Ingredients in Renotol

Each capsule contains:

Rubia cordifolia: Introduction: It belongs to Family Rubiaceae and commonly called as Manjistha. It is a climbing plant growing in the North-West Himalayas, Nilgiris and other hilly districts of India, SriLanka, Indonesia and tropical Africa. Charaka mentions the use of plant for skin exudation and burning pruritus. In the Unani System of Medicine, it has been prescribed for Paralysis, dropsy, jaundice, amenorrhoea, and urinary tract obstructions. Also used for skin disorders of many varieties, menstrual disorders (excessive or painfull bleeding), renal stone, urinary disorders, blood detoxifcation, one of the best Pitta-pacifying herbs,also pacifies Kapha1.

Photoactives:
Roots contain resinous and extractive matter, gum, sugar, colouring matter and salts of Lime. Colouring matter consists of a red crystalline principle- purpurin, a yellow principle glucoside – manjistin , besides garancin, alizarin (orange-red) and xanthine (yellow) are also present. Anthroquinones, pentacyclic triterpenes, quinines, cyclic hexapeptides and diethyl esters are also reported1.

Uses:
Ø Blood Purifier.
Ø Increases Blood circulation
Ø Anti Inflammatory
Ø Skin Disorders like Eczema.
Ø Scabies.
Ø Anti Tumor.
Ø Infection against Tinea pedis.
Ø Diuretic.
Ø Astringent.
Ø Paralysis
Ø Jaundice
Ø Amenorrhoea
Ø Visceral Obstructions.

Scientific Evidence:

• Anti-inflammatory activity:
  The plant extract showed significant anti inflammatory activity at a dose of 10 and 20 ml/kg body weight on carrageenin – induced oedema in rat hind paw comparable to that of phenylbutazone2.
  
• Anti Oxidant activity:
  The phenolic constituents in the roots of Rubia cordifolia were identified with the aid of high-performance liquid chromatography and liquid chromatography-mass spectrometry and by comparison with authentic standards. A total of 17 hydroxyanthraquinones, gallic acid, and tannins were separated, and 14 of them were identified, being the main phenolic constituents present. Their antioxidant activity (Trolox equivalent antioxidant capacity) was evaluated using the improved 2,2-azino-bis(3-ethylbenzothiazoline-6-sulfonicacid)diammonium salt method. Hydroxyanthraquinones were the predominant antioxidant phenolic constituents in the roots of R. cordifolia, and tannins and gallic acid were the predominant antioxidant phenolic constituents in the roots of R. officinale. The structure-radical scavenging activity relationships of the tested hydroxyanthraquinones were systematically demonstrated as follows: Hydroxy groups on one benzene ring of the anthraquinone structure were essential for hydroxyanthraquinones to show activity, the ortho-dihydroxy structure in the hydroxyanthraquinone molecules could greatly enhance their radical scavenging effect, and glycosylation of the hydroxyanthraquinones reduced activity3.
  
• Anti platelet activity:
  Rubia cordifolia is clinically used for the purification of blood by the physicians of the Indian System of Medicine. For the first time, the effect of the partially purified fraction of this whole plant has been studied on rabbit platelets. It inhibits the platelet aggregation induced by PAF (platelet activating factor) but not thrombin. It also inhibits the binding of 3H-PAF to the platelets in the dose-dependent manner. Thus it appears that R. cordifolia inhibits action of PAF at its receptor level either by it's blocking or by desensitization4.

