Index of Herbs

Herbal formula

Triphala

Also known as Triphala churna, Triphala curna, Triphala choornam, Phala trika, Itrifal Saghir, three fruits

An Ayurvedic powder of three dried fruits, taken at night as a mild laxative. Its trials are small and product quality varies.

Main use: Occasional constipation

Long traditional use

3 ingredients

Updated October 10, 2026

Key points

  1. 01

    Three dried fruits in equal parts

    The Ayurvedic Formulary of India defines Triphala churna as equal parts of haritaki, bibhitaki, and amla fruit rind, taken at 3 to 6 g.

  2. 02

    No placebo-controlled constipation trial

    In the best trial, adults improved about as much on triphala powder as on a prescribed diet over four weeks. No placebo-controlled trial of triphala alone was found.

  3. 03

    Mouthwash results are more consistent

    Small randomized trials found triphala rinses cut plaque and gum inflammation about as well as chlorhexidine, although the trials differed widely.

  4. 04

    Weight and cholesterol results are early

    One Iranian trial found 4.8 kg more weight loss than placebo over 12 weeks, but a guggulu-triphala trial found no benefit for cholesterol or waist size.

  5. 05

    Check for heavy metals and interactions

    One in five Ayurvedic medicines bought online contained lead, mercury, or arsenic. Laboratory studies suggest triphala can block liver enzymes that clear medicines.

Triphala, Sanskrit for “three fruits,” is the best-known blend in Ayurveda, India’s traditional medicine. The Ayurvedic Formulary of India, the Government of India’s official compendium of classical recipes, defines Triphala churna (powder) as equal parts of the dried fruit rind of three trees: haritaki (Terminalia chebula), bibhitaki (Terminalia bellirica), and amalaki or amla (Phyllanthus emblica). It gives the dose as 3 to 6 g, taken with ghee, honey, or warm water, and traces the recipe to the Bhavaprakasha, a classical Ayurvedic text. Today triphala is sold worldwide as loose powder, tablets, capsules, liquid extracts, and mouthwashes, in the United States as a dietary supplement. Most people take it as a gentle bedtime laxative, which is why this page rates its evidence for occasional constipation. Commercial products do not always follow the classical recipe: some contain concentrated extracts rather than powdered fruit, many do not state the proportions, and some mix triphala with other laxatives such as senna and psyllium.

Peterson and colleagues (Journal of Alternative and Complementary Medicine 2017) write that triphala has been used in India for more than 1,000 years, according to the Charaka Samhita and the Sushruta Samhita, two foundational texts of Ayurveda. Charaka claimed that triphala taken daily with honey and ghee could let a person live a hundred years free of old age and disease, and Sushruta recommended it for ulcers and wounds. Ayurveda classes the formula as a tridoshic rasayana, a rejuvenating tonic considered suitable for every constitution, and describes it as a bowel tonic at low doses, a mild laxative at normal doses, and a purgative at high doses. The Ayurvedic Formulary of India lists its uses in Ayurvedic disease terms, among them eye diseases, weak digestion, loss of appetite, and skin disease. The blend traveled west as well. Persian medicine knows it as Itrifal Saghir, and Kamali and colleagues (DARU 2012) prepared it by kneading the three powdered fruits, in equal parts, with almond oil and honey, following the formula in Avicenna’s Canon of Medicine.

How triphala might work is not well understood. Peterson’s review names tannins, gallic acid, ellagic acid, and chebulinic acid as its major constituents and describes how gut bacteria turn these polyphenols into smaller compounds such as urolithins. Tarasiuk and colleagues (Chinese Medicine 2018) note that gallic acid is the main constituent of all three fruits and that haritaki fruit is 30–40% tannin. Tannins are astringent, and in rats with castor oil–induced diarrhea, triphala extracts actually slowed gut transit, so its laxative reputation is not simple to explain. Health Canada, which lets triphala products carry a traditional laxative claim, states that it is neither a stimulant nor a bulk-forming laxative, that its mode of action is unclear, and that the laxative effect is mild. This page covers what the three fruits are, what trials of the combination itself have found for constipation, gum health, and weight, how the classical powder and modern products are taken, and how to use them safely, including the heavy-metal problem in Ayurvedic products. Nothing here is medical advice.

