Gardenia
RubiaceaeGardenia jasminoides
Also known as: Zhi Zi, 栀子, Fructus Gardeniae
clinical_notes Clinical Summary
Gardenia (Gardenia jasminoides / Zhi Zi) is a Rubiaceae bitter-cold TCM herb that clears heat from all three burners, drains fire, cools blood, and resolves damp-heat.
Its iridoid glycoside geniposide and crocins (shared with saffron) provide anti-inflammatory, cholagogic, and mild antidepressant actions.
Short-term at 6-10 g/day is safe; high-dose or prolonged use risks hepatotoxicity and mesenteric phlebosclerosis.
Pregnancy Safety
Avoid during pregnancy without supervision. Cold, blood-moving properties; limited safety data.
Lactation Safety
Insufficient data; avoid prolonged use.
warning Contraindications
- Spleen/Stomach cold deficiency with loose stools (caution)Theoretical
- Prolonged high-dose use (avoid)Clinically Proven
- Pre-existing liver disease (caution)Theoretical
- Mesenteric phlebosclerosis risk (avoid)Clinically Proven
vital_signs Clinical Profile
Primary Indications
- check_circle jaundice (damp-heat)
- check_circle irritability with fever
- check_circle insomnia from heat
- check_circle epistaxis and hematemesis
- check_circle UTI (damp-heat)
- check_circle conjunctivitis
- check_circle trauma with swelling (topical)
Therapeutic Actions
System Affinities
- check_circle hepatic/biliary
- check_circle heart/mind
- check_circle urinary
- check_circle digestive
labs Active Constituents
geniposide
genipin
gardenoside
crocin-1
crocin-2
crocetin
geniposidic acid
ursolic acid
history_edu Traditional Use
Traditional Chinese Medicine (TCM)
栀子 (Zhi Zi)
Nature: cold
- Heat in the three burners with irritability
- Damp-heat jaundice
- blood heat bleeding (epistaxis, hematemesis, blood in urine)
- red swollen painful eyes
- damp-heat Lower Burner
- sprains and trauma (topical)
Raw Zhi Zi clears heat and drains fire; charred (Jiao Zhi Zi) for stopping bleeding.
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.
Clears heat from all three burners, cools blood, resolves toxicity, drains damp-heat.
One of the 'three yellow' heat-clearing herbs in Huang Lian Jie Du Tang.
Used in Japanese formulations such as San'oshashinto for irritability and heat patterns.
Adopted as a hepatic, cholagogue, and sedative for heat-type presentations.
Fruits also used as natural yellow/orange dye (Gardenia yellow).
Crocins give yellow color shared with saffron.
spa Parts Used
fruit
- jaundice
- irritability
- bleeding
- eye inflammation
Ripe dried fruit. Raw for clearing fire; Jiao Zhi Zi (charred) for stopping bleeding.
shield Safety
Contraindications — Evidence Basis
Spleen/Stomach cold deficiency with loose stools
TCM: cold herb contraindicated in cold-deficiency diarrhea.
Prolonged high-dose use
High doses (>10 g/day) linked to hepatotoxicity; geniposide LD50 oral ~1431 mg/kg rats; doses ≥574 mg/kg caused acute hepatic injury.
Pre-existing liver disease
Hepatotoxic potential at supratherapeutic doses; monitor LFTs.
Mesenteric phlebosclerosis risk
Japanese reports link prolonged use (>5 years, >2000 g cumulative) to idiopathic mesenteric phlebosclerosis.
Monitoring Parameters
Monitor during use, especially with prolonged or high-dose therapy.
Liver enzymes (ALT, AST, ALP, bilirubin)
Baseline and every 4-8 weeksDose-dependent hepatotoxicity from geniposide.
flagThreshold: ALT/AST >3× ULN: discontinue
Colonoscopy (with chronic use >1 year)
If abdominal symptoms developLong-term use associated with idiopathic mesenteric phlebosclerosis.
flagThreshold: Any colonic discoloration: discontinue
Toxicity
Chinese Pharmacopoeia 6-10 g/day. Geniposide oral LD50 rats 1431 mg/kg; acute hepatotoxicity ≥574 mg/kg. Long-term (>2000 g cumulative) linked to mesenteric phlebosclerosis.
Elevated ALT/AST/ALP, jaundice (high dose); colonic discoloration with chronic use; nausea, diarrhea.
Discontinue; LFT monitoring; colonoscopy if mesenteric phlebosclerosis suspected.
Adverse Effects
CYP Metabolism
Concurrent simvastatin + gardenia in rats altered pharmacokinetics and enhanced hepatotoxicity; affects CYP2C11 and OATP1B2. Theoretical interactions with CYP3A/2C substrates.
swap_horiz Interactions
Simvastatin
Class: HMG-CoA reductase inhibitor (statin)
Co-administration of simvastatin (SV) and Gardenia jasminoides in rats altered the pharmacokinetics of SV and its active metabolite simvastatin acid (SVA) and enhanced hepatotoxicity. Geniposide's active metabolite genipin decreases CYP2C19/CYP3A4 expression/activity and increases P-gp; Gardenia also reduced Oatp1b2 mRNA by ~62%, impairing hepatic statin uptake.
