Kutki (Picrorhiza kurroa)
Also called Picrorhiza kurroa, picrorhiza, katuka, kutaki, picroliv, picrosides.
Best grade D across 5 graded outcomes Botanical Last checked
The short answer
From 9 sourcesKutki is a bitter Ayurvedic root used for liver complaints. The only placebo-controlled liver trial of kutki alone is a 1996 study of 33 people with acute viral hepatitis, in which bilirubin fell faster than on placebo. A 2024 trial of a kutki extract in mild COVID-19 reported faster recovery. Other trials used blends.
Every graded outcome on this page
5 rows · line = participants- DGrade DLiver fat in fatty liver disease with a blend containing picrolivFatty livern 127
- DGrade DRecovery from mild COVID-19 in older adultsCOVID-19 recoveryn 70
- DGrade DRecovery in acute viral hepatitis with a kutki-containing blendLiver testsn 58
- DGrade DBilirubin and liver enzymes in acute viral hepatitisLiver testsn 33
- DGrade DCough-related health status in COPDCOPD coughn 33
- 2 more graded outcomes, in the evidence chapter
Key facts
- Acute viral hepatitis
- Kutki root powder (375 mg three times daily for 2 weeks) brought bilirubin down to 2.5 mg/dL in about 27 days vs 76 days on placebo in 33 patients1
- Funding
- That trial was run at the Ciba Research Centre in Bombay, and it has not been repeated in the decades since1
- Blends
- A seven-herb Ayurvedic blend containing kutki sped recovery in acute viral hepatitis (58 patients) but caused stomach pain and diarrhea in some2
- COVID-19
- A patented kutki extract (300 mg/day for 30 days) shortened recovery to 4.5 days vs 9.1 on placebo in 70 adults over 50 with mild COVID-197
- Fatty liver
- A many-ingredient blend that includes picroliv reduced liver fat more than placebo over 12 weeks in 127 adults who completed the trial; kutki alone has not been tested8
- COPD
- A blend of Picrorhiza, ginkgo and ginger did not improve cough-related health status vs placebo over 8 weeks in 33 people with COPD3
What it is
Kutki (Picrorhiza kurroa) is a bitter Himalayan herb whose root and rhizome are used in Ayurveda, mainly for the liver.
Forms, side by side
3 forms named in our sources. The rest show what our data holds, and say plainly where it holds nothing yet.
Kutki (Picrorhiza kurroa) forms compared
3 forms| 3 forms | Root powder capsules standardized to picrosides | Patented kutki extract (AEV01) | Ayurvedic and patented blends |
|---|---|---|---|
| Absorption in people | Not measured in humans.1 | Not measured in humans.7 | Not measured.23 |
| GI tolerance | Adverse events are not reported in the 1996 trial abstract.1 | Over 30 days, 7 people on the extract and 11 on placebo had stomach or bowel side effects, and 3 on the extract (none on placebo) had low blood sugar episodes (full text).7 | Epigastric pain and diarrhea reported with one seven-herb blend.23 |
| Studied for | Acute viral hepatitis | Mild COVID-19 in older adults | Liver tests, COPD cough |
- Root powder capsules standardized to picrosides
- Patented kutki extract (AEV01)
- Ayurvedic and patented blends
- Studied for
- Liver tests, COPD cough
What the human research says
Human trials only, one row per outcome. The form line shows what each trial actually tested. Grades follow our evidence-grading policy.
Trial map
5 graded outcomes, largest study first5 graded outcomes: 4 improved, 1 no effect. The largest, a 2022 randomized trial of 127 people on liver fat in fatty liver disease with a blend containing picroliv, found an improvement.
1Liver fat in fatty liver disease with a blend containing picroliv
Improved · Grade D · RCT, 127 people, 2022
Adults with liver steatosis (Italy)
Dose, result and source| Outcome | Found | People | Study | Who was studied |
|---|---|---|---|---|
| Liver fat in fatty liver disease with a blend containing picroliv | Improved | 127 | Grade D · RCT, 2022 | Adults with liver steatosis (Italy) |
| Recovery from mild COVID-19 in older adults | Improved | 70 | Grade D · RCT, 2024 | Adults over 50 with mild COVID-19, added to standard care (India) |
| Recovery in acute viral hepatitis with a kutki-containing blend | Improved | 58 | Grade D · RCT, 2010 | Patients with uncomplicated acute viral hepatitis (India) |
| Cough-related health status in COPD | No effect | 33 | Grade D · Pilot RCT, 2014 | Adults with COPD and chronic cough (UK) |
| Bilirubin and liver enzymes in acute viral hepatitis | Improved | 33 | Grade D · RCT, 1996 | Patients with acute viral hepatitis, hepatitis B surface antigen negative (India) |
Every graded row
5 rowsShowing 5 of 5 outcomes. Human trials only.