See also

Herbs for Digestion and Bloating Herbs for Constipation

02 The blend

What’s in it

Ingredients in label order. Results from trials of this formula belong to the combination, not to any single herb in it.

  1. Haritaki · Dried fruit rind (pericarp)

    1 part (one third)

    Terminalia chebula

    The chebulic myrobalan, Terminalia chebula, listed first in the Ayurvedic Formulary of India. Its fruit is 30–40% tannin, and the Ayurvedic Pharmacopoeia of India lists constipation first among its uses.

    Read the haritaki monograph →

  2. Bibhitaki · Dried fruit rind (pericarp)

    1 part (one third)

    Terminalia bellirica

    The beleric myrobalan, Terminalia bellirica. The Ayurvedic Pharmacopoeia of India lists it for cough, hoarseness, eye diseases, and constipation. Human research on it alone is very limited.

    Read the bibhitaki monograph →

  3. Amla · Dried fruit rind (pericarp)

    1 part (one third)

    Phyllanthus emblica

    Indian gooseberry, Phyllanthus emblica (Emblica officinalis), rich in tannins and vitamin C. In a small study a concentrated amla extract slowed platelet clumping, which matters for people on blood thinners.

    Read the amla monograph →

03 Evidence

What the research shows

Long traditional use

Our rating for occasional constipation, based on trials of this combination.

The most relevant constipation trial is small and open. Saini and Agrawal (Journal of Ayurveda 2022) randomized 80 adults aged 18 to 60 with constipation at the National Institute of Ayurveda in Jaipur either to 3–6 g of Triphala churna at night after a meal with lukewarm water or to a dietary plan built on Ayurvedic principles, for four weeks. Triphala was the comparison arm; the diet was what the researchers set out to test. Six people dropped out of the triphala group and two from the diet group, leaving 72. Both groups improved significantly from their starting point on almost every measure, including stool form, straining, and the feeling of incomplete emptying, and the only differences between the groups favored the diet, which did better on weekly bowel movements and colic pain. No adverse effects were reported, and the institute funded the study. With no placebo group and no blinding, the trial cannot separate triphala’s effect from natural improvement, extra attention, or expectation, and it suggests that a prescribed diet did at least as well.

Other constipation evidence is weaker still. A study often cited for triphala, by Munshi and colleagues (Journal of Ayurveda and Integrative Medicine 2011), gave 34 people with functional constipation a proprietary powder for 14 days, and weekly bowel movements rose from about 10 to 18. But the product combined isabgol (psyllium) husk, senna extract standardized to sennosides, and triphala extract, and the study was open-label with no control group, so it shows what two established laxatives plus triphala can do, not what triphala adds. Tarasiuk and colleagues, in a review funded by the Medical University of Lodz and Poland’s National Science Centre, described it as a triphala trial, yet in the body of their review they concluded that the literature “does not provide any clear evidence” of triphala’s effect on the human digestive tract and found no trials in irritable bowel syndrome (IBS). Memorial Sloan Kettering Cancer Center (MSKCC) likewise says animal models suggest gut-protective effects but human studies are lacking. Because no placebo-controlled trial of triphala alone for constipation was found, this page rates it as long traditional use.

