Rupturewort

Other Names

Behaartes BruchkrautBruchkrautBrudurtCent-en-granaChikilDense mat-plantErniaria glabraGlabrous rupturewortGranelludaGreen carpetHairy rupturewortHashishat Al FatikHerba de les mil granesHerba del mal de pedraHerbe nouéeHerniaireHerniaire glabreHerniaire hirsuteHerniaire velueHerniariaHerniàriaHerniaria africanaHerniaria alpestrisHerniaria arenariaHerniaria besseriHerniaria ceretanaHerniaria ceretanicaHerniaria cinereaHerniaria corrigioloidesHerniaria germanica var. glabraHerniaria glabraHerniaria glabra L.Herniaria glabra subsp. ceretanaHerniaria glabra subsp. microcarposHerniaria glabra subsp. nebrodensisHerniaria glabra subsp. rotundifoliaHerniaria glabra var. hirsutaHerniaria hirsutaHerniaria hirsuta L.Herniaria hirsuta var. incanaHerniaria incanaHerniaria incana Lam.Herniaria incana var. africanaHerniaria polymorpha proles glabraHerniaria vulgaris subsp. glabraHerniaria vulgaris subsp. hirsutaHerniariae herbaHerniaryHerniary breastwortHernioleKahles BruchkrautKnytlingLuddknytlingParonychia herniariaParonychia hirsutaParonychia incanaRupture wortShowailSmooth burstwortSmooth Rupture-WortSmooth rupturewortSmoother rupture-wortTrencapedraTurquette

Synopsis

Rupturewort (Herniaria glabra L.): A Comprehensive Reference

1. Identity and Botanical Classification

Taxonomic Position and Accepted Names

Herniaria glabra, the smooth rupturewort, is a plant of the family Caryophyllaceae, and grows in North America and Europe. It is an annual or biennial plant native to Northern Africa, Asia-Temperate, and Europe, and has been naturalized in Japan and North America. A noted botanical synonym is H. suavis Klokov.

Other common names include: smooth rupturewort, glabrous rupturewort, herniary, green carpet, brudurt (Danish), herniaire (French), Bruchkraut (German), and herniaria (Spanish). The drug form used in traditional European herbal medicine is known as Herniariae herba, which refers to the aerial parts (above-ground plant material) collected during flowering, and may encompass the allied species Herniaria hirsuta and H. incana.

The genus name Herniaria comes from the Latin word "hernia" because it was believed the herb could cure a hernia. This belief is also reflected in the English common name "rupturewort."

Morphology and Habitat

Herniaria glabra is a low-growing perennial, rarely exceeding 15 cm in height, with prostrate stems that form a dense mat carpet reminiscent of moss. It is usually a perennial but may also be an annual. Its short and hairy tap roots grow horizontally in all directions, thereby forming flat, circular mats that can be up to 30 cm in diameter.

Smooth rupturewort is native to Europe and western Asia, and is sometimes cultivated as a dense ground- or grave-cover. It is in flower in July and the seeds ripen in August. The species is hermaphrodite and is pollinated by insects, and is self-fertile. It is suitable for light (sandy) and medium (loamy) soils, prefers well-drained soil and can grow in nutritionally poor soil; it cannot grow in the shade and prefers dry or moist soil while being tolerant of drought.

There are around 15 to 20 species of annual or perennial plants that belong to the genus Herniaria. Most are found in Europe, Asia, and Africa, especially in the Mediterranean area. Rupturewort is the only species within the genus that is cultivated.

Drug Form and Preparations

Rupturewort is the common name for the flowering above-ground parts of the plants Herniaria glabra L., H. hirsuta L., or H. incana Lam. The HMPC conclusions of the European Medicines Agency (EMA) cover rupturewort preparations obtained by drying and comminuting (reducing into tiny pieces) the flowering parts of a single species or a mixture of them.

Herbal medicines containing rupturewort preparations are usually available as herbal tea to be drunk. Rupturewort preparations may also be found in combination with other herbal substances in some herbal medicines. Historically and in folk medicine, the plant appears in diuretic teas and blends used for "flushing" the urinary tract, easing water retention, and providing comfort during minor urinary complaints.

2. Traditional and Historical Use

European Tradition

Smooth rupturewort was first documented in European herbals of the 16th century. In traditional medicine, extract from the whole plant of H. glabra was valued chiefly as a diuretic agent with antispasmodic and hypotensive properties, and was widely used against cystitis, irritable bladder, and urinary tract infections, and to treat and prevent urolithiasis.

