Oushadha means medicine and sevanakala means time of administration. The time of administration of medicines is called oushadha sevana kala. The efficacy and safety of a particular medicine depends on many factors and among them the time of intake of medicine also plays an important role.
Types of bheshajakala
Generally 10 oushadha sevana kalas are explained in Ayurveda
- Empty stomach
- Before food
- After food
- In between food
- Before and after food
- Along with food
- Along with each morsel
- In between two morsels
- Bed time
Synonyms: Prataha niranna, abaktam, ananna
This oushadha sevanakala represents administration of medicine in the morning without taking any food. The morning time can be considered as early morning during sunrise [Sha.Pu.2/2] or it may be the time after the increased kapha has moved out of the stomach [A.S.Sutra Sthana.23/14] that is the time of breakfast (7.30AM-8.30AM). The potency of the medicines will be more at this time. Thus it can cure the diseases immediately. The therapeutic vomiting and purgative drugs should be administered at this time. By this scarifying property can be attained [Sha.Pu.2/4].
Indications and contraindications: It is contraindicated to children, old aged persons; ladies etc debilitated persons because it may cause tiredness and weakness [Su.Sa.Uttarasthana.64/67]. It is also contraindicated to persons having thirst, who took cold water, who is hungry [A.S.Sutra sthana.23/23]. Because of these reasons the medicine should be given at this time only to the person with good strength [Ka.Sa. Khilasthana 3/45]
Synonyms: Bhuktaadau, prakbaktam, purvabhakta, annadau
In this oushadha kala the medicine is administered prior to the food intake. The medicine will undergo digestion with ease, it won’t reduce strength of the patient, and it won’t expel through mouth as it gets covered with food. It cures diseases in the lower part of body and strengthens the lower part of body. In order to make the body thin medicine should be given at this time. [A.S.Sutrasthana. 23/15] By this the dosha present in the stomach (amasaya) gets destroyed. [Ka.Sa. Khilasthana 3/44]
Indications: It is indicated for old aged, children, ladies and coward. [Su.Sa.Uttarasthana.64/69]
Synonyms: Bukta paschat, adobaktam, adahabaktam, ante
In this oushadha kala the medicine is administered just after the food intake. Administration of medicine after food cures diseases of upper part of body and it provides more strength to upper part of body. [Su.Sa.Uttarasthana.64/72][A.S.Sutrasthana. 23/17] It pacifies the diseases of chest, throat and head immediately. [Ka.Sa. Khilasthana 3/47] It causes stoutness of body. [A.S.Sutrasthana 23/17]
In between food
Synonyms: Bukta Madhya, madhyabaktam, madhye
It is used to treat persons with less digestive fire.[Sha.Pu.2/6] It cures diseases of middle part of body. [Su.Sa.Uttarasthana.64/72] The medicine gets obstructed by food in both directions and thus easily extracts the doshas from internal organs (antaraashaya). [Ka.Sa. Khilasthana 3/47] It cures the diseases related to gut. [A.S.Sutrasthana 23/16]
Before and after food (samudgam)
It is used to treat hiccups, tremors and convulsions. [Sha.Pu.2/7][A.Hr Sutrasthana 13/41] The medicine should be given along with light meal and meal should be in less quantity. [A.S.Sutrasthana.23/20] [Cha.Sa.Chikitsa Sthana30/301] If dosha spreads in both directions, upper and lower [Su.Sa.Uttarasthana.64/77] [Ka.Sa.Khilasthana 3/48][A.S.Sutrasthana.23/20] the medicines should be given at this time.
Along with food
Synonym: Annaihi yuktam, sabhaktam, saannam
Administration of medicines by mixing with different (attractive) meals. [Cha.Sa.Chikitsa Sthana 30/301] It is used to treat anorexia. [Sha.Pu.2/5] The medicine can be given at this time to both who have strength and without strength, those who have aversion towards medicine and for children and old aged. [Su.Sa.Uttarasthana.64/75] This helps to protect strength and digestive fire. It is used to treat the diseases affecting whole body. [A.S.Sutrasthana 23/18]
Indications: Persons with less digestive fire, ladies, delicate, wounded and weak. [Ka.Sa. Khilasthana 3/49]
Along with each morsel
Synonym: Grasa, grase grase, sagrasam
Indications: Weak persons, persons having seminal debility (ksheenashukra), scanty semen (alpasukra) [Ka.Sa Khilasthana 3/50], less digestive fire [Su.Sa.Uttarasthana.64/82], disorders of speech (swarabanga) and diseases related to throat. [Sha.Pu.2/10]
In between two morsels
Synonyms: Grasaantare, kavalantare
Emetic smoking in conditions of dyspnoea etc should be given in between morsels of food.[Su.Sa.Uttarasthana.64/82] Medicines for cardiac diseases, drugs for therapeutic vomiting and medicated smoke [A.S.Su.23/22] should be given at this time. Disorders of speech (swarabanga) and diseases related to throat [Sha.Pu.2/10] also should be treated at this time.