Terminalia Chebula:

Introduction:
It is commonly called as Haritaki or Harad and belongs to the Family Combretaceae. T. chebula is found in the sub-Himalayan tracts from the Ravi eastwards to West Bengal and Assam, ascending up to an altitude of 1,500 m. in the Himalayas. In the deciduous forests of India, it attains a girth of 1.5-1.8 m., with a bole of 4.5-6.0 m. in length. In the moister forests of the west coast, it reaches a girth of 2.4 m. or more, with a bole of 9 m. in favourable localities. In high-level rocky and dry places in the outer Himalayas and in the hills of Deccan and South India it is a small tree. Dried mature or immature fruits are used.
Triphala is an important formulation in the Ayurvedic phamacopoeia containing haritaki and other constituents, which are well known “Rasayana drugs. They are used to prevent aging and impart longevity, immunity and body resistant against diseases. They have benefical effects on all the tissues. It is also externally used in vata swellings, eye diseases and skin diseases.
In Unani medicine it is used as a tonic to brain and vision, diarrhoea, piles, paralysis, headache, leprosy, urinary diseases.

Phytoactives:
Haritaki fruits are an important source of tannin. The approximate analysis of the fruit is as follows: Moisture 10%, Tannin 25-32 %, Water insoluble matter 40-50 %.
The tannins of Haritaki are of pyrogallol type (hydroysable tannins), which on hydrolysis yield chebulic acid and d- galloy glucose. Chebulagic, chebulinic, ellagic, and gallic acid are the other contents of the fruit. It also contains glucose and sorbitol (about 3.5%). Resin and a purgative principle of the nature of anthraquinone, and sessoside are also present.

Uses:
Ø Blood purifier.
Ø Obesity
Ø Epilepsy.
Ø Asthma.
Ø As rasayana (rejuvenator).
Ø Astringent.
Ø Tonic.
Ø Laxative.
Ø Chronic constipation.
Ø Peptic ulcer.
Ø Eye infections.

Scientific Evidence:

• Anti Oxidant activity:
  Sabu MC, Kuttan R. Anti-diabetic activity of medicinal plants and its relationship with their antioxidant property. J Ethnopharmacol 2002 Jul; 81(2): 155-60
  Methanolic extract (75%) of Terminalia chebula, Terminalia belerica, Emblica officinalis and their combination named 'Triphala' (equal proportion of above three plant extracts) are being used extensively in Indian system of medicine. They were found to inhibit lipid peroxide formation and to scavenge hydroxyl and superoxide radicals in vitro. The concentration of plant extracts that inhibited 50% of lipid peroxidation induced with Fe(2+)/ascorbate were food to be 85.5, 27, 74 and 69 micro g/ml, respectively. The concentration needed for the inhibition of hydoxyl radical scavenging were 165, 71, 155.5 and 151 micro g/ml, and that for superoxide scavenging activity were found to be 20.5, 40.5, 6.5 and 12.5 micro g/ml, respectively. Oral administration of the extracts (100 mg/kg body weight) reduced the blood sugar level in normal and in alloxan (120 mg/kg) diabetic rats significantly within 4 h. Continued, daily administration of the drug produced a sustained effect.
  
• Anti atherosclerotic activity:
  Shaila HP, Udupa SL, Udupa AL. Hypolipidemic activity of three indigenous drugs in experimentally induced atherosclerosis. Int J Cardiol 1998 Dec 1; 67(2): 119-24
  The effect of orally administered indigenous drugs Terminalia arjuna, T. belerica and T. chebula were investigated on experimental atherosclerosis. Rabbits were fed a cholesterol-rich diet to induce atherosclerosis. The three drugs were fed along with cholesterol. At the end of the experimental period the animals were killed and their plasma and tissue lipid components estimated. Atherosclerotic lesions of the aorta were examined histologically. T. arjuna was found to be the most potent hypolipidemic agent and induced partial inhibition of rabbit atheroma. The results indicate that T. arjuna may play an anti-atherogenic role.
  
• Immunomodulatory:
  Sohni YR, Bhatt RM. Activity of a crude extract formulation in experimental hepatic amoebiasis and in immunomodulation studies. J Ethnopharmacol 1996 Nov; 54(2-3): 119-24
  The activity of a crude extract formulation was evaluated in experimental amoebic liver abscess in golden hamsters and in immunomodulation studies. The formulation comprises the following five plants-Boerhavia diffusa, Tinospora cordifolia, Berberis aristata, Terminalia chebula and Zingiber officinale. The formulation had a maximum cure rate of 73% at a dose of 800 mg/kg/day in hepatic amoebiasis reducing the average degree of infection (ADI) to 1.3 as compared to 4.2 for sham-treated controls. In immunomodulation studies humoral immunity was enhanced as evidenced by the haemagglutination titre. The T-cell counts remained unaffected in the animals treated with the formulation but cell-mediated immune response was stimulated as observed in the leukocyte migration inhibition (LMI) tests.
  