The first mention of the plant as a medicinal herb is from the 1500s, and it was used for centuries as a diuretic agent in the treatment of chronic cystitis and urethritis. It was also used traditionally as a treatment for ailments of the upper respiratory tract, arthritis, rheumatism, and as a "blood cleansing" agent.

In European folk medicine, H. glabra is also used to treat neuritis, neural catarrh, arthritis, and rheumatism, and applied as an antispasmodic agent for bladder disorders. An infusion of H. glabra is traditionally recommended for external application to manage skin conditions and diathesis, and as a poultice to support the healing of ulcers and wounds.

Historic herbalist preparations included decoctions, powders in wine, and expressed juices. Classical sources such as Schroder credited it with curing principally the rupture (hernia), internally and topically; promoting urine; breaking stones in the kidney and bladder; addressing gout and rheumatism; and cutting and bringing forth mucilage or slime in the stomach. Historical dosage forms recorded include: powder (approximately 3 grams taken in white wine for edema, strangury, and gravel); a decoction of the herb in water or wine (from one-quarter to half a pint); and juice (2 spoonfuls, up to 3 times daily).

In traditional medicine, Herniariae herba — which can consist of both H. glabra and H. hirsuta — is used in the form of an infusion as a urological drug.

North African Tradition

In traditional Moroccan medicine, Herniaria is widely used as a diuretic and for the treatment of kidney diseases. In Algeria, the plant is used with other herbs against gravel and catarrh of the bladder. The toxicology literature also notes that Herniaria glabra has been gathered when in bloom (June–July) and used as an astringent, diuretic, and expectorant in Moroccan traditional medicine.

Pharmacopeial Recognition

The ethnomedicinal significance of H. glabra has been confirmed by its presence in the pharmacopeias of several European countries, including Poland, Czech Republic, Austria, and Hungary. At the European regulatory level, the EMA's Committee on Herbal Medicinal Products (HMPC) has reached scientific conclusions on the medicinal uses of rupturewort, which are taken into account by EU Member States when evaluating applications for the licensing of herbal medicines containing rupturewort.

3. Key Constituents and Active Compounds

Triterpenoid Saponins (Herniariasaponins)

Saponins are the most abundant group of compounds present in smooth rupturewort's herb, up to 82% on a dry mass basis. These are predominantly glucuronide oleanane-type triterpenoid carboxylic acid 3,28-O-bidesmosides (GOTCABs), and their structural complexity in the Caryophyllaceae family is notably high.

Phytochemical analysis has revealed that Herniaria glabra contains triterpene saponins designated herniaria saponins I–VII, with aglycones including medicagenic acid, gypsogenin, and 16-hydroxy-medicagenic acid. In quantitative analyses, the total herniariasaponin content in H. glabra was found to reach 465.68 ± 3.24 mg/g, with dominant compounds HS1 (97.69 ± 2.99 mg/g), HS6 (81.73 ± 0.49 mg/g), and HS10 (60.28 ± 0.44 mg/g).

Flavonoids

Flavonols identified in H. glabra include narcissin, rutin, apiorutin, and nicotiflorin. Using LC-HR-QTOF-ESI-MS analysis, 38 non-saponin metabolites have been identified across Herniaria species, with the most abundant phenolic compound in H. glabra being narcissin (7.4%). Additional flavonoids reported include isoquercitrin, luteolin, and rutin, along with phenolic acids including caffeic and chlorogenic acid.

Coumarins

H. glabra contains herniarin, a methoxy analog of umbelliferone. Among the coumarins, herniarin and umbelliferone have been identified in Herniaria species. These compounds belong to the hydroxycoumarin class.

Other Compounds

Additional identified compounds in H. glabra include maltol derivatives (licoagroside B, maltoglabrosides A–C), benzyl β-gentiobioside, hydroxycoumarins (herniarin, scopoletin), and monosaccharides (pinitol, myo-inositol, mannitol). The herb also contains phenolic acids, tannins, and essential oil.

The saponins are amphipathic molecules that can influence membrane permeability and may account for the diuretic action seen in preclinical work. While constituent levels vary by species, harvest timing, and preparation method, standardized laboratory analyses of H. glabra demonstrate meaningful saponin content, and these compounds are frequently used as quality markers.

