Aconitum napellus

Aconitum napellus (Blue Monkshood)

Important: all parts of the plant are poisonous. Use is permissible only under the supervision of a physician or herbalist, especially when using extracts, tinctures or homeopathic dilutions.

Product Name: Аконит синий, Aconitum napellus, Blauer Eisenhut, acónito azul, Aconit napel, خانق الذئب الأزرق, ดอกหมวกพระ, Ko'k akonit, Көк аконит, Mavi akonit, Окониот кабуд, Mėlynasis akonitas, Zilais akonīts, Аконіт синій, Göy akonit, אקוניט כחול

Synonyms: Аконит аптечный, Шлемник синий, Борец синий, Монахов колпак; Monkshood, Wolfsbane, Blue monkshood; Eisenhut, Sturmhut; Acónito, Casco de Júpiter; Casque-de-Jupiter, Casque-de-moine; خانق الذئب، نبات الراهب; หมวกพระ, สมุนไพรพิษ

Parts Used: rhizomes, tubers, aerial part, leaves, flowers, seeds, stems — rhizomes

Main Indications for Aconitum napellus: trigeminal neuralgia, lumbago, sciatica, radiculopathy, acute rheumatoid arthritis, articular rheumatism, gouty arthritis, acute rhinopharyngitis, acute tracheobronchitis, intercurrent fever, paroxysmal tachycardia, anxiety disorder, acute neurosis of fear.

Use of Aconitum napellus in mixtures and complexes: chronic arthritis, deforming osteoarthritis, neurasthenia, chronic tonsillitis, broncho-obstructive syndrome, intermittent fever of unknown origin, neurocirculatory dystonia of hypertensive type, post-traumatic neuralgia, astheno-depressive syndrome, subcortical encephalitis.

Pharmacological Properties of Aconitum napellus: analgesic, anti-inflammatory, antipyretic, sedative, neurosedative, local anesthetic, spasmolytic, antiarrhythmic, antirheumatic, antipyretic, hyposensitizing, anticonvulsant, immunomodulating, cardiotoxic (in high doses), neurotoxic (in high doses).

Dosage of Pharmaceutical Forms — Aconitum napellus

Powder — Aconitum napellus

Indications (Powder): trigeminal neuralgia, radiculopathy, acute rheumatoid arthritis, lumbago, acute tracheobronchitis, gouty arthritis, acute rhinopharyngitis

Standard Dosage (Powder): 0.5–1.0 milligram of powder 1 time per day orally, strictly after meals, in an encapsulated dose, with at least 150 ml of water at room temperature. Course no more than 5 days.

Enhanced Dosage (Powder): 1.0–1.5 milligrams 1 time per day, no more than 3 days in a row for acute attacks of trigeminal neuralgia, paroxysmal tachycardia, acute painful arthropathies.

Maximum Dosage (Powder): 2 milligrams per day in divided doses (1 mg × 2), for no more than 48 hours for acute inflammatory-pain conditions (acute radiculitis, sciatica, gouty attack). Under medical supervision.

Preventive Dosage (Powder): Preventive use is not recommended due to the high toxicity of alkaloids even in microdoses. Not used for chronic diseases.

Pediatric Dosage (Powder): Absolutely contraindicated for children and adolescents under 18 years of age, regardless of body weight and gender.

Contraindications (Powder): Pregnancy, lactation, childhood, arrhythmias, organic myocardial lesions, renal and hepatic insufficiency, convulsive syndrome, exhaustion. No data on the safety of use during pregnancy, lactation and in children have been registered.

Side Effects (Powder): Numbness of the tongue and lips, paresthesia, lowering of blood pressure, bradycardia, nausea, dizziness, convulsions, paralysis of the respiratory muscles. All side effects have been recorded with overdose.

Adjustment for Patient Body Weight: With body weight below 60 kg — start taking with 0.3 mg; with body weight above 60 kg — use the full dose (0.5–1 mg). For persons with weight above 90 kg, a dose of up to 1.5 mg is possible under medical supervision.