• Anti atherosclerotic activity.
  Thakur CP, Thakur B, Singh S, Sinha PK, Sinha SK. The Ayurvedic medicines Haritaki, Amala and Bahira reduce cholesterol-induced atherosclerosis in rabbits. Int J Cardiol 1988 Nov; 21(2): 167-75
  Four groups of 25 rabbits each were studied to determine the effect of Haritaki (Terminalia chebula), Amla (Emblica officinalis) and Bahira (Terminalia belerica) on cholesterol-induced hypercholesteolaemia and atherosclerosis. The control group was fed with cholesterol alone; the Haritaki group received Haritaki and cholesterol; the Bahira group received Bahira and cholesterol; and the Amla group received Amla and cholesterol for 16 weeks. Cholesterolaemia was significantly less (P less than 0.001) in the Haritaki group (166 mg/dl), the Bahira group (240 mg/dl) and the Amla group (205 mg/dl) than in the control group (630 mg/dl). The Haritaki group had significantly less cholesterolaemia (P less than 0.001) as compared to the Bahira and Amla groups. Aortic sudanophilia was significantly less (P less than 0.001) in the Haritaki group (6%), the Bahira group (16%), and the Amla group (12%) than in the control group (38%). The cholesterol contents of the liver and aorta, respectively, were significantly less in the Haritaki group (46 mg/100 g, 28 mg/100 g), the Bahira group (78 mg/100 g, 72 mg/100 g) and the Amla group (46 mg/100 g, 42 mg/100 g), than in the control group (604 mg/100 g, 116 mg/100 g). Among the drug-fed groups, the Haritaki group had significantly lower degrees of sudanophilia and cholesterol content of aorta and liver (P less than 0.001) as compared to the Bahira and Amla groups. Although all three drugs reduced serum cholesterol, aortic sudanophilia and cholesterol contents of liver and aorta, their effects were in ascending order of magnitude. The drugs did not influence serum triglyceride levels, euglobulin clot lysis time or platelet adhesiveness.

Saraca indica:

Introduction:
It belongs to family Caesalpiniaceae and commonly called Ashoka. It is one of the sacred trees of the Hindus and is found plentiful all over India because of its decorative orange red flowers and evergreen beautiful foliage. It is also found in SriLanka and Malaya.It occurs upto the altitude of 600 metres. Medicinal use of the plant has been described in Sushrutasamhita, Chakradatta, Yogaratnakar, and Bhaishajya, Ratnavali. The literal meaning of name if translated will be "remover of all ailments". Ancient rishis have lauded this drug for its efficacy in menstrual disorders. Bark and fruit are used to prepare the medicine
.
Bark is strongly astrigent and uterine sedative by acting directly on the muscular fibres of the Uterus. It has a stimulating effect on the endometrium and the ovarian tissues. It is also used against scorpion bite. Oxytocic activities of the plant have also been reported on rat and human isolated uterine preparations. Seed extract is found effective against dermatophytic fungi. K = grahi, rakta sangrahak;. Ketosterol and calcium salt are considered important in treatment fo menorrhagia

Phytoactives:
Ashoka contains about 6% tannins, haematoxylin, ketosterol, saponin and organic calcium and iron compounds. The tannins are found in condensed type. The ketosterol seems to be androgenic in nature. Leucopelargonidin and leucocyanidin have been isolated from ashoka bark. The activity of the drug is due to the presence of steroidal component and the calcium salt. Bark is found to contain a powerful oxytocic principle, a phenolic glycoside P2. Its methanol fraction contains haematoxylene, tannin, and water-soluble glycoside. The latter has glucose,galactose and mannose as sugars(2).

