{"entity":{"id":"berberine","kind":"technology","name":"Berberine","aka":["Berberine HCl","Berberine alkaloid","Daruharidra"],"tldr":"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.","status":"phase-2","asOf":"2026-11-04","links":[{"label":"Chen et al., berberine versus placebo for the prevention of recurrence of colorectal adenoma (Lancet Gastroenterol Hepatol 2020)","url":"https://doi.org/10.1016/S2468-1253(19)30409-1"},{"label":"MSK About Herbs: Berberine (page last updated 12 June 2023)","url":"https://www.mskcc.org/cancer-care/integrative-medicine/herbs/berberine"}],"tags":["complementary","supportive-care","evidence:moderate"],"related":["ban-xia-xie-xin-tang","garlic-supplements"],"cancers":["colorectal"],"sections":["supportive-care","prevention"],"technologies":["integrative-oncology","chemoprevention","traditional-chinese-herbal-medicine","dietary-supplements-treatment-interactions"],"targets":[],"drugs":["bosutinib","imatinib"],"companies":[],"institutions":[],"pathways":[],"terms":[],"trials":[],"people":[],"bottlenecks":["b-toxicity-qol"],"keyPapers":[],"journals":[],"dependsOn":[],"notes":[],"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"]},"route":"/technologies/berberine/","neighbours":{"technology":[{"id":"ban-xia-xie-xin-tang","kind":"technology","name":"Ban Xia Xie Xin Tang (Hangeshashinto)","route":"/technologies/ban-xia-xie-xin-tang/"},{"id":"chemoprevention","kind":"technology","name":"Chemoprevention & risk-reducing surgery","route":"/technologies/chemoprevention/"},{"id":"dietary-supplements-treatment-interactions","kind":"technology","name":"Dietary supplements during cancer treatment: interactions and harms","route":"/technologies/dietary-supplements-treatment-interactions/"},{"id":"integrative-oncology","kind":"technology","name":"Evidence-based integrative oncology","route":"/technologies/integrative-oncology/"},{"id":"garlic-supplements","kind":"technology","name":"Garlic supplements","route":"/technologies/garlic-supplements/"},{"id":"traditional-chinese-herbal-medicine","kind":"technology","name":"Traditional Chinese herbal medicine alongside treatment","route":"/technologies/traditional-chinese-herbal-medicine/"}],"cancer":[{"id":"colorectal","kind":"cancer","name":"Colorectal cancer","route":"/cancers/colorectal/"}],"section":[{"id":"prevention","kind":"section","name":"Prevention & Risk","route":"/fronts/prevention/"},{"id":"supportive-care","kind":"section","name":"Supportive Care & Survivorship","route":"/fronts/supportive-care/"}],"drug":[{"id":"bosutinib","kind":"drug","name":"Bosutinib","route":"/drugs/bosutinib/"},{"id":"imatinib","kind":"drug","name":"Imatinib","route":"/drugs/imatinib/"}],"bottleneck":[{"id":"b-toxicity-qol","kind":"bottleneck","name":"Toxicity and quality of life are undervalued","route":"/bottlenecks/b-toxicity-qol/"}]}}