Compound Monograph

Tetrandrine

Alkaloids Isoquinoline Alkaloids Natural (plant-derived)

Tetrandrine is a bis-benzylisoquinoline alkaloid from Stephania tetrandra (Han Fang Ji) and Abuta — a genuine calcium-channel blocker with decades of Chinese clinical use for hypertension and silicosis, notable P-glycoprotein and two-pore-channel activity, and real pulmonary-toxicity and herb-substitution safety concerns.

Sources · 4

Where Does It Come From?

Tetrandrine is a naturally occurring bis-benzylisoquinoline alkaloid, found in Stephania tetrandra, Abuta, Cyclea spp. and 1 other source. It is flagged as moderately toxic.

Also found in
Cyclea spp. Monograph coming soon
Stephania Monograph coming soon
Stephania tetrandra Monograph coming soon

Concentration

Content by Source

Concentrations not reported. No percent-dry-weight or mg/g figures have been published for this compound in its source plants.

Tetrandrine at a Glance

Tetrandrine is a bis-benzylisoquinoline alkaloid from Stephania tetrandra (han fang ji) and abuta.

It is a genuine calcium-channel blocker — not a weak in-vitro one — with decades of Chinese clinical use in hypertension and, distinctively, in silicosis, the occupational lung fibrosis caused by inhaling silica dust, for which there is otherwise almost no drug treatment.

It also inhibits P-glycoprotein, giving it real drug-interaction potential, and it concentrates in lung tissue — the same property that underlies both its pulmonary use and its pulmonary toxicity.

Han Fang Ji vs. Guang Fang Ji

The most important thing to know about tetrandrine is not about tetrandrine. It is about what the herb it comes from might turn out to be.

In Chinese materia medica, “fang ji” is a category, not a species. Stephania tetrandra (Menispermaceae) is han fang ji, the tetrandrine source. Aristolochia fangchi (Aristolochiaceae) is guang fang ji — an entirely different plant, containing aristolochic acid, one of the most potent nephrotoxins and urothelial carcinogens known. The two have been confused and substituted for each other in trade for decades.

The consequence is documented. A Belgian weight-loss clinic dispensed a herbal preparation in which Aristolochia fangchi had replaced Stephania tetrandra; the result was a cluster of progressive interstitial renal fibrosis and, in the follow-up study, urothelial carcinoma in 18 of 39 patients who underwent prophylactic nephroureterectomy, with aristolochic-acid–DNA adducts found in the removed tissue 7Reference 7Nortier JL et al. · 2000ObservationalUrothelial carcinoma associated with the use of a Chinese herb (Aristolochia fangchi) — cohort studyView study →. The syndrome now carries the name aristolochic-acid nephropathy 8Reference 8Nortier J et al. · 2015ReviewNortier J, Pozdzik A, Roumeguere T, et al. (2015). [Aristolochic-acid nephropathy (“Chinese herb nephropathy”)] — review. Néphrologie & Thérapeutique. https://pubmed.ncbi.nlm.nih.gov/26515658/View study →.

Tetrandrine did not cause that. It is chemically unrelated to aristolochic acid, and it is not nephrotoxic or carcinogenic in that way. But the substitution risk is a property of the supply chain rather than of the molecule, so it attaches to any fang-ji-sourced material regardless of what the label says. Any such material has to be verified aristolochic-acid-free by analysis, not by name.

The Bisbenzylisoquinoline Class

Tetrandrine is a bisbenzylisoquinoline (bisBIQ) — two benzylisoquinoline units joined through diaryl ether bridges into a large, rigid macrocycle of 622.7 Da. The chemistry of the family, its biosynthesis and the pharmacology and toxicology its members share are set out on berbamine.

