{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,16]],"date-time":"2026-02-16T02:42:25Z","timestamp":1771209745999,"version":"3.50.1"},"reference-count":31,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2011,10,17]],"date-time":"2011-10-17T00:00:00Z","timestamp":1318809600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Phytotherapy Research"],"published-print":{"date-parts":[[2012,5]]},"abstract":"<jats:p>Two commonly used berberine\u2010containing Chinese herbs, <jats:italic>Rhizoma coptidis<\/jats:italic> (RC) and <jats:italic>Cortex phellodendri<\/jats:italic> (CP), have been banned in Singapore for the past three decades due to implication of berberine in aggravating jaundice and kernicterus in neonates with glucose\u20106\u2010phosphate dehydrogenase deficiency. Here we conducted a single arm, phase I\/II clinical study on Chinese herbal medicine for patients with chronic cytopenic haematological conditions and we analysed a subset of 20 patients who also had RC, CP or both in their herbal concoction. We found no organ toxicity or electrolyte imbalance in these 20 patients where RC was administered for 1055 patient\u2010days and CP for 1252 patient\u2010days. In three patients with thalassemia intermedia, transient elevation in serum bilirubin level was observed but this was not associated with any aggravation of anaemia or liver dysfunction. A review of the literature found conflicting evidence of varying levels either supporting or refuting the allegation of neonatal jaundice and kernicterus caused by berberine. There were, however, very few clinical reports of adverse reaction attributable to RC or CP in oral TCM concoction. We conclude that based on traditional dosage and indication, the use of RC and CP in oral concoction is safe. Copyright \u00a9 2011 John Wiley &amp; Sons, Ltd.<\/jats:p>","DOI":"10.1002\/ptr.3617","type":"journal-article","created":{"date-parts":[[2011,10,17]],"date-time":"2011-10-17T10:52:00Z","timestamp":1318848720000},"page":"682-686","source":"Crossref","is-referenced-by-count":51,"title":["Berberine\u2010induced Haemolysis Revisited: Safety of <i>Rhizoma coptidis<\/i> and <i>Cortex phellodendri<\/i> in Chronic Haematological Diseases"],"prefix":"10.1002","volume":"26","author":[{"given":"Yeh\u2010ching","family":"Linn","sequence":"first","affiliation":[{"name":"Department of Haematology Singapore General Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jiahui","family":"Lu","sequence":"additional","affiliation":[{"name":"Department of Haematology Yueyang Hospital  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Lay\u2010cheng","family":"Lim","sequence":"additional","affiliation":[{"name":"Department of Haematology Singapore General Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Huili","family":"Sun","sequence":"additional","affiliation":[{"name":"Bao Zhong Tang TCM Center  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jue","family":"Sun","sequence":"additional","affiliation":[{"name":"Bao Zhong Tang TCM Center  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yongming","family":"Zhou","sequence":"additional","affiliation":[{"name":"Department of Haematology Yueyang Hospital  Shanghai China"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Han\u2010seong","family":"Ng","sequence":"additional","affiliation":[{"name":"Department of Gastroentorology and Hepatology Singapore General Hospital  Singapore"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2011,10,17]]},"reference":[{"key":"e_1_2_6_2_1","doi-asserted-by":"crossref","first-page":"1058","DOI":"10.1182\/blood.V79.4.1058.bloodjournal7941058","article-title":"Characterization and comparison of the red blood cell membrane damage in severe human alpha\u2010 and beta\u2010thalassemia","volume":"79","author":"Advani R","year":"1992","journal-title":"Blood"},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1182\/blood-2005-04-1520"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000243932"},{"key":"e_1_2_6_5_1","first-page":"238","article-title":"The prevalence use and harmful potential of some Chinese herbal medicines in babies and children","volume":"36","author":"Chan TY","year":"1994","journal-title":"Vet Hum Toxicol"},{"key":"e_1_2_6_6_1","first-page":"3671","article-title":"Report of an international working group to standardize response criteria for myelodysplastic syndromes","volume":"96","author":"Cheson BD","year":"2000","journal-title":"Blood"},{"key":"e_1_2_6_7_1","first-page":"214","volume-title":"Pharmacopoeia of the People's Republic of China","author":"Commission of the Ministry of Public Health","year":"2000"},{"key":"e_1_2_6_8_1","first-page":"708","article-title":"Allergic reaction induced by Berberine hydrochloride tablet","volume":"21","author":"Ding J","year":"2002","journal-title":"Herald Med"},{"key":"e_1_2_6_9_1","first-page":"70","article-title":"A review on the causation and prevention of haemolytic jaundice by Huanglian","volume":"27","author":"Gao X","year":"2002","journal-title":"China J Chin Mat Med"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.tiv.2008.03.017"},{"issue":"7","key":"e_1_2_6_11_1","first-page":"661","article-title":"New clinical application of Berberine and its adverse reactions","volume":"19","author":"Li H","year":"2008","journal-title":"Med J Chin People's Arm Pol Forces"},{"key":"e_1_2_6_12_1","first-page":"562","article-title":"Influence of huanglian and berberine on the erythrocytic osmotic fragility of experimental glucose\u20106\u2010phosphate dehydrogenase (G6PD) deficiency in rates","volume":"23","author":"Lin N","year":"1998","journal-title":"China J Chin Mat Med"},{"key":"e_1_2_6_13_1","first-page":"2543","article-title":"Investigation of Coptis Chinensis on jaundice of glucose\u20106\u2010phosphate dehydrogenase (G\u20106PD) deficient neonates from Guigang, Guangxi province","volume":"32","author":"Lin X","year":"2007","journal-title":"China J Chin Mat Med"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ctcp.2011.01.004"},{"key":"e_1_2_6_15_1","unstructured":"National Toxicology Program.2010.Studies on goldenseal root powder (Hydrastis Canadensis) in F344\/N rats and B6C3F1 mice. 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