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|title=Charak Samhita
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Terminalia arjuna
Terminalia arjuna
{{Infobox
{{Infobox
|title = Arjuna
|title = Arjuna
Line 6: Line 17:
|label2 = Botanical name(s)
|label2 = Botanical name(s)
|data2 = Terminalia arjuna
|data2 = Terminalia arjuna
|label3 = Contributors
|label3 = Family
|data3 = --
|data3 = Combretaceae
|label4 = Year of publication  
|label4 = Availability
|data4 =  2021
|data4 = Available
|label5 = Publisher  
|label5 = Contributors
|data5 =  [[Charak Samhita Research, Training and Skill Development Centre]]
|data5 = Team Dravyaguna
|label6 = DOI  
|label6 = Year of publication  
|data6 = Awaited
|data6 =  2026
|label7 = Publisher  
|data7 =  [[Charak Samhita Research, Training and Skill Development Centre]]
|label8 = DOI  
|data8 = Awaited
}}
}}


==English name ==  
'''Terminalia arjuna''' (family Combretaceae), commonly referred to as '''Arjuna''', is one of the most prominent cardiovascular tonics in traditional [[Ayurveda|Ayurvedic]] pharmacology (''Hridya'').<ref name="Dwivedi2014">{{cite journal |last1=Dwivedi |first1=Shridhar |last2=Chopra |first2=Deepti |year=2014 |title=Revisiting Terminalia arjuna – An Ancient Cardiovascular Drug |journal=Journal of Traditional and Complementary Medicine |volume=4 |issue=4 |pages=224–231 |doi=10.4103/2225-4110.139103 |pmid=25379361 |pmc=4220503}}</ref> Used for over a millennium to treat chest pain, heart failure, hypertension, and dyslipidemia, modern clinical and pharmacological research has validated its multi-target mechanisms<ref name="Mould2023">{{cite journal |last1=Mould |first1=M. A. |last2=Sridhar |first2=M. |year=2023 |title=Terminalia arjuna, a Cardioprotective Herbal Medicine–Relevancy in the Modern Era of Pharmaceuticals and Green Nanomedicine—A Review |journal=Pharmaceuticals |volume=16 |issue=1 |pages=126 |doi=10.3390/ph16010126 |pmid=36678623 |pmc=9865188}}</ref>. The therapeutic profile of ''T. arjuna'' stem bark stems from a complex matrix of oleanane triterpenoids, triterpenoid glycosides, flavonoids, and hydrolyzable tannins that collectively confer anti-ischemic, anti-atherosclerotic, antihypertensive, and antioxidant cardioprotection.<ref name="Pauzi2021">{{cite journal |last1=Pauzi |first1=Ahmad Naim |last2=Lim |first2=Soo Tein |last3=Jantan |first3=Ibrahim |year=2021 |title=Arjunolic acid: A promising triterpenoid against cardiovascular and metabolic disorders |journal=Phytomedicine |volume=85 |pages=153540 |doi=10.1016/j.phymed.2021.153540 |pmid=33789182}}</ref>
 
==Therapeutic Use==
[[File:Arjuna.jpg|thumb|'''Arjuna (''Terminalia arjuna'')''']]
Obesity (medoroga), wound management (vrana), heart diseases (hridroga), loss fof strength due to injury (kshatakshaya), obstinate urinary disorders including diabetes mellitus (prameha), thirst (trishna), melasma (vyanga)<ref>The Ayurvedic Pharmacopoeia of India. Department of Ayush, Ministry of Health and Family welfare, Govt. of India, New Delhi, Part I. 1986; Volume II:8</ref>
 
==Other varieties / other botanical names==
 
* Terminalia paniculata
* Terminalia tomentosa
* Sterculia urens


--
==Identification Characters==
* '''Dhavala''' – Bark is white in colour.
* '''Shvetavaha''' - Bark is white in colour.
* '''Sarpana''' – Large tree with spreading barks.
* '''Madhugandhiprasunaka'''– Flowers are sweet scented.
* '''Kakubha''' – Large tree covers large area.
* '''Nadisarja''' – Commonly grows near river banks.