Two relationships are worth carrying here. Isotetrandrine is tetrandrine’s epimer — identical connectivity, opposite configuration at one benzylic carbon — and is itself the O-methyl ether of berbamine, so tetrandrine and berbamine are two small changes apart 18Reference 18Schütz R et al. · 2020A modular approach to the bisbenzylisoquinoline alkaloids tetrandrine and isotetrandrineView study →. And fangchinoline, the co-alkaloid that travels with tetrandrine in Stephania tetrandra root, is tetrandrine minus one methyl group, which is why the two are always measured together 22Reference 22Li YQ et al. · 2007Li YQ, Chen XG, Qi YX, et al. (2007). [Determination of tetrandrine and fangchinoline in Radix Stephaniae tetrandrae and its preparation by nonaqueous capillary chromatography]. Zhongguo Zhong Yao Za Zhi. https://pubmed.ncbi.nlm.nih.gov/18161288/View study →.

The class properties that matter clinically are all present in tetrandrine, and more strongly than in its relatives: L-type calcium-channel blockade, P-glycoprotein inhibition, poor aqueous solubility with low oral bioavailability, and metabolic activation to reactive intermediates 5,12Reference 5Zhang H et al. · 2021Systematic reviewThirteen bisbenzylisoquinoline alkaloids in five Chinese medicinal plants: botany, traditional uses, phytochemistry, pharmacokinetics and toxicity — systematic reviewView study →Reference 12Jin H et al. · 2011AnimalPulmonary toxicity and metabolic activation of tetrandrine in CD-1 mice — animal in vivoView study →.

What It's Used For

Tetrandrine is unusual among plant alkaloids in having genuine pharmacology and real clinical use. Its defining mechanism is non-selective L-type calcium-channel blockade, giving vasodilation and smooth-muscle relaxation, and it has been used in China for hypertension and — for decades — for silicosis as an antifibrotic 5,10Reference 5Zhang H et al. · 2021Systematic reviewThirteen bisbenzylisoquinoline alkaloids in five Chinese medicinal plants: botany, traditional uses, phytochemistry, pharmacokinetics and toxicity — systematic reviewView study →Reference 10Qian JQ · 2002ReviewCardiovascular pharmacological effects of bisbenzylisoquinoline alkaloid derivatives — reviewView study →.

Its more interesting mechanisms (two-pore-channel blockade, P-glycoprotein inhibition) are preclinical, and the anticancer concentrations far exceed anything a decoction delivers, so those results belong to the concentrated isolate.

A genuine calcium-channel blocker:vasodilation, negative inotropy and pulmonary-smooth-muscle relaxation, with older Chinese clinical use for hypertension and angina 10,11Reference 10Qian JQ · 2002ReviewCardiovascular pharmacological effects of bisbenzylisoquinoline alkaloid derivatives — reviewView study →Reference 11Wang HL et al. · 2002Effects of tetrandrine on smooth-muscle contraction induced by mediators in pulmonary hypertension — ex vivoView study →.
Real (if low-grade) silicosis evidence:decades of Chinese antifibrotic use, a 2025 retrospective cohort showing slowed lung-function decline in artificial-stone silicosis, and a 2026 randomised trial in which tetrandrine was the background therapy in both arms 4,17Reference 4Zhou S et al. · 2025ObservationalTetrandrine slows disease progression on high-resolution computed tomography and lung-function decline in artificial-stone-associated silicosis: a retrospective cohort study — observationalView study →Reference 17Xiao K et al. · 2026RCTThe clinical efficacy of hydrogen combined with tetrandrine in the treatment of silicosis fibrosis: a randomised controlled intervention studyView study →.
The honest headline:its evidence is old/observational or preclinical, it accumulates in lung and liver (the basis for both use and toxicity) 12Reference 12Jin H et al. · 2011AnimalPulmonary toxicity and metabolic activation of tetrandrine in CD-1 mice — animal in vivoView study →, and fang-ji-sourced material may carry aristolochic acid from botanical substitution 7,8Reference 7Nortier JL et al. · 2000ObservationalUrothelial carcinoma associated with the use of a Chinese herb (Aristolochia fangchi) — cohort studyView study →Reference 8Nortier J et al. · 2015ReviewNortier J, Pozdzik A, Roumeguere T, et al. (2015). [Aristolochic-acid nephropathy (“Chinese herb nephropathy”)] — review. Néphrologie & Thérapeutique. https://pubmed.ncbi.nlm.nih.gov/26515658/View study →.
Evidence by IndicationStrength of support · Beta

