ARNICA -- Arnica montana L. (Asteraceae/Compositae) + (external); X (internal)

HERBAL

MEDICINAL

PLANT

 

 

 

 

 

 

 

  

                                                                              

   

  

 

ARNICA

Arnica montana L. (Asteraceae/Compositae) + (external); X (internal)

 

 BY

 

RETTODWIKART THENU

ARNICA

 (ahr’ni-kuh)  

 

 

Arnica montana L. (Asteraceae/Compositae) + (external); X (internal)

 

SUMMARY AND PHARMACEUTICAL COMMENT

 

The chemistry and pharmacology of arnica are well documented, but there is a paucity of clinical data. Antiinflammatory properties associated with sesquiterpene lactones justify the herbal uses, although allergenic and cytotoxic properties are also associated with this class of constituents. Arnica is not suitable for internal use, although it

is present in some homeopathic products. External use of arnica tincture, which is included as an ingredient in some cosmetics, hair shampoos and bath preparations, may cause an allergic reaction. The pyrrolizidine alkaloids tussilagine and isotussilagine, reportedly present in arnica, are non-toxic. Moreover, they are artefacts produced during the extraction process with methanol.

 

OTHER COMMON NAMES

Arnica Flowers, Arnica Root, Leopard's Bane, Mountain Tobacco, Wolfsbane

Common Arnica, Sneezewort, Mountain Snuff,

 

DESCRIPTION

MEDICINAL PARTS: The medicinal parts of Arnica are the ethereal oil of the flowers, the dried flowers, the leaves collected before flowering and dried, the roots, and the dried rhizome and roots.

FLOWER AND FRUIT: The terminal composite flower is found in the leaf axils of the upper pair of leaves. They have a diameter of 6 to 8 cm, are usually egg yolk-yellow to orangeyellow, but occasionally light yellow. The receptacle and epicalyx are hairy. The 10 to 20 female ray flowers are lingui-form. In addition, there are about 100 disc flowers, which are tubular. The 5-ribbed fruit is black-brown and has a bristly tuft of hair.

LEAVES, STEM AND ROOT: Arnica is a herbaceous plant growing 20 to 50 cm high. The brownish rhizome is 0.5 cm thick by 10 cm long, usually unbranched, 3-sectioned and sympodial. The rhizome may also be 3-headed with many yellow-brown secondary roots. Leaves are in basal rosettes. They are in 2 to 3 crossed opposite pairs and are obovate and entire-margined with 5 protruding vertical ribs. The glandular- haired stem has 2 to 6 smaller leaves, which are ovate to lanceolate, entire-margined or somewhat dentate.

CHARACTERISTICS: The flower heads are aromatic; the taste is bitter and irritating.

HABITAT: Arnica is found in Europe from Scandinavia to southern Europe. It is also found in southern Russia and central Asia.

PRODUCTION: Arnica flower consists of the fresh or dried inflorescence of Arnica montana or Arnica chamissonis. The flower should be dried quickly at 45° to 50°C.

NOT TO BE CONFUSED WITH: Other yellow-flowering Asteracea.

 

 

SPECIES (FAMILY)

Arnica montana L. (Asteraceae/Compositae)

Arnica chamissonis Less. subsp. foliosa (Nutt.) Maguire also allowed in German Pharmacopoeia.(G52)

 

Arnica montana L.; may also include A. chamissonis less., A. cordifolia hook, A. fulgens pursh, A. soronia greene

 

SYNONYM(S)

Arnicae Flos, Leopard's Bane, Mountain Tobacco, Wolf's Bane

 

ORIGIN

Arnica grows wild in the mountains of Europe and Russia. Some species can be found in the western United States.

 

 

PHARMACOPODIAL AND OTHER MONOGRAPHS

BHP 1996(G9)

BP 2007(G84)

ESCOP 1997(G52)

Martindale 35th edition(G85)

Ph Eur 2007(G81)

 

LEGAL CATEGORY (LICENSED PRODUCTS)

GSL, for external use only.(G37)

 

CONSTITUENTS

The following is compiled from several sources, including References 1–3, and General References G2 and G52.