== Synonyms in Charak Samhita==
== Synonyms in Charak Samhita==


Arjuna
Arjuna(means the white one, clear), Dhava, Kakubha(a large tree covers large area), Indradru(tree which is a very potent medicine), Nadisarja(commonly grows on river banks), Dhavala(bark in white in colour), Partha, Shweta Vaha(it has whitish outer bark)
 
==Synonyms in Bhavaprakasha Nighantu==
Kakubha, Arjuna, Nadisarja, Indradu, Viravriksha, Vira, Dhavala<ref>Shri Bhavamishra, Bhavaprakash Nighantu, Vatadi Varga, Verse no. 23 - 24, Edited by Padmashree Pro. Krushnachandra Chunekar, Reprint Edition, Chaukhambha Bharati Academy, 2015;</ref>
 
== Ayurvedic pharmacological properties ==


Dhava
In Ayurvedic pharmacology, ''Arjuna'' is regarded as the primary ''Hridya'' (cardiotonic) herb, possessing cool and astringent characteristics that pacify ''[[Kapha]]'' and ''[[Pitta]]'' [[Dosha|doshas]]<ref name="Dwivedi2014"/>.
 
{| class="wikitable"
|+ Properties
|-
! Sr.no. !! Pharmacological criteria !! Properties
|-
| 1 || Taste ([[rasa]])  || Astringent (kashaya)
|-
| 2 || Potency ([[veerya]]) || Cold (sheeta)
|-
| 3 || Post digestion effect ([[vipaka]]) || Pungent (katu)
|-
| 4 || Qualities ([[Guna]])|| Light (laghu), Rough (ruksha)
|-
| 5 || Actions ([[karma]]) || Pacify Kapha and Pitta,
|-
| 6 || Extra ordinary effect ([[prabhava]]) || Cardiac tonic (hridya)
|-
| 7 || Therapeutic actions || Cardiac tonic (hridya) Hridya (Cardioprotective/Cardiotonic), Kshataksheedhara (Healer of tissue injury and hemorrhage), Sandhananiya (Tissue/bone joining promoter), Raktashodhaka (Blood purifier), Medohara (Hypolipidemic/Anti-obesity).
|}


== Reference in Charak Samhita and its actions ==  
== Reference in Charak Samhita and its actions ==  
Line 33: Line 89:
! Sr.no. !! Reference in Charak Samhita !! Activity  
! Sr.no. !! Reference in Charak Samhita !! Activity  
|-
|-
| 1 || [[Kalpa Sthana]] 1/8|| Deshavichara
| 1 || Cha.Sa.[[Sutra Sthana]]  3/5
| Siddhatama  churna pradeha(local application in powder form)
|-
| 2 || Cha.Sa.[[Sutra Sthana]]  4/9(43)
| Sheetaprashaman mahakashaya(ingredient of group of herbs for pacifying cold)
|-
| 3 || Cha.Sa.[[Sutra Sthana]]  5/73
| Danta pavana(recommended for use in teeth-cleansing)
|-
|4
|Cha.Sa.[[Vimana Sthana]] 8/144
|Kashaya-skandha(ingredient of group of astringent drugs)
|-
|5
|Cha.Sa.[[Kalpa Sthana]] 1/8
|Deshavichara (jangal desha )(kakubh)
|-
|6
|Cha.Sa.[[Chikitsa Sthana]] 2/3/4
|For Cows
|-
|7
|Cha.Sa.[[Chikitsa Sthana]] 3/258
|As an ingredient of Chandanadhya taila.
|-
|8
|Cha.Sa.[[Chikitsa Sthana]] 6/27
|Used for making decoction in Kaphaja prameha
|-
|9
|Cha.Sa.[[Chikitsa Sthana]] 6/31
|Used for making decoction in Pittaja  prameha
|-
|10
|Cha.Sa.[[Chikitsa Sthana]] 6/38
|Trikantakadhya Tail/Ghrit in Vata-kaphaja prameha
|-
|11
|Cha.Sa.[[Chikitsa Sthana]] 8/129
|Ingredient in Atisara nashaka  Khad-yusha
|-
|12
|Cha.Sa.[[Chikitsa Sthana]] 25/95
|Used as Patra-aachhadana on vrana.
|-
|13
|Cha.Sa.[[Chikitsa Sthana]] 25/113
|Used for tvak janana.
|-
|14
|Cha.Sa.[[Chikitsa Sthana]] 26/98
|As an ingredient of  Udumbaravleha.
|-
|15
|Cha.Sa.[[Chikitsa Sthana]] 26/272
|As an ingredient of Mahaneela taila.
|-
|-
| || ||  
|16
|Cha.Sa.[[Chikitsa Sthana]]29/141
|Used in formulation of Erandamuladi pralepa.
|-
|-
| ||  ||  
|17
|Cha.Sa.[[Chikitsa Sthana]] 30/92
|As an ingredient of Pushyanuga churna.
|}
|}


