⚠ Restricted by at least one regulator (EC) — see Regulatory alerts by country below.
⚠ See overview for critical safety [1]
ℹ️ Not obtained from food. Not applicable — this is not obtained from food in meaningful amounts; supplementation is the practical route.
🔬 Lab interpreter
ℹ️ No validated blood test. There is no established laboratory test to assess status or guide dosing for this ingredient. Clinical response and symptoms are the practical guide.
⚕ For professionals — confirm ranges against your local laboratory.
Clinical verdict
Rhubarb root has a unique dose-dependent paradox: LOW dose = astringent (anti-diarrheal), HIGH dose = laxative (anthraquinone stimulant). Same chronic-use risks as senna (hypokalemia, melanosis coli). Emodin is hepato/nephrotoxic at high doses. NOT the same as culinary rhubarb stalks (which are safe food). Critical: Da Huang is in many TCM formulas — patients may not realize they're taking a stimulant laxative [1].
1 How much do I need?
👤 Adults: Specific dosage data under clinical review
👴 Elderly: Specific dosage data under clinical review
🤰 Pregnancy: See guidance
AVOID — anthraquinones are stimulant laxatives; traditional emmenagogue [1].
👦 Pediatric: See guidance
Not recommended [1].
🏃 Athletes: Standard dose
⚖️ Obesity: Standard dose
Fat-soluble compounds may require dose adjustment in obesity.
🩺 Renal: Consult specialist
Dose adjustment may be needed in renal impairment.
🌱 Vegan: Standard dose
How to take
🍽 Timing: See overview [1].
💊 With food: See overview [1].
🚫 Avoid: See overview [1].
2 Which form?
| Form | Bioavailability | Vegan | Cost |
|---|---|---|---|
| ['Various forms', 'standard', 'See overview [1].'] | Standard | Check label |
3 Common questions
Key point ▼
Rhubarb root has a unique dose-dependent paradox: LOW dose = astringent (anti-diarrheal), HIGH dose = laxative (anthraquinone stimulant). Same chronic-use risks as senna (hypokalemia, melanosis coli). Emodin is hepato/nephrotoxic at high doses. NOT the same as culinary rhubarb stalks (which are safe food). Critical: Da Huang is in many TCM formulas — patients may not realize they're taking a stimulant laxative [1].
4 Clinical evidence
Strong
See overview [1]. HIGH
Moderate
See overview [1]. MODERATE
Insufficient
See overview [1]. LOW
5 Safety, toxicity & adverse events
Absolute contraindications
✕ Bowel obstruction, IBD (acute) or undiagnosed abdominal pain
✕ Pregnancy and lactation
Relative
⚠ History of calcium-oxalate kidney stones — high oxalate content
⚠ Chronic laxative use — electrolyte loss, dependence
⚠ Digoxin/diuretics — hypokalemia risk
6 Interactions
Drug interactions
Digoxin Major
Mechanism: Anthraquinone hypokalemia → digoxin toxicity (same as senna) [1].
7 Regulatory alerts by country
1 regulatory action on record, each linking to the issuing authority.
Restricted · 1
🇪🇺
EC — Hydroxyanthracene derivatives restricted in food supplements (2021 EU regulation).
Commission Regulation (EU) 2021/468 — hydroxyanthracene derivatives (aloe-emodin, emodin, danthron, and Aloe preparations) restricted/prohibited in food under Reg (EC) 1925/2006 Annex III.
Source ↗ · 2021-03-18
8 References (2)
[1]Zheng Y, et al. A review of the pharmacology of Rheum palmatum (Da Huang). Evid Based Complement Alternat Med. 2021;2021:6669143. doi:10.1155/2021/6669143 REVIEW Accessed: 2026-05-29
[2]Wang J, et al. Hepatotoxicity and nephrotoxicity of Rheum officinale anthraquinones. J Ethnopharmacol. 2021;270:113805. doi:10.1016/j.jep.2021.113805 REVIEW Accessed: 2026-05-29
9 Related articles
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10 Cite this page
Vancouver: Pkhakadze G. Rhubarb Root — safety profile [Internet]. Tbilisi: PHIG; 2026 [cited 2026 Jun 02]. Available from: https://eur-lex.europa.eu/eli/reg/2021/468/oj
APA 7th: Pkhakadze, G. (2026). Rhubarb Root — Safety profile. Public Health Institute of Georgia. https://eur-lex.europa.eu/eli/reg/2021/468/oj
📋 Editorial information
Author: Prof. G. Pkhakadze, MD, MPH, PhD
Institution: Public Health Institute of Georgia (PHIG)
Affiliation: David Tvildiani Medical University (DTMU)
First published: January 2026
Last reviewed: 2026-05-29
Next review: December 2026
References: 2 cited sources
COI: SupplementIndex receives no funding from supplement manufacturers. All content independently authored by PHIG.
Process: Systematic literature review
📄 License & reuse
Published under Creative Commons Attribution 4.0 International (CC BY 4.0). You may share and adapt for any purpose with attribution.
Pkhakadze G. "Rhubarb Root — Safety Profile." SupplementIndex, PHIG, 2026. https://eur-lex.europa.eu/eli/reg/2021/468/oj CC BY 4.0.
GP
Educational and public health purposes. CC BY 4.0. Consult your healthcare provider before starting any supplement. Corrections: info@accreditation.ge. Publisher: PHIG