Triphala has more trials as a mouthwash than as a laxative. Pradeep and colleagues (Journal of Periodontology 2016) randomized 90 people with chronic gingivitis to a placebo, triphala, or chlorhexidine mouthwash twice daily. Over 60 days, plaque, gum inflammation, oral hygiene scores, and bacterial counts fell more with triphala than with placebo, and triphala and chlorhexidine did not differ on any measure. AlJameel and Almalki (International Journal of Dental Hygiene 2020) pooled seven randomized trials comparing triphala with chlorhexidine for plaque-induced gingivitis and concluded that triphala was equally effective, but the trials disagreed so much (heterogeneity of about 92% for gum inflammation and 96% for plaque) that the pooled result is uncertain. MSKCC calls the antiplaque results comparable to chlorhexidine but not definitive, and it notes a laboratory finding that triphala compounds may also activate enzymes that help mouth bacteria build biofilm. These trials are small, they measured plaque and gum scores rather than tooth loss, and because a rinse is spat out, they say nothing about swallowing triphala.

For weight and metabolic health, the most striking result comes from Iran. Kamali and colleagues (DARU 2012) randomized 62 people with obesity, aged 16 to 60, to 5 g of Itrifal Saghir, the three fruits in equal parts kneaded with almond oil and honey, or a look-alike placebo confection, twice daily for 12 weeks. The triphala group lost 4.82 kg more than the placebo group (95% confidence interval 3.52 to 6.11 kg) and 4.01 cm more from the waist, with no adverse effects and no changes in liver or kidney tests; the authors declared no competing interests, and the result has not been independently replicated. Phimarn and colleagues (Journal of Evidence-Based Integrative Medicine 2021), in a systematic review that received no funding, found 12 randomized trials with 749 participants published between 1990 and 2019. Six reported lower LDL cholesterol, total cholesterol, or triglycerides, five reported lower weight, body mass index, or waist size in people with obesity, and fasting glucose fell in people with diabetes but not in those without it. The authors warned that most trials were small, that many did not say whether they used powder or extract, and that doses varied widely.

Not every trial is positive. In a double-blind trial by Donato and colleagues (Complementary Medicine Research 2021), 90 adults with high cholesterol took guggulu, a tree resin, combined with triphala, or a placebo, three times daily for three months; cholesterol, body mass index, and waist size did no better than with placebo. In contrast, Ekanayaka and colleagues (Ceylon Medical Journal 2017) reported that a proprietary triphala caplet added to atorvastatin lowered cholesterol more than placebo in 198 Sri Lankan patients over three months. Regulators treat triphala as a traditional remedy. Health Canada’s 2024 monograph lets products claim traditional Ayurvedic use as a mild laxative for occasional constipation, an eye tonic, and a rejuvenating tonic. In the United States it is sold as a dietary supplement, which the Food and Drug Administration (FDA) does not approve before marketing, and we found no European Medicines Agency (EMA) herbal monograph for triphala or its fruits. Results from single-fruit extracts, such as those on the amla and bibhitaki pages, cannot be borrowed for the blend, and in a rat study cited by Tarasiuk, changing the proportions of the three fruits changed the effect.

04 In practice

How it is taken

The classical form is the powder. The Ayurvedic Formulary of India gives 3 to 6 g of Triphala churna, taken with ghee, honey, or warm water, and the Jaipur constipation trial used 3–6 g at night after a meal with lukewarm water. Modern products vary far more than the name suggests. Health Canada’s monograph allows dried powder or ethanolic extracts, with doses expressed as grams of dried fruit, and the trials in Phimarn’s review ranged from 250 mg capsules to 5 g of powder twice a day; many did not say whether they used powder or extract. Kamali’s weight trial used a confection with almond oil and honey, and Ekanayaka’s cholesterol trial used proprietary caplets. Mouthwashes are a separate product, rinsed and spat out. Because extracts are concentrated, a capsule and a spoonful of powder are not interchangeable, and a product labeled simply “triphala” may not state the share of each fruit. Some Ayurvedic laxative powders add senna or psyllium, as in the product Munshi and colleagues tested, which makes them a different product with a stimulant laxative in it.