==Dose==
3 – 6 gm of the drug in powder form.<ref>The Ayurvedic Pharmacopoeia of India. Department of Ayush, Ministry of Health and Family welfare, Govt. of India, New Delhi, Part I. 1986; Volume II:8</ref>
==Important Formulations==
As per A.P.I.<ref>The Ayurvedic Pharmacopoeia of India. Department of Ayush, Ministry of Health and Family welfare, Govt. of India, New Delhi, Part I. 1986; Volume II:8</ref>
* Parthadyarishta
* Nagarjunabhra Rasa
* Arjuna Ghrita
== Current availability==
Available
* In India – Uttar Pradesh, Bihar, Maharashtra, Madhya Pradesh, Odissa, West Bengal
* Out of India – Sri Lanka, Bangladesh, Pakistan, Malaysia, Indonesia, Kenya, Africa, Australia, South America
== Current researches ==


== Ayurvedic pharmacological properties ==  
=== Major Phytochemical Constituents ===
The pharmacological activities of ''Terminalia arjuna'' bark are attributed to four primary bioactive classes<ref name="Mould2023"/>:


{| class="wikitable"
{| class="wikitable"
|+ Properties
|+ Phytochemical Constituents of ''Terminalia arjuna'' Bark
|-
! Phytochemical Class !! Key Active Constituents !! Primary Pharmacological Roles
|-
| '''Oleanane Triterpenoids''' || Arjunolic acid, Arjunic acid, Arjungenin, Terminic acid || Cardioprotective, anti-platelet, anti-apoptotic, and direct free-radical scavenging<ref name="Sinha2008">{{cite journal |last1=Sinha |first1=M. |last2=Manna |first2=P. |last3=Sil |first3=P. C. |year=2008 |title=Arjunolic acid, a novel phytomedicine with multifunctional therapeutic potential |journal=Natural Product Reports |volume=25 |issue=3 |pages=543–552 |doi=10.1039/B713728P |pmid=18497899}}</ref>.
|-
|-
! Sr.no. !! Pharmacological criteria !! Properties
| '''Triterpenoid Glycosides''' || Arjunetin, Arjunosides I–IV, Arjunglucosides I & II || Inotropic, chronotropic, and cardiac membrane-stabilizing activities.
|-
|-
| 1 || Taste ([[rasa]])  || --
| '''Flavonoids & Phenolics''' || Arjunone, Arjunolone, Baicalein, Luteolin, Quercetin || Endothelial nitric oxide stimulation, vasodilation, and inhibition of LDL oxidation.
|-
|-
| 2 || Potency ([[veerya]]) || --
| '''Hydrolyzable Tannins''' || Punicalagin, Punicallin, Casuarinin, Terflavin C || Vascular astringency, anti-inflammatory, and extracellular matrix protection.
|}
 