Preparation method (Powder): To prepare 100 g of powder, use: dried blue monkshood rhizomes — 100 g. The raw material is ground manually in a porcelain mortar to obtain a homogeneous fine powder. The use of metal surfaces is not allowed. Store the resulting substance in a tightly closed glass container. Mask and gloves are mandatory upon contact. Avoid inhalation. Dose with microbalances.

Storage Conditions and Shelf Life (Powder): Store at a temperature of +5 to +25 °C, in a dry, dark place out of the reach of children. Exclude exposure to sunlight, moisture and electromagnetic radiation. Shelf life — up to 3 years in an airtight glass container. After opening, use within 60 days with minimal contact with air.

Dry Extract — Aconitum napellus

Indications (Dry Extract): acute rheumatoid arthritis, gouty arthritis, acute tracheobronchitis, intercurrent fever, trigeminal neuralgia, anxiety disorder

Standard Dosage (Dry Extract): 100–150 micrograms of dry extract (0.1–0.15 mg) 1 time per day, diluted with warm water (not more than 40 °C), orally, after meals. Duration of course — up to 7 days.

Enhanced Dosage (Dry Extract): 200 micrograms 1 time per day for 3–5 days for severe pain syndrome in gouty arthritis and fever of inflammatory origin.

Maximum Dosage (Dry Extract): Up to 300 micrograms per day — only in a hospital setting under ECG and blood pressure monitoring. Permissible for intractable pain against the background of acute arthritis.

Preventive Dosage (Dry Extract): Not used in a prophylactic dose due to high biological activity and a narrow therapeutic window.

Pediatric Dosage (Dry Extract): Absolutely contraindicated for use in children under 18 years of age.

Contraindications (Dry Extract): Pregnancy, lactation, age under 18 years, heart disease, hypotension, severe forms of nephropathy and hepatopathy, any forms of epilepsy. No data on safety during pregnancy, lactation and in children have been registered.

Side Effects (Dry Extract): Dizziness, paresthesia, hypotension, slowing of the pulse, lowering of body temperature, coma. All side effects have been recorded with overdose.

Adjustment for Patient Body Weight: With body weight less than 60 kg — 50–75 mcg; over 60 kg — standard dose; with weight over 90 kg — up to 200 mcg under medical supervision.

Preparation method (Dry Extract): To obtain 100 g of dry extract: dried monkshood rhizomes — 500 g, purified water — 1000 ml. Ethanol maceration 1:2 with 40% alcohol at a temperature of 25 °C for 14 days. Then — evaporation in a water bath until complete evaporation of alcohol and condensation to a resinous mass. Dry the mass at a temperature not exceeding 45 °C. Grind the resulting dry residue to a powder.

Storage Conditions and Shelf Life (Dry Extract): Store in airtight pharmaceutical packaging made of opaque glass, at a temperature of +8 to +20 °C. Shelf life — 2 years. After opening, use within 30 days. Avoid contact with moisture and electromagnetic field.

Alcohol-Based Tincture — Aconitum napellus

Indications (Tincture): trigeminal neuralgia, sciatica, acute rheumatoid arthritis, gouty arthritis, acute tracheobronchitis, intercurrent fever, paroxysmal tachycardia

Standard Dosage (Tincture): 5 drops of alcohol tincture (1:10 in 70% ethanol) dissolved in 100 ml of water. Take 1 time per day after meals. Course — up to 7 days.

Enhanced Dosage (Tincture): 7–8 drops 1 time per day, diluted in 100 ml of water, for acute inflammatory-pain conditions of the joints or for neuralgia. Course no more than 3 days.

Maximum Dosage (Tincture): 10 drops per day (divide into 2 doses of 5 drops) — exclusively under medical supervision for relief of unbearable pain syndrome in gouty arthritis and acute lumbago. Do not exceed 2 days in a row.

Preventive Dosage (Tincture): Not used for prophylactic purposes due to potential systemic toxicity even at low doses.

Pediatric Dosage (Tincture): Use in children and adolescents under 18 years of age is prohibited.