For laxative use, Health Canada’s monograph sets 2 to 6 g of dried fruit a day for adults 18 and over, and 1 to 3 g a day when triphala is sold as a rejuvenating, digestive, or eye tonic. It tells users to take triphala a few hours before or after other medicines or health products, to ask a health care practitioner if symptoms worsen or if no laxative effect occurs within seven days, and not to use it as a laxative with a fever or any undiagnosed digestive trouble. The constipation trials lasted two to four weeks, the gingivitis trial 60 days, and the metabolic trials in Phimarn’s review from 25 days to a year, so there is little information on taking triphala for years. People who try it usually start at the low end of the range at night with water, and loose stools or cramps are a signal to cut back or stop. If you find you need a laxative most days for more than a couple of weeks, see a clinician about the cause rather than raising the dose.

Product quality matters more than brand claims. Saper and colleagues (JAMA 2008) bought 193 Ayurvedic medicines online and found lead, mercury, or arsenic in 20.7%, at similar rates for products made in the United States (21.7%) and in India (19.5%); every contaminated product exceeded at least one standard for acceptable daily intake, and 75% of them claimed to follow Good Manufacturing Practices. Products made by rasa shastra, the deliberate combination of herbs with metals, minerals, or gems, were contaminated more often (40.6% versus 17.1%). The study did not single out triphala, but the risk applies to any imported Ayurvedic powder or tablet. Look for a product that names all three species, states the amount of each fruit or extract per dose, contains no added metals or minerals, and publishes independent batch testing for heavy metals. Health Canada’s model label lists each of the three fruits with its amount per capsule, a useful standard to look for. Check whether the product also contains senna or other laxatives, stop it if it causes new symptoms, and bring the package to your clinician.

05 Caution

Before you use Triphala

In trials, triphala has been well tolerated over short periods. Phimarn’s review of 12 trials found no serious adverse events; only one trial reported side effects in its triphala group, namely loose stools in four people plus single reports of hard stools, altered taste, a skin reaction, and tiredness. The Jaipur constipation trial and Kamali’s 12-week weight trial reported no adverse effects, and MSKCC lists gastrointestinal side effects as rare. Health Canada treats a laxative effect as expected: products sold for other uses must warn that users may experience one. Ayurveda itself calls triphala purgative at high doses, so diarrhea, urgency, and cramps are the predictable result of taking too much, and repeated diarrhea can lead to dehydration and loss of salts, which matters most for older adults and people with kidney or heart disease. Rash is possible: in Donato’s trial, 2 of 46 people taking guggulu with triphala developed a hypersensitivity rash, against none on placebo, although guggulu may have caused it. Most trials were small, short, and not designed to detect uncommon harms.

Pregnancy and breastfeeding: there are no safety studies, the Jaipur trial excluded pregnant and breastfeeding women, and Health Canada requires labels to tell people who are pregnant or breastfeeding to ask a health care practitioner before use. A laxative with uncertain contents and a risk of metal contamination is best avoided unless an obstetrician or midwife advises it. Children: Health Canada’s monograph covers only adults 18 and over, and the trials of swallowed triphala enrolled adults and teenagers. Peterson notes that Ayurveda considers triphala suitable for the very young, but there are no modern safety data in childhood, and constipation in a child deserves a pediatric assessment rather than an adult herbal laxative. Health conditions: do not use triphala as a laxative if you have a fever or any undiagnosed digestive problem (Health Canada), ongoing diarrhea or diarrhea-predominant IBS (Tarasiuk), or a suspected bowel blockage. People with diabetes, a bleeding disorder, or kidney disease, those taking several prescription medicines, and anyone due for surgery should check with their clinician first, for the reasons below.