== Pharmacological Mechanisms & Scientific Evidence ==
 
=== Cardioprotective & Anti-Ischemic Actions ===
''T. arjuna'' extracts preserve myocardial structural integrity during ischemic events and reperfusion injury<ref name="Dwivedi2014"/>:
* '''Endogenous Antioxidant Preservation:''' Prevents the depletion of key intracellular antioxidant enzymes, including superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx)<ref name="Pauzi2021"/>.
* '''Anti-Apoptotic Regulation:''' Downregulates pro-apoptotic markers (Bax, caspase-3) while upregulating anti-apoptotic proteins ([[Bcl-2]]) and heat shock proteins (HSP-70) in ischemic cardiomyocytes<ref name="Mould2023"/>.
 
A double-blind, randomized, placebo-controlled crossover study evaluated 58 patients with chronic stable angina (NYHA Class II–III). Administration of 500 mg of ''T. arjuna'' bark extract every 8 hours significantly reduced anginal frequency and nitrate consumption, accompanied by objective improvements in treadmill exercise duration and reduced peak ST-segment depression compared to placebo<ref name="Bharani2002">{{cite journal |last1=Bharani |first1=A. |last2=Ganguly |first2=A. |last3=Bhargava |first3=K. D. |year=2002 |title=Efficacy of Terminalia arjuna in chronic stable angina: a double-blind, placebo-controlled, crossover study comparing Terminalia arjuna with isosorbide mononitrate |journal=Indian Heart Journal |volume=54 |issue=2 |pages=170–175 |pmid=12086380}}</ref>. Furthermore, clinical evaluations in congestive heart failure and ischemic heart disease demonstrate improved left ventricular ejection fraction<ref name="Vaidya2010">{{cite journal |last1=Vaidya |first1=A. B. |last2=Rajagopalan |first2=F. |last3=Kale |first3=A. Q. |year=2010 |title=Clinical evaluation of Terminalia arjuna in ischemic heart disease and congestive cardiac failure |journal=Journal of Association of Physicians of India |volume=58 |pages=411–416}}</ref>.
 
=== Vascular Tone & Anti-Hypertensive Efficacy ===
* '''Endothelial Nitric Oxide Activation:''' Flavonoid and glycoside fractions stimulate endothelial nitric oxide synthase (eNOS), increasing vascular [[Nitric oxide|NO]] availability and inducing endothelium-dependent vasodilation<ref name="Mould2023"/>.
* '''Inotropic & Chronotropic Balance:''' Demonstrates positive inotropic (enhancing force of contraction) and mild negative chronotropic (regulating pulse rate) effects without increasing myocardial oxygen demand<ref name="Dwivedi2014"/>.
 
=== Anti-Platelet & Anti-Atherosclerotic Effects ===
* '''Thrombin-Induced Inhibition:''' The isolated triterpenoid '''arjunolic acid''' inhibits thrombin-induced platelet aggregation with an <math>IC_{50}</math> of 0.048 mM—exhibiting greater potency than aspirin (<math>IC_{50} = 0.088\text{ mM}</math>)<ref name="Sinha2008"/><ref name="Pauzi2021"/>.
* '''Lipid Modulation & Foam Cell Suppression:''' Reduces circulating total cholesterol, low-density lipoprotein (LDL), and triglycerides while raising high-density lipoprotein (HDL) via upregulation of PPAR-γ pathways and suppression of oxidative LDL modification<ref name="Dwivedi2014"/>.
 