Mechanisms

Target / pathwayEffectRelevant to
L-type voltage-gated Ca²⁺ channel (block)vasodilation, negative inotropy, smooth-muscle relaxation
antihypertensive / antiarrhythmic
Two-pore channel TPC2 (endolysosomal Ca²⁺, block)blocks viral escape from the endosome
antiviral (EbolaSARS-CoV-2; preclinical)
P-glycoprotein / ABCB1 (inhibition)raises intracellular drug/co-drug levels
MDR reversal; drug interactions
IKK–IκBα–NF-κB (inhibition)↓ pro-inflammatory cytokines
anti-inflammatoryarthritisantifibrotic
Lysosomal trapping of the dibasic moleculevery large volume of distribution; heterogeneous tissue loading
lung/liver accumulation — use and toxicity
CYP-mediated bioactivation to reactive intermediatescovalent adduct formation
pulmonary and hepatic toxicity

Pharmacokinetics

Load-bearing, and better characterised than for most alkaloids on this scale.

Tetrandrine has poor aqueous solubility and low, variable oral bioavailability — limitation enough that a sizeable literature exists on nanocrystal and nanoparticle formulations to improve absorption 9Reference 9Ling J et al. · 2024ReviewAdvances in nano-preparations for improving tetrandrine solubility and bioavailability — reviewView study →. Systemic clearance is primarily hepatic metabolism, and metabolism includes activation to reactive intermediates implicated in its organ toxicity 3,12Reference 3Wang F et al. · 2024Quantitative pulmonary pharmacokinetics of tetrandrine for SARS-CoV-2 repurposing: a physiologically based pharmacokinetic modeling approachView study →Reference 12Jin H et al. · 2011AnimalPulmonary toxicity and metabolic activation of tetrandrine in CD-1 mice — animal in vivoView study →.

The distinctive feature is distribution. Tetrandrine is a dibasic, lipophilic molecule that is trapped in lysosomes, and that trapping was identified as the pivotal driver of its very large volume of distribution and its markedly uneven tissue loading — it also modulates absorption in the gut 3Reference 3Wang F et al. · 2024Quantitative pulmonary pharmacokinetics of tetrandrine for SARS-CoV-2 repurposing: a physiologically based pharmacokinetic modeling approachView study →. The practical result is high concentrations in lung and liver: modelling of the approved clinical dose put the unbound lung concentration at 1.67–1.74 µg/mL 3Reference 3Wang F et al. · 2024Quantitative pulmonary pharmacokinetics of tetrandrine for SARS-CoV-2 repurposing: a physiologically based pharmacokinetic modeling approachView study →. That lung tropism is the pharmacokinetic basis for both the silicosis use and the pulmonary toxicity, and route matters — in mice, inhaled administration raised lung exposure while reducing exposure elsewhere 16Reference 16Liu J et al. · 2023AnimalAntiviral effects and tissue exposure of tetrandrine against SARS-CoV-2 infection and COVID-19 — animal in vivoView study →.

Silicosis, and What the Trials Test

Silicosis is the indication that makes tetrandrine unusual: an irreversible fibrotic lung disease caused by inhaled crystalline silica, with essentially no approved pharmacotherapy anywhere, and a molecule used against it in one country for decades.

The evidence has never caught up with the use. The strongest observational data are a 2025 retrospective cohort in artificial-stone silicosis reporting slower HRCT progression and slower lung-function decline 4Reference 4Zhou S et al. · 2025ObservationalTetrandrine slows disease progression on high-resolution computed tomography and lung-function decline in artificial-stone-associated silicosis: a retrospective cohort study — observationalView study →. The strongest experimental data are a 2026 prospective, randomised, double-blind trial in 108 patients with stage II silicosis — and its design is the point. Both arms received tetrandrine; the randomisation was to added hydrogen inhalation or not 17Reference 17Xiao K et al. · 2026RCTThe clinical efficacy of hydrogen combined with tetrandrine in the treatment of silicosis fibrosis: a randomised controlled intervention studyView study →. It found that hydrogen plus tetrandrine improved carbon-monoxide diffusing capacity and lowered serum IL-6 relative to tetrandrine alone. That is a well-conducted trial of hydrogen, with tetrandrine as the assumed-effective background.