Drug-metabolizing enzymes: in human liver microsomes, Nontakham and colleagues (Heliyon 2022) found that a triphala extract inhibited the cytochrome P450 enzymes CYP1A2, CYP3A4, CYP2C9, and, more weakly, CYP2D6, and in rats 500 mg/kg of triphala raised blood exposure to phenacetin by about 61% and to midazolam by about 41%. MSKCC advises against triphala for people taking drugs broken down by CYP3A4 and CYP2D6. No study has measured this in people, but many common medicines rely on these enzymes, so ask a pharmacist, and follow Health Canada’s advice to take triphala a few hours apart from other medicines. Blood thinners: in an open crossover study of ten people with type 2 diabetes, 500 mg of amla extract reduced platelet clumping and prolonged bleeding and clotting times, alone and with clopidogrel or aspirin (Fatima and colleagues, Phytomedicine 2014). Diabetes medicines: Phimarn found lower fasting glucose with triphala in diabetes, so glucose-lowering drugs may act more strongly. Other laxatives such as senna add to the risk of diarrhea. We found no human interaction studies for haritaki or bibhitaki alone.

Constipation is usually harmless, but some symptoms need a clinician rather than a remedy: blood in or on the stool, black or tarry stools, unexplained weight loss, severe or constant abdominal pain, vomiting, a swollen belly with no wind passing, fever, or a lasting change in bowel habit, especially after middle age or with a family history of bowel cancer. Health Canada also advises seeing a practitioner if no laxative effect occurs within seven days or if symptoms worsen. Constipation that begins after starting a new medicine is worth raising with the prescriber, and constipation that keeps coming back deserves a look at its cause rather than a permanent laxative habit. For gum problems, bleeding or receding gums, loose teeth, or persistent bad breath need a dentist, because a mouthwash cannot treat periodontal disease. Finally, metal poisoning from contaminated products can build up slowly and be mistaken for other illness, so anyone who becomes unwell while taking an Ayurvedic product should show the product itself to their doctor and ask whether a blood lead test is appropriate.

06 Questions

Frequently Asked Questions

Classical Triphala churna is a powder of equal parts of three dried fruits: haritaki (Terminalia chebula), bibhitaki (Terminalia bellirica), and amla (Phyllanthus emblica), as set out in the Ayurvedic Formulary of India. Only the dried fruit rind is used. Modern products may use water or alcohol extracts instead of powdered fruit, may not state the ratio, and sometimes add other ingredients such as guggulu, senna, or psyllium, so check the label for the amount of each fruit.

It may help some people, but the evidence is weak. In the best trial, 80 adults were randomized to triphala powder or a prescribed diet for four weeks; both groups improved, the diet did slightly better on bowel frequency, and there was no placebo group. A study often quoted for triphala used a product that also contained psyllium and senna. Health Canada allows only a traditional-use claim and calls the effect mild. Fiber such as psyllium has much stronger evidence, and senna is a better-studied short-term option.

The Ayurvedic Formulary of India gives 3 to 6 g of powder with ghee, honey, or warm water, and the main constipation trial used 3–6 g at night after a meal. Health Canada’s monograph sets 2 to 6 g of dried fruit a day for adults as a laxative and advises taking it a few hours apart from other medicines. Extract capsules are more concentrated, so follow the label rather than converting. If nothing happens within seven days, Health Canada advises asking a practitioner rather than taking more.

Trials lasting weeks to months reported few side effects, mainly loose stools, but there are no long-term safety studies. Laboratory and animal research suggests triphala can block liver enzymes that clear many medicines, and contamination is a real risk: about one in five Ayurvedic medicines bought online in a 2008 JAMA study contained lead, mercury, or arsenic. If you need a laxative most days, it is worth finding out why rather than relying on any herb indefinitely.

The evidence is early. One Iranian placebo-controlled trial found that people with obesity lost about 4.8 kg more over 12 weeks on a triphala confection, and a 2021 review of 12 small trials reported lower weight or waist size in five of them. But the results have not been confirmed in large independent trials, and a three-month trial of guggulu with triphala found no change in body mass index or waist size. Laxatives are not a weight-loss tool, and repeated diarrhea is a reason to stop.

