Evigrade
DrugsCosmetic ingredientsCalculatorsInteractionsEvigrade SkinEvigrade Meds ↗
ConditionsJournalMethodologyPro for practitioners
ESRU

Stinging nettle leaf

Botanical supplement, stinging nettle leaf (Urtica dioica folium); in the EU registered as a traditional-use herbal medicinal product (EMA HMPC) for mild rheumatic pain and as a diuretic; sold on iHerb for «blood detox» and immunity. NOTE: nettle root (Urtica dioica radix) is a different product, indicated for benign prostatic hyperplasia

ATC code: M01AX-NETTLE-LEAF

Brand names – supplements: NOW Nettle Leaf, Nature's Way Nettle Leaf, Gaia Herbs Nettle Leaf, Eclectic Institute Nettle LeafSupplements are not tested in clinical trials and are not registered as medications.

Updated · Methodology

Indications

C

Osteoarthritis

Adjunct

Nettle leaf is an over-the-counter herbal remedy. The Chrubasik systematic review (Phytomedicine 2007) analysed available nettle studies in joint and muscle pain: small open-label studies and one RCT by Randall (J R Soc Med 2000) using topical leaf stinging on base-of-thumb pain showed moderate VAS pain reduction, but methodology was weak, blinding incomplete and samples small. HMPC in 2010 recognised nettle leaf as adjunctive treatment in mild rheumatic and muscle pain based on traditional use, not RCT evidence. 2022 and 2019 recommend exercise, weight control, paracetamol and topical NSAIDs as first line in osteoarthritis, with short-course oral NSAIDs if needed. Nettle is not in international or Spanish rheumatology guidelines; it is not considered a substitute for NSAIDs, only an option as adjunct therapy in mild pain. If nettle leaf is being considered as an add-on to standard treatment for mild joint pain, discuss with a doctor – when combined with NSAIDs, monitor blood pressure and potassium because nettle has a diuretic effect.

Sources

  1. EMA HMPC: Community herbal monograph on Urtica dioica L. and Urtica urens L., folium (2010)
  2. Phytomedicine (Chrubasik et al.): A systematic review on the Rosa canina effect and efficacy profiles, plus a review on stinging nettle preparations in joint pain (2007)
  3. J R Soc Med (Randall et al.): Randomized controlled trial of nettle sting for treatment of base-of-thumb pain (2000)
  4. NICE: Osteoarthritis in over 16s: diagnosis and management (NG226) (2022)

ICD-10: M19 · ICD-11: FA0Z

Marketing claims without evidence base

The drug is promoted for these uses outside international guidelines. Each entry below is analyzed against AEMPS, FDA, EMA, Cochrane and major RCTs.

D

Body detoxification and cleansing

Not recommended

Stinging nettle leaf is sold as a way to "detox" or "cleanse" the body, usually in teas, infusions, and supplements. Studies have not shown a convincing benefit for this use, and there is no evidence base for "flushing out toxins". The liver and kidneys clear the body on their own, so a healthy person does not need separate "detox courses".

Sources

  1. EMA HMPC: Community herbal monograph on Urtica dioica L. and Urtica urens L., folium (2010)
  2. EFSA NDA Panel: Scientific Opinion on the substantiation of health claims related to Urtica dioica L. (2011)
How to read tiers A–F
  • AStrong evidence – first or second line in international guidelines
  • BRecommended in selected cases
  • CStudy data contradict each other
  • DBenefit not proven, no documented harm
  • FDocumented harm, or risk without benefit

Mechanism of action

Stinging nettle leaf contains chlorophyll, flavonoids (quercetin, kaempferol, rutin), caffeic and chlorogenic acids, sterols, minerals (iron, calcium, magnesium) and vitamins K and B. Histamine and acetylcholine in the stinging hairs cause the typical local burning contact dermatitis on touching the fresh plant, but they are inactivated in dried and processed material. HMPC in 2010 registered nettle leaf as a traditional-use herbal medicinal product for two indications: adjunctive use in mild joint and muscle pain, and increasing urine volume. Registration is based on at least 30 years of traditional European use, including 15 years in the EU, without RCT evidence. in 2011 rejected all nettle health claims. AESAN classifies the product as a complemento alimenticio without therapeutic indication. The main clinical pitfall is confusing the leaf with the root: nettle root is used for benign prostatic hyperplasia under a different profile (phytosterols) and its effects are not transferable.

Safety

Contraindications

  • Pregnancy and lactation (EMA HMPC 2010)
  • Children under 12 years
  • Severe heart or renal failure with oedema requiring registered diuretics
  • Warfarin therapy – nettle contains vitamin K and reduces anticoagulation
  • Diuretics or lithium – risk of hypokalaemia and electrolyte imbalance
  • Known nettle hypersensitivity

Serious adverse effects

  • Reduced warfarin efficacy with thrombosis risk
  • Hypokalaemia and dehydration when combined with diuretics
  • Severe allergic reactions in sensitised users (rare)

Common adverse effects

  • Gastrointestinal discomfort, nausea
  • Increased urinary frequency
  • Stinging contact dermatitis when handling the fresh plant

Pregnancy: can you take Stinging nettle leaf?

Nettle leaf safety in human pregnancy has not been studied in RCTs. EMA HMPC 2010 advises against use in pregnancy because of lack of data. Nettle contains vitamin K and may affect uterine tone. AEMPS and AESAN advise against supplements without therapeutic indication during pregnancy.

Breastfeeding: can you take Stinging nettle leaf?

Lactation safety has not been studied in RCTs. EMA HMPC 2010 advises against use in lactation. Nettle vitamin K can pass into human milk.

Calculate RID

Reference information, not a clinical decision. Discuss feeding pauses or changes with your physician or an IBCLC.

Check interaction with another drug

Opens the checker prefilled with this drug. Pick the second one from your regimen.

Open checker

Summary of a multi-drug list →

Medicine list: everything you take in one place →

Frequently asked

What is Stinging nettle leaf used for?

Stinging nettle leaf is evaluated for the following indications with varying evidence strength: Osteoarthritis (evidence tier C), Body detoxification and cleansing (evidence tier D). See the full indication matrix with dosing and citations above on this page.

What are the side effects of Stinging nettle leaf?

Common side effects of Stinging nettle leaf (≥ 1 in 100): Gastrointestinal discomfort, nausea, Increased urinary frequency, Stinging contact dermatitis when handling the fresh plant. See the Safety section for uncommon and serious reactions.

Is Stinging nettle leaf safe during pregnancy?

Nettle leaf safety in human pregnancy has not been studied in RCTs. EMA HMPC 2010 advises against use in pregnancy because of lack of data. Nettle contains vitamin K and may affect uterine tone. AEMPS and AESAN advise against supplements without therapeutic indication during pregnancy.

Is Stinging nettle leaf compatible with breastfeeding?

Lactation safety has not been studied in RCTs. EMA HMPC 2010 advises against use in lactation. Nettle vitamin K can pass into human milk.

Who should not take Stinging nettle leaf?

Stinging nettle leaf is contraindicated in: Pregnancy and lactation (EMA HMPC 2010); Children under 12 years; Severe heart or renal failure with oedema requiring registered diuretics; Warfarin therapy – nettle contains vitamin K and reduces anticoagulation; Diuretics or lithium – risk of hypokalaemia and electrolyte imbalance. Full list in the Safety section.

Other drugs in this group

Nimesulide, Proteolytic enzyme complex (bromelain, papain, pancreatin, trypsin, chymotrypsin, rutoside), Aceclofenac, Boswellia, Dexketoprofen, Glucosamine + Chondroitin, Ketorolac, Celecoxib