== Posology & Preparations ==
 
{| class="wikitable"
|+ Dosage Forms and Indications of ''Terminalia arjuna''
|-
|-
| 3 || Post digestion effect ([[vipaka]]) || --
! Traditional / Modern Preparation !! Standardized Dosage !! Primary Clinical Applications
|-
|-
| 4 || Qualities ([[Guna]])|| --
| '''Arjuna Churna''' (Stem Bark Powder) || 3–6 g daily (with milk or warm water) || General cardiotonic, hyperlipidemia, mild hypertension.
|-
|-
| 5 || Actions ([[karma]]) || --
| '''Arjuna Kwath''' (Decoction) || 50–100 ml daily (1:4 reduced decoction) || Angina pectoris, heart failure support, fluid overload.
|-
|-
| 6 || Extra ordinary effect ([[prabhava]]) || --
| '''Arjunarishta''' (Hydro-alcoholic Ferment) || 15–30 ml twice daily after meals || Post-myocardial recovery, palpitations, cardiac fatigue.
|-
| '''Standardized Dry Extract''' (Capsule/Tablet) || 250–500 mg twice or thrice daily || Ischemic heart disease, coronary artery disease prophylaxis.
|}
|}
 
== Current availability==


Available
== Safety, Toxicology & Contraindications ==
* '''Toxicological Profile:''' Preclinical safety evaluations demonstrate high oral safety thresholds (<math>LD_{50} > 2000\text{ mg/kg}</math> in rodent models)<ref name="Mould2023"/>. Clinical studies confirm excellent tolerability across long-term administration<ref name="Bharani2002"/>.
* '''Adverse Reactions:''' Mild, transient gastrointestinal effects (such as mild constipation or dyspepsia) may occur due to the high tannin concentration.
* '''Precautions & Interactions:'''
** '''Anticoagulants & Antiplatelets:''' Given arjunolic acid's inhibitory effect on thrombin-induced aggregation, monitor coagulation metrics when co-prescribed with agents like Warfarin, Aspirin, or Clopidogrel<ref name="Sinha2008"/>.
** '''Antihypertensives:''' Potential additive hypotensive effects; routine blood pressure monitoring is advised when integrated into existing antihypertensive regimens<ref name="Dwivedi2014"/>.
 
== References ==
{{reflist}}


== Current researches ==
== External Links ==


[[Category: Database of herbs and minerals | Herbs]]
[https://cb.imsc.res.in/imppat/therapeutics/Terminalia%20arjuna IMPPAT database]


This article is under development
[[index.php?title=Category:Database of herbs and minerals|Herbs]]

Latest revision as of 06:11, 28 July 2026


Terminalia arjuna

Arjuna
Section/Chapter Herb database/Arjuna
Botanical name(s) Terminalia arjuna
Family Combretaceae
Availability Available
Contributors Team Dravyaguna
Year of publication 2026
Publisher Charak Samhita Research, Training and Skill Development Centre
DOI Awaited

Terminalia arjuna (family Combretaceae), commonly referred to as Arjuna, is one of the most prominent cardiovascular tonics in traditional Ayurvedic pharmacology (Hridya).[1] Used for over a millennium to treat chest pain, heart failure, hypertension, and dyslipidemia, modern clinical and pharmacological research has validated its multi-target mechanisms[2]. The therapeutic profile of T. arjuna stem bark stems from a complex matrix of oleanane triterpenoids, triterpenoid glycosides, flavonoids, and hydrolyzable tannins that collectively confer anti-ischemic, anti-atherosclerotic, antihypertensive, and antioxidant cardioprotection.[3]

Therapeutic Use

Arjuna (Terminalia arjuna)

Obesity (medoroga), wound management (vrana), heart diseases (hridroga), loss fof strength due to injury (kshatakshaya), obstinate urinary disorders including diabetes mellitus (prameha), thirst (trishna), melasma (vyanga)[4]

Other varieties / other botanical names

  • Terminalia paniculata
  • Terminalia tomentosa
  • Sterculia urens

Identification Characters

  • Dhavala – Bark is white in colour.
  • Shvetavaha - Bark is white in colour.
  • Sarpana – Large tree with spreading barks.
  • Madhugandhiprasunaka– Flowers are sweet scented.
  • Kakubha – Large tree covers large area.
  • Nadisarja – Commonly grows near river banks.