Avoid high-dose Gardenia with simvastatin, lovastatin, or atorvastatin. Monitor liver function (ALT/AST) and creatine kinase, especially in patients with NAFLD or NASH. If needed, switch to rosuvastatin or pravastatin.
Cyclosporine
Class: Immunosuppressant (calcineurin inhibitor)
Geniposide and genipin (from Gardenia fruit) modulate P-glycoprotein (geniposide is a P-gp substrate; genipin upregulates P-gp expression) and inhibit CYP3A4. Cyclosporine is a narrow-therapeutic-index P-gp and CYP3A4 substrate; the interaction may decrease or increase cyclosporine plasma levels depending on timing.
Avoid concurrent use in transplant patients. If unavoidable, monitor cyclosporine trough concentrations weekly and renal function.
Acetaminophen (Paracetamol)
Class: Analgesic / antipyretic
Oral administration of 200 mg/kg of genipin (the aglycone of geniposide) produced 78% mortality (7/9 rats) with severe hepatotoxicity. Gardenia at high doses has been linked to liver injury in humans, and additive hepatotoxicity with acetaminophen is a concern.
Avoid high-dose or prolonged Gardenia use in patients taking regular acetaminophen. Use cautiously in patients with liver disease. Monitor LFTs.
Midazolam
Class: Benzodiazepine (CYP3A4 probe)
Geniposide from Gardenia jasminoides decreases hepatic CYP3A immunoreactive protein and inhibits CYP3A-mediated monooxygenase activity in rat liver, which would increase plasma concentrations of CYP3A4 substrates such as midazolam.
Reduce initial benzodiazepine doses or avoid combination. Monitor for excessive sedation, respiratory depression, or prolonged recovery from procedural sedation.
Aspirin
Class: Antiplatelet / NSAID
Crocetin, a carotenoid from Gardenia jasminoides fruit, protects against hypertension and cerebral thrombogenesis in spontaneously hypertensive rats, suggesting antiplatelet/antithrombotic activity that could be additive with aspirin.
Monitor for bruising or bleeding with combined use. Caution in patients on dual antiplatelet therapy or anticoagulants.
hub Combinations
Synergistic pairings can enhance therapeutic outcomes, while knowing suitable substitutes helps when specific herbs are unavailable or contraindicated.
Classical Formulas
5Chinese Rhubarb
Traditional UseZhi Zi and Da Huang paired for strong heat-clearing with purgation.
Classical formula.
Chinese Skullcap
Strong EvidenceHuang Lian Jie Du Tang clears fire toxin from all three burners.
Classical formula with pharmacological validation.
Gentian
Traditional UseLong Dan Xie Gan Tang drains Liver/Gallbladder fire; hypertension with irritability, migraine.
Classical formula.
Magnolia Bark
Traditional UseZhi Zi Hou Po Tang for chest tension, irritability, insomnia from heat constraint.
Classical Shang Han Lun formula.
Sweet Wormwood
Strong EvidenceYin Chen Hao Tang for damp-heat jaundice — Artemisia capillaris, Zhi Zi, Da Huang; synergistic cholagogic action.
Used for 2000+ years; pharmacokinetic synergy studied.
science Studies
Gardenia jasminoides Ellis: Ethnopharmacology, phytochemistry, and pharmacological and industrial applications of an important traditional Chinese medicine
Systematic ReviewThis comprehensive review systematically summarized the traditional uses, phytochemistry, pharmacology, and toxicity of Gardenia jasminoides. Approximately 162 bioactive compounds have been identified, with iridoid glycosides (notably geniposide and genipin) and crocins as the major active constituents. Validated pharmacological activities include hepatoprotective, antidepressant, anti-inflammatory, anxiolytic, neuroprotective, and cardiovascular effects, both in vitro and in vivo. The review concludes that G. jasminoides pharmacology robustly supports its traditional applications for jaundice, insomnia, depression, and anxiety, while identifying genipin as a uniquely valuable biological crosslinking agent.
Effect of crocetin from Gardenia jasminoides Ellis on sleep: a pilot study
RCTThis double-blind, placebo-controlled, crossover pilot trial enrolled 21 healthy adult men with mild sleep complaints who received crocetin (an active carotenoid from Gardenia jasminoides) over two 2-week periods separated by a washout. Crocetin supplementation significantly improved sleep efficiency and reduced the proportion of non-REM sleep compared to placebo, as measured by actigraphy and sleep diaries. Crocetin is a major bioactive constituent derived from crocin pigments found in Gardenia jasminoides fruits. These results provide preliminary clinical evidence for the sleep-promoting effects of this Gardenia-derived compound, consistent with its traditional use for insomnia.
medication Dosing
decoction
6-10 g dried fruit
daily, divided
Chinese Pharmacopoeia dose. Do not exceed 10 g/day or use >4 weeks without monitoring.
tincture
1-3 mL (1:5 in 40% ethanol)
TID
Western herbalist dosing.
topical
Crushed raw fruit as poultice
BID
Mixed with flour/egg white for sprains and bruises.
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.
© 2026 Evara Health. All rights reserved.