✓
No active regulatory warnings
Sources: FDA MedWatch, EMA EudraVigilance, WHO VigiBase, WADA Prohibited List · 2026-05-29
Updated: 2026-05-29 · v2.0 · Prof. G. Pkhakadze, MD, MPH, PhD📎 Cite 📄 PDF
1 Identity

Stephania (Fang Ji)

Stephania tetrandra — CONFUSION with Aristolochia
Use with CautionEvidence: ModerateRestricted
Stephania tetrandra (Han Fang Ji) was involved in the BELGIAN NEPHROPATHY DISASTER (1990s) — but due to MISIDENTIFICATION with Aristolochia fangchi (Guang Fang Ji) [1]. The confusion between 'Han Fang Ji' (Stephania, contains tetrandrine) and 'Guang Fang Ji' (Aristolochia, contains aristolochic acid — a potent nephrotoxin and carcinogen) caused >100 cases of end-stage renal failure and urothelial carcinoma in Belgian patients. This is the most consequential herbal misidentification in modern history and led to global restrictions on aristolochic acid-containing herbs [1].
4
Stephania (Fang Ji)
Stephania tetrandra — CONFUSION with Aristolochia
Use with CautionModerateRestricted
Clinical verdict: Stephania/Fang Ji is the entry point for the BELGIAN NEPHROPATHY DISASTER — >100 patients developed renal failure and cancer from Aristolochia fangchi misidentified as Stephania tetrandra. The most consequential herbal misidentification in history. 'Fang Ji' in Chinese can refer to EITHER plant. Any TCM product containing 'Fang Ji' must be verified at species level — Aristolochia = aristolochic acid = nephrotoxin + carcinogen [1].
RDA
IDENTITY VERIFICATION CRITICAL
Target
N/A
UL
No safe dose if contaminated
Category
Restricted
Population dosing
2 Risk self-assessment
HIGH RISK — see overview [1].
Select factors above to see your risk level
Clinical pearl for practitioners
SupplementIndex
Stephania (Fang Ji)
Stephania tetrandra — CONFUSION with Aristolochia · Use with Caution · Evidence: Moderate
RDA
IDENTITY VERIFICATION CRITICAL
Upper limit
No safe dose if contaminated
Evidence
Moderate
Clinical bottom line
Stephania/Fang Ji is the entry point for the BELGIAN NEPHROPATHY DISASTER — >100 patients developed renal failure and cancer from Aristolochia fangchi misidentified as Stephania tetrandra. The most consequential herbal misidentification in history. 'Fang Ji' in Chinese can refer to EITHER plant. Any TCM product containing 'Fang Ji' must be verified at species level — Aristolochia = aristolochic acid = nephrotoxin + carcinogen [1].
Do not miss
⚠ HIGH RISK — see overview [1]
Pregnancy
AVOID unless species verified by expert — Aristolochia contamination risk [1].
4 Lab interpreter

See overview

<12 Deficient
12–20 Insufficient
20–50 Optimal
50–100 Excess
>150 Toxic
Your level:
Enter a value above
⚕ For healthcare professionals. Does not replace clinical judgment.
5 Quick facts
CategoryRestricted
Safety levelUse with Caution
EvidenceModerate
RDAIDENTITY VERIFICATION CRITICAL
Upper limit (UL)No safe dose if contaminated
Scientific nameStephania tetrandra — CONFUSION with Aristolochia
HIGH RISK — see overview[1]
6 Dosage by population

Adults Moderate

See product label

Elderly Moderate

See product label
Consider reduced renal/hepatic clearance. Start at lower end of range.

Pregnancy Moderate

See guidance
AVOID unless species verified by expert — Aristolochia contamination risk [1].

Pediatric Moderate

See guidance
NOT recommended [1].

Athletes Limited

Standard dose

Obesity Limited

Standard dose
Fat-soluble compounds may require dose adjustment in obesity.

Renal Limited

Consult specialist
Dose adjustment may be needed in renal impairment.

Vegan Moderate

Standard dose
HIGH RISK — see overview [1].
7 Form comparison
FormBioavailabilityVeganCost/day
['See overview', 'restricted', 'See overview [1].']StandardCheck label
8 Clinical evidence

Strong evidence

See overview [1]. HIGH

Moderate evidence

See overview [1]. MODERATE

Insufficient evidence

See overview [1]. LOW
9 Safety

🚩 Red flags — when to stop and refer

● HIGH RISK — see overview [1]

Pregnancy

AVOID unless species verified by expert — Aristolochia contamination risk [1].

Pediatric

NOT recommended [1].
10 Toxicity and overdose

11 Drug interactions
See overview Major
Mechanism: See overview [1].
Effect: See overview [1].
Action: See overview [1].
12 Supplement interactions
13 Laboratory monitoring
See overview Primary
Target: N/A · N/A
See overview [1].
14 Deficiency and prevalence
0%
[1]

Risk factors

• HIGH RISK — see overview [1].
15 Frequently asked questions
Key safety ▼
Stephania/Fang Ji is the entry point for the BELGIAN NEPHROPATHY DISASTER — >100 patients developed renal failure and cancer from Aristolochia fangchi misidentified as Stephania tetrandra. The most consequential herbal misidentification in history. 'Fang Ji' in Chinese can refer to EITHER plant. Any TCM product containing 'Fang Ji' must be verified at species level — Aristolochia = aristolochic acid = nephrotoxin + carcinogen [1].
16 Regulatory status
See overview: [1].
17 References
[1]See overview for key references. REVIEW
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19 Cite this page
Vancouver
Pkhakadze G. Stephania (Fang Ji) — safety profile [Internet]. Tbilisi: Public Health Institute of Georgia; 2026 [cited 2026 May 30]. Available from: https://supplement.ge/ingredients/stephania-fang-ji/
APA 7th
Pkhakadze, G. (2026). Stephania (Fang Ji) — Safety profile. Public Health Institute of Georgia. https://supplement.ge/ingredients/stephania-fang-ji/
CC BY 4.0
🛡 SupplementIndex receives no funding from supplement manufacturers. All content independently authored by PHIG.
GP
Reviewed by Prof. G. Pkhakadze, MD, MPH, PhD
Editor-in-Chief, Georgian Medical Journal · Chair, PHIG
Last reviewed: May 2026 · Next: November 2026
This entry is provided for educational and public health purposes under CC BY 4.0. Consult your healthcare provider before starting any supplement. For corrections: info@accreditation.ge.
Publisher: PHIG · Editor-in-Chief: Prof. Giorgi Pkhakadze, MD, MPH, PhD