Synonyms in Charak Samhita

Arjuna(means the white one, clear), Dhava, Kakubha(a large tree covers large area), Indradru(tree which is a very potent medicine), Nadisarja(commonly grows on river banks), Dhavala(bark in white in colour), Partha, Shweta Vaha(it has whitish outer bark)

Synonyms in Bhavaprakasha Nighantu

Kakubha, Arjuna, Nadisarja, Indradu, Viravriksha, Vira, Dhavala[5]

Ayurvedic pharmacological properties

In Ayurvedic pharmacology, Arjuna is regarded as the primary Hridya (cardiotonic) herb, possessing cool and astringent characteristics that pacify Kapha and Pitta doshas[1].

Properties
Sr.no. Pharmacological criteria Properties
1 Taste (rasa) Astringent (kashaya)
2 Potency (veerya) Cold (sheeta)
3 Post digestion effect (vipaka) Pungent (katu)
4 Qualities (Guna) Light (laghu), Rough (ruksha)
5 Actions (karma) Pacify Kapha and Pitta,
6 Extra ordinary effect (prabhava) Cardiac tonic (hridya)
7 Therapeutic actions Cardiac tonic (hridya) Hridya (Cardioprotective/Cardiotonic), Kshataksheedhara (Healer of tissue injury and hemorrhage), Sandhananiya (Tissue/bone joining promoter), Raktashodhaka (Blood purifier), Medohara (Hypolipidemic/Anti-obesity).

Reference in Charak Samhita and its actions

Herbs and their activities
Sr.no. Reference in Charak Samhita Activity
1 Cha.Sa.Sutra Sthana 3/5 Siddhatama churna pradeha(local application in powder form)
2 Cha.Sa.Sutra Sthana 4/9(43) Sheetaprashaman mahakashaya(ingredient of group of herbs for pacifying cold)
3 Cha.Sa.Sutra Sthana 5/73 Danta pavana(recommended for use in teeth-cleansing)
4 Cha.Sa.Vimana Sthana 8/144 Kashaya-skandha(ingredient of group of astringent drugs)
5 Cha.Sa.Kalpa Sthana 1/8 Deshavichara (jangal desha )(kakubh)
6 Cha.Sa.Chikitsa Sthana 2/3/4 For Cows
7 Cha.Sa.Chikitsa Sthana 3/258 As an ingredient of Chandanadhya taila.
8 Cha.Sa.Chikitsa Sthana 6/27 Used for making decoction in Kaphaja prameha
9 Cha.Sa.Chikitsa Sthana 6/31 Used for making decoction in Pittaja prameha
10 Cha.Sa.Chikitsa Sthana 6/38 Trikantakadhya Tail/Ghrit in Vata-kaphaja prameha
11 Cha.Sa.Chikitsa Sthana 8/129 Ingredient in Atisara nashaka Khad-yusha
12 Cha.Sa.Chikitsa Sthana 25/95 Used as Patra-aachhadana on vrana.
13 Cha.Sa.Chikitsa Sthana 25/113 Used for tvak janana.
14 Cha.Sa.Chikitsa Sthana 26/98 As an ingredient of Udumbaravleha.
15 Cha.Sa.Chikitsa Sthana 26/272 As an ingredient of Mahaneela taila.
16 Cha.Sa.Chikitsa Sthana29/141 Used in formulation of Erandamuladi pralepa.
17 Cha.Sa.Chikitsa Sthana 30/92 As an ingredient of Pushyanuga churna.

