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)
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