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| REVIEW ARTICLE |
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| Year : 2022 | Volume
: 7
| Issue : 2 | Page : 171-178 |
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A bird's eye view on Kantakari Avaleha: A polyherbal Ayurveda formulation for bronchial asthma
Sagar Mahendrabhai Bhinde1, Sonam Sagar Bhinde2, Virendra K Kori1, Kalpna S Patel1
1 Department of Kaumarbhritya, ITRA, Jamnagar, Gujarat, India
2 Department of Rasa Shastra and Bhaishajya Kalpana, ITRA, Jamnagar, Gujarat, India
| Date of Submission | 11-Jun-2021 |
| Date of Decision | 04-Jun-2022 |
| Date of Acceptance | 05-Jul-2022 |
| Date of Web Publication | 06-Dec-2022 |
Correspondence Address:
Sagar Mahendrabhai Bhinde
No. 533, 5th Floor, ITRA Institute Building, Jamnagar - 361 008, Gujarat
India
 Source of Support: None, Conflict of Interest: None  | Check |
DOI: 10.4103/bjhs.bjhs_61_21
Avaleha (linctus) is a unique dosage form of Ayurveda pharmaceutics, which is frequently used in various disorders and especially in respiratory disorders. Kantakari Avaleha (KA) is one such formulation being used extensively for Shwasa (asthma) and Kasa (cough) along with its classical use in various other disorders too. Because of its demand in clinical settings, many pharmaceutical companies are also preparing this, and hence freely available in market. This review was carried out to get thorough idea related to its composition, method of preparation, and therapeutic uses along with its pharmaceutical standards. For this review, classical and compiled texts having subject of Ayurveda pharmaceutics were screened from Central Library of Institute of Teaching and Research in Ayurveda, Jamnagar. Out of total 15 texts screened, 7 texts had mentioned KA, and hence reviewed for its ingredients, dose, Anupana, and therapeutic uses. Synonyms, Rasapanchaka (Ayurveda principles of drug action), and Dosha Karma (therapeutic action) of ingredients were compiled from Bhavaprakasha Nighantu. Pharmaceutical parameters of KA were compiled from original research articles from peer-reviewed journals through Google Scholar, PubMed, ResearchGate, and J-Gate portal. After review, it was found that Acharya Sharangdhara (12th Century) had described this formulation for the first time. There are four variations available in formulation composition. Milk or water should be the Anupana for this drug as per Ayurvedic Formulary of India and Pharmacopoeia of India (API). Almost all references have recommended its use in Shwasa and Kasa, along with Arati (distress), Shula (colicky pain), Gulma (a type of lump), Hikka (hiccup), and Hradroga (heart disease) mentioned in one and the other classics. Maximum ingredients of this formulation possess hot potency (12 out of 18 drugs) and pungent biotransformation property (11 out of 18 drugs). As per available original research works, two laboratory samples and one market sample of KA had fulfilled almost all analytical parameters, mentioned in API. The current review work may be helpful as stepping stone for various researches on KA such as network pharmacology, in silico, pharmacology, and longitudinal cross-sectional, clinical study.
Keywords: Avaleha, bronchial asthma, Kantakari Avaleha, Kasa
How to cite this article:
Bhinde SM, Bhinde SS, Kori VK, Patel KS. A bird's eye view on Kantakari Avaleha: A polyherbal Ayurveda formulation for bronchial asthma. BLDE Univ J Health Sci 2022;7:171-8 |
How to cite this URL:
Bhinde SM, Bhinde SS, Kori VK, Patel KS. A bird's eye view on Kantakari Avaleha: A polyherbal Ayurveda formulation for bronchial asthma. BLDE Univ J Health Sci [serial online] 2022 [cited 2023 Jun 3];7:171-8. Available from: https://www.bldeujournalhs.in/text.asp?2022/7/2/171/362839 |
Avaleha (linctus) are multiple component preparation, which are used in the treatment of various disorders in Ayurveda. Some known Avaleha are Kantakari Avaleha (KA), Bharangyadi Avaleha, Chitraka Haritaki Avaleha, Vasavaleha, Chyavanprasha Avaleha, and Kansaharitaki Avaleha are specially mentioned for ailments of respiratory tract.[1],[2] KA is one of the important Avaleha formulation used for Shwasa (bronchial asthma). KA consists of 20 ingredients, given in Ayurvedic Formulary of India (AFI). It is also known to pacify symptoms of diseases such as Hikka (hiccup), Shula (colicky pain), and Kasa (cough).[3] KA has not been mentioned in Bruhattrayi (three authority books of Ayurveda, namely Charaka Samhita, Sushruta Samhita, and Ashtanga Samgraha) and described by Sharangdhara Samhita[4] in 12th Century for the first time, and emended by many authors as per their requirements thereafter. Because of its demand in clinical settings, many pharmaceutical companies are also preparing this, and hence easily available to consumer. Hence, it is important to get complete historical and research oriented idea of this Avaleha.
