White Peony

Paeonia lactiflora · Bai shao · Total glucosides of paeony

Snapshot

Indications	Contraindications
Rheumatoid arthritis^1–4 Systemic lupus erythematosus^{5, 6} Psoriasis⁷ Oral lichen planus⁸ Recurrent aphthous ulcers⁹ Inflammatory arthritis²	Pregnancy or breastfeeding¹⁰ Bleeding disorders¹¹ Anticoagulant medication use¹¹

White peony is the root of Paeonia lactiflora (bai shao), and its concentrated extract, total glucosides of paeony (TGP), is used for immune-modulating and anti-inflammatory effects through inflammatory signaling pathways¹². That effect drives its use as an add-on in rheumatoid arthritis, systemic lupus erythematosus, psoriasis, oral lichen planus, and recurrent aphthous ulcers. Typical patients are adults with these chronic inflammatory conditions who already receive conventional therapy.

In psoriasis, TGP alone did not differ from other monotherapies, while add-on use showed an advantage. A 2026 pragmatic randomized trial in refractory oral lichen planus found faster complete response when TGP was added to prednisone. In postmenopausal women, a 2024 small clinical study of a topical cream combining five herbal extracts, including Paeonia lactiflora, reported less skin redness and facial flushing; no trial has replicated it¹³. Thousands of products list white peony, mostly liquids and capsules, with root powder and tea also sold; see Form comparison.

Diarrhea and abdominal symptoms are the adverse effects most consistently reported with TGP¹⁴. Health Canada lists a do-not-use statement for pregnancy and breastfeeding on its licensed products¹⁰. United States product labels ask users on anticoagulant or antiplatelet medications to consult a healthcare provider before use¹¹.

Last updated October 16, 2026. Read how we make monographs.

In the full monograph

37 sources, 32 studies

When to useThe situations practitioners use it for, each with the reason and the study behind it.
SafetyWho should avoid it, who needs extra care, and the side effects reported in studies.
InteractionsThe medicines and supplements it interacts with, the effect of each, and what labeling says to watch.
Protocol notesThe doses used in studies, how and when they were taken, and how the forms on the market compare.
How it worksWhat it is and how it works in the body, in plain terms.
Published studiesThe studies behind each use, popular claims checked against them, and trials still under way.
Word of mouthWhat patients and practitioners report online, kept separate from the clinical evidence.
Clinical perspectiveA closing read of where the evidence is solid, where it is thin, and what has not been studied.

Snapshot

In the full monograph

Sources