EXTRAMMUNE TABLET

Indications

• Chronic pain management
• Acute pain relief
• Anxiety relief
• Sedation
• Anti-inflammatory conditions

Dosage

Children: There is limited information on the use of Cardifolia in pediatric populations. It is advised to consult a healthcare professional for guidance on appropriate dosing in children.

Adults: Dosing for Cardifolia can vary widely based on the form of preparation (e.g., extract, powder) and the specific condition being treated. It is recommended to refer to specific product guidelines or consult a healthcare professional for appropriate dosing.

Mechanism of action

The primary active components of Cardifolia, particularly the alkaloids, are believed to exert their effects by modulating neurotransmitter levels, particularly dopamine and serotonin. This modulation may lead to analgesic effects by influencing pain pathways in the central nervous system and promoting relaxation.

Pharmacodynamics

Cardifolia exhibits a range of pharmacodynamic effects, primarily through its influence on the central nervous system. Its analgesic properties are attributed to its ability to inhibit the reuptake of certain neurotransmitters, thus enhancing their availability in synaptic clefts. Additionally, it may have anti-inflammatory effects by inhibiting pro-inflammatory cytokines and mediators, which could be beneficial in conditions characterized by inflammation and pain.

Pharmacokinetics

The pharmacokinetics of Cardifolia are not well-documented in the literature. However, it is assumed that the active compounds are absorbed through the gastrointestinal tract, with peak plasma concentrations occurring within a variable time frame depending on the formulation. The metabolism of the alkaloids is likely to occur in the liver, with subsequent excretion primarily via the kidneys. The half-life of the compounds may vary.

Pregnancy

There is limited information regarding the use of cardifolia during pregnancy. It is recommended to avoid use unless the benefits outweigh the risks.

Breast-feeding

Caution is advised when using cardifolia during breastfeeding due to insufficient data on excretion in human milk.

Storage

Store in a cool, dry place away from direct sunlight and moisture.

Indications

• Inflammatory conditions
• Cancer prevention and treatment
• Antioxidant therapy
• Digestive disorders
• Cardiovascular health

Dosage

Children: Refer to the BNF for Children for appropriate pediatric dosing recommendations.

Adults: Refer to the BNF for specific dosing guidelines, as dosages can vary based on the formulation and clinical indication.

Mechanism of action

Curcumin acts as a scavenger of reactive oxygen species, including hydroxyl radicals and superoxide anions, and inhibits lipid peroxidation as well as peroxide-induced DNA damage. It exhibits potent anti-inflammatory and anti-carcinogenic effects by modulating various signaling molecules. Curcumin inhibits protein kinases, c-Jun/AP-1 activation, and cyclooxygenase (COX)-2 activity, impacting cellular signal transduction pathways related to growth and malignant transformation.

Pharmacodynamics

In experimental animal models, curcumin has demonstrated significant pharmacological effects, such as increasing bile flow and inhibiting inflammation and edema formation. It has been shown to decrease cell proliferation and promote apoptosis in cancer cells. Additionally, curcumin inhibits platelet aggregation induced by arachidonic acid, suggesting its role in cardiovascular health.

Pharmacokinetics

Curcumin's pharmacokinetics are characterized by low bioavailability due to rapid metabolism and systemic elimination. It undergoes extensive hepatic metabolism, leading to the production of several metabolites. The absorption of curcumin can be enhanced by co-administration with piperine. Oral bioavailability remains a challenge, which has led to the exploration of various formulations to improve its therapeutic efficacy.

Adverse effects

• Gastrointestinal disturbances
• Nausea
• Diarrhea
• Allergic reactions

Interactions

• May enhance the effects of anticoagulants
• Potential interaction with antidiabetic medications
• May interfere with the metabolism of certain drugs due to inhibition of cytochrome P450 enzymes

Precautions

• Use with caution in patients with gallbladder disease
• Monitor patients on anticoagulant therapy
• Caution in patients with diabetes due to potential hypoglycemic effects

Pregnancy

Safety during pregnancy has not been established, caution is advised.