4. Mechanisms of Action

Diuretic Mechanism

While the precise mechanism in humans remains to be clarified, several plausible contributors exist. Triterpenoid saponins may modulate tubular handling of electrolytes or influence glomerular filtration indirectly, leading to an increase in isotonic urine output. Chronic oral administration of saponins from Herniaria glabra in animal studies has been shown to decrease arterial blood pressure and affect salt and water transport in renal tubules.

Antibacterial and Anti-Biofilm Mechanisms

The main constituents (herniariasaponins) are responsible for bactericidal activity against uropathogenic Escherichia coli and possess a strong inhibitory effect on biofilm formation. In a study comparing multiple medicinal plant extracts, extracts of H. glabra and Vaccinium vitis-idaea showed the highest growth-inhibitory effects against uropathogenic E. coli (p < 0.05). All tested extracts exhibited anti-biofilm activity.

Antioxidant and Anti-Inflammatory Mechanisms

Antioxidant properties of Herniaria purified extracts (PEs) were evaluated in an experimental model of human blood plasma exposed to peroxynitrite-induced oxidative stress. The assays demonstrated significant reduction of oxidative damage to protein and lipid plasma components, estimated by measurements of 3-nitrotyrosine, protein thiol groups, and thiobarbituric acid-reactive substances, as well as moderate protection of non-enzymatic antioxidant capacity.

Anti-inflammatory properties of the Herniaria PEs were evaluated in vitro as inhibitory effects against cyclooxygenases (COX-1 and COX-2) and concanavalin A-induced inflammatory responses. Related work on Herniaria fractions revealed protective effects against oxidative damage to blood plasma components, and the fractions effectively ameliorated the inflammatory response of concanavalin A-stimulated human peripheral blood mononuclear cells (PBMCs).

Xanthine Oxidase and Enzyme Inhibition

Twelve herniariasaponins, a purified crude extract, and the saponin fraction were evaluated in vitro for xanthine oxidase, collagenase, elastase, and tyrosinase inhibitory activity; selected saponins were also screened for cholinesterase inhibitory potential. As a result, no or low inhibition towards these enzymes was observed. This finding is notable because it suggests that the antiurolithiatic effect against uric acid stones does not appear to proceed via xanthine oxidase inhibition for these particular fractions.

5. Scientific Evidence by Area of Use

5.1 Urinary Tract — Diuresis and Irrigation Therapy

Regulatory conclusion (traditional use): The HMPC concluded that, on the basis of its long-standing use, rupturewort preparations can be used for minor problems affecting the urinary tract to increase the production of urine and flush the urinary tract. Rupturewort medicines should only be used in adults.

Preclinical evidence: Experiments were performed on male and female spontaneously hypertensive rats weighing 310–340 g (10 animals per group). Oral administration of 200 mg/kg/day of saponins from Herniaria glabra for 30 days resulted in a significant decrease in blood pressure in hypertensive rats. Systolic and diastolic blood pressure decreased significantly from 187.60 ± 20.63 / 119.00 ± 7.09 mmHg at day 0 to 141.60 ± 7.51 / 90.40 ± 7.68 mmHg at day 30 (p < 0.001).

Saponins administration in this animal model provoked a significant increase in urinary flow, and also increased potassium and sodium excretion (p < 0.001 in both cases). In controlled animal studies with standardized extracts of Herniaria glabra, researchers observed statistically significant increases in urine volume within 5–24 hours after dosing, along with increased urinary sodium, potassium, and chloride. At higher test doses, a saponin-rich fraction produced diuretic effects comparable to a reference loop diuretic in rats. These results are consistent with traditional reports of "flushing" actions and support the role of triterpenoid saponins as the primary active constituents.

Evidence strength: Modern preclinical research backs traditional claims of increased urine volume and electrolyte excretion, while EU herbal guidance provides practical dosing boundaries for adult use. At the same time, there are no robust human clinical trials for single-herb Herniaria glabra, so expectations should remain measured. The EMA/HMPC classification is as a traditional use product — meaning evidence of long-standing use is accepted in lieu of modern clinical trial data, rather than the product meeting the higher bar of "well-established use."

5.2 Urolithiasis — Kidney and Bladder Stones

Traditional basis: Ruptureworts are mainly recommended to alleviate disorders related to the urinary system, including kidney and bladder stones as well as bladder infections.