Alkaloids  Traces of non-toxic alkaloids tussilagine and isotussilagine(4) but these are reportedly artefacts produced during extraction.(5)

Amines   Betaine, choline and trimethylamine.

Carbohydrates   Mucilage, polysaccharides including inulin.

Coumarins   Scopoletin and umbelliferone.

Flavonoids   Betuletol, eupafolin, flavonol glucuronides,(1–3) hispidulin, isorhamnetin, kaempferol, laciniatin, luteolin, patuletin, quercetin, spinacetin, tricin and 3,5,7-trihydroxy-6,30,40- trimethoxyflavone.

Terpenoids   Sesquiterpene lactones of the pseudoguaianolidetype, 0.2–0.8%.(G52) Pharmacopoeial standard not less than 0.4%.(G81, G85) Helenalin,(6) 11a,13-dihydrohelenalin and their esters with acetic, isobutyric, methacrylic, tiglic and other carboxylic acids.(G52) Diterpenes including z-labda-13-ene-8a,15-diol.(7)

Volatile Oils   Up to 1%, normally about 0.3%. Thymol and thymol derivatives.

Other Constituents   Amino acid (2-pyrrolidine acetic), bitter principle (arnicin), caffeic acid, carotenoids, fatty acids, phytosterols, polyacetylenes, resin, tannin (unspecified).

 

CHEMICAL COMPONENTS

COMPOUNDS

Sesquiterpene lactones of the pseudo-guaianolid-type: particularly esters of the helenalin- and 11,13-dihydrohelenalins with short-chained fatty acids such as acetic acid, isobutyric acid, 2- methyl-butyric acid, methylacrylic acid, isovaleric acid or tiglic acid

Volatile oil: with thymol, thymol esters, free fatty acids

Polyynes: including tri-dec-l-en-penta-3,5,7,9 11-in Hydroxycumarines

Cajfeic acid derivatives: including chlorogenic acid, 1,5-dicaffeoyl quinic acid

Flavonoids: numerous flavone and flavonol glycosides and their aglycones

 

USES

USES

Arnica is used topically to decrease inflammation in bruises, sprains, wounds, acne, boils, rashes. It may be used in cardiovascular problems to decrease cholesterol if supervised by a qualified herbalist. Arnica should not be used internally except under the supervision of a qualifi ed herbalist. It is used in small quantities as a flavor in beverages and desserts (Jellin et al, 2008).

 

FOOD USE

Arnica is listed by the Council of Europe as a natural source of food flavouring (category N2). This category indicates that arnica can be added to foodstuffs in small quantities, with a possible limitation of an active principle (as yet unspecified) in the final product.(G16) Previously, arnica has been listed by the Food and Drugs Administration (FDA) as an 'unsafe herb', (G22) and is only approved for food use in alcoholic beverages.(G41)

 

HERBAL USE

Arnica is stated to possess topical counter-irritant properties. It has been used for unbroken chilblains, alopecia neurotica, insect bites, gingivitis, aphthous ulcers, rheumatoid complaints and specifically for sprains and bruises.(G2,G7, G52, G64)

German Commission E approved external use for injuries and consequences of accidents, e.g. haematoma, dislocation, contusions, oedema due to fracture, rheumatoid muscle and joint pains, inflammation of oral and throat region, furuncolosis, inflammation caused by insect bites and superficial phlebitis.(G3, G4) Arnica is mainly used in homeopathic preparations; it is used to a lesser extent in herbal products.

 

 

 

Figure 1. Arnica (Arnica montana).

Figure 2. Arnica – dried drug substance (flower).

 

ACTIONS

 

Antiinfl ammatory Action

Two studies have identifi ed antiinfl ammatory properties of arnica. One study (Lussignoli et al, 1999) found that infl ammation was decreased in rat paw edema, possibly due to a decrease in interleukin-6. Another study (Schaffener, 1997) showed the antiinfl ammatory effect of helenalin, one of the chemical components of arnica. A more recent study (Brinkhaus et al, 2006) showed that clients who took homeopathic arnica had much less postoperative swelling after arthroscopy.

Cytotoxic Action

One study (Willuhn et al, 1994) showed low cytotoxicity when compared with other antineoplastics. Helenalin showed the greatest cytotoxic effect.