Hence, this review aimed to get thorough idea of KA by identifying the variations made by various classical texts in composition, method of preparation, Anupana (a fluid vehicle for medicine), and therapeutic uses along with its pharmaceutical standards.
| Methods of Literature Search | |  |
Various compiled/classical texts having subject of Ayurveda pharmaceutics and available in Central Library, Institute of Teaching and Research in Ayurveda, were searched to find out the classical references of formulations named as KA or formulations with different names but having the same ingredients as mentioned in AFI. Compiled/classical texts which did not mention such formulations were excluded from the study.
Along with the literature search of KA, synonyms of its ingredients, Rasapanchaka (Ayurveda principles of drug action), and Dosha Karma (therapeutic action) were compiled from Bhavaprakash Nighantu.
Currently available data of organoleptic and analytical parameters were also reviewed from articles of peer-reviewed journal through Google Scholar, PubMed, ResearchGate and J-Gate portal. Keywords such as “Kantakari Avaleha,” “organoleptic,” and “analytical study” were applied to find the relevant research articles.
| Results of the Literature Search | | |
Out of total of 15 classical texts screened, KA was not found in eight Ayurveda texts (Charaka Samhita, Sushruta Samhita, Ashtanga Hridaya, Ashtanga Samgraha, Kashyapa Samhita, Yoga Tarangini, Sahastrayoga, and Rasa Ratna Sammuchaya) and hence excluded from the review. The rest of the seven texts have mentioned this formulation with the same or different names.
Sharangdhara Samhita (12th Century) had described this formulation for the first time and considered standard comparator (as same is mentioned in AFI). Later on, this formulation appears in Vrindamadhava, Chakradatta, Vangasena, Gadanigraha, Sharangdhara Samhita, Bhavaprakasha, and Yogaratnakara and two gazetted books AFI and Pharmacopoeia of India (API).
The formulation composition of KA as per Sharangdhara Samhita is mentioned in [Table 1].
Basic method of the preparation of Kantakari Avaleha
KA includes four major components: Drava Dravya (containing decoction of Kantakari whole plant), powdered drug (Guduchi, Chavya, Chitraka, Musta, Karkatashrungi, Sunthi, Maricha, Pippali, Dhanvayasaka, Bharangi, Rasna, and Shati), Madhura Dravya (sugar and honey), and Prakshepa Dravya (Vamshalochana and Pippali). Drava Dravya helps in the extraction of water-soluble active principles; powdered Dravya add on to the drug efficacy; Madhura Dravya is responsible for palatability and also acts as preservatives; Prakshepa Dravya enhances the taste as well as increases the bioavailability of the drugs.[5]
The details of name, ingredient, Anupana, and therapeutic indications in different texts are mentioned in [Table 2].
As mentioned in [Table 2], total 12 references of KA were found and almost all references have recommended its use in Shwasa and Kasa; along with Arati, Shula, Gulma, Hikka and Hradroga mentioned in one and the other classics. Slight modifications in ingredients and their quantity were also there in various references. Sharangdhara Samhita, Vrindamadhava,[6] Bhaishajya Ratnavali,[7] and Bhavaprakasha[8] have described the same KA formulation composition.
Two formulations are mentioned in Yogaratnakara,[9] where one formulation (KA-2) has additional ingredients such as Duralabha (Fagonia cretica L.), Pushkaramula (Inula racemosa Hook), Gajapippali (Scindapsus officinalis Schott.), Surasa (Ocimum sanctum Linn.), and Vacha (Acorus calamus Linn.) as Churna Dravya. All Churna Dravyas are taken in one Tola each in place of one Pala each of Sharangadhara Samhita. One Kudava of ghee is mentioned instead of eight Pala ghee. The other ingredients are mentioned in the same proportion as mentioned in Shrangadhara Samhita.
