# Berberine

Source: https://onco.cc/technologies/berberine/  
OnCo record `berberine` (Technology). Data CC BY-NC 4.0, attribute "Data from OnCo (onco.cc)"; commercial use needs a licence.

## TL;DR

Berberine is a plant compound used in Chinese medicine and sold for blood sugar and cholesterol. In a placebo-controlled trial in China, it lowered the chance of bowel polyps coming back after removal. It has not been tested as a cancer treatment, and it raises levels of some drugs, including tacrolimus and ciclosporin.

## Summary

Berberine is an alkaloid found in barberry, goldthread, goldenseal and Oregon grape. Memorial Sloan Kettering's About Herbs summary describes meta-analyses suggesting small improvements in lipids and blood sugar from mostly low-quality trials, and notes that berberine lowered the risk of colorectal adenoma recurrence. That finding comes from a double-blind randomised trial at seven Chinese hospitals (Chen et al., Lancet Gastroenterology and Hepatology 2020): among people who had adenomas removed, 36 per cent taking berberine 0.3 g twice daily and 47 per cent taking placebo had a recurrent adenoma during follow-up (relative risk 0.77), with no serious adverse events. Adenomas are a precursor rather than cancer, no cancers were detected in either group, and the result has not yet been repeated outside China, so this is a promising prevention signal rather than a recommendation. Berberine has not been tested as a treatment for cancer. MSK lists interactions: repeated doses reduced the activity of CYP2D6, CYP2C9 and CYP3A4 in people; it raised tacrolimus levels with kidney toxicity in a child and raised ciclosporin levels in transplant recipients; and modelling predicts a 1.3-fold increase in exposure to bosutinib but not imatinib. It should be avoided in pregnancy and breastfeeding.

## Fields

- Kind: Technology
- Status: phase-2
- Last checked: 2026-11-04
- Also known as: Berberine HCl; Berberine alkaloid; Daruharidra
- Tags: complementary; supportive-care; evidence:moderate
- Principle: Berberine activates AMP-activated protein kinase and has anti-inflammatory and antimicrobial effects in the gut; oral bioavailability is low, so gut-local effects may matter for adenomas.
- Strengths: Double-blind randomised trial in adenoma recurrence; Mild side effects (constipation, stomach upset)
- Limitations: One trial, in one country, of a precancer endpoint; Not tested as a cancer treatment; Inhibits several drug-metabolising enzymes

## Sources

- Chen et al., berberine versus placebo for the prevention of recurrence of colorectal adenoma (Lancet Gastroenterol Hepatol 2020): https://doi.org/10.1016/S2468-1253(19)30409-1
- MSK About Herbs: Berberine (page last updated 12 June 2023): https://www.mskcc.org/cancer-care/integrative-medicine/herbs/berberine

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- cancers: [Colorectal cancer](https://onco.cc/cancers/colorectal/)
- fronts: [Prevention & Risk](https://onco.cc/fronts/prevention/), [Supportive Care & Survivorship](https://onco.cc/fronts/supportive-care/)
- drugs: [Bosutinib](https://onco.cc/drugs/bosutinib/), [Imatinib](https://onco.cc/drugs/imatinib/)
- bottlenecks: [Toxicity and quality of life are undervalued](https://onco.cc/bottlenecks/b-toxicity-qol/)

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