Other Actions

Arnica montana decreased mild postpartum bleeding in a randomized doubleblind, placebo-controlled study of 40 participants (Oberbaum et al, 2005).

 

PHARMACOLOGICAL ACTIONS

IN VITRO AND ANIMAL STUDIES

Antimicrobial Activity Arnica has been reported to exhibit bactericidal properties against Listeria monocytogenes and Salmonella typhimurium.(G41) Helenalin and related sesquiterpenes from arnica have antimicrobial activity against Bacillus subtilis and Staphylococcus aureus,(8) Corynebacterium insidosum, Micrococcus roseus, Mycobacterium phlei, Sarcinia lutea and Proteus vulgaris.(G52) Antifungal activity against Trichophyton mentagrophytes, Epidermaphyton spp. and Botrytis cinerea is reported for helenalin.(8, G52)

Antitumour Activity The cytotoxicity of 21 flavonoids and five sesquiterpene lactones from Arnica spp. has been investigated in vitro in studies using GLC4 (a human small cell lung carcinoma) and COLO 320 (a human colorectal cancer) cell lines.(9) The most potent compound, helenalin, had an IC₅₀ value of 0.44 mmol/L against GLC4 and 1.0 mmol/L against COLO 320 after two hours' exposure.(9) Some of the individual flavonols and flavones of arnica at non-toxic concentrations significantly reduced helenalininduced cytotoxicity in vitro.(10)

Anti-Inflammatory Activity Moderate (29%) anti-inflammatory effect in the carageenan rat paw model has been reported for arnica.(11) Helenalin is a potent inhibitor in this test and in chronic adjuvant arthritis tests in rats.(12) The a-methylene-glactone moiety of sesquiterpenes is required for activity, and the potency of helenalin is enhanced by the presence of the 6-hydroxy group.(13) The mode of action of sesquiterpene lactones as antiinflammatory agents is at multiple sites. At a concentration of 5x10^-4 mol/L, the compounds uncoupled oxidative phosphorylation of human polymorphoneutrophils, elevated cyclic adenosine monophosphate (cAMP) levels of rat neutrophils, and rat and mouse liver cells, and inhibited free and total lysosymal enzyme activity.(12) Human polymorphonuclear neutrophil chemotaxis was inhibited at 5x10^-4 mol/L, whereas prostaglandin synthetase activity was inhibited at concentrations of 10^-3 mol/L. Helenalin and 11a-13-dihydrohelenalin inhibited collageninduced platelet aggregation, thromboxane formation and 5- hydroxytryptamine secretion in a concentration-dependent manner.(14)

Other Activities Helenalin has potent activity in the hotplate tail flick analgesic test in mice.(13) Helenalin has also been reported to possess immunostimulant activity in vitro,(15) while high molecular weight polysaccharides have been found to exhibit immunostimulant activity in vivo in the carbon clearance test in mice.(15, 16) Arnica contains an adrenaline-like pressor substance and a cardiotonic substance.(G24)

 

CLINICAL STUDIES

Clinical investigation of the effects of arnica is limited, and rigorous randomised controlled clinical trials are required. A gel preparation of arnica flowers applied externally to the limbs of 12 male volunteers was more effective than placebo in the treatment of muscle ache.(G50, G52) In a randomised, double-blind, placebocontrolled study, 89 patients with venous insufficiency received arnica gel (20% tincture) or placebo.(G50) It was reported that arnica treatment produced improvements in venous tone, oedema and in feeling of heaviness in the legs.

 