DGrade DLiver fat in fatty liver disease with a blend containing picrolivFatty liverLess liver fat (blend)RCT
n 127 · 2022
Improved After adjustment, liver fat (CAP score) fell more with the blend than with placebo (−34 vs −20 dB/m, p = 0.045).
- Design
- RCT, n = 127, 2022
- Population
- Adults with liver steatosis (Italy)
- Form
- Livogen Plus (curcumin, bergamot polyphenols, artichoke leaf, black seed oil, fish oil, picroliv root, glutathione, SAMe and other ingredients) vs maltodextrin placebo
- Dose
- Six softgels daily
- Duration
- 12 weeks
- Source
- Reference 8 · PubMed 35986358 (opens PubMed)
DGrade DRecovery from mild COVID-19 in older adultsCOVID-19 recoveryFaster recoveryRCT
n 70 · 2024
Improved Time to recovery was 4.5 days with AEV01 vs 9.1 days with placebo; oxygen saturation and cough improved faster, and severity scores improved from day 3.
- Design
- RCT, n = 70, 2024
- Population
- Adults over 50 with mild COVID-19, added to standard care (India)
- Form
- AEV01, a patented kutki (Picrorhiza kurroa) extract, vs placebo
- Dose
- 100 mg three times daily (300 mg/day)
- Duration
- 30 days
- Source
- Reference 7 · PubMed 38320447 (opens PubMed)
DGrade DRecovery in acute viral hepatitis with a kutki-containing blendLiver testsFaster recovery (blend)RCT
n 58 · 2010
Improved Weakness resolved sooner, and more patients had normal bilirubin and ALT at 2, 4 and 8 weeks; epigastric pain and diarrhea were reported with Livwin.
- Design
- RCT, n = 58, 2010
- Population
- Patients with uncomplicated acute viral hepatitis (India)
- Form
- Livwin capsules (ashwagandha, arjuna, bhumyamalaki, daruharidra, guduchi, kutki, punarnava) vs lactose placebo
- Dose
- Two capsules twice daily
- Duration
- 8 weeks plus 4 weeks follow-up
- Source
- Reference 2 · PubMed 21455448 (opens PubMed)
DGrade DBilirubin and liver enzymes in acute viral hepatitisLiver testsFaster bilirubin recoveryRCT
n 33 · 1996
Improved Bilirubin, SGOT and SGPT differed significantly between groups; time for bilirubin to fall to 2.5 mg/dL was 27.4 days with kutki vs 75.9 days with placebo.
- Design
- RCT, n = 33, 1996
- Population
- Patients with acute viral hepatitis, hepatitis B surface antigen negative (India)
- Form
- Picrorhiza kurroa root powder capsules (standardized to picrosides) vs matching placebo
- Dose
- 375 mg three times daily (1,125 mg/day)
- Duration
- 2 weeks
- Source
- Reference 1 · PubMed 9715310 (opens PubMed)
DGrade DCough-related health status in COPDCOPD coughNo significant benefitPilot RCT
n 33 · 2014
No effect Leicester Cough Questionnaire change did not differ (difference 1.8, p = 0.28); St George's Respiratory Questionnaire favoured AKL1 but was not significant (p = 0.064).
- Design
- Pilot RCT, n = 33, 2014
- Population
- Adults with COPD and chronic cough (UK)
- Form
- AKL1 (Picrorhiza kurroa, Ginkgo biloba and ginger extracts) vs placebo, added to usual care
- Dose
- Twice daily
- Duration
- 8 weeks
- Source
- Reference 3 · PubMed 25031533 (opens PubMed)
Animal studies: drug metabolism
1 noteRat and test-tube work, not tested in people; not an interaction finding.