Breast-feeding

Curcumin may be excreted in breast milk, caution is advised.

Storage

Store in a cool, dry place away from light.

Formulations

• Powder
• Capsules
• Tablets
• Liquid extracts

Indications

• Hyperlipidemia
• Obesity
• Atherosclerosis
• Hypothyroidism
• Arthritis

Dosage

Children: Refer to established guidelines and consult with a healthcare professional for appropriate dosing.

Adults: Refer to established guidelines and consult with a healthcare professional for appropriate dosing.

Mechanism of action

Guggulsterone, the active compound in guggul, acts as a ligand for the farnesoid X receptor (FXR) and has been shown to modulate various signaling pathways involved in lipid metabolism. This action helps increase the breakdown of cholesterol and promotes the clearance of lipids from the bloodstream. Additionally, guggul exhibits antioxidant properties and may influence the secretion of thyroid hormones, thereby enhancing metabolic rate.

Pharmacodynamics

Guggul's effects on lipid metabolism can lead to decreased levels of low-density lipoprotein (LDL) cholesterol and total cholesterol in the blood. It may also have anti-inflammatory properties, which can be beneficial in conditions characterized by chronic inflammation. The overall impact on metabolism can contribute to weight loss and improved cardiovascular health.

Pharmacokinetics

The bioavailability of guggul is influenced by its formulation and the presence of other compounds. After oral administration, guggulsterones are absorbed and metabolized in the liver. They undergo phase I and II metabolization, leading to various metabolites that may exert biological effects. The elimination half-life and excretion pathways are not well-characterized, and more research is needed to fully understand its pharmacokinetic profile.

Adverse effects

• Diarrhea
• Nausea
• Headache
• Skin rash
• Allergic reactions

Interactions

• May enhance the effects of anticoagulants
• May interact with medications that alter liver enzymes
• Potential interaction with thyroid medications

Precautions

• Use with caution in patients with liver disease
• Monitor thyroid function in patients on thyroid medications
• Assess for possible allergic reactions

Pregnancy

The safety of guggul during pregnancy has not been established. It is advisable to avoid use unless prescribed by a healthcare provider.

Breast-feeding

The effects of guggul during breastfeeding are not well studied. Caution is advised.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Formulations

• Guggul resin capsules
• Guggul extract tablets
• Guggul powder

Indications

• Anxiety
• Insomnia
• Nutritional supplement
• Antioxidant support
• Immune system support

Dosage

Children: Refer to authoritative sources for specific dosing information.

Adults: Refer to authoritative sources for specific dosing information.

Mechanism of action

The mechanism of action of Longan is not fully elucidated, but it is believed to exert its effects through the modulation of neurotransmitters, particularly influencing serotonin and gamma-aminobutyric acid (GABA) pathways. The fruit is rich in antioxidants, which may contribute to its protective effects against oxidative stress.

Pharmacodynamics

Longan is known for its high content of vitamins, minerals, and antioxidants, including vitamin C, B vitamins, and polyphenols. These compounds may enhance immune function, promote nervous system health, and improve skin health. Its calming effects may be attributed to constituents that influence neurotransmitter activity.

Pharmacokinetics

The pharmacokinetics of Longan is not well-studied, but as a food source, it is likely to be absorbed through the gastrointestinal tract. The bioavailability of its active compounds may vary depending on preparation methods (fresh, dried, or processed). The metabolism and excretion pathways are not clearly defined in the literature.

Pregnancy

Insufficient data on the safety of longa during pregnancy. Consult a healthcare provider before use.

Breast-feeding

Insufficient data on the excretion of longa in human milk. Caution is advised when using during breastfeeding.

Storage

Store in a cool, dry place away from direct sunlight. Keep out of reach of children.