Which is the honest summary of the whole indication: tetrandrine’s silicosis efficacy is the premise of the trials rather than their finding. It is plausible — the antifibrotic mechanism is real, the lung concentrations are high, and the clinical tradition is long — and it has not been tested against no treatment in a modern randomised design.

Isolate vs. Plant Studies

Everything here is the isolate, and unusually the plant side barely exists.

Tetrandrine’s clinical use in China is as tetrandrine tablets — a purified single compound at a defined milligram dose 5Reference 5Zhang H et al. · 2021Systematic reviewThirteen bisbenzylisoquinoline alkaloids in five Chinese medicinal plants: botany, traditional uses, phytochemistry, pharmacokinetics and toxicity — systematic reviewView study →. The silicosis cohort and trial used that product 4,17Reference 4Zhou S et al. · 2025ObservationalTetrandrine slows disease progression on high-resolution computed tomography and lung-function decline in artificial-stone-associated silicosis: a retrospective cohort study — observationalView study →Reference 17Xiao K et al. · 2026RCTThe clinical efficacy of hydrogen combined with tetrandrine in the treatment of silicosis fibrosis: a randomised controlled intervention studyView study →. The antiviral, anticancer and MDR-reversal work all used purified tetrandrine at micromolar concentrations 1,6,16Reference 1Sakurai Y et al. · 2015Two-pore channels control Ebola virus host cell entry and are drug targets for disease treatmentView study →Reference 6Zhou X et al. · 2022In vitroTetrandrine overcomes drug resistance mediated by the bone-marrow microenvironment by regulating P-glycoprotein expression in acute leukemia — in vitroView study →Reference 16Liu J et al. · 2023AnimalAntiviral effects and tissue exposure of tetrandrine against SARS-CoV-2 infection and COVID-19 — animal in vivoView study →. No study anywhere gives Stephania tetrandra decoction and measures an outcome.

That gap is not academic. The concentrations at which tetrandrine is active far exceed what whole-plant material delivers, so a han fang ji decoction is not a low-dose version of the drug — it is a different exposure entirely, carrying the co-alkaloid fangchinoline and whatever else the root contains, and carrying the substitution risk described above. On the plant side, abuta and related Cissampelos/Abuta species are traditional medicines in which tetrandrine is one alkaloid among many, with no isolate-attributable human evidence at all.

Its Role in Plants

Tetrandrine’s biosynthesis was worked out by isotope feeding before any of the enzymes were cloned: labelled precursor studies established that the dimer is assembled from two benzylisoquinoline units through phenol coupling, in the pattern now known for the class 19Reference 19Bhakuni DS et al. · 1980Biosynthesis of the bisbenzylisoquinoline alkaloid, tetrandrineView study →. The enzymology was later solved in a relative — berbamunine synthase, a cytochrome P450 from Berberis, couples two N-methylcoclaurine molecules and the stereochemistry of the pairing decides which dimer results 20Reference 20Kraus PF · 1995Molecular cloning and heterologous expression of a cDNA encoding berbamunine synthase, a C–O phenol-coupling cytochrome P450 from the higher plant Berberis stoloniferaView study →. That is why Stephania tetrandra root accumulates tetrandrine, its demethyl analogue fangchinoline and its epimer isotetrandrine together rather than one clean product.

These alkaloids sit in the tuberous root, the plant’s perennial storage organ — the tissue with the most to lose to a herbivore and the longest to defend.

