmacodynamic studies.
Monitor serum potassium, renal function, and blood pressure when Yin-Chen or YCHT formulas are used with spironolactone. Consider spacing doses by several hours.
Irinotecan / SN-38
Class: Chemotherapy (topoisomerase inhibitor)
Scoparone (6,7-dimethylesculetin), the principal active coumarin of Artemisia capillaris, activates the constitutive androstane receptor (CAR) and upregulates hepatic CYP2A5 and UGT1A1. CAR activation accelerates glucuronidation and clearance of irinotecan's active metabolite SN-38, reducing antitumor efficacy.
Avoid use during active chemotherapy with CAR-inducing sensitivity. Discuss with oncologist before starting Yin Chen, especially with irinotecan, methotrexate, or hormone-sensitive chemotherapies.
Acetaminophen (Paracetamol)
Class: Analgesic / antipyretic
Artemisia capillaris induces hepatic CYP2A5 (the murine ortholog of human CYP2A6) and increases hepatic sulfotransferase activity 1.8-fold. This could alter acetaminophen metabolism and theoretically shift metabolism toward hepatotoxic NAPQI intermediates, although capillarisin also has hepatoprotective activity.
Avoid chronic high-dose combination with acetaminophen, especially in patients with pre-existing liver disease. Monitor ALT/AST if co-administered for more than 2 weeks.
Warfarin
Class: Anticoagulant
Scoparone and scopoletin inhibit rabbit platelet aggregation induced by ADP, PAF, arachidonate, and collagen. Combined with warfarin, these antiplatelet coumarins may increase bleeding risk; additionally, CAR activation may alter warfarin metabolism.
Monitor INR and bleeding signs with concomitant use. Discontinue at least 7 days before surgery.
Diazepam
Class: Benzodiazepine
Artemisia capillaris produces sedative-hypnotic effects in mice, likely via potentiation of the GABA-A receptor, overlapping with the benzodiazepine mechanism of action.
Monitor for excessive sedation or cognitive impairment. Warn patients about driving or operating machinery. Avoid in elderly patients at risk of falls.
hub Combinations
Synergistic pairings can enhance therapeutic outcomes, while knowing suitable substitutes helps when specific herbs are unavailable or contraindicated.
Classical Formulas
3Chinese Rhubarb
Strong EvidenceStandard pairing in Yin Chen Hao Tang — Da Huang purges heat-damp complementing cholagogic action.
Classical formula.
Gardenia
Strong EvidenceYin Chen Hao Tang — Yin Chen + Zhi Zi + Da Huang for damp-heat jaundice. Pharmacokinetic synergy studied.
Classical formula with 2000+ years of use.
Poria
Traditional UseYin Chen Wu Ling San for jaundice with fluid retention; drains dampness via urine.
Classical formula.
Synergistic Combinations
2Dan Shen
Moderate EvidenceCombined for chronic hepatitis and liver fibrosis — Dan Shen invigorates blood, Yin Chen clears damp-heat.
Modern TCM combination.
Milk Thistle
Limited EvidenceComplementary hepatoprotection — silymarin stabilizes hepatocyte membranes, Yin Chen promotes bile flow.
Common integrative combination.
science Studies
Anti-hepatitis B virus effects of the traditional Chinese herb Artemisia capillaris and its active enynes
In VitroThis in vitro study systematically investigated the anti-HBV activity of Artemisia capillaris fractions and isolated enyne compounds using the HepG2.2.15 cell line, which constitutively produces HBV. Bioassay-guided fractionation identified 14 enynes as active anti-HBV constituents, characterized by their ability to inhibit HBsAg and HBeAg secretion and HBV DNA replication. Several new enyne structures were elucidated for the first time. This work provides phytochemical validation for the ethnopharmacological use of Yin-Chen (A. capillaris) in treating hepatitis B and identifies specific active compounds responsible for the antiviral activity.
Aqueous extract of Artemisia capillaris exerts hepatoprotective action in alcohol-pyrazole-fed rat model
In VivoAn in vivo rat study assessed the hepatoprotective effects of aqueous Artemisia capillaris extract (WAC) in an alcohol-pyrazole-induced liver injury model. WAC administration at 50 and 100 mg/kg for 10 days significantly ameliorated liver histopathology, reduced hepatic transaminase elevation, and restored antioxidant capacity including glutathione, SOD, and catalase activities. WAC also modulated Nrf2/HO-1 signaling and suppressed pro-inflammatory cytokines TNF-α and TGF-β in hepatic tissue. These findings support the traditional use of Artemisia capillaris for alcohol-associated hepatic disorders via dual antioxidant and anti-inflammatory mechanisms.
medication Dosing
decoction
6-15 g dried aerial parts
daily, divided
Chinese Pharmacopoeia; added last 5-10 min to preserve oils.
tincture
2-4 mL (1:5 in 40% ethanol)
TID
Western clinical herbalist dosing.
powder
3-6 g granulated extract
BID-TID
Yin Zhi Huang commonly used for neonatal jaundice under medical supervision.
Disclaimer: This information is largely AI-generated and reviewed by human experts at Evara Health. It is intended for educational and clinical reference purposes only and should not replace professional medical advice.
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