Sinopodophyllum hexandrum

01 Identity and provenance

Accepted binomial: Sinopodophyllum hexandrum
Common names: Indian Podophyllum
Family (APG IV): Berberidaceae
Part used: Rhizome
Verification tier: Tier 2 · Verified Clinical columns reviewed and a source is on record.
Reviewer note (2026 audit): Filley CM et al. Neurology 1982;32:308-11 | CDC STI treatment guidelines | VERIFIED 2026 (batch 3) - synthetic analogue, application, interactions, side effects and references populated from retrieved primary/regulatory sources. Interactions labelled CLINICAL vs THEORETICAL. Marketed-formulation column intentionally blank. | ROUTE

02 Constituent chemistry

Chemical class	Marker compound	Synthetic analogue in use
Aryltetralin lignans	Podophyllotoxin Rhizome	Etoposide, Teniposide, Etopophos (semi-synthetic derivatives of podophyllotoxin - a genuine plant-to-drug lineage).

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: Source of podophyllotoxin for semi-synthetic anticancer drugs. Podophyllin resin was used topically for anogenital warts, but CDC NO LONGER recommends it because safer alternatives exist. The Indian species contains about three times more podophyllotoxin than the American P. peltatum.
Reported adverse effects: SEVERE. Podophyllotoxin is lipid-soluble, crosses membranes readily and arrests the mitotic spindle (colchicine-like). NEUROTOXICITY is the most serious systemic effect - altered sensorium, confusion, hallucinations, stupor, seizures, coma, sensory ataxic neuropathy - plus bone marrow depression, GI irritation, hepatic and renal dysfunction. TOXIC BY THE TOPICAL ROUTE AS WELL AS ORAL: a 2-year-old died of multiorgan dysfunction after cutaneous exposure. Estimated fatal dose 0.3-0.6 g resin (about half a teaspoon of 25% podophyllin). Embryotoxic - limb malformations, septal heart defects reported. NO SPECIFIC ANTIDOTE.

04 Interaction matrix

Source column, verbatim: THEORETICAL: additive myelosuppression with cytotoxics. Systemic absorption is increased by application to large or denuded skin areas.
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
Cytotoxic and targeted anticancer drugs Oncology	4Contraindicated	PK-CYP3A4/UGT + PD-antagonistic	predicted D	Neutropenic sepsis and severe diarrhoea from over-exposure, or reduced an…	why ▾
Chemistry of this pair. Isoflavone and lignan aglycones bind oestrogen receptor beta with measurable affinity and inhibit aromatase and sulfotransferase. Class mechanism. Botanical CYP3A4 and UGT1A1 modulation alters exposure to irinotecan, taxanes, vinca alkaloids and kinase inhibitors. High-dose antioxidant botanicals may also oppose the oxidative mechanism of some cytotoxics and of proteasome inhibitors. Expected Neutropenic sepsis and severe diarrhoea from over-exposure, or reduced antitumour effect; boronic-acid proteasome inhibitors are directly antagonised by polyphenols. Management No botanical should be taken during active cytotoxic therapy without oncology sign-off. Record all supplements in the chemotherapy chart. Onset unspecified 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. Isoflavone and lignan aglycones bind oestrogen receptor beta with measurable affinity and inhibit aromatase and sulfotransferase. 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
Thyroid hormones and antithyroid drugs Endocrine	3Major	PK-absorption + PD-modulation	predicted D	Iatrogenic hyper- or hypothyroidism, unexplained TSH drift, loss of euthy…	why ▾
Chemistry of this pair. Isoflavone and lignan aglycones bind oestrogen receptor beta with measurable affinity and inhibit aromatase and sulfotransferase. Class mechanism. Guggulsterone stimulates thyroid function and T4-to-T3 conversion; goitrogenic glucosinolates and lithospermic acid suppress it; high-fibre and cation-rich botanicals bind levothyroxine in the gut and reduce absorption. Expected Iatrogenic hyper- or hypothyroidism, unexplained TSH drift, loss of euthyroid control. Management Separate levothyroxine from fibre and mineral products by 4 hours. Recheck TSH 6-8 weeks after any botanical change. Onset unspecified Evidence D - in silico rule prediction only Find evidence for this pair Map this mechanism

05 Hazard register

exposure route - systemically toxic by the TOPICAL route, not on

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
Pueraria tuberosa Vidarikand	Fabaceae	3	0.50
Sesamum indicum Til (Sesame)	Pedaliaceae	3	1.00
Schisandra chinensis Schisandra	Schisandraceae	3	1.00
Arctium lappa Burdock	Asteraceae	3	1.00
Pueraria montana var. lobata Kudzu	Fabaceae	3	0.50
Urtica dioica Stinging Nettle	Urticaceae	3	1.00

10 References and notes

Source column: Jain MK et al. Indian J Crit Care Med 2020;24:477-9. doi:10.5005/jp-journals-10071-23448

Jain MK et al. Indian J Crit Care Med 2020

Jain MK et al. Indian J Crit Care Med 2020 manual

24:477-9. doi:10.5005/jp-journals-10071-23448

doi:10.5005/jp-journals-10071-23448 manual

BibTeX for all 2 records

@article{JainMKeta2020,
  title = {Jain MK et al. Indian J Crit Care Med 2020},
  author = {Jain MK et al.},
  journal = {Indian J Crit Care Med},
  year = {2020},
}

@article{anon,
  title = {24:477-9. doi:10.5005/jp-journals-10071-23448},
  doi = {10.5005/jp-journals-10071-23448},
}

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