Prevalence in Nature

Bisbenzylisoquinoline alkaloids occur mainly in the Menispermaceae, Berberidaceae, Monimiaceae and Ranunculaceae of tropical and subtropical regions 5Reference 5Zhang H et al. · 2021Systematic reviewThirteen bisbenzylisoquinoline alkaloids in five Chinese medicinal plants: botany, traditional uses, phytochemistry, pharmacokinetics and toxicity — systematic reviewView study →. Tetrandrine is a Menispermaceae alkaloid, and its commercial source is one species: the tuberous root of Stephania tetrandra, the Chinese drug han fang ji. It travels there with fangchinoline, its demethyl analogue, and the two are routinely quantified together as the pair that defines the drug’s identity and quality 22Reference 22Li YQ et al. · 2007Li YQ, Chen XG, Qi YX, et al. (2007). [Determination of tetrandrine and fangchinoline in Radix Stephaniae tetrandrae and its preparation by nonaqueous capillary chromatography]. Zhongguo Zhong Yao Za Zhi. https://pubmed.ncbi.nlm.nih.gov/18161288/View study →.

It has also been reported from Cyclea species and from the Menispermaceae used as abuta (Cissampelos/Abuta spp.), where it is one member of a complex bisbenzylisoquinoline mixture rather than a dominant constituent.

Quantitatively the plant figures are thin. Analytical methods for tetrandrine and fangchinoline in Stephania tetrandra root and in finished preparations are established 22Reference 22Li YQ et al. · 2007Li YQ, Chen XG, Qi YX, et al. (2007). [Determination of tetrandrine and fangchinoline in Radix Stephaniae tetrandrae and its preparation by nonaqueous capillary chromatography]. Zhongguo Zhong Yao Za Zhi. https://pubmed.ncbi.nlm.nih.gov/18161288/View study →, but no consistent percentage range has been published that could be compared across provenances — and because the therapeutic material is purified alkaloid, nobody has needed one.

Major Natural Sources

SourcePartLevelNote
Stephania tetrandra (han fang ji)tuberous rootthe commercial source; not published as a rangemeasured together with fangchinoline as the pair defining the drug’s identity 22Reference 22Li YQ et al. · 2007Li YQ, Chen XG, Qi YX, et al. (2007). [Determination of tetrandrine and fangchinoline in Radix Stephaniae tetrandrae and its preparation by nonaqueous capillary chromatography]. Zhongguo Zhong Yao Za Zhi. https://pubmed.ncbi.nlm.nih.gov/18161288/View study →
Cyclea spp.rootnot quantifiedMenispermaceae, same tribe
Abuta (Cissampelos/Abuta spp.)root, stemnot quantifiedone member of a complex bisbenzylisoquinoline mixture, not a dominant constituent
Aristolochia fangchi (guang fang ji)rootnonea different family entirely; contains aristolochic acid instead 7,8Reference 7Nortier JL et al. · 2000ObservationalUrothelial carcinoma associated with the use of a Chinese herb (Aristolochia fangchi) — cohort studyView study →Reference 8Nortier J et al. · 2015ReviewNortier J, Pozdzik A, Roumeguere T, et al. (2015). [Aristolochic-acid nephropathy (“Chinese herb nephropathy”)] — review. Néphrologie & Thérapeutique. https://pubmed.ncbi.nlm.nih.gov/26515658/View study →

Discovery & Synthesis

Tetrandrine is a long-established alkaloid of Stephania tetrandra, named for the species; a single first-isolation date is not reliably fixed in the accessible record. Its biosynthesis was traced in 1980 by precursor-feeding experiments 19Reference 19Bhakuni DS et al. · 1980Biosynthesis of the bisbenzylisoquinoline alkaloid, tetrandrineView study →, and its clinical identity in China as a silicosis and antihypertensive drug dates from the middle of the twentieth century 5Reference 5Zhang H et al. · 2021Systematic reviewThirteen bisbenzylisoquinoline alkaloids in five Chinese medicinal plants: botany, traditional uses, phytochemistry, pharmacokinetics and toxicity — systematic reviewView study →.

