Cremastra Pseudobulb — Safety & Interactions
Shan Ci Gu · Pseudobulbus Cremastrae Seu Pleiones
Use with caution. Practitioner review recommended before use.
Contraindications
- Pregnancy — absolutely contraindicated; colchicine is teratogenic (disrupts spindle formation in dividing cells) and associated with miscarriage and fetal abnormalities at supratherapeutic doses
- Spleen-Stomach Deficiency Cold without Phlegm-toxin masses — cool, dispersing action injures digestive Yang in Cold deficiency patterns
- Known colchicine hypersensitivity
Cautions
- Standard dose: 3–9 g dried pseudobulb in decoction; 30–60 g fresh herb ground to poultice for external use; do not exceed standard doses
- Colchicine content: standard decoction doses contain far less colchicine than pharmaceutical anti-gout doses; myopathy and bone marrow suppression risks are low at therapeutic TCM doses — but the risk multiplies dramatically with CYP3A4/P-gp inhibitors (see drug interactions)
- Distinguish Cremastra vs Pleione source: Cremastra appendiculata contains colchicine; Pleione bulbocodioides lacks colchicine but has orchid lectins — pharmacologically distinct; market supplies often mix the two; Pleione source carries lower interaction risk
Drug Interactions
| Drug Class / Substrate | Mechanism | Severity | Source |
|---|---|---|---|
| CYP3A4 inhibitors (clarithromycin, erythromycin, azithromycin, verapamil, diltiazem, itraconazole, ketoconazole) — SERIOUS: CYP3A4 is the primary metabolic pathway for colchicine; concurrent CYP3A4 inhibitors dramatically increase colchicine plasma levels to potentially toxic concentrations; macrolide antibiotic + colchicine is a known clinically fatal drug combination at pharmaceutical doses; monitor carefully even at TCM decoction doses | |||
| P-glycoprotein inhibitors (cyclosporine, quinidine, verapamil) — P-gp is the primary efflux pump for colchicine; P-gp inhibitors increase colchicine bioavailability and toxicity risk; cyclosporine combination is particularly dangerous | |||
| Statins (HMG-CoA reductase inhibitors — simvastatin, atorvastatin) — colchicine + statins increases myopathy risk; monitor for muscle pain and weakness | |||
Pregnancy
Not recommended during pregnancy. Consult a qualified practitioner before any use.
This information is for educational purposes only and does not constitute medical advice. Always consult a qualified healthcare provider before using herbal medicines, especially if you take prescription medications.