ACTIVITIES

Allergenic (1; MAB; PHR); Analeptic (1; BIS; PH2); Analgesic (2; APA; CRC; KOM; MAB; PH2; WAM); Antiaggregant (1; MAB); Antibacterial (1; CAN; MAB); Anticomplementary (1; WO3); Antiedemic (1; CAN; MAB; SHT); Antiinflammatory (2; BGB; KOM; PH2; WAM); Antineuralgic (2; BIS; KOM); Antipyretic (f; CRC); Antirheumatic (1; BIS); Antiseptic (2; BIS; KOM; PH2); Anti-TNF (1; WO3); Antitumor (1; MAB); Blood Thinner (1; MAB); Candidicide (1; MAB); Cardiotonic (1; BIS; CAN; PHR); Cardiotoxic (f; BGB); Cerebrotonic (f; BGB); Choleretic (1; APA; BGB); CNS-Stimulant (f; APA; CRC); Counterirritant (1; APA; CAN); Dermatitigenic (1; MAB); Diuretic (1; APA; MAB); Expectorant (f; CRC); Fungicide (1; CRC); Hemostat (f; CRC); Hypocholesterolemic (f; CRC); Immunostimulant (1; APA; BGB; CAN); Irritant (1; MAB); Nervine (f; CRC); Phagocytotic (1; WO3); Phospholipase-Inhibitor (1; MAB); Positive Inotropic (1; BGB; PH2; SHT); Resolvent (f; CRC); Respirastimulant (1; BGB; PH2; SHT); Sedative (f; CRC); Sternutator (f; CRC); Stimulant (F; MAB); Tonic (f; CRC); Uterotonic (1; BGB; PH2; SHT); Vulnerary (f; CRC; PNC).

 

INDICATIONS

Abrasion (f; APA); Abscess (f; BGB); Acne (f; APA; CRC); Alopecia (f; CRC); Alopecia neurotica (f; CAN; MAB; PH2); Amenorrhea (1; BGB; SHT); Anemia (f; BGB); Angina (f; PH2); Apoplexy (f; CRC); Atherosclerosis (f; PHR; PH2); Arthrosis (2; BIS; KOM; MAB; PH2; SHT); Backache (f; CRC); Bacteria (1; CAN; MAB); Bite (f; PH2); Bleeding (f; CRC; PH2); Boil (f; APA; PIP); Brain (1; CRC; BGB); Bronchosis (2; CRC; PHR; PH2); Bruise (1; BGB; CAN; WAM); Bug Bite (f; PIP); Cancer (f; CRC; JLH); Cancer, intestine (f; CRC; JLH); Cancer, liver (f; CRC; JLH); Cancer, stomach (f; CRC; JLH); Candida (1; MAB); Carbuncle (f; CRC); Cardiac Insufficiency (f; BGB; PHR); Chilblains (f; CAN; MAB); [Cold (2; PHR)?]; Contusion (2; KOM; PIP); [Cough (2; PHR; PH2)?]; CVI (1; MAB); Dandruff (f; MAB); Decubitis (f; CRC); Depression (f; BGB); Dermatosis (2; CRC; PHR; PH2); Diarrhea (f; BGB); Dislocation (2; KOM); Dyspnea (f; BGB); Edema (2; KOM; PH2); Enterosis (f; CRC; JLH); Fatigue (f; PHR; PH2); [Fever (2; CRC; PHR)?]; Fracture (f; MAB); Fungus (1; CRC; MAB); Furunculosis (2; BIS; KOM; PH2); Gastrosis (f; CRC; JLH); Gingivosis (f; APA); Hematoma (2; BIS; KOM; MAB; PH2); Hemorrhoid (f; APA); High Cholesterol (f; CRC); Immunodepression (1; APA; BGB; CAN); Infection (2; CRC; KOM; PH2; WAM); Inflammation (2; BGB; KOM; PH2; WAM); Insomnia (f; CRC); Mastosis (f; BGB); Myalgia (2; KOM; MAB; SHT); Mycosis (1; CRC); Myocardosis (f; PH2); Myosis (f; PH2); Nervousness (f; CRC); Neuralgic (2; BIS; KOM); Pain (2; APA; CRC; KOM; MAB; PH2; WAM); Pharyngosis (2; KOM; PH2; PIP); Phlebitis (2; BIS; KOM; MAB); Pneumonia (f; BGB); Psoriasis (f; APA); Rash (f; CRC); Rheumatism (2; BIS; KOM; PH2; PIP); Seborrhea (f; APA); Sore (f; BGB); Sore Throat (f; APA); Sports Injury (1; WAM); Sprain (2; BGB; CAN; PH2); Stomatosis (2; BIS; KOM; PH2); Swelling (2; APA; CAN; KOM; MAB; PH2; SHT); Thrombophlebitis (2; PIP); Tumor (1; CRC; MAB); Typhoid (f; BGB); Uterosis (f; PH2); Varicosis (f; MAB); Water Retention (1; APA; MAB); Wound (2; BGB; CRC; PHR); Yeast (1; MAB).

