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Adhatoda vasica + Centella asiatica

Allopathic
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Indications
  • Adhatoda vasica:
    • Treatment and symptomatic relief of respiratory disorders such as bronchitis, asthma, chronic cough, and upper respiratory tract infections.
    • Traditionally used to support mucus clearance and ease bronchospasm in obstructive pulmonary conditions.
  • Centella asiatica:
    • Promotion of wound healing in minor skin injuries, burns, and ulcers.
    • Management of chronic venous insufficiency and related edema.
    • Cognitive enhancement and anxiety reduction in mild neurological conditions.
    • Supportive treatment in inflammatory skin disorders.
  • Combined Uses:
    • Herbal formulations combining both are commonly used to improve respiratory health, promote tissue repair, and enhance microcirculation.
Dosage & Administration
  • Adults:
    • Oral administration of standardized extracts:
      • Adhatoda vasica extract: 300–500 mg daily, divided doses.
      • Centella asiatica extract: 300–600 mg daily, divided doses.
    • Taken with water, preferably after meals.
    • Duration typically ranges from 7 days to several weeks depending on indication and clinical response.
  • Pediatrics:
    • Insufficient safety and efficacy data; use only under medical supervision.
  • Elderly:
    • Use cautiously; monitor for tolerance and adverse effects.
  • Renal/Hepatic Impairment:
    • No specific dose adjustments established; caution advised.
Mechanism of Action (MOA)
  • Adhatoda vasica contains alkaloids such as vasicine and vasicinone which exert bronchodilator effects by relaxing bronchial smooth muscles and stimulating respiratory secretions, facilitating expectoration. It also exhibits anti-inflammatory and mild antimicrobial properties.
  • Centella asiatica is rich in triterpenoids (asiaticoside, madecassoside) that enhance collagen synthesis and angiogenesis, promoting wound healing and improved venous tone. It also possesses antioxidant and neuroprotective effects, modulating inflammatory pathways.
  • Together, they synergize to relieve respiratory symptoms, enhance mucus clearance, and support tissue repair and vascular health.
Pharmacokinetics
  • Adhatoda vasica:
    • Moderate oral absorption; metabolized hepatically.
    • Excreted via renal and biliary routes.
    • Half-life data limited; clinical effects guide dosing.
  • Centella asiatica:
    • Oral absorption of active triterpenoids with hepatic metabolism.
    • Metabolites excreted in urine and feces.
    • Pharmacokinetic data limited; dosing based on clinical use.
Pregnancy Category & Lactation
  • Pregnancy:
    • Limited human safety data; use not recommended during pregnancy.
  • Lactation:
    • Insufficient data on excretion in breast milk; caution advised, avoid unless benefits justify risk.
Therapeutic Class
  • Herbal medicine / Phytopharmaceuticals
  • Adhatoda vasica: Bronchodilator and expectorant agent
  • Centella asiatica: Wound healing and vascular protective agent
Contraindications
  • Known hypersensitivity to either Adhatoda vasica, Centella asiatica, or related compounds.
  • Pregnancy and lactation (due to insufficient safety data).
  • Severe hepatic or renal impairment (use cautiously).
  • Concurrent use with anticoagulants without medical supervision.
Warnings & Precautions
  • Use with caution in patients on blood thinners due to possible additive effects.
  • Monitor for allergic reactions including rash and respiratory symptoms.
  • Avoid in children unless prescribed by a healthcare provider.
  • Long-term safety not established; recommended for short-term use.
Side Effects
  • Common:
    • Gastrointestinal upset (nausea, abdominal discomfort)
    • Headache and dizziness (mostly with Centella asiatica)
    • Skin rash or itching
  • Rare/Serious:
    • Hypersensitivity reactions such as bronchospasm or angioedema (rare)
    • Possible hepatotoxicity with prolonged excessive use (rare)
Drug Interactions
  • Potential increased bleeding risk with anticoagulants/antiplatelets.
  • Possible additive sedation with CNS depressants or alcohol.
  • No well-documented CYP450 enzyme interactions; caution advised with multiple medications.
  • Avoid concurrent use with other herbs or supplements without medical advice.
Recent Updates or Guidelines
  • Evidence increasingly supports Centella asiatica in chronic venous insufficiency and wound healing.
  • Adhatoda vasica’s bronchodilator effect is confirmed in traditional and some clinical studies.
  • Neither herb has formal FDA or EMA approval; use as complementary herbal therapy.
  • Ongoing research to standardize extracts and optimize dosing.
Storage Conditions
  • Store at 20°C to 25°C (68°F to 77°F) in a dry, well-ventilated place.
  • Protect from direct sunlight and moisture.
  • Keep out of reach of children.