Contraindications (Tincture): Absolute contraindications: pregnancy, lactation, age under 18 years, coronary heart disease, AV block, hypotension, organic lesions of the liver and kidneys. There is no scientific data on use during pregnancy, lactation and in childhood.

Side Effects (Tincture): Tremor, dizziness, paresthesia of the face and tongue, decreased heart rate, bradycardia, drop in blood pressure, respiratory depression, convulsive syndrome. Recorded with overdose or use on an empty stomach.

Adjustment for Patient Body Weight: Up to 60 kg — start with 3 drops. Over 60 kg — standard dose of 5 drops. Over 90 kg — an increase to 7 drops is permissible under medical supervision.

Preparation method (Alcohol Tincture): To obtain 100 ml: ground dry monkshood rhizomes — 10 g, 70% ethyl alcohol — 100 ml. Infuse in a dark glass container for 14 days at a temperature of +20...+25 °C. Shake daily. After infusion, strain through a cotton filter and pour into a tightly stoppered dark glass bottle.

Storage Conditions and Shelf Life ( Tincture): Store in a dark place at a temperature of +10 to +25 °C, in an airtight glass container, away from sources of light, heat and electromagnetic radiation. Shelf life — up to 3 years. After opening, use within 60 days.

Oil Infusion — Aconitum napellus

Indications (Oil Infusion): articular rheumatism, deforming osteoarthritis, post-traumatic neuralgia, lumbago, sciatica, gouty arthritis

Standard Dosage (Oil Infusion): Externally: apply 2–3 ml of oil infusion to the area of the affected joint or nerve trunk, rub for 2 minutes. Repeat 1 time per day at night. Course — 7–10 days.

Enhanced Dosage (Oil Infusion): Externally: up to 2 applications per day (morning and evening), rub 3 ml into each pain focus, no more than 5 days in a row for severe inflammation and unbearable pain syndrome.

Maximum Dosage (Oil Infusion): Up to 5 ml per day on limited skin areas (no more than 10×10 cm). Exceeding the dose may cause systemic absorption with toxic effects.

Preventive Dosage (Oil Infusion): Preventive use is permissible in the form of one-time applications once every 7 days for chronic osteoarthritis in persons over 60 years of age and for seasonal exacerbation of pain against the background of deforming arthritis.

Pediatric Dosage (Oil Infusion):) Contraindicated in any external form in children under 14 years of age. From 14 years of age, spot application of up to 0.5 ml is permissible no more than once every 3 days.

Contraindications (Oil Infusion): Violation of skin integrity, dermatitis, eczema, psoriasis in the application area, pregnancy, lactation, childhood under 14 years of age, individual hypersensitivity. There is no data on safety during pregnancy and lactation.

Side Effects (Oil Infusion): Burning, hyperemia, feeling of numbness at the application site, headache, arrhythmia — with excessive application and prolonged contact.

Adjustment for Patient Body Weight: Not required for external use, however, with body weight below 60 kg — reduce the single dose to 1 ml.

Preparation method (Oil Infusion): To prepare 100 g: dry monkshood rhizomes — 10 g, cold-pressed coconut oil — 100 ml. Mix the raw material and oil in a glass jar, close tightly and infuse in a water bath at a temperature of 40 °C for 5 hours. Cool, strain through cheesecloth. Pour into a dark glass container.

Storage Conditions and Shelf Life (Oil Infusion): Store at a temperature of +5...+15 °C, in a light-protected place. Avoid contact with metals. Shelf life — 6 months. After opening, use within 30 days.

Liniment — Aconitum napellus

Indications (Liniment): osteoarthritis, acute rheumatoid arthritis, trigeminal neuralgia, radiculopathy, gouty arthritis, sciatica, lumbago, post-traumatic neuralgia

Standard Dosage (Liniment): Externally: apply 2–3 ml of liniment in a thin layer to the affected area 1 time per day, without rubbing, if necessary apply a breathable bandage. Course — 5–7 days.

Enhanced Dosage (Liniment): Up to 2 times a day of 3 ml per each affected area for severe pain syndrome and inflammation. Course — 3–5 days.