Indications

• Cancer treatment
• Anti-inflammatory therapy
• Antimicrobial infections
• Antioxidant support

Dosage

Children: Refer to specific prescribing guidelines for appropriate dosing.

Adults: Refer to specific prescribing guidelines for appropriate dosing.

Mechanism of action

Plumbagin, the primary bioactive compound in Plumbago, exerts its effects through several mechanisms, including the induction of apoptosis in cancer cells, inhibition of NF-kB signaling, and modulation of reactive oxygen species (ROS) levels. It is believed to interfere with cellular signaling pathways that promote cell survival and proliferation, leading to cell death in malignant cells.

Pharmacodynamics

Plumbagin demonstrates various pharmacodynamic properties, including cytotoxic effects against certain cancer cell lines. It has been shown to inhibit the growth of tumor cells, induce oxidative stress, and modulate immune responses. Its anti-inflammatory properties may also contribute to its therapeutic potential in various diseases.

Pharmacokinetics

The pharmacokinetics of plumbagin include absorption, distribution, metabolism, and excretion, although detailed human studies are limited. Plumbagin is lipophilic, allowing it to cross cell membranes easily. It undergoes metabolism in the liver, and its elimination half-life can vary based on the route of administration. More research is needed to fully elucidate its pharmacokinetic profile.

Pregnancy

There is insufficient data on the use of plumbago during pregnancy. Caution is advised.

Breast-feeding

There is limited information regarding the excretion of plumbago components in breast milk. Use with caution.

Storage

Store in a cool, dry place, away from direct sunlight.

Indications

• Anti-inflammatory conditions
• Antimicrobial applications
• Antioxidant support
• Traditional dyeing agent

Dosage

Children: Refer to established herbal dosage guidelines or consult with a healthcare professional.

Adults: Refer to established herbal dosage guidelines or consult with a healthcare professional.

Mechanism of action

The active compounds in Rubia tinctorum, particularly anthraquinones, are believed to exert their effects through several mechanisms. These include inhibition of certain enzymes, modulation of inflammatory pathways, and interaction with cellular signaling pathways. The compounds may also exhibit antioxidant properties, contributing to their therapeutic potential.

Pharmacodynamics

Rubia tinctorum has been shown to possess anti-inflammatory, antimicrobial, and antioxidant properties. The anthraquinones can influence various biological pathways, potentially leading to the modulation of immune responses and the reduction of oxidative stress in cells. Its effects may vary based on the dosage and preparation used.

Pharmacokinetics

The pharmacokinetics of Rubia tinctorum have not been extensively studied. However, it is understood that the bioavailability of its active compounds may be influenced by factors such as their solubility and stability in the gastrointestinal tract. Metabolism typically occurs in the liver, and excretion is primarily via the kidneys. Specific half-life and elimination data are not well documented.

Pregnancy

There is limited data on the safety of rubia during pregnancy. It is advisable to avoid use unless the potential benefits outweigh the risks.

Breast-feeding

The excretion of rubia in human milk is unknown. Caution is advised when used during breastfeeding.

Storage

Store in a cool, dry place, away from direct sunlight. Keep out of reach of children.

Indications

• Diabetes mellitus
• Chronic infections
• Inflammatory conditions
• Immunomodulation
• Antioxidant support

Dosage

Children: Refer to specific traditional or herbal medicine guidelines, as there is no standardized dosage established in clinical settings.

Adults: Refer to specific traditional or herbal medicine guidelines, as there is no standardized dosage established in clinical settings.

Mechanism of action

The active compounds in Tinospora, such as tinosporide and other alkaloids, interact with various molecular pathways. They are believed to modulate immune responses by affecting the activity of immune cells, enhancing phagocytosis and promoting the production of cytokines. Additionally, the compounds may exhibit antioxidant effects by scavenging free radicals, thereby reducing oxidative stress.