Uses:
Ø Antihypertensive.
Ø Dysmenorrhoea. (Pain starts much before menses).
Ø Haemorrhoidic.
Ø Menorrhagic. (Profuse bright red bleeding).
Ø Leucorrhoeic (Thick whitish with pain is sacrum, < on movement and before menses).
Ø As rasayana (rejuvenator).
Ø Hemostatic.
Ø Anticonvulgant.
Ø Diuertic.
Ø Piles.

Scientific Evidence:
Not available.

Corchorus depressus.
Introduction:
It is commonly called as Jute belonging to Family Tiliaceae. A genus of about 40 species of annual herbs distributed throughout the tropics. About 8 species occur in India, C.depressus is mainly found in drier parts of North India which is a wild species rarely used for extracting fibre; some of these are of medicinal value.
The plant is used in the indigenous system of medicine as a tonic, and cooling medicine in fevers; its mucilage is prescribed in gonorrhoes. It is also used to increase the viscosity of seminal fluid. An extract of plant is applied as a paste in healing of wounds. The leaves of some Corchorus species are eaten as potherb.

Phytoactives:
The whole plant contains three new a-amyrin derivatives, namely cordepressic acid (C30H46O7, mp 360°), cordepressenic acid (C30H44O6, mp 295°), and ordepressin ( monogalactoside of cordepressic acid) together with apigenin, luteolin, sitosterol and its glucoside. Presence of quercetin and kaempferol has been reported in leaves and lowers. A principle, 2a, 3ß-acetoxy-20 ß-hydroxy-urs-12-en, 23,28-dioic acid, isolated from the whole plant exhibits antimicrobial activity, although, no such activity has been reported in the aqueous and ethanotic extracts.

Uses:
Ø Tonic.
Ø Anti pyretic. (Fl Delhi, 88; Khan et al, Phytochemistry, 1991, 30, 1989; Harsh & Nag, Geobios, 1988, 15, 32, Naqvi et al, Fitoterapia, 1991, 62, 221; Vohra & Dandiya, ibid, 1992, 63,95).
Ø Blood purifier.

Scientific Evidence:
Not available.

Smilax china Linn

Sarsaparilla has been used for centuries by the indigenous peoples of Central
and South America for sexual impotence, rheumatism, skin ailment, and a tonic for
physical weakness. In ayurveda it is used as one who clears urine and stools insanity, pains in body, skin diseases as a gynecological aid. In Unani system of medicine it is used as Demulcent, in souda diseases as leprosy and syphilis, Kidney and bladder diseases, Paralysis, headache, Convulsions.

Phytoactives:
It contains sapoinis, sarsaponin and parallin. It yields isomeric sapogenins, sarsaponin and smilogenin. It also contains sitosterol, stigmasterol and pollinastanol , in free and as glucosides. Are now recognized as sarsaponin, smilacin, sitosterol-d- glucoside, and pollinastanin. One modern figure indicated the usual level of steriod saponins in unidentified Smilax species, indicated to be sarsaparilla, as 1.8-2.4%. (Wagner, H., et al. 1984)
Other constituents include, paroaparic acid, sarsapic acid, resin, volatile oil, starch, a mixture of fatty acids (palmitic, stearic, behenic, oleic and linoleic), oxalic acid and a polysaccharide.
The mineral ions were quantified in the dry root of Honduran sarsaparilla and determined to be 1.25% SiO, 0.42% Al, 0.41% Ca, 0.30% Mg, 1.25% K and 0.46% Cl. The vitamin C content of Mexican sarsaparilla, S. aristolochiaefolia (dry root) was determined to be 19.4 mg%.
Diosgenin, a common phytosterol, has been isolated from Smilax china.

