Hyperuricemia is a condition where there is an elevated blood uric acid level above normal range. Hyperuricemia occurs due to increased uric acid metabolism, decreased uric acid expenditure, or a combination of both. The Jamu formula containingPiper retrofractum, Plantago majorandApiumgraveolens have the potential to overcome hyperuricemia. This study aims to evaluate the safety and efficacy of formula inhuman subjects with hyperuricemia. The method used was pre and posttest design for 28 days. Safety parameters were assessed by renal function (urea and creatinine) and liver function (SGOT and SGPT). The parameters of efficacy were measured by uric acid change (H0, H14, and H28), improvement of clinical symptoms and quality of life (SF-36). This study showed that kidney and liver function still in the normal rangeafter28 days of intervention. The levels of uric acid showed a significant decrease (p <0.05). Clinical symptoms of the subjectsimproved after 17 daysofintervention. SF-36indicated significant improvement (p <0.05). It can be concluded that the formula was proved to be safe and effective for 28 daysof intervention.