Preclinical evidence (botanical combination): The effect of a botanical formulation of Herniaria glabra, Agropyron repens, Equisetum arvense, and Sambucus nigra was studied as a preventive agent in an experimentally induced urolithiasis model in rats (using 0.75% ethylene glycol and 1% ammonium chloride). Rats were treated at doses of 30, 60, 125, 250, and 500 mg/kg of the plant extract formulation. Animals treated with 125 mg/kg had statistically significantly lower calcium oxalate crystal deposits compared to the control group; all doses statistically significantly decreased the number of microcalcifications compared to the control group; and the number of kidneys showing subcapsular fibrosis was significantly higher in the control group than in treated groups.

Mechanistic in vitro evidence: The physicochemical properties of Herniariae herba regarding antiurolithiasis and its anti-scalant and antimicrobial actions have been recognized in the literature. However, no study had been published (as of the cited review) specifically aiming at the impact of herniariasaponins on enzymes directly linked to urinary stone formation.

Evidence strength: Evidence for antiurolithiatic effects is preclinical (animal models and in vitro studies), and derived partly from combination formulas rather than H. glabra alone. No adequately powered, independent randomized controlled trials in humans have been identified in the peer-reviewed literature for this specific indication.

5.3 Antimicrobial Activity Against Uropathogenic E. coli

Saponin-rich H. glabra extracts show the strongest bactericidal activity among multiple tested plants in comparative assays. The growth of bacteria was totally inhibited by extract concentrations ranging from 1.0 to 20.0 mg/mL for H. glabra.

Evidence strength: This evidence is entirely in vitro. No human clinical trials examining the antimicrobial activity of rupturewort against urinary tract pathogens have been identified in the peer-reviewed literature.

5.4 Antioxidant Activity

A 2022 peer-reviewed study published in Molecules (PMC8779723) carried out phytochemical characterization and in vitro evaluation of antioxidant actions, anti-inflammatory effects, and cytotoxicity of purified extracts from three Herniaria species, including H. glabra. The total phenolic content in the purified extract of H. glabra was established at 13.0%. Antioxidant properties were evaluated in an experimental model of human blood plasma exposed to peroxynitrite-induced oxidative stress. The assays demonstrated significant reduction of oxidative damage to protein and lipid plasma components.

Evidence strength: Antioxidant activity has been demonstrated in vitro and in plasma-based ex vivo models. No human intervention trials assessing antioxidant outcomes with rupturewort have been identified.

5.5 Anti-Inflammatory Activity

Herniaria glabra has been reported to possess hypotensive, diuretic, antiurolithiasis, antimicrobial, insecticidal, and antioxidant effects in pharmacological review. Anti-inflammatory properties have been evaluated in vitro, including inhibitory effects against cyclooxygenases.

Evidence strength: Preliminary and in vitro only. No human clinical data for anti-inflammatory indications have been identified.

5.6 Hypotensive Effects

As noted above under diuresis, chronic oral administration of saponins from Herniaria glabra was shown to decrease arterial blood pressure and affect salt and water transport in renal tubules in animal studies. This is consistent with the diuretic mechanism and is an animal-only finding, with no human trial data identified.

6. Body Systems and Health Areas of Association

Urinary system: Diuresis, urinary tract flushing, cystitis, urethritis, urolithiasis prevention (kidney and bladder stones), and antispasmodic action on the bladder. This is the primary area of traditional and regulatory recognition.
Cardiovascular system: Hypotensive effects demonstrated in animal models via renal saponin mechanisms.
Musculoskeletal system: Traditional use as a treatment for arthritis and rheumatism.
Respiratory system: Traditional use for ailments of the upper respiratory tract.
Skin and wound healing: Traditional external application to manage skin conditions and diathesis, and as a poultice for ulcers and wounds.
Oxidative stress / systemic antioxidant: In vitro and ex vivo evidence for reduction of peroxynitrite-induced oxidative damage to blood plasma components.

7. Dosage Forms and Reported Dosages

Herbal Tea / Infusion

The typical preparation is 1.5–3 g of herb in 150 mL water, taken 3–5 times daily; with a maximum daily total of 10 g. Short-term adult use only is indicated. The EU herbal monograph specifies a maximum daily dose of 10 g.

In traditional medicine, Herniariae herba is used in the form of infusion as a urological drug. Harvesting is carried out during the flowering period, as it is at this time that the plant is richest in active ingredients.

