[Advances of toxicity evaluation of cinnabar and compatibility necessity analysis]

Cinnabars are widely used in the clinic and shows unique efficacy, and it has been used in treating diseases for thousands of years either single-use or combination with other traditional Chinese medicines. Cinnabar mainly contains mercury, which displays obvious hepatotoxicity and nephrotoxicity. The safety of cinnabar and its rational use caused extensive attention. However, there are some misunderstanding that cinnabar shows equivalent toxicity to the toxicity of mercury compounds such as mercuric chloride and methylmercury in safety evaluation of cinnabar, which in our view exaggerates the toxicity. For traditional Chinese medicine containing cinnabar, some researchers questioned the medicinal value of cinnabar, and even proposed to remove cinnabar in order to avoid possible poisoning. This review reported adverse events, summarized its toxicity characteristics, mechanism and the medicinal value in preparations of traditional Chinese medicine. The significance of this paper is to further understand the toxicity of cinnabar and reduce its side effect in clinical application, and to provide a scientific basis for reasonable clinical application and a scientific understanding of cinnabar.