Uses:
Ø Blood purifier.
Ø Anti rheumatic.
Ø Antiseptic.
Ø Epilepsy.
Ø Vatarakta.(Gout)
Ø Depurative.
Ø Diapherotic.
Ø Stimulant.
Ø Alterative.
Ø Antipruritic
Ø Anti-inflammatory.
Ø Diuretic.
Ø Febrifuge.
Ø Hepatoprotective.
Ø Hormonal
Ø Steroidal.
Ø Anti allergic.

Scientific evidence:

• Anti Oxidant.
  Lee SE, Ju EM, Kim JH. Free radical scavenging and antioxidant enzyme fortifying activities of extracts from Smilax china root.
  Exp Mol Med. 2001 Dec 31; 33(4): 263-8.
  The extract from Smilax china root has been used as medicinal remedy and reported to retain antimicrobial and antimutagenic acitivities. In this study, a possible presence of antioxidant activity of Smilax china root extract was investigated. Methanol extract (Me) revealed the presence of high 1,1-diphenyl-2-picrylhydrazyl (DPPH) free radical scavenging activity (IC50 7.4 microg/ml) and protective property of cell's viability. Further fractionation with various solvent extraction and assay showed high levels of DPPH free radical scavenging activity in the ethyl acetate, butanol and water extracted fractions. In addition, V79-4 cells treated with me of Smilax china root induced an increase of superoxide dismutase, catalase and glutathione peroxidase activities in a dose-dependent manner between 4-100 microg/ml. These results suggest that the medicinal component of the root of Smilax china extracts also contains antioxidant activity.

Tinospora Cordifolia:

Introduction:
According to the Ayurvedic lexicons Tinospora cordifolia is referred to as 'Amrita'. The term 'Amrita' is attributed to this drug in recognition of its ability to impart youthfulness, vitality and longevity to its patron. It therefore figures as one of an important 'Rasayana' drug in the Vedic scriptures. In modern medicine it is well known for its adaptogenic and immunomodulatory activities.
Tinospora cordifolia consist of dried matured pieces of stem also fresh stem, leaves, root, fruits, are being used for medicinal purposes. Tinospora cordifolia is a perennial, wild, climber, glabrous, succulent, shrub often attaining a great height and sending down long thread like aerial roots. The plant seems to be particularly found climbing up the trunks of large Neem trees.
Stem of Tinospora cordifolia mainly contains phenylpropene disaccharides, viz., cordifolioside A & B, a sesquiterpene glucoside named tinocordifolioside, furano diterpenes viz., columbin and a number of alkaloids.
Extensive pharmacological studies have shown its usefulness in many disorders mainly including, stress, and diabetes and as an adjuvant for cancer therapy etc.

Phytoactives
Stem of Tinospora cordifolia contains, clerodane furano diterpenes viz., columbin, tinosporidine, bitter furanoid; tinosporaside, a lignan, 3,4-bis-(4-hydroxy-3-methoxy benzyl) tetrahydrofuran; alkaloids viz., jatrorhizine, palmatine, berberine, tembeterine.
A sesquiterpene glucoside, tinocordifolioside,phenylpropene disaccharides viz., cordifolioside A & B; other include choline, tinosporic acid, tinsporine, tinosporide, tinosporon, cordifolide, cordifol, heptacosanol, ß-sitosterol, tinosporol, tinosporon, magnoflorine and tembetarine.1,23

Three main phytoactive compounds are columbin, cordifolioside A and tinosporaside
From Tinospora cordifolia root, isocolumbin (Yeild 0.0032%) tetrahydropalmatine (0.0018) magnoflorine (0.005) and palmatine (0.002) were isolated & identified.24

Five novel diterpene furan glycosides, viz., cordifolisides A-E and two phenyl propane glycosides Two phenylpropene disaccharides 3-{4'-O-beta-apiosyl-(1"'->3")-O-beta-D-glucopyranosyl-3', 5'-dimethoxyphenyl}-2-trans-propene-1-ol (identified as cordifolioside heptaacetate C36H46O20, mp 135 degree C) and 3-{4'-O-beta-D-glucosyl-(1"'->5")-O-beta-D-apiosyl-3', 5’-dimethoxyphenyl}-2-trans-propene-1-ol (identified as cordifolioside B hepta -acetate C36H46O20, mp 175 degree C) were isolated from Tinospora cordifolia stems and their structures were elucidated on the basis of spectroscopic evidences.25