The chemistry stayed difficult for a long time. Closing a macrocyclic bis-diaryl-ether while controlling two benzylic stereocentres is not easy, and the reference modern solution is a 2020 modular synthesis that reaches both tetrandrine and its epimer isotetrandrine from separately prepared halves — which is also the cleanest demonstration that the two epimers are a single connectivity with two configurations 18Reference 18Schütz R et al. · 2020A modular approach to the bisbenzylisoquinoline alkaloids tetrandrine and isotetrandrineView study →.

Supply is extraction, not synthesis. Tetrandrine tablets are made from Stephania tetrandra root, and most modern pharmaceutical work on the molecule is formulation rather than manufacture — nanocrystals, nanomicelles and inhaled preparations aimed at its poor solubility and its uneven tissue distribution 9,16Reference 9Ling J et al. · 2024ReviewAdvances in nano-preparations for improving tetrandrine solubility and bioavailability — reviewView study →Reference 16Liu J et al. · 2023AnimalAntiviral effects and tissue exposure of tetrandrine against SARS-CoV-2 infection and COVID-19 — animal in vivoView study →.

Patents: not yet researched (future patent-loop pass).

Toxicity & Safety

Tetrandrine has real, dose-dependent organ toxicity — but the bigger practical hazard is what you might actually be buying, since fang-ji material has historically been substituted with the aristolochic-acid-containing Aristolochia fangchi.

Safety at a Glance
Moderate toxicityDrug interactionsLiver riskCardiac risk
  • Dose-related pulmonary toxicity. It accumulates in lung tissue and is metabolically activated to reactive species; chronic dosing raises phospholipidosis concerns.
  • Dose-dependent liver toxicity at high exposure. Hepatic accumulation plus CYP-mediated bioactivation.
  • Botanical-substitution hazard. Real-world fang-ji product may carry aristolochic acid — the cause of the Belgian slimming-clinic nephropathy, not tetrandrine itself.
  • Avoid in pregnancy and lactation.
  • P-glycoprotein and likely CYP inhibitor. Can raise blood levels of co-administered substrate drugs.
  • Additive hypotension. Plausible alongside antihypertensives, given the calcium-channel blockade.
Full Safety & Interactions Detail

Tetrandrine carries real, dose-dependent toxicity plus a serious sourcing hazard. It accumulates in lung tissue and is metabolically activated to reactive species, and a controlled mouse study demonstrated dose-related pulmonary toxicity, with phospholipidosis-type concerns on chronic dosing — the same lung tropism that underlies its silicosis use 12Reference 12Jin H et al. · 2011AnimalPulmonary toxicity and metabolic activation of tetrandrine in CD-1 mice — animal in vivoView study →.

Hepatic accumulation and CYP-mediated bioactivation confer a dose-dependent liver-toxicity risk at high exposure 5,12Reference 5Zhang H et al. · 2021Systematic reviewThirteen bisbenzylisoquinoline alkaloids in five Chinese medicinal plants: botany, traditional uses, phytochemistry, pharmacokinetics and toxicity — systematic reviewView study →Reference 12Jin H et al. · 2011AnimalPulmonary toxicity and metabolic activation of tetrandrine in CD-1 mice — animal in vivoView study →, and quinone-methide formation is the proposed mechanism across the bisbenzylisoquinoline class 5Reference 5Zhang H et al. · 2021Systematic reviewThirteen bisbenzylisoquinoline alkaloids in five Chinese medicinal plants: botany, traditional uses, phytochemistry, pharmacokinetics and toxicity — systematic reviewView study →.

The load-bearing safety-context point is species confusion: han fang ji (Stephania tetrandra, the tetrandrine source) has historically been confused with or substituted by guang fang ji (Aristolochia fangchi), and the Belgian slimming-clinic nephropathy — aristolochic-acid nephropathy, including urothelial carcinoma — was caused by the Aristolochia substitution, not by tetrandrine 7,8Reference 7Nortier JL et al. · 2000ObservationalUrothelial carcinoma associated with the use of a Chinese herb (Aristolochia fangchi) — cohort studyView study →Reference 8Nortier J et al. · 2015ReviewNortier J, Pozdzik A, Roumeguere T, et al. (2015). [Aristolochic-acid nephropathy (“Chinese herb nephropathy”)] — review. Néphrologie & Thérapeutique. https://pubmed.ncbi.nlm.nih.gov/26515658/View study →. Tetrandrine is chemically unrelated to aristolochic acid and is not nephrotoxic or carcinogenic in that way, but the substitution hazard is genuine and unavoidable: real-world fang-ji product may carry aristolochic acid.