It looks promising. In a 90-person trial, triphala mouthwash used twice daily for 60 days reduced plaque and gum inflammation more than placebo and about as much as chlorhexidine, and a 2020 meta-analysis of seven trials reached a similar conclusion, though the trials varied widely. MSKCC calls the data not definitive. A mouthwash is an add-on to brushing, flossing, and dental checkups, and bleeding or receding gums need a dentist.

Ask a pharmacist first. In laboratory studies triphala blocked several liver enzymes that clear drugs, and in rats it raised blood levels of two test drugs by about 40% to 60%; this has not been studied in people. Amla, one of the three fruits, slowed platelet clumping in a small study, which matters with blood thinners, and triphala may lower fasting blood sugar in diabetes. Health Canada advises taking triphala a few hours before or after other medicines.

It has not been studied in either group. Health Canada’s monograph covers adults only and requires labels to tell people who are pregnant or breastfeeding to ask a health care practitioner first. Concerns about lead and mercury in Ayurvedic products apply with particular force in pregnancy and childhood. For constipation in pregnancy, fiber, fluids, and treatments recommended by a midwife or doctor are better choices, and a constipated child should see a pediatrician.

07 References

Sources

These references support the claims on this page. They are not an endorsement of any product. Each ingredient’s monograph carries its own full source list.

  1. The Ayurvedic Formulary of India, Part I (2nd revised English edition), entry 7:15 Triphala Curna

    Government of India, Ministry of Health and Family Welfare, via Internet Archive (Wellcome Library copy), 2003

    Classical recipe from the Bhavaprakasha: haritaki, bibhitaki, and amalaki pericarp, 1 part each; dose 3 to 6 g with ghee, honey, or warm water; uses listed in Ayurvedic terms including eye disease, weak digestion, and loss of appetite.

  2. Natural Health Product Monograph: Triphala

    Health Canada, Natural and Non-prescription Health Products Directorate, 2024

    Dated November 29, 2024: traditional Ayurvedic laxative, eye tonic, and rasayana claims; 2 to 6 g dried fruit a day for laxative use in adults; mode of action unclear and effect mild; take apart from other medicines; pregnancy, fever, and 7-day warnings.

  3. Therapeutic Uses of Triphala in Ayurvedic Medicine

    Journal of Alternative and Complementary Medicine (PubMed 28696777), 2017

    Peterson, Denniston, and Chopra: use for over 1,000 years per the Charaka and Sushruta Samhitas; tridoshic rasayana; bowel tonic, mild laxative, and purgative by dose; major constituents; gut microbial metabolism. First author partly funded by the Chopra Foundation.

  4. Triphala: current applications and new perspectives on the treatment of functional gastrointestinal disorders

    Chinese Medicine (PubMed 30034512), 2018

    Tarasiuk, Mosińska, and Fichna (PMC6052535): equal-part composition; haritaki 30–40% tannin; anti-diarrheal effect in rats; no clear evidence of an effect on the human digestive tract; no IBS trials; not suited to diarrhea-predominant IBS.

  5. A Randomized Controlled Trial to Evaluate the Laxative Effect of Prescribed Diet Compared with Triphala Churna in Vibandha with Special Reference to Constipation

    Journal of Ayurveda 16(2):106–111, 2022

    Saini and Agrawal: open randomized trial of 80 adults; 3–6 g triphala churna at night versus a prescribed diet for four weeks; 72 completed; both improved, the diet more on bowel frequency and colic pain; no adverse effects; funded by the National Institute of Ayurveda.

  6. An open-label, prospective clinical study to evaluate the efficacy and safety of TLPL/AY/01/2008 in the management of functional constipation

    Journal of Ayurveda and Integrative Medicine (PubMed 22022157), 2011

    Munshi et al. (PMC3193686): uncontrolled study in 34 patients of a powder combining isabgol (psyllium) husk, senna extract, and triphala extract; weekly bowel movements rose from 10.19 to 18.29 over 14 days.