Pharmacodynamics

Tinospora exerts various pharmacodynamic effects including immunomodulation, anti-inflammatory actions, and potential blood glucose-lowering effects. Its immunomodulatory effects may help enhance the body's defense against infections and diseases. The anti-inflammatory properties can contribute to the alleviation of symptoms in conditions such as arthritis and other inflammatory disorders.

Pharmacokinetics

The pharmacokinetics of Tinospora, including absorption, distribution, metabolism, and excretion, are not well-characterized in the literature. However, it is known that the active components are absorbed in the gastrointestinal tract after oral administration. The metabolites may be processed by the liver, and the elimination half-life can vary. Further studies are needed to fully elucidate the pharmacokinetic profile of Tinospora extracts.

Adverse effects

• Gastrointestinal upset
• Hypoglycemia
• Allergic reactions

Interactions

• May enhance the effects of antidiabetic medications, increasing the risk of hypoglycemia
• Potential interaction with immunosuppressants due to its immune-modulating effects

Precautions

• Use with caution in patients with diabetes due to potential hypoglycemic effects
• Monitor for allergic reactions in sensitive individuals

Pregnancy

Limited clinical data is available. Caution is advised due to insufficient evidence of safety.

Breast-feeding

Insufficient data available. Caution is advised as it may affect milk production or composition.

Storage

Store in a cool, dry place away from direct sunlight and moisture.

Formulations

• Oral extract
• Powdered form
• Capsules

Indications

• Dyspepsia
• Loss of appetite
• Digestive disorders
• Respiratory ailments
• Metabolic support

Dosage

Children: Refer to established herbal guidelines or consult a qualified practitioner for specific dosing information.

Adults: Refer to established herbal guidelines or consult a qualified practitioner for specific dosing information.

Mechanism of action

The active compounds in trikatu, such as piperine from black pepper and piperlongumine from long pepper, enhance bioavailability and absorption of nutrients and other compounds. They may stimulate digestive enzymes and increase gastric motility, leading to improved digestion. Ginger has anti-inflammatory properties and can help alleviate gastrointestinal discomfort. Collectively, these components may also facilitate mucosal health in the respiratory tract.

Pharmacodynamics

Trikatu exhibits various pharmacological effects, including stimulating digestion and metabolism, promoting appetite, and exerting anti-inflammatory and antioxidant effects. The presence of piperine is known to enhance the efficacy and absorption of other therapeutic agents, making trikatu a valuable adjunct in various treatment regimens.

Pharmacokinetics

The pharmacokinetics of trikatu as a whole has not been extensively studied. However, the individual components have demonstrated rapid absorption in the gastrointestinal tract. Piperine, for instance, is rapidly absorbed and extensively metabolized in the liver, influencing the pharmacokinetics of co-administered drugs. The half-life of piperine is relatively short, necessitating frequent dosing for sustained effects.

Adverse effects

• Gastrointestinal upset
• Nausea
• Vomiting
• Diarrhea
• Allergic reactions

Precautions

• Use with caution in individuals with gastrointestinal conditions
• Consider potential interactions with anticoagulants or antiplatelet agents

Pregnancy

Trikatu should be used with caution during pregnancy due to limited safety data.

Breast-feeding

Consult a healthcare provider before use while breastfeeding.

Storage

Store in a cool, dry place away from direct sunlight.

Formulations

• Powder
• Capsules
• Tablets

Indications

• Constipation
• Digestive disorders
• Detoxification
• Antioxidant support
• Immune enhancement

Dosage

Children: For children, it is advisable to consult a healthcare professional for appropriate dosing recommendations, as specific pediatric doses may vary based on age and condition.

Adults: General guidance suggests starting with 1-2 teaspoons of triphala powder mixed in warm water, taken once or twice daily. For specific dosing, refer to established guidelines.