- CYP2C and CYP3A (rats)
- In rats, repeated picroside II (a main kutki compound) reduced CYP2C activity at the higher dose (10 mg/kg) and raised CYP3A activity at the lower dose (2.5 mg/kg), measured with probe drugs such as diclofenac and midazolam; it did not inhibit human liver enzymes in the test tube. No human study has tested this.9
What the numbers add up to
Each point is worked out from the data and the sources numbered on this page, with the arithmetic shown under it. It adds no new data and is not medical advice.
Studied doses
Doses used in research, shown against the official limits. They describe the studies, not a recommendation for you.
Studied doses in research, not advice. These are amounts used in research, not personal advice. Your clinician or pharmacist can say what fits you.
Doses studied in human trials
When trials measured an effect
2 outcomes| Outcome | Measured at | Basis |
|---|---|---|
| Bilirubin in acute viral hepatitis | About 27 days to reach 2.5 mg/dL (vs about 76 on placebo) | 1996 trial of root powder 1,125 mg/day for 2 weeks in 33 patients1 |
| Mild COVID-19 severity scores | From day 3 | 2024 trial of a kutki extract 300 mg/day in 70 older adults; ordinal and early-warning scores improved from day 3 to the end of the study7 |
Interactions and safety
Published interactions only: each row cites a source. No row means none was found in our sources, not that a combination is safe.
What Kutki meets
0 cited rows 5 tested togetherMedicines 0
No medicine rows in our sources.
Supplements and foods 5
- Tested together in a graded trial
Choose a medicine or supplement above to read its cited rows here.
Also cited: 5 tested together
AshwagandhaAshwagandha page
Tested together
Recovery in acute viral hepatitis with a kutki-containing blend. Graded on the Kutki page; tested together is not a claim that they work better together.
GingerGinger page
Tested together
Cough-related health status in COPD. Graded on the Kutki page; tested together is not a claim that they work better together.
Ginkgo bilobaGinkgo biloba page
Tested together
Cough-related health status in COPD. Graded on the Kutki page; tested together is not a claim that they work better together.
Terminalia arjunaTerminalia arjuna page
Tested together
Recovery in acute viral hepatitis with a kutki-containing blend. Graded on the Kutki page; tested together is not a claim that they work better together.
Tinospora cordifoliaTinospora cordifolia page
Tested together
Recovery in acute viral hepatitis with a kutki-containing blend. Graded on the Kutki page; tested together is not a claim that they work better together.
Interactions
0 agentsNone found in our sources.
Check with what you take
Kept on this device onlyAdd what you take. We list every interaction our evidence profiles cite between Kutki and your picks, and between your picks.
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Add a supplement or medicine you take to check it against Kutki.
Starting from one medicine? The interaction checker rates how serious each pair is, on a curated list of 19 entries for 11 medicines. This cabinet has no severity rating: it lists every interaction row our supplement pages cite.
Who should be careful
5 groups- People with hepatitis or other liver disease
- The only single-herb trial lasted 2 weeks in 33 people and has not been repeated; most other liver-protection evidence comes from animal and cell studies. It does not support using kutki in place of medical care for liver disease.15
- People prone to diarrhea or stomach upset
- Kutki is used traditionally as a laxative, and a blend containing it caused epigastric pain and diarrhea in some patients.42
- Drug interactions
- No published human drug-interaction studies were found. In rats, picroside II changed the activity of CYP2C and CYP3A enzymes that clear many drugs, so anyone on prescription medicine should check with a pharmacist.94
- People with autoimmune disease or on immunosuppressants
- In mice, kutki extract strongly stimulated the immune system, boosting both cell-mediated and antibody responses. Whether this worsens autoimmune disease or weakens immunosuppressant drugs in people has not been studied, so this is a theoretical concern.6
- Pregnancy and breastfeeding
- A 2022 review describes kutki as abortifacient and says it should be avoided in pregnancy. LactMed has no entry, and no trial has included pregnant or breastfeeding women, so there are no safety data for breastfeeding.4
How to read the label
What to check on the Supplement Facts panel.
How to read the label
2 checksStandardization
The 1996 trial capsules contained about 2.7-2.9 mg picroside I and 5.5-6.0 mg picroside II each; products standardized to picrosides are closest to what was studied.1
Frequently asked questions
Short answers to common questions; the numbers link to the sources below.