Uses
Ø Aphrodisiac
Ø As rasayana (rejuvenator)
Ø Anti-stress
Ø Asthma
Ø Stomachic
Ø Emetic
Ø Sedative
Ø Diuretic rheumatism
Ø Anti-pyretic
Ø Vatarakta (Gout)
Ø Kustha (Skin disease)
Ø Amlapitta (Acid gastritis)

The plant of T. cordifolia is used in Ayurvedic rasayanas to improve immune system and body resistance against infections. The plant extract is used as immunomodulator in immunosuppression of obstructive jaundice, hepatic fibrosis, peritonitis and sepsis. T. cordifolia is an ingredient of a fortified Ayurvedic formula Raktawardak given in chronic fatigue syndrome, anemia and depression.

Scientific Evidence
Immunostimulant
Tinospora cordifolia (TC) is an indigenous medicinal plant and found to be a potent immunostimulant. The whole, aqueous, standardized extracts of Tinospora cordifolia was administered orally to experimental animals, in a dose extrapolated from the human dose, following which they were exposed to a variety of biological, physical and chemical stressors. This plant was found to offer protection against these stressors, as judged by using markers of stress responses and objective parameters for stress manifestations. Using a model of cisplatin induced alterations in gastrointestinal motility; the ability of this plant to exert a normalizing effect, irrespective of direction of pathological change was tested. It reversed the effects of cisplatin on gastric emptying, while Tinospora cordifolia also normalized cisplatin induced intestinal hypermotility. Tinospora cordifolia was also tested for its ability to modulate the changes occurring in the phagocytic activity of peritoneal macrophages after exposure of rats to either carbon tetrachloride or horse serum. It was found to normalize the phagocytic function irrespective to the direction of change, complying with the definition of an adaptogen. All the plant drugs were found to be safe in both acute and subacute toxicity studies. Studies on the mechanisms of action of Tinospora cordifolia revealed that it produced immunostimulation. The protection offered by Tinospora cordifolia against stress induced gastric mucosal damage was lost if macrophage activity was blocked. Recent data obtained with Tinospora cordifolia suggested that it might induce genotypic adaptation26.

Screening of 16 patients for phagocytic and microbicidal activity of polymorphonuclear cells (PMN) revealed a significant depression of these functions, as compared to normal values. An animal model of cholestasis was also established, using rats, in which a significant depression of activity of PMN and peritoneal macrophages was observed. These cellular abnormalities were found to precede and predispose to infection. The rats also showed an increased susceptibility to Escherichia coli infection. A defect was detected in their serum responsible for depressing the function of phagocytic cells. An attempt was made to improve this immunosuppression by treating the rats with water extract of Tinospora cordifolia 100 mg/kg for 7days, following development of
cholestasis. The extract improved the cellular immune functions. Mortality rate following E.coli infection was significantly reduced to 16.67 per cent.

Anti-stress
The antistress or anxiolytic activity of Tinospora cordifolia is well documented by researchers and clinically tested. Some of the stress symptoms were found reduces in some experiments. The ethanol extract of the roots administered at a dose of 100 mg./kg daily was found to induce a marked protective action against a stress induced ulceration. The activity was found to be comparable to that of diazepam at 2.5 mg/kg in experimental albino rats. This antiulcer activity has been reported as a part of anxiolytic activity.

The alcoholic extract of the roots of Tinospora cordifolia was found to posses normalising activity against stress induced changes in norepinephrine (NE), dopamine (DA), 5-hydroxytryptamine (5-HT) and 5-hydroxyindoleacetic acid (5-HIA) levels in experimental rats.

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