 

INDICATIONS AND USAGE

Approved by Commission E:

• Fever and colds

• Inflammation of the skin

• Cough/bronchitis

• Inflammation of the mouth and pharynx

• Rheumatism

• Common cold

• Blunt injuries

• Tendency to infection

UNPROVEN USES: External folk medicine uses include consequences of injury such as traumatic edema, hematoma, contusions, as well as rheumatic muscle and joint problems. Other applications are inflammation of the oral and throat region, furunculosis, inflammation caused by insect bites and phlebitis. In Russian folk medicine, the drug is used to treat uterine hemorrhaging. Furthermore, the drug is used for myocarditis, arteriosclerosis, angina pectoris, exhaustion, cardiac insufficiency, sprains, contusions and for hair loss due to psychological causes. While some uses are plausible, most are unproven.

 

PRODUCT AVAILABILITY

Topical: Spray, Cream, Salve, Ointment; Oral: Tablets, Tea, Tincture, Sublingual

PLANT PARTS USED: Dried Flower Heads, Rhizome

 

DOSAGES

 

DOSAGES

·         Adult topical: apply to affected area as needed

Very little information is available on dosages.

 

DOSAGES

Recommendations for external use (adults) for traditional uses recommended in older standard herbal reference texts are given below.

·         Tincture of arnica flower (BPC 1949) 2–4mL for external application only.

·         Preparations Ointments, creams, gels, compresses made with 5– 25% v/v tinctures, 5–25% v/v fluid extracts, diluted tinctures or fluid extract (1 : 3–1 : 10), Decoctions 2.0 g drug/100 mL water.(G3, G4)

 

DOSAGES

DO NOT TAKE INTERNALLY (APA); 2 g herb fl (1 tsp = ~0.5 g)/100 ml water (APA;BIS); 2 g herb/100 mL water (KOM).

 

DOSAGES

MODE OF ADMINISTRATION: Arnica is used in the form of the whole herb, cut herb or herb powder for infusions, extracts, and tinctures; gel, oil and poultice for external application.

HOW SUPPLIED: Commercial pharmaceutical preparations include gels, ointments, tinctures, oils and plasters.

 

PREPARATION: Arnica tincture (3x to lOx dilutions with water) is used to prepare a poultice. A tincture is prepared using 1 part Arnica flowers and 10 parts ethanol 70% v/v (according to DAB 10). Arnica oil is an extract of 1 part herb and 5 parts slightly warmed fatty oil. Ointments are made up with up to 15% Arnica oil or with 10 to 25% tinctures in a neutral ointment base. Mouthwashes are prepared as a tincture in lOx dilution.

 

DAILY DOSE: Tincture for cataplasm: tincture in 3x to lOx dilution. For mouth rinses: tincture in lOx dilution. Ointments should contain a maximum of 15% Arnica oil.

STORAGE: When stored, die drug should be tightly sealed and protected from light.

 

 

OVERDOSAGE

Overdoses taken internally can lead to poisonings, characterized by severe mucous membrane irritation (vomiting, diarrhea, mucous membrane hemorrhage) and a brief stimulation of cardiac activity followed by cardiac muscle palsy.

For mat reason, internal administration of the drug is strongly discouraged.

 

PRECAUTIONS AND ADVERSE REACTIONS

GENERAL: The risks connected with the external, appropriate administration of therapeutic dosages of the drug are minimal. Frequent administration, in particular of the undiluted tincture, as well as with contacts with the plant, can nevertheless lead to sensitization. Allergy-related skin rashes with itching, blister formation, ulcers and superficial necroses can result from repeated contact with, among odier things, cosmetics containing Arnica flowers or other composites (for example tansy, chrysanthemums, sunflowers). External application of very high concentrations can also result in primary blister formation and necroses.

DRUG INTERACTIONS: The coumarin componant may theoretically interact with warfarin, resulting in an additive anticoagulant effect.