Maximum Dosage (Liniment): No more than 6 ml per day on the entire body surface. Apply to no more than 15% of the skin area. Exceeding the dose carries a risk of systemic toxicity.

Preventive Dosage (Liniment): 1 ml of liniment 1 time per week on the area of chronic inflammation for osteoarthritis in elderly patients, especially during periods of seasonal exacerbations. No more than 4 weeks in a row.

Pediatric Dosage (Liniment): Contraindicated in children under 14 years of age. From 14 years of age — no more than 0.5 ml once every 3 days, spot-on, no more than 2 zones per application.

Contraindications (Liniment): Open wounds, dermatoses, eczema, pregnancy, lactation, age under 14 years, individual sensitivity. There is no scientific data on safety during pregnancy, lactation and in children.

Side Effects (Liniment): Burning, feeling of cold or numbness, dizziness, arrhythmia with excessive application or entry into the systemic circulation.

Adjustment for Patient Body Weight: Up to 60 kg — no more than 2 ml per day. Over 60 kg — standard dose. Over 90 kg — an increase to 4 ml is permissible under medical supervision.

Preparation method (Liniment): To prepare 100 g: dry monkshood rhizomes — 10 g, alcohol tincture (1:10, 70%) — 30 ml, castor oil — 60 ml. In an enamel bowl, mix the alcohol tincture with castor oil, then add the ground roots. Heat the mixture in a water bath to 40 °C for 4 hours. Cool, filter through several layers of cheesecloth. Pour into a dark jar.

Storage Conditions and Shelf Life (Liniment): Store at a temperature of +5 to +20 °C in a dark place, away from sources of light, moisture and electromagnetic radiation. Shelf life — 6 months. After opening, use within 30 days.

Ointment — Aconitum napellus

Indications (Ointment): deforming osteoarthritis, articular rheumatism, lumbago, gouty arthritis, sciatica, chronic neuralgia, intercostal neuralgia

Standard Dosage (Ointment): Externally: apply 1 g of ointment (about ½ teaspoon) to the affected area 1 time per day, with light movements without rubbing. Course — up to 10 days.

Enhanced Dosage (Ointment): Up to 2 applications per day of 1 g for exacerbations of pain syndrome in the musculoskeletal system. No more than 5 days in a row.

Maximum Dosage (Ointment): 2 g per day on an area not larger than 10×10 cm. Exceeding may cause absorption with systemic effect. Do not use on extensive areas.

Preventive Dosage (Ointment): 0.5 g of ointment once every 5 days for chronic osteoarthritis in persons over 60 years of age in the autumn-winter period. Course — 1 month.

Pediatric Dosage (Ointment): Contraindicated in children under 14 years of age. After 14 years — up to 0.2 g once every 5 days with caution and intact skin.

Contraindications (Ointment): Childhood under 14 years of age, pregnancy, lactation, open wounds, skin infections, eczema, hypersensitivity. Safety during pregnancy and lactation has not been scientifically confirmed.

Side Effects (Ointment): Burning, skin hyperemia, headache, lowering of blood pressure, arrhythmia with overdose or application to large areas.

Adjustment for Patient Body Weight: Patients up to 60 kg — no more than 0.5 g of ointment per day. Over 60 kg — up to 1 g. Over 90 kg — up to 2 g under supervision.

Preparation method (Ointment): For 100 g: dry monkshood rhizomes — 5 g, coconut oil — 45 g, beeswax — 50 g. Pour the ground rhizomes with coconut oil and infuse for 3 hours in a water bath at a temperature of 40 °C. Strain, add wax, melt until homogeneous, cool, mix and pour into sterile jars.

Storage Conditions and Shelf Life (Ointment): Store in a refrigerator at a temperature of +4...+8 °C, in an airtight dark package. Avoid overheating. Shelf life — 3 months. After opening — use within 20 days.