Animal Study Doses (Not Directly Translatable to Humans)

The oral administration dose used in the spontaneously hypertensive rat study was 200 mg/kg/day of purified saponins from Herniaria glabra for 30 days. In the acute toxicology study, a lyophilized aqueous extract was administered to mice in single doses of 5–14.5 g/kg by gavage; the sub-chronic study administered the extract orally at doses of 1, 2, and 4 g/kg daily for 90 days to Wistar rats. These are animal doses and cannot be extrapolated directly to human dosing.

Regulatory Scope of Dosage

Modern regulatory summaries in Europe position Herniariae herba as a traditional herbal medicinal product for urinary tract flushing during minor complaints, intended for adults and short-term use.

8. Safety Considerations

Rodent Toxicology Studies

A dedicated investigation was carried out to evaluate the safety of an aqueous extract of Herniaria glabra by determining its potential toxicity after acute and sub-chronic administration in rodents. For the acute study, a lyophilized aqueous extract was administered to adult mice in single doses of 5–14.5 g/kg given by gavage, with general behavior and mortality determined for up to 14 days. In the sub-chronic dose study, the extract was administered orally at doses of 1, 2, and 4 g/kg daily for 90 days to Wistar rats, and selected biochemical and hematological parameters were determined after 30, 60, and 90 days.

In the acute study in mice, the crude aqueous extract caused dose-dependent general behavior adverse effects and mortality. However, because of the relatively high NOAEL values in the acute study and the lack of mortality or clinically significant changes in biological (except for hypoglycemia) and hematological parameters in rats after 90 days of daily dosing, it may be concluded that the HG extract does not appear to have significant toxicity except at high doses. In view of the doses consumed empirically in traditional medicine, there is a wide margin of safety for the therapeutic use of Herniaria glabra.

Side Effects Reported to Regulatory Bodies

At the time of the HMPC assessment, no side effects had been reported with these medicines.

Contraindications

Rupturewort preparation medicines must not be used in conditions where a reduced fluid intake is recommended, such as severe heart or kidney disease. Known allergy to Herniaria species or any component of the product is also a contraindication.

Use in Pregnancy and Lactation

Use is to be avoided during pregnancy and breastfeeding. No clinical safety data for these populations are available from the sources reviewed.

Drug Interactions

No well-documented, high-certainty drug interactions are established for Herniaria glabra. The main concern is pharmacodynamic — additive diuresis — rather than a specific enzyme inhibition or induction pathway. Concurrent use with diuretics or antihypertensives warrants caution, as added diuresis may alter blood pressure and electrolytes.

Duration of Use

Short-term adult use only is appropriate; users should stop and seek medical care if symptoms persist beyond two weeks.

9. Quality, Standardization, and Species Considerations

According to the EMA monograph, H. glabra can be used interchangeably with H. incana and H. hirsuta. These species are used altogether, most probably due to their similar phytochemical constituents, including GOTCABs, monodesmosidic derivatives of medicagenic acid, and rutinosides of quercetin and isorhamnetin.

Constituent levels vary by species, harvest timing, and preparation method. Standardized laboratory analyses of H. glabra demonstrate meaningful saponin content, and these compounds are frequently used as quality markers. Harvesting is carried out in the flowering period, since it is at this time that the plant is richest in active ingredients. Once dried, the herb should be kept in airtight containers and out of light.

10. Overall Evidence Assessment

Herniaria glabra is one of a small number of European medicinal plants with formal regulatory recognition at the EU level (EMA/HMPC traditional-use monograph) for urinary tract indications. On the basis of its long-standing use, the HMPC concluded that rupturewort preparations can be used for minor problems affecting the urinary tract to increase the production of urine and flush the urinary tract. This classification explicitly reflects a traditional-use category, not a well-established-use category backed by modern randomized controlled trials.

The phytochemical evidence for bioactive constituents — particularly triterpenoid saponins — is robust and well-characterized. Preclinical (animal) evidence supports diuretic, antispasmodic, antihypertensive, and antiurolithiatic mechanisms at pharmacological doses. In vitro evidence supports antimicrobial activity against uropathogenic E. coli and anti-inflammatory effects. However, as of the sources reviewed, there remains a significant absence of well-designed, adequately powered human clinical trials evaluating rupturewort as a single-herb preparation for any indication. The evidence base remains preliminary, preclinical, and (for the regulatory indication) traditional.

References

Health Conditions

Health conditions that Rupturewort may help support.

No conditions available.

Body Systems

Body systems that Rupturewort may help support.

No body systems available.