 

CONTRAINDICATIONS, INTERACTIONS, AND SIDE EFFECTS

CLASS 2D EXTERNALLY; NOT FOR USE ON BROKEN SKIN; CLASS 2B INTERNALLY (AHP). Commission E reports contraindications of hypersensitivity and adverse effects of local reactions. Contraindications of hypersensitivity to sesquiterpene lactones and adverse effects of allergic reactions also reported. The tincture should not be applied in undiluted form (AEH). Irritant and allergic reactions from topical applications of arnica preparations. CAN caution that sesquiterpene lactones (SL), aromatic compounds widely distributed in certain plant families, with highest concentrations generally found in leaves and flowers, may cause dermatosis and GI tract irritation. Sheep and cattle poisonings due to SL-containing species have been reported. Cases of allergic contact dermatosis in humans have also been reported (AHED1). “Arnica is poisonous if taken internally. It is irritant to mucous membranes and ingestion may result in fatal gastroenterosis, muscle paralysis (voluntary and cardiac), increase or decrease in pulse rate, palpitation of the heart, shortness of breath, and may even result in death” (CAN). It contains cardiotonic principles and an adrenaline-like pressor substance (CAN). Vomiting, rapid pulse, redness of the face, stinging pains, heart and respiratory dysfunction, cerebral symptoms, rigor, severe diarrhea, abdominal pains, and bloody expectoration result from abuse of the flower tincture or decoction as an abortifacient possibly fatal. Children should not use internally or on open wounds (WAM). Because of the oxytocic sesquiterpene lactones, to be avoided when pregnant (BIS). Internal use not recommended anymore. Risk:benefit ratio probably not good. One fatal case resulted from ingestion of 70 g arnica tincture (SHT).

 

CONTRA-INDICATIONS, WARNINGS

Arnica should not be taken internally except in suitable hSomeopathic dilutions.(G42)

Externally, arnica is poorly tolerated by some people, precipitating allergic reactions in sensitive individuals.(G42) It should only be applied to unbroken skin and withdrawn at the first sign of reaction.(G7)

Toxic allergic skin reactions have occurred following application of the tincture.(G33)

Pregnancy And Lactation There are insufficient data on the use of arnica preparations during pregnancy and breastfeeding, and their use should be avoided during these periods.

 

CONTRAINDICATIONS

PREGNANCY category 7; BREASTFEEDING category 5A.

Because arnica is considered poisonous, injection is contraindicated. Death can occur. Internal use is contraindicated unless supervised by an expert; serious renal and hepatic damage can occur. Arnica should not be used in children. Do not use full-strength tincture on broken skin as contact dermatitis can occur. Do not use for prolonged periods.

 

SIDE EFFECTS/ADVERSE REACTIONS

INTEG: Rash, contact dermatitis

If taken internally (contraindicated)

CNS: Nervousness, restlessness, coma, death

CV: Cardiac arrest, cadiotoxicity, hypertension

GI: Abdominal pain, diarrhea, vomiting, anorexia, hepatic failure

HEMA: Bleeding

INTEG: Contact dermatitis (topical), Sweet syndrome

MS: Weakness

RESP: Dyspnea

 

INTERACTIONS

Drug

Antihypertensives: May decrease the antihypertenisve effect if arcina is taken internally.

Lab Test

APTT, PT, INR: Arnica increases these lab tests.

 

EFFECTS

Arnica preparations have an antiphlogistic, analgesic and antiseptic effect when applied topically, due to the sesquiterpene lactone componant. The flavonoid bonds, essential oils and polyynes may also be involved. In cases of inflammation, Arnica preparations also show analgesic and antiseptic activity. The sesquiterpenes (helenalin) in the drug have an antimicrobial effect in vitro and an antiphlogistic effect in animal tests. A respiratory-analeptic, uterine tonic and cardiovascular effect (increase of contraction amplitude with simultaneous increase in frequency, i.e. positive inotropic effect) was demonstrated.