Mechanism of action

The mechanism of action of triphala is attributed to its rich polyphenolic content, vitamins, and minerals. It exhibits antioxidant activity by scavenging free radicals, thus reducing oxidative stress. Additionally, triphala has been shown to modulate gut microbiota, improve digestion, and promote regular bowel movements by enhancing peristalsis. It may also possess anti-inflammatory properties that contribute to its therapeutic effects.

Pharmacodynamics

Triphala demonstrates a variety of pharmacodynamic effects. Its components exhibit laxative properties, which help alleviate constipation. Amla is known for its high vitamin C content and immune-boosting effects, while haritaki is recognized for its digestive and detoxifying properties. The combined action of these fruits provides a synergistic effect, enhancing gastrointestinal function and supporting overall health.

Pharmacokinetics

The pharmacokinetics of triphala have not been extensively studied in clinical settings. However, it is generally believed that the absorption and bioavailability of its active constituents occur in the gastrointestinal tract. The metabolites exert their effects locally within the gut, while some components may enter systemic circulation, contributing to their antioxidant and anti-inflammatory activities. The elimination pathway is primarily through the gastrointestinal tract.

Adverse effects

• Gastrointestinal upset
• Diarrhea
• Abdominal cramping
• Nausea

Interactions

• May enhance the effects of anticoagulants
• May affect the absorption of other medications due to its laxative effects

Precautions

• Use with caution in patients with gastrointestinal disorders
• Patients on anticoagulant therapy should consult a healthcare provider before use

Pregnancy

Consult a healthcare provider before use, as safety during pregnancy has not been established.

Breast-feeding

Consult a healthcare provider before use, as safety during breastfeeding has not been established.

Storage

Store in a cool, dry place away from direct sunlight.

Formulations

• Powder
• Capsules
• Tablets
• Liquid extract

Indications

• Schizophrenia
• Bipolar disorder
• Acute manic episodes
• Maintenance treatment of bipolar disorder

Dosage

Children: Refer to the BNF for Children for specific dosing recommendations.

Adults: Refer to clinical guidelines and product information for specific dosing recommendations.

Mechanism of action

Olanzapine functions as an antagonist at multiple neurotransmitter receptors, including the dopamine D2 and serotonin 5-HT2A receptors. By blocking these receptors, it reduces dopaminergic overactivity and serotonin levels in certain pathways, which is believed to contribute to its antipsychotic and mood-stabilizing effects. Additionally, olanzapine may influence other neurotransmitter systems, including norepinephrine and histamine, contributing to its overall therapeutic profile.

Pharmacodynamics

The pharmacodynamics of olanzapine involve its effects on neurotransmitter systems, leading to improvements in psychotic symptoms and mood stabilization. It has a lower affinity for D2 receptors compared to first-generation antipsychotics, which may result in a reduced incidence of extrapyramidal side effects. The drug's broad receptor binding profile contributes to its efficacy and side effect profile, including sedation and metabolic changes.

Pharmacokinetics

Olanzapine is well absorbed after oral administration, with peak plasma concentrations occurring within 6 hours. It has a high volume of distribution and is extensively bound to plasma proteins. The drug undergoes hepatic metabolism primarily via cytochrome P450 enzymes, particularly CYP1A2. Its elimination half-life ranges from 21 to 54 hours, allowing for once-daily dosing in most cases. Renal clearance is minimal, but caution is advised in patients with hepatic impairment.

Pregnancy

Consult healthcare provider before use, as safety in pregnancy has not been established.

Breast-feeding

Consult healthcare provider before use, as it is unknown if the drug is excreted in human milk.

Storage

Store at room temperature, away from moisture and light.