  7. Triphala

    Memorial Sloan Kettering Cancer Center, About Herbs, 2022

    Last updated January 5, 2022: equal portions of the three fruits; human studies limited; gut benefits only in animals; plaque effects not definitive versus chlorhexidine; possible biofilm promotion; rare GI side effects; CYP3A4 and CYP2D6 inhibition.

  8. Triphala, a New Herbal Mouthwash for the Treatment of Gingivitis: A Randomized Controlled Clinical Trial

    Journal of Periodontology (PubMed 27442086), 2016

    Pradeep et al.: 90 people with chronic gingivitis; triphala mouthwash twice daily reduced plaque, gingival index, and microbial counts more than placebo over 60 days, with no difference from chlorhexidine.

  9. Effect of triphala mouthrinse on plaque and gingival inflammation: A systematic review and meta-analysis of randomized controlled trials

    International Journal of Dental Hygiene (PubMed 32383334), 2020

    AlJameel and Almalki: seven randomized trials of triphala versus chlorhexidine mouthwash; equal clinical efficacy for plaque-induced gingivitis, with heterogeneity of about 92% (gingival index) and 96% (plaque index).

  10. Efficacy of ‘Itrifal Saghir’, a combination of three medicinal plants in the treatment of obesity; A randomized controlled trial

    DARU Journal of Pharmaceutical Sciences (PubMed 23351558), 2012

    Kamali et al.: 62 obese adults; 5 g twice daily of the three fruits with almond oil and honey versus placebo for 12 weeks; 4.82 kg more weight loss and 4.01 cm more waist reduction; no adverse effects; no competing interests declared.

  11. Effects of Triphala on Lipid and Glucose Profiles and Anthropometric Parameters: A Systematic Review

    Journal of Evidence-Based Integrative Medicine (PubMed 33886393), 2021

    Phimarn, Sungthong, and Itabe: 12 randomized trials, 749 participants; lipid improvements in six and weight or waist reductions in five; lower fasting glucose only in diabetes; no serious adverse events; product forms and doses varied; no funding.

  12. Guggulu and Triphala for the Treatment of Hypercholesterolaemia: A Placebo-Controlled, Double-Blind, Randomised Trial

    Complementary Medicine Research (PubMed 33242870), 2021

    Donato et al.: 90 adults with high cholesterol; guggulu with triphala three times daily for three months was no better than placebo for total or LDL cholesterol, BMI, or waist size; 2 of 46 developed a hypersensitivity rash.

  13. Inhibitory effects of Triphala on CYP isoforms in vitro and its pharmacokinetic interactions with phenacetin and midazolam in rats

    Heliyon (PubMed 35785236), 2022

    Nontakham et al.: triphala extract inhibited CYP1A2, 3A4, 2C9, and 2D6 in human liver microsomes and raised phenacetin and midazolam exposure by about 61% and 41% in rats; no effect on P-glycoprotein.

  14. Study of pharmacodynamic interaction of Phyllanthus emblica extract with clopidogrel and ecosprin in patients with type II diabetes mellitus

    Phytomedicine (PubMed 24291054), 2014

    Fatima, Pingali, and Muralidhar: open-label crossover in 10 patients; amla extract alone and with clopidogrel or aspirin reduced platelet aggregation and prolonged bleeding and clotting times.

  15. Lead, mercury, and arsenic in US- and Indian-manufactured Ayurvedic medicines sold via the Internet

    JAMA (PubMed 18728265), 2008

    Saper et al.: 20.7% of 193 Ayurvedic medicines bought online contained lead, mercury, or arsenic (21.7% US-made, 19.5% Indian-made); rasa shastra 40.6% versus 17.1%; 75% of contaminated products claimed Good Manufacturing Practices.

  16. Questions and Answers on Dietary Supplements

    US Food and Drug Administration, 2026

    Under the Dietary Supplement Health and Education Act, the FDA does not approve dietary supplements or their labeling before they are marketed.

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