Common questions
5 answersDoes kutki help fatty liver?
What are the side effects of kutki?
Human data are minimal. A 2022 review notes no documented adverse effects from kutki root extracts despite wide use in India, but a seven-herb blend containing kutki caused stomach pain and diarrhea in some patients, and in a COVID-19 trial 3 people on a kutki extract (none on placebo) had low blood sugar episodes.427
Is kutki safe to take long term?
Is kutki the same as picrorhiza?
Yes. Kutki is the common Indian name for Picrorhiza kurroa.1
Sources
9 sources: trial abstracts, NIH fact sheets and reference databases. Numbers in the text link here.
Sources cited on this page
9 sources- 1Picrorhiza kurroa (Kutaki) Royle ex Benth as a hepatoprotective agent--experimental & clinical studies.RCT J Postgrad Med, 1996 · PMID 9715310
- 2Efficacy and safety of livwin (polyherbal formulation) in patients with acute viral hepatitis: A randomized double-blind placebo-controlled clinical trial.RCT Int J Ayurveda Res, 2010 · PMID 21455448
- 3Adjunctive treatment with oral AKL1, a botanical nutraceutical, in chronic obstructive pulmonary disease.Pilot RCT Int J Chron Obstruct Pulmon Dis, 2014 · PMID 25031533
- 4Pharmacological and Clinical Efficacy of Picrorhiza kurroa and Its Secondary Metabolites: A Comprehensive Review.Review Molecules, 2022 · PMID 36500409
- 5Picrorhiza kurroa, Royle ex Benth:Traditional uses, phytopharmacology, and translational potential in therapy of fatty liver disease.Review J Ayurveda Integr Med, 2023 · PMID 35659739
- 6Immunomodulating agents of plant origin. I: Preliminary screening.Animal study J Ethnopharmacol, 1986 · PMID 3560991
- 7A randomized, placebo controlled, double blinded, parallel group clinical study to evaluate the efficacy and safety of AEV01 along with standard care for elderly patients with mild COVID-19.RCT J Ayurveda Integr Med, 2024 · PMID 38320447
- 8A new nutraceutical (Livogen Plus®) improves liver steatosis in adults with non-alcoholic fatty liver disease.RCT J Transl Med, 2022 · PMID 35986358
- 9Evaluation potential effects of Picroside II on cytochrome P450 enzymes in vitro and in vivo.Animal study J Ethnopharmacol, 2023 · PMID 37192720
What changed
Every dated change to this page: what changed, who made it and why.
Change log
3 entries| Date | Change | Who and why |
|---|---|---|
| evidence, summary, key facts, forms, studied doses, who should avoid, interactions, FAQ, questions, time to effect, related | Added a 2024 trial of a patented kutki extract in 70 older adults with mild COVID-19 and a 2022 fatty liver trial (140 enrolled, 127 analysed) of a many-ingredient blend containing picroliv, with the extract as a new form. Added a rat CYP2C/CYP3A signal for picroside II as a research note (animal data, not an interaction row), reworded the immune-stimulation caution, and a pregnancy note citing a 2022 review that calls kutki abortifacient; LactMed, LiverTox and NCCIH have no kutki entry. Rewrote the FAQ around side effects, long-term safety and fatty liver, added page questions, time-to-effect rows and goal-hub links. PubMed found no meta-analysis or other single-herb trial; a 19-patient multi-herb lipid pilot (2022) was not added. | Writer: Kymata Health EditorialTrigger: A–Z audit against docs/supplements/AUDIT-STANDARD.md |
| all | Initial editorial evidence review (first draft). Every PMID checked against NCBI E-utilities esummary (titles and years taken from the record, none retracted) and the abstract read for each cited row. Studied doses are reported as research doses, not dosing advice. | Writer: Kymata Health EditorialTrigger: new page |
| evidence, safety | Adversarial review: COPD pilot regraded from no-effect to D (too small to rule out an effect); added autoimmune and immunosuppressant caution (mouse immunostimulation data, labelled theoretical); liver caution notes animal-only evidence. | Writer: Kymata Health EditorialTrigger: adversarial review |
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