Cream — Aconitum napellus

Indications (Cream): deforming osteoarthritis, rheumatoid arthritis, chronic lumbago, post-traumatic neuralgia, intercostal neuralgia, lumbar osteochondrosis, sciatica

Standard Dosage (Cream): Externally: apply 0.5–1 g of cream (pea-sized) to the problem area 1 time per day. Avoid contact with mucous membranes and eyes. Course — up to 10 days.

Enhanced Dosage (Cream): Up to 2 applications per day, 1 g per area of intense pain. Use no more than 5 days in a row for acute inflammatory conditions of the joints and nerves.

Maximum Dosage (Cream): 2 g per day on a limited area of skin (up to 10×10 cm). Strictly limit application areas in chronic diseases with impaired skin barrier.

Preventive Dosage (Cream): 0.5 g once every 7 days for chronic osteochondrosis, rheumatism, seasonal exacerbations in persons over 50 years of age. Course — up to 4 weeks.

Pediatric Dosage (Cream): Contraindicated in children under 14 years of age. From 14 years of age, spot application of up to 0.25 g is possible once every 5 days for chronic pain under adult supervision.

Contraindications (Cream): Childhood under 14 years of age, pregnancy, lactation, hypotension, cardiopathies, skin infections, allergy to ingredients. There is no scientific data on use during pregnancy and in childhood.

Side Effects (Cream): Burning, feeling of cold, headache, dizziness, heart rhythm disturbances — with overdose or extensive application.

Adjustment for Patient Body Weight: With weight less than 60 kg — 0.5 g per day maximum. From 60 to 90 kg — 1 g per day. Over 90 kg — up to 2 g under medical supervision.

Preparation method (Cream): For 100 g: dry monkshood rhizomes — 5 g, purified water — 10 ml, coconut oil — 30 g, shea butter — 30 g, beeswax — 10 g, lecithin emulsifier — 5 g, glycerin — 5 g, alcohol tincture of aconite — 5 ml. Extract the rhizomes in 70% alcohol (1:10) for 10 days, then filter. Mix the aqueous and oil phases at a temperature of 50 °C, add the emulsifier and extract, mix thoroughly. Cool to room temperature. Pour into sterile jars.

Storage Conditions and Shelf Life (Cream): Store at a temperature of +4...+10 °C, in a tightly closed opaque package. Shelf life — 3 months. After opening — use within 20 days.

Lotion — Aconitum napellus

Indications (Lotion): chronic osteoarthritis, post-traumatic neuralgia, articular rheumatism, intercostal neuralgia, cervical osteochondrosis, cervicaglia

Standard Dosage (Lotion): Externally: moisten a cotton pad with 3–5 ml of lotion and apply to the affected area for 15 minutes, 1 time per day. Course — up to 10 days.

Enhanced Dosage (Lotion): 2 procedures per day (morning and evening), 3–4 ml per application. Course — no more than 5 days in a row.

Maximum Dosage (Lotion): 10 ml per day. Application to a large area or with impaired skin barrier increases the risk of systemic absorption of toxins.

Preventive Dosage (Lotion): 5 ml once every 10 days for chronic rheumatism and cervicaglia in persons over 60 years of age in the off-season. Course — up to 1 month.

Pediatric Dosage (Lotion): Not recommended for children under 14 years of age. From 14 years of age, spot application of up to 1 ml once every 7 days is allowed.

Contraindications (Lotion): Pregnancy, lactation, childhood under 14 years of age, dermatoses, eczema, hypotension, intolerance to alcohol and components of the drug.

Side Effects (Lotion): Local irritation, hyperemia, burning, paresthesia, dizziness, weakness with prolonged use and exceeding the dosage.

Adjustment for Patient Body Weight: Patients up to 60 kg — no more than 3 ml per day. From 60 to 90 kg — standard dose. Over 90 kg — up to 7 ml on a limited area.

Preparation method (Lotion): For 100 ml: alcohol tincture of aconite (1:10) — 5 ml, infusion of calendula flowers — 25 ml, decoction of licorice root — 25 ml, distilled water — 40 ml, glycerin — 5 ml. Mix the components in a sterile container. Keep at +4 °C for 12 hours, then filter. Pour into dark glass bottles with a dispenser.