Synonym: Muhurmuhu, muhuhu
In this oushadhakala the medicine is administered often and often. To treat thirst (thrit), vomiting (chardi), hiccups (hikka), dyspnea (swasa) and poision (gara) the medicine should be given frequently. The medicines can be given along with food or without food. [Sha.Pu.2/11] For cough also this oushadhakala should be selected [Cha.Sa.Chikitsa Sthana30/300] [Su.Sa.Uttarasthana.64/79] [Ka.Sa. Khilasthana 3/48] [A.Hr.Sutrasthana.13/40][A.S.Sutrasthana.23/21]
Bed time (Nishi)
Here the medicine is administered in night after food at bedtime. It is used to treat the diseases of head and neck. [Sha.Pu.02/12][A.Hr.Sutrasthana.13/41][A.S.Sutrasthana.23/22] Scarifying (lekhana), nourishing (brimhana), digestive (pachana) and pacifying (shaman) medications can be given at night.
Apart from these ten oushadha sevankala some scholars consider certain other time period for the administration of medicine. They are as follows
In between two meals
Synonyms: Antarabhaktam, bhaktasya madhyam
In this oushadhakala the intake of medicine is at midday after the digestion of breakfast and after the digestion of medicine food is given at evening.
It is indicated for those who are having good digestive fire.[A.S.Sutrasthana.23/19] and persons with mild diseases. [Ka.Sa Khilasthana 3/49] The medicine at this time is good to heart (hridhya), gives more strength to mind (manobalakara), increases the digestive fire (deepana) and is wholesome (pathya). [Su.Sa.Uttarasthana.64/75]
Medicine mixed with food(bhaktasamyuktam) [Cha.Sa.Chikitsa Sthana30/297]
Importance of oushadha sevanakala
The oushadha sevanakala is mentioned especially for pacification (shamana) therapies. [A.Hr.Sutrasthana.13]
Based on dosha
Empty stomach – Medicines for aggravated kapha and pitta conditions should be given at this time. [Sha.Pu.2/4] In the vitiation of vyana vata medicines should be administered at this time. [Cha.Sa.Chikitsa Sthana30/299]
Before food – This helps to treat the diseases caused by vitiation of apaana vata[Cha.Sa.Chikitsa Sthana30/299] Some scholars have the opinion that it will helps to treat the diseases caused by vitiation of apaana vata if the medicine is given before the breakfast. [Sha.Pu.2/5]
After food – Administration of medicines at this time can treat udana vata vitiation. [Cha.Sa.Chikitsa Sthana30/299] If medicine administered after breakfast helps to treat vyana vata disorders [Sha.Pu.2/7][A.Hr.Sutrasthana.13/39][A.S.Sutra sthana. 23/17] and if medicines are given after evening food the disorders caused by prana vata can be treated. [Sha.Pu.2/10] Certain other scholars opine that if medicines are given after evening food, can treat udana vata vitiation. [A.Hr.Sutrasthana.13/39][A.S.Su. 23/17] In disorders of kapha origin, medicines should be given at this time. [A.S.Sutrasthana. 23/17]
In between food – It is used to treat samana vata vitiation.[Sha.Pu.2/6][Cha.Sa.Chikitsa Sthana30/299] [A.Hr.Sutrasthana.13/38][A.S.Sutrasthana. 23/16] In disorders of pitta origin medicines should be given at this time. [A.S.Sutrasthana. 23/16]
Along with each morsel and in between two morsel – When prana vata is vitiated, medicine is to be advocated along with each morsel or in between two morsel [Cha.Sa.Chikitsa Sthana30/300] [A.Hr.Sutrasthana.13/39][A.S.Sutrasthana.23/22] Some scholars have the opinion that to treat udaana vata, medicine should be given at this time period. [Sha.Pu.2/10]
Based on the form of medicine
- Empty stomach – Decoction[Sha.Pu.2/3]
- Before and after food – Electuaries (avaleha) for digestion (pachana)
- Along which each morsel – Medicines in powder,electuary and tablet form [AS.Su.23/22]
- In between two morsel – Electuaries [Su.Sa.Uttarasthana.64/82]
The study of how the effects of drugs vary with biological timings is called chronopharmacology. In a study it is reported that the absorption of diclofenac was significantly low if administered in the evening when compared with the morning dosage. It also shows a delay in absorption for the evening dosage. The absorption of paracetamol after overnight fasting is five times more when ingested after a high carbohydrate diet. The drug flurbiprofen shows more effective in improving the symptoms like pain and spinal flexibility in rheumatoid arthritis patients if given in morning than in evening. This suggests that the time of drug administration may also be a factor which influences the therapeutic efficacy.
For certain drugs the time of administration may be as important as the dose and route of administration. In order to prevent the variations in pharmacokinectics of a drug the time of administration should also be controlled. Lipophilic drugs are found to be absorbed faster in the morning when compared to the evening. In a day gastric acid secretion, gastric pH, gastric motility, gastric emptying time and gastric blood flow vary according to time. These factors might have an impact over the absorption of drug.
A large number of drugs like analgesics, antibiotics, antitumor drugs, immunosuppressive agents, cardio vascular drugs, antidepressants etc show varying potency and disposition kinectics based on the time of drug administration.
At the same time for certain drugs like aminoglycosides the drug administration time shows no difference in pharmacokinectics and nephrotoxicity.
List of theses done
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