 

SIDE-EFFECTS, TOXICITY

Arnica is poisonous if taken internally. It is irritant to mucous membranes and ingestion may result in fatal gastroenteritis, muscle paralysis (voluntary and cardiac), increase or decrease in pulse rate, palpitation of the heart, shortness of breath, and may even lead to death.(G33, G41) Helenalin is stated to be the toxic  principle responsible for these effects.(G33) Thirty millilitres of a 20% arnica tincture, taken by mouth, was reported to produce serious, but not fatal, symptoms.(G41) The topical application of arnica has been documented to cause dermatitis.(17,G51) Arnica is a strong sensitiser, with the sesquiterpene lactone constituents implicated as the contact allergens: they possess an a-methylene group exocyclic to a g-lactone ring, which is recognised as an immunological prerequisite for contact allergy.(17, 18) Helenalin is also reported to possess cytotoxic activity and this has been attributed to its ability to alkylate with sulfhydryl groups.(G33) Helenalin was not mutagenic in the Salmonella typhimurium assay.(G52)

 

 

CLIENT CONSIDERATIONS

ASSESS

·         Assess the reason the client is using this product.

·         Assess the condition of the skin: broken, bruised, rashes. Arnica should not be used for prolonged periods on this type of skin.

·         Assess for Sweet syndrome, psoriasis.

ADMISNISTER

·         Use only topically, unless under the supervision of a qualifi ed herbalist.

·         Do not use for prolonged periods; allergic reactions may occur.

·         Do not use full-strength on broken, hypersensitive skin. Do not use on open wounds or abrasions.

TEACH CLIENT/FAMILY

·         Teach the client not to use internally unless supervised by a competent herbalist.

·         Arnica is considered poisonous and can be cardiotoxic. Serious hepatic and renal toxicity can occur.

·         Inform the client that pregnancy category is 7 and breastfeeding category is 5A.

·         Instruct the client not to use for extended periods on broken or bruised skin; contact dermatitis can occur.

·         Keep out of reach of children; ingestion of fl owers or roots can lead to death.

 

PREPARATIONS

 

PROPRIETARY SINGLE-INGREDIENT PREPARATIONS

Chile: Arnikaderm. France: Arnican; Pharmadose teinture d'arnica. Germany: Arnikatinktur; Arthrosenex AR; Doc; Enelbin-Salbe; Hyzum N. Mexico: Balsamo Nordin; Estimul. Portugal: Arnigel.

 

PROPRIETARY MULTI-INGREDIENT PREPARATIONS

Argentina: Fluido. Australia: Joint & Muscle Relief Cream; Percutane. Austria: Arnicet; Asthmatee EF-EM-ES; Berggeist; Cional; Dynexan; Heparin Comp; Rheuma. Brazil: Dermol; Traumed. Chile: Lefkaflam; Matikomp. Czech Republic: Arnidol; Heparin-Gel. France: Arnicadol; Creme Rap; Dermocica; Evarose. Germany: Cefawell; Combudoron; Dolo-cyl; Gothaplast Rheumamed AC; Heparin Comp; Lindofluid N; Retterspitz Ausserlich; Retterspitz Quick; Sportino Akut; Stullmaton; Trauma-cyl; Varicylum-S; Venengel. Hong Kong: New Patecs A. Italy: Flebolider. Mexico: Reudol. South Africa: Combudoron; Dynexan; Lotio Pruni Comp cum Cupro; Muscle Rub; Wecesin. Spain: Arnicon. Switzerland: Combudoron; Euceta avec camomille et arnica; Fortacet; Onguent aux herbes Keller; Perskindol Cool Arnica; Topaceta. UK: Hansaplast Herbal Heat Plaster; Profelan. USA: MSM with Glucosamine Creme. Venezuela: Biomicovo.

 

 

REFERENCE

 

 

Barnes, J., Anderson, L. A., and Phillipson, J. D. 2007. Herbal Medicines Third Edition. Pharmaceutical Press. Auckland and London.

 

Duke, J. A. with Mary Jo Bogenschutz-Godwin, Judi duCellier, Peggy-Ann K. Duke. 2002. Handbook of Medicinal Herbs 2nd Ed. CRC Press LLC. USA.

 

Gruenwald, J., Brendler, T., Jaenicke, Ch. 2000.  PDR for Herbal Medicines.  Medical Economics Company, Inc. at Montvale, NJ 07645-1742. USA

 

Linda S-Roth. 2010. Mosby’s Handbook Of Herbs & Natural Supplements, Fourth Edition. Mosby Elsevier. USA

 

Figure 3. Primary Chemical Components and Possible Actions

(Linda, S-R. 2010)