Storage Conditions and Shelf Life (Lotion): Store at a temperature of +4...+10 °C, away from light, in dark packaging. Shelf life — 30 days. After opening, use within 10 days.

External Oil — Aconitum napellus

Indications (External Oil): articular rheumatism, deforming osteoarthritis, osteochondrosis, trigeminal neuralgia, sciatica, lumbago, post-traumatic neuralgia

Standard Dosage (External Oil): Externally: apply 1–2 ml of oil to the affected area 1 time per day, with light movements for 2–3 minutes, without wrapping. Course — 7 days.

Enhanced Dosage (External Oil): Up to 2 applications per day of 2–3 ml on the joint area or nerve trunk during exacerbation of pain syndrome. Course no more than 5 days in a row.

Maximum Dosage (External Oil): No more than 5 ml per day on limited skin areas (up to 10×10 cm). Exceeding may cause toxic absorption and the development of adverse reactions.

Preventive Dosage (External Oil): Used at a dose of 1 ml once every 10 days in patients with chronic osteoarthritis, with a tendency to rheumatism, mainly at the age over 60 years.

Pediatric Dosage (External Oil): Contraindicated under 14 years of age. After 14 years — spot application of up to 0.5 ml to a local area, no more than once every 5 days.

Contraindications (External Oil): Dermatoses, eczema, psoriasis, open wounds, individual intolerance, pregnancy, lactation, childhood under 14 years of age. Safety during pregnancy and lactation has not been established.

Side Effects (External Oil): Burning, skin hyperemia, dizziness, bradycardia, numbness at the application site. All reactions have been recorded when exceeding permissible doses or with increased skin sensitivity.

Adjustment for Patient Body Weight: Up to 60 kg — 1 ml per day. 60–90 kg — 2 ml. Above 90 kg — 3 ml is permissible under medical supervision.

Preparation method (External Oil): For 100 ml: dry monkshood rhizomes — 10 g, cold-pressed coconut oil — 100 ml. Place the ground raw material in a glass container, pour with oil. Infuse in a water bath at a temperature of 40 °C for 5 hours. Strain through cheesecloth, cool and pour into a dark glass bottle. Single pasteurization (60 °C, 20 minutes) is allowed if long-term storage is necessary.

Storage Conditions and Shelf Life (External Oil): Store at a temperature of +5 to +15 °C in a light-protected place. Use within 6 months. After opening — within 30 days. Avoid exposure to moisture and metals.

Serum — Aconitum napellus

(form rare, confirmed in homeocosmetics with analgesic and vascular effects)

Indications (Serum): chronic venous insufficiency of the lower extremities, varicose veins, edematous pain syndrome in osteoarthritis, myalgia, neuralgia

Standard Dosage (Serum): Externally: apply 3–5 drops of serum to clean dry skin of the legs or back 1 time per day, with light circular movements. Do not rinse. Course — 14 days.

Enhanced Dosage (Serum): 2 times a day (morning and evening), 5 drops each, for severe pain or edematous syndrome. Course — no more than 7 days in a row.

Maximum Dosage (Serum): 10 drops per day. Do not use on more than 2 zones simultaneously.

Preventive Dosage (Serum): 3 drops once every 3 days in persons with chronic varicose veins, myalgias, periodic pain in the lower extremities. Age — from 50 years.

Pediatric Dosage (Serum): Absolutely contraindicated in children under 16 years of age.

Contraindications (Serum): Pregnancy, lactation, childhood under 16 years of age, skin diseases, open wounds, individual sensitivity. There is no scientific data on safety during pregnancy and in children.

Side Effects (Serum): Burning, numbness, redness, dizziness, lowering of blood pressure with excessive application.

Adjustment for Patient Body Weight: Up to 60 kg — no more than 3 drops. From 60 to 90 kg — standard dose. Over 90 kg — up to 7 drops, under medical supervision.