Vangasena and Bhavaprakasha have advocated administration of flowers of Kantakari along with honey in Kasa of pediatric patients and named this formulation as KA.[8]
It is stated that if a person with Shwasa licks KA combined with Katu Taila (mustard oil) and jaggery, they will be free of the illness entirely in 21 days.[10] No any other classic suggests the use of Katu Taila in this formulation.
There are two references cited in Bharata Bhaishajya Ratnakara which are quoted from Vangasena Samhita and Gada Nigraha.[11] The formulation composition cited from the Gada Nigraha is typically similar to the Sharangadhara Samhitha and only Bharangi Churna has been omitted and Pippali Mula is added to the Kalka Dravya. Tila Taila was not mentioned and quantity of honey is also reduced up to one Kudava.
Synonyms of the ingredients of Kantakari Avaleha
Ingredients with their different names are depicted in [Table 3], and the source of the synonyms is Bhavaprakasha Nighantu. The synonyms are mentioned to avoid confusion between various synonymous names of the same drugs mentioned by different texts.
Rasapanchaka of ingredients of Kantakari Avaleha
The ingredients of KA and their Rasapanchaka (Ayurveda principles of drug action) and Dosha Karma (therapeutic action) are depicted in [Table 4] and [Table 5]. Maximum Dravya of this formulation possess Ushna Virya (12 out of 18 drugs) and Katu Vipaka (11 out of 18 drugs). The source of the Rasapanchaka and Dosha Karma is Bhavaprakasha Nighaṇṭu. | Table 5: Dosha Karma and Vyadhi Karma of Ingredients of Kantakari Avaleha[14]
Click here to view |
As mentioned in [Table 6], KA is a combination of multiple phytochemicals and that might be the reason for its efficacy in various diseases of respiratory and gastrointestinal tract.
These ingredients were also proved to have anti-asthmatic, anti-pyretic, anti-allergic, anti-inflammatory, etc., activity as mentioned in [Table 7]. | Table 7: Pharmacological activity of individual drugs of Kantakari Avaleha
Click here to view |
Organoleptic and physicochemical parameters of Kantakari Avaleha
As shown in [Table 8], a total of two articles had mentioned organoleptic and physicochemical parameters of KA. Hence, results of these original research works are compared with available standards of API. | Table 8: Organoleptic characters of Kantakari Avaleha as per available published articles
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According to standards of API, KA should be blackish brown, semisolid paste having bitter sweet astringent taste. However, according to original research articles, no one samples had sweetness. The reason behind this mismatch seems to be a different perspective of a taste assessor for that particular sample. Hence, it is required to assess such parameters through some stringent methods such as analytical taste-sensing multichannel sensory system called as electronic tongue (artificial tongue).[44]
Color and appearance of KA of all research samples were found almost same as mentioned in API.
Physicochemical parameters are important to confirm the purity of any pharmaceutical product. As mentioned in [Table 9], total ash, acid-insoluble ash, alcohol-soluble extractive, water-soluble extractive, and pH of all three research samples are fulfilling the standards of API. Total sugar percentage mentioned in the research work of Senarathna et al. was different than mentioned in API. This difference in spite of the same formulation and same proportion of ingredient is matter of further research. | Table 9: Physicochemical parameters of Kantakari Avaleha as per available published articles
Click here to view |
| Conclusion | | |
KA was introduced by Acharya Sharangdhara in Ayurveda pharmaceutics, and this was repeated thereafter in various texts. Acharya had amended the basic formulation composition with different ingredients for different disease conditions, which indicates its acceptance in clinical settings. Most of the ingredients in KA have Katu Vipaka, Ushna Virya, Vatakapha Shamaka, and Tridoshahara properties make it effective in the treatment of bronchial asthma. Hence, this review might help the clinician and researcher to get a bird's eye view on KA.
Financial support and sponsorship
This study was financially supported by the Department of KB, ITRA.
Conflicts of interest
There are no conflicts of interest.
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[Table 1], [Table 2], [Table 3], [Table 4], [Table 5], [Table 6], [Table 7], [Table 8], [Table 9]
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