Dose

3 – 6 gm of the drug in powder form.[6]

Important Formulations

As per A.P.I.[7]

  • Parthadyarishta
  • Nagarjunabhra Rasa
  • Arjuna Ghrita

Current availability

Available

  • In India – Uttar Pradesh, Bihar, Maharashtra, Madhya Pradesh, Odissa, West Bengal
  • Out of India – Sri Lanka, Bangladesh, Pakistan, Malaysia, Indonesia, Kenya, Africa, Australia, South America

Current researches

Major Phytochemical Constituents

The pharmacological activities of Terminalia arjuna bark are attributed to four primary bioactive classes[2]:

Phytochemical Constituents of Terminalia arjuna Bark
Phytochemical Class Key Active Constituents Primary Pharmacological Roles
Oleanane Triterpenoids Arjunolic acid, Arjunic acid, Arjungenin, Terminic acid Cardioprotective, anti-platelet, anti-apoptotic, and direct free-radical scavenging[8].
Triterpenoid Glycosides Arjunetin, Arjunosides I–IV, Arjunglucosides I & II Inotropic, chronotropic, and cardiac membrane-stabilizing activities.
Flavonoids & Phenolics Arjunone, Arjunolone, Baicalein, Luteolin, Quercetin Endothelial nitric oxide stimulation, vasodilation, and inhibition of LDL oxidation.
Hydrolyzable Tannins Punicalagin, Punicallin, Casuarinin, Terflavin C Vascular astringency, anti-inflammatory, and extracellular matrix protection.

Pharmacological Mechanisms & Scientific Evidence

Cardioprotective & Anti-Ischemic Actions

T. arjuna extracts preserve myocardial structural integrity during ischemic events and reperfusion injury[1]:

  • Endogenous Antioxidant Preservation: Prevents the depletion of key intracellular antioxidant enzymes, including superoxide dismutase (SOD), catalase (CAT), and glutathione peroxidase (GPx)[3].
  • Anti-Apoptotic Regulation: Downregulates pro-apoptotic markers (Bax, caspase-3) while upregulating anti-apoptotic proteins (Bcl-2) and heat shock proteins (HSP-70) in ischemic cardiomyocytes[2].

A double-blind, randomized, placebo-controlled crossover study evaluated 58 patients with chronic stable angina (NYHA Class II–III). Administration of 500 mg of T. arjuna bark extract every 8 hours significantly reduced anginal frequency and nitrate consumption, accompanied by objective improvements in treadmill exercise duration and reduced peak ST-segment depression compared to placebo[9]. Furthermore, clinical evaluations in congestive heart failure and ischemic heart disease demonstrate improved left ventricular ejection fraction[10].

Vascular Tone & Anti-Hypertensive Efficacy

  • Endothelial Nitric Oxide Activation: Flavonoid and glycoside fractions stimulate endothelial nitric oxide synthase (eNOS), increasing vascular NO availability and inducing endothelium-dependent vasodilation[2].
  • Inotropic & Chronotropic Balance: Demonstrates positive inotropic (enhancing force of contraction) and mild negative chronotropic (regulating pulse rate) effects without increasing myocardial oxygen demand[1].

Anti-Platelet & Anti-Atherosclerotic Effects

  • Thrombin-Induced Inhibition: The isolated triterpenoid arjunolic acid inhibits thrombin-induced platelet aggregation with an <math>IC_{50}</math> of 0.048 mM—exhibiting greater potency than aspirin (<math>IC_{50} = 0.088\text{ mM}</math>)[8][3].
  • Lipid Modulation & Foam Cell Suppression: Reduces circulating total cholesterol, low-density lipoprotein (LDL), and triglycerides while raising high-density lipoprotein (HDL) via upregulation of PPAR-γ pathways and suppression of oxidative LDL modification[1].

Posology & Preparations

Dosage Forms and Indications of Terminalia arjuna
Traditional / Modern Preparation Standardized Dosage Primary Clinical Applications
Arjuna Churna (Stem Bark Powder) 3–6 g daily (with milk or warm water) General cardiotonic, hyperlipidemia, mild hypertension.
Arjuna Kwath (Decoction) 50–100 ml daily (1:4 reduced decoction) Angina pectoris, heart failure support, fluid overload.
Arjunarishta (Hydro-alcoholic Ferment) 15–30 ml twice daily after meals Post-myocardial recovery, palpitations, cardiac fatigue.
Standardized Dry Extract (Capsule/Tablet) 250–500 mg twice or thrice daily Ischemic heart disease, coronary artery disease prophylaxis.