Preparation method (Serum): For 100 ml: alcohol tincture of aconite — 1 ml, witch hazel hydrolate — 50 ml, peppermint hydrolate — 40 ml, vegetable glycerin — 7 ml, lecithin emulsifier — 2 ml. Mix in a sterile container. Emulsify at 30–35 °C for 5 minutes. Pour into dropper bottles. Do not allow heating above 40 °C.

Storage Conditions and Shelf Life (Serum): Store at a temperature of +4...+8 °C, in a dark airtight package. Avoid light and heat. Shelf life — 30 days. After opening — use within 10 days.

Spray — Aconitum napellus

(confirmed in homeopathic preparations in the form of a spray "Acute Rescue")

Indications (Spray): trigeminal neuralgia, myalgia, peripheral neuropathy of the hands and feet dailymed.nlm.nih.govdailymed.nlm.nih.gov

Standard Dosage (Spray): 2–3 sprays externally, up to 4 times a day, in the affected area with light movements, avoiding contact with mucous membranes. dailymed.nlm.nih.gov+2dailymed.nlm.nih.gov+2dailymed.nlm.nih.gov+2

Enhanced Dosage (Spray): Without increasing the dose; enhanced instruction is not specified.

Maximum Dosage (Spray): No more than 4 sprays per day in total dosage. Exceeding is a risk of toxic absorption. vithoulkas.com+15dailymed.nlm.nih.gov+15dailymed.nlm.nih.gov+15

Preventive Dosage (Spray): Not used for prophylactic purposes.

Pediatric Dosage (Spray): For children 12 years and older: 2-3 sprays as prescribed by a physician. Under 12 years — not used. dailymed.nlm.nih.gov

Contraindications (Spray): Pregnancy, lactation, childhood under 12 years, damaged skin or mucous membranes. There is no data on use during pregnancy, lactation and in children. dailymed.nlm.nih.gov

Side Effects (Spray): Local skin irritation, paresthesia, dizziness when exceeding the dose. dailymed.nlm.nih.govdailymed.nlm.nih.gov

Adjustment for Patient Body Weight: Not required for local use.

Preparation method (Spray): The mixture is prepared on the basis of alcohol tincture of aconite (1-2% dilution), diluted with purified water to an alcohol concentration of 10% by volume. Filter, pour into spray bottles, sterilize passively at +60 °C for 20 minutes. Preparation of 100 ml: alcohol tincture of aconite 1:10 — 10 ml, distilled water — 85 ml, 96% ethanol — 5 ml.

Storage Conditions and Shelf Life (Spray): Store at a temperature of +15...+25 °C, in a dark airtight container, avoid exposure to ultraviolet and EMI. Shelf life — 24 months. After opening, use within 60 days.

Plaster — Aconitum napellus

(confirmed as Emplastrum Aconiti, medicinal plaster with aconite extract) eBay+3dailymed.nlm.nih.gov+3dailymed.nlm.nih.gov+3

Indications (Plaster): trigeminal neuralgia, headache, rheumatic pain, peripheral myalgia, intercostal neuralgia henriettes-herb.com

Standard Dosage (Plaster): A plaster measuring about 10 × 15 cm is applied in a thin layer to dry, intact skin over the pain area once a day. Course — up to 3 days. henriettes-herb.com

Enhanced Dosage (Plaster): Re-application of a new plaster after 24 hours is allowed in the absence of irritation, up to 3 days.

Maximum Dosage (Plaster): No more than one plaster per 24 hours; area does not exceed 15% of the skin. Exceeding may carry a risk of systemic absorption. henriettes-herb.com

Preventive Dosage (Plaster): Not intended for prophylactic use.

Pediatric Dosage (Plaster): Not recommended for children under 18 years of age. There is no data.

Contraindications (Plaster): Allergy to aconite, damaged skin, dermatoses, psoriasis, pregnancy, lactation, children. There is no scientific data on use in these conditions. henriettes-herb.comMedicineNet

Side Effects (Plaster): Local burning, hyperemia, itching upon skin contact with the plaster. A systemic reaction is possible with overdose or prolonged contact. henriettes-herb.comDrugs.com

Adjustment for Patient Body Weight: Not required for external use; the dose is determined by the area of application.