Mechanism of action

Curcumin acts as a scavenger of oxygen species, such as hydroxyl radical, superoxide anion, and singlet oxygen and inhibit lipid peroxidation as well as peroxide-induced DNA damage. Curcumin mediates potent anti-inflammatory agent and anti-carcinogenic actions via modulating various signalling molecules. It suppresses a number of key elements in cellular signal transduction pathways pertinent to growth, differentiation, and malignant transformation; it was demonstrated _in vitro_ that curcumin inhibits protein kinases, c-Jun/AP-1 activation, prostaglandin biosynthesis, and the activity and expression of the enzyme cyclooxygenase (COX)-2. Curcumin, a polyphenolic natural product, exhibits therapeutic activity against a number of diseases, attributed mainly to its chemical structure and unique physical, chemical, and biological properties. It is a diferuloyl methane molecule [1,7-bis (4-hydroxy-3- methoxyphenyl)-1,6-heptadiene-3,5-dione)] containing two ferulic acid residues joined by a methylene bridge. It has three important functionalities: an aromatic o-methoxy phenolic group, alpha, beta-unsaturated beta-diketo moiety and a seven carbon linker. Extensive research in the last two decades has provided evidence for the role of these different functional groups in its crucial biological activities. A few highlights of chemical structural features associated with the biological activity of curcumin are: The o-methoxyphenol group and methylenic hydrogen are responsible for the antioxidant activity of curcumin, and curcumin donates an electron/ hydrogen atom to reactive oxygen species. Curcumin interacts with a number of biomolecules through non-covalent and covalent binding. The hydrogen bonding and hydrophobicity of curcumin, arising from the aromatic and tautomeric structures along with the flexibility of the linker group are responsible for the non-covalent interactions. The alpha, beta-unsaturated beta-diketone moiety covalently interacts with protein thiols, through Michael reaction. The beta-diketo group forms chelates with transition metals, thereby reducing the metal induced toxicity and some of the metal complexes exhibit improved antioxidant activity as enzyme mimics. New analogues with improved activity are being developed with modifications on specific functional groups of curcumin... The present study demonstrates that curcumin acts as pro-oxidant and sensitizes human lung adenocarcinoma epithelial cells (A549) to apoptosis via intracellular redox status mediated pathway. Results indicated that curcumin induced cell toxicity (light microscopy and MTT assay) and apoptosis (AnnexinV-FITC/PI labeling and caspase-3 activity) in these cells. These events seem to be mediated through generation of reactive oxygen species (ROS) and superoxide radicals (SOR) and enhanced levels of lipid peroxidation. These changes were accompanied by increase in oxidized glutathione (GSSG), reduced glutathione (GSH) and gamma-glutamylcysteine synthetase (gamma-GCS) activity, but decrease in GSH/GSSG ratio. The induction of apoptosis and decrease in GSH/GSSG ratio was also accompanied by sustained phosphorylation and activation of p38 mitogen activated protein kinase (MAPK). On the other hand, addition of N-acetyl cysteine (NAC), an antioxidant, blocked the curcumin-induced ROS production and rescued malignant cells from curcumin-induced apoptosis through caspase-3 deactivation. However, L-buthionine sulfoximine (BSO), a GSH synthesis blocking agent, further enhanced curcumin-induced ROS production and apoptosis in A549 cells. Decreased GSH/GSSG ratio seems to be a crucial factor for the activation of MAPK signaling cascade by curcumin. The study therefore, provides an insight into the molecular mechanism involved in sensitization of lung adenocarcinoma cells to apoptosis by curcumin. Curcumin has many pharmaceutical applications, many of which arise from its potent antioxidant properties. The present research examined the antioxidant activiti

Pharmacodynamics

Intravenous application of 25 mg/kg bw curcumin to rats resulted in an increase in bile flow by 80 and 120%. In the rat model of inflammation, curcumin was shown to inhibit edema formation. In nude mouse that had been injected subcutaneously with prostate cancer cells, administration of curcumin caused a marked decrease in the extent of cell proliferation, a significant increase of apoptosis and micro-vessel density. Curcumin may exert choleretic effects by increasing biliary excretion of bile salts, cholesterol, and bilirubin, as well as increasing bile solubility. Curcumin inhibited arachidonic acid-induced platelet aggregation _in vitro_.