Safety, Toxicology & Contraindications

  • Toxicological Profile: Preclinical safety evaluations demonstrate high oral safety thresholds (<math>LD_{50} > 2000\text{ mg/kg}</math> in rodent models)[2]. Clinical studies confirm excellent tolerability across long-term administration[9].
  • Adverse Reactions: Mild, transient gastrointestinal effects (such as mild constipation or dyspepsia) may occur due to the high tannin concentration.
  • Precautions & Interactions:
    • Anticoagulants & Antiplatelets: Given arjunolic acid's inhibitory effect on thrombin-induced aggregation, monitor coagulation metrics when co-prescribed with agents like Warfarin, Aspirin, or Clopidogrel[8].
    • Antihypertensives: Potential additive hypotensive effects; routine blood pressure monitoring is advised when integrated into existing antihypertensive regimens[1].

References

  1. ↑ 1.0 1.1 1.2 1.3 1.4 1.5 Dwivedi, Shridhar; Chopra, Deepti (2014). "Revisiting Terminalia arjuna – An Ancient Cardiovascular Drug". Journal of Traditional and Complementary Medicine. 4 (4): 224–231. PMC 4220503 Freely accessible. PMID 25379361. doi:10.4103/2225-4110.139103. 
  2. ↑ 2.0 2.1 2.2 2.3 2.4 Mould, M. A.; Sridhar, M. (2023). "Terminalia arjuna, a Cardioprotective Herbal Medicine–Relevancy in the Modern Era of Pharmaceuticals and Green Nanomedicine—A Review". Pharmaceuticals. 16 (1): 126. PMC 9865188 Freely accessible Check |pmc= value (help). PMID 36678623 Check |pmid= value (help). doi:10.3390/ph16010126. 
  3. ↑ 3.0 3.1 3.2 Pauzi, Ahmad Naim; Lim, Soo Tein; Jantan, Ibrahim (2021). "Arjunolic acid: A promising triterpenoid against cardiovascular and metabolic disorders". Phytomedicine. 85: 153540. PMID 33789182 Check |pmid= value (help). doi:10.1016/j.phymed.2021.153540. 
  4. ↑ The Ayurvedic Pharmacopoeia of India. Department of Ayush, Ministry of Health and Family welfare, Govt. of India, New Delhi, Part I. 1986; Volume II:8
  5. ↑ Shri Bhavamishra, Bhavaprakash Nighantu, Vatadi Varga, Verse no. 23 - 24, Edited by Padmashree Pro. Krushnachandra Chunekar, Reprint Edition, Chaukhambha Bharati Academy, 2015;
  6. ↑ The Ayurvedic Pharmacopoeia of India. Department of Ayush, Ministry of Health and Family welfare, Govt. of India, New Delhi, Part I. 1986; Volume II:8
  7. ↑ The Ayurvedic Pharmacopoeia of India. Department of Ayush, Ministry of Health and Family welfare, Govt. of India, New Delhi, Part I. 1986; Volume II:8
  8. ↑ 8.0 8.1 8.2 Sinha, M.; Manna, P.; Sil, P. C. (2008). "Arjunolic acid, a novel phytomedicine with multifunctional therapeutic potential". Natural Product Reports. 25 (3): 543–552. PMID 18497899. doi:10.1039/B713728P. 
  9. ↑ 9.0 9.1 Bharani, A.; Ganguly, A.; Bhargava, K. D. (2002). "Efficacy of Terminalia arjuna in chronic stable angina: a double-blind, placebo-controlled, crossover study comparing Terminalia arjuna with isosorbide mononitrate". Indian Heart Journal. 54 (2): 170–175. PMID 12086380. 
  10. ↑ Vaidya, A. B.; Rajagopalan, F.; Kale, A. Q. (2010). "Clinical evaluation of Terminalia arjuna in ischemic heart disease and congestive cardiac failure". Journal of Association of Physicians of India. 58: 411–416. 

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