Tribulus terrestris · PhytoNexus

01 Identity and provenance

Accepted binomial: Tribulus terrestris
Common names: Gokshura
Family (APG IV): Zygophyllaceae
Part used: Fruit
Verification tier: Tier 2 · Verified Clinical columns reviewed and a source is on record.
Reviewer note (2026 audit): ACG Case Rep J 2024: PMC10849413 | MSKCC About Herbs monograph | VERIFIED 2026 - synthetic analogue, application, interactions, side effects and references populated from retrieved primary/regulatory sources (see References). Interaction entries are labelled CLINICAL (case reports or trials in humans) vs THEORETICAL (in-vitro or animal only). Marketed-formulation column intentionally left blank. | INTRINSIC

02 Constituent chemistry

Chemical class	Marker compound	Synthetic analogue in use
Steroidal saponins	Protodioscin Fruit	None established. Marketed against sildenafil / testosterone but there is no structural or validated functional equivalence.

The analogue column is what makes the interaction reasoning tractable: where a constituent has a marketed structural counterpart, the counterpart's interaction profile is the starting hypothesis for the plant.

Looking up structures and physicochemical properties from PubChem…

03 Stated application

Reported activity: Traditional aphrodisiac and antiurolithiatic (Gokshura). Trials in erectile dysfunction and late-onset hypogonadism are equivocal; observed effects may be nitric-oxide mediated and independent of testosterone.
Reported adverse effects: SERIOUS - documented human hepatotoxicity, nephrotoxicity (acute tubular necrosis) and neurotoxicity with seizure; severe hyperbilirubinaemia and acute renal failure. Steroidal saponin diosgenin implicated in hepatotoxic effect. Also gastric irritation and reflux.

04 Interaction matrix

Source column, verbatim: CLINICAL: case of rhabdomyolysis in a 71-year-old on long-term atorvastatin following Tribulus use. THEORETICAL: CYP450-mediated interactions.
Normalised onto 0 canonical drug classes below.

Predicted from constituent chemistry

These edges are not clinical findings. Each one is a rule inference: a constituent class in this plant is known to act on a target that the drug class also acts on. They are shown because a blank cell reads as “safe”, and for a Tier 1 entry a blank cell only means “not yet looked at”. Treat them as a literature-search agenda, not as a warning.

Drug class	Severity	Mechanism type	Provenance	Expected effect
Antidiabetic drugs (insulin, sulfonylureas, biguanides, GLP-1, SGLT2) Endocrine	3Major	PD-additive	predicted D	Symptomatic hypoglycaemia, sweating, tremor, confusion; severe events rep…	why ▾
Chemistry of this pair. Triterpene and steroidal saponins alter membrane permeability, inhibit platelet aggregation and show weak steroid-receptor affinity. Class mechanism. Hypoglycaemic botanicals act through insulin secretagogue, insulin-sensitising, alpha-glucosidase-inhibiting or glucose-transport routes. Added to a titrated pharmacological regimen the effects summate rather than plateau. Expected Symptomatic hypoglycaemia, sweating, tremor, confusion; severe events reported with insulin and sulfonylureas. Management Increase self-monitoring frequency for 2 weeks after starting or stopping. Anticipate a downward dose adjustment of insulin or sulfonylurea. Onset rapid Evidence D - in silico rule prediction only Find evidence for this pair Map this mechanism
Antiplatelet agents Haemostasis	3Major	PD-additive	predicted D	Prolonged bleeding time, surgical and post-procedural bleeding, bruising,…	why ▾
Chemistry of this pair. Triterpene and steroidal saponins alter membrane permeability, inhibit platelet aggregation and show weak steroid-receptor affinity. Class mechanism. Organosulfur compounds, gingerols, salicylates, ginkgolides and eugenol inhibit thromboxane A2 synthesis, platelet aggregation and PAF-mediated activation, duplicating the pharmacology of aspirin and P2Y12 blockers. Expected Prolonged bleeding time, surgical and post-procedural bleeding, bruising, haematuria. Management Stop the botanical 7-14 days before elective surgery or neuraxial anaesthesia. Record it on the pre-operative medicines list. Onset rapid Evidence D - in silico rule prediction only Find evidence for this pair Map this mechanism
Hormonal therapy, oral contraceptives and HRT Endocrine	3Major	PK-CYP3A4 induction + PD-oestrogenic	predicted D	Breakthrough bleeding and contraceptive failure; unpredictable effect in …	why ▾
Chemistry of this pair. Triterpene and steroidal saponins alter membrane permeability, inhibit platelet aggregation and show weak steroid-receptor affinity. Class mechanism. CYP3A4-inducing botanicals accelerate ethinylestradiol and progestin clearance. Separately, isoflavone, lignan and coumestan phyto-oestrogens bind oestrogen receptors and may add to or compete with prescribed hormones. Expected Breakthrough bleeding and contraceptive failure; unpredictable effect in hormone-sensitive malignancy. Management Advise a second, non-hormonal contraceptive method. Avoid phyto-oestrogens in oestrogen-receptor-positive breast cancer without oncology advice. Onset delayed Evidence D - in silico rule prediction only Find evidence for this pair Map this mechanism

05 Hazard register

organ toxicity - hepato-, nephro- and neurotoxicity documented d

06 Confusable material

No same-genus or shared-common-name entry in the corpus.

07 Mechanism map

Chemistry sorts to the left, pharmacology to the right. Dashed edges are predicted. Drag nodes, scroll to zoom, export at 3× for a figure.

species

chemical class

marker compound

drug class

expected effect

hazard

08 Open literature

Abstract-scoped query built from this binomial, its common names and its marker compounds, run live against Europe PMC, PubMed and OpenAlex, then ranked locally against an evidence hierarchy.

Checking openFDA spontaneous reports…

09 Isomechanistic neighbours

Species whose interaction profile overlaps this one, ranked by shared severity weight rather than by count — a shared contraindication counts for more than a shared minor signal. Practical use: these are the plants you should not stack with this one, because the mechanisms summate.

Species	Family	Shared classes	Jaccard
Gymnema sylvestre Gurmar	Apocynaceae	3	1.00
Achyranthes aspera Apamarga	Amaranthaceae	3	1.00
Sapindus mukorossi Reetha	Sapindaceae	3	1.00
Cheilocostus speciosus Kebuka	Costaceae	3	1.00
Dioscorea villosa Wild Yam	Dioscoreaceae	3	1.00
Dioscorea bulbifera Air Potato	Dioscoreaceae	3	1.00

10 References and notes

Source column: Talasaz AH et al. Nephrol Dial Transplant 2010;25:3792-3. doi:10.1093/ndt/gfq457

Talasaz AH et al. Nephrol Dial Transplant 2010

Talasaz AH et al. Nephrol Dial Transplant 2010 manual

25:3792-3. doi:10.1093/ndt/gfq457

doi:10.1093/ndt/gfq457 manual

BibTeX for all 2 records

@article{TalasazAHe2010,
  title = {Talasaz AH et al. Nephrol Dial Transplant 2010},
  author = {Talasaz AH et al.},
  journal = {Nephrol Dial Transplant},
  year = {2010},
}

@article{anon,
  title = {25:3792-3. doi:10.1093/ndt/gfq457},
  doi = {10.1093/ndt/gfq457},
}

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