As a P-glycoprotein (and likely CYP) inhibitor, tetrandrine can raise blood levels of co-administered P-gp and CYP-substrate drugs — this is the mechanism it is deliberately used for in multidrug-resistance reversal, so it is not speculative 5,6Reference 5Zhang H et al. · 2021Systematic reviewThirteen bisbenzylisoquinoline alkaloids in five Chinese medicinal plants: botany, traditional uses, phytochemistry, pharmacokinetics and toxicity — systematic reviewView study →Reference 6Zhou X et al. · 2022In vitroTetrandrine overcomes drug resistance mediated by the bone-marrow microenvironment by regulating P-glycoprotein expression in acute leukemia — in vitroView study →. Additive hypotension with antihypertensives is plausible given the calcium-channel blockade 5Reference 5Zhang H et al. · 2021Systematic reviewThirteen bisbenzylisoquinoline alkaloids in five Chinese medicinal plants: botany, traditional uses, phytochemistry, pharmacokinetics and toxicity — systematic reviewView study →.

Dosage

There is no validated supplement dose, and nothing here is a recommendation.

ContextFormDose
Silicosis, hypertension (Chinese medical practice)tetrandrine tablets, oralroughly 60–120 mg/day in divided doses 5Reference 5Zhang H et al. · 2021Systematic reviewThirteen bisbenzylisoquinoline alkaloids in five Chinese medicinal plants: botany, traditional uses, phytochemistry, pharmacokinetics and toxicity — systematic reviewView study →
Silicosis trialtetrandrine tablets ± hydrogen inhalationapproved clinical dosage in both arms 17Reference 17Xiao K et al. · 2026RCTThe clinical efficacy of hydrogen combined with tetrandrine in the treatment of silicosis fibrosis: a randomised controlled intervention studyView study →
Antiviral, anticancer, MDR reversal—no human dose established; preclinical concentrations are substantially higher 1,6,16Reference 1Sakurai Y et al. · 2015Two-pore channels control Ebola virus host cell entry and are drug targets for disease treatmentView study →Reference 6Zhou X et al. · 2022In vitroTetrandrine overcomes drug resistance mediated by the bone-marrow microenvironment by regulating P-glycoprotein expression in acute leukemia — in vitroView study →Reference 16Liu J et al. · 2023AnimalAntiviral effects and tissue exposure of tetrandrine against SARS-CoV-2 infection and COVID-19 — animal in vivoView study →

Any fang-ji-sourced material must be verified free of aristolochic acid. These are doses studied in research and are not a personal recommendation.

References

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  3. Wang F, Dong L, Hu J, et al. (2024). Quantitative pulmonary pharmacokinetics of tetrandrine for SARS-CoV-2 repurposing: a physiologically based pharmacokinetic modeling approach. Frontiers in Pharmacology. https://pubmed.ncbi.nlm.nih.gov/39346557/
  4. Zhou S, Shi J, Chen Z, et al. (2025). Tetrandrine slows disease progression on high-resolution computed tomography and lung-function decline in artificial-stone-associated silicosis: a retrospective cohort study — observational. BMC Pulmonary Medicine. https://pubmed.ncbi.nlm.nih.gov/40684152/
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  22. Li YQ, Chen XG, Qi YX, et al. (2007). [Determination of tetrandrine and fangchinoline in Radix Stephaniae tetrandrae and its preparation by nonaqueous capillary chromatography]. Zhongguo Zhong Yao Za Zhi. https://pubmed.ncbi.nlm.nih.gov/18161288/