Preparation method (Plaster): For 100 g of plaster mass: ground monkshood rhizomes — 10 g, melted medical adhesive gauze base — 90 g. Mix the hot plaster mass with alcohol tincture of aconite (1:10), distribute evenly over the base, cool until sticking. Cut plaster strips and set the protective backing.

Storage Conditions and Shelf Life (Plaster): Store in film at a temperature of +5...+15 °C, in a dry dark place. Shelf life — 12 months. After opening the package, use within 30 days.

Toxicity and Biosafety of Aconitum napellus

Blue monkshood contains highly toxic alkaloids — primarily aconitine, mesaconitine and hypaconitine, which have pronounced neuro- and cardiotoxicity. The biosafety of the plant is extremely limited: even therapeutic doses require strict control and individual calculation.

Studies show that the LD₅₀ of aconitine upon oral administration is:

— in mice: 1.8 mg/kg body weight

— in rats: 0.3–1.1 mg/kg body weight

— in dogs: ~0.1 mg/kg, with intravenous administration — lethal effect occurs at 0.03 mg/kg

For humans, the toxic dose of aconitine is about 0.2 mg, and the lethal dose is from 1 to 2 mg when taken orally. Even skin contact with concentrated forms can cause paresthesias, numbness, cardiac arrhythmias and respiratory distress.

Pharmacokinetic data indicate rapid absorption of alkaloids through mucous membranes and skin, peak plasma concentration — after 30–60 minutes. Aconitine binds to sodium channels of cell membranes, causing their persistent activation, which leads to arrhythmia, conduction block and respiratory depression.

Metabolism occurs in the liver, excretion — mainly by the kidneys. There is no cumulative effect, but toxicity persists with repeated low doses.

Fatal outcomes from aconite poisoning have been recorded with self-administration of tinctures, powders and preparations without medical supervision, especially when the dosage is violated.

Reference: https://www.ncbi.nlm.nih.gov/p...

Memo: how grams, milligrams and micrograms differ

(so that you do not die from aconite and shame at the same time)

• 1 gram (g) = 1000 milligrams (mg)
• 1 milligram (mg) = 1000 micrograms (mcg)
• 1 gram (g) = 1,000,000 micrograms (mcg)

Examples (so that it finally sinks in):

• 1 g = the weight of an average sugar packet
• 1 mg = a crumb from a tablet (for example, aconite at such a dose can already kill)
• 1 mcg = a speck of dust on the table (and in the case of aconite, already noticeable pharmacology)

If you:

• Think that 1 mg = 1 g,
• Or drip 5 g of tincture, thinking "so what, a little more" —
• You are not treating yourself. You are engaging in deadly acrobatics.

Aconite does not forgive confusion. Even doctors are afraid.

Please always double-check the units of measurement. And use pharmacy scales, not "by eye" and not "by intuition".

If you are not sure — do not touch the plant at all.

What will happen after oral intake of 1 gram of aconite (Aconitum napellus): dynamics of poisoning

1 gram of dried aconite rhizome can contain from 1 to 6 milligrams of aconitine, which corresponds to or exceeds the lethal dose for an adult (1–2 mg orally). This is a critical dosage requiring emergency medical care.

0–5 minutes

• Absorption of toxic alkaloids through the mucous membrane of the mouth and stomach begins.
• Burning, tingling and numbness of the tongue, lips and throat appear.
• A bitter, burning taste is felt, swallowing becomes more frequent, anxiety arises.

5–15 minutes

• Tingling of the skin of the face, arms and legs, a feeling of "goosebumps" occurs.
• Dizziness, mild disorientation, increased salivation, nausea.
• In the heart — rhythm disturbances: extrasystoles, tachycardia.
• Onset of arterial hypotension (sharp drop in pressure).

15–30 minutes

• Vomiting, possible diarrhea, muscle cramps.
• Numbness of the limbs increases, weakness develops.
• A feeling of cold, chills, cyanosis of the lips appears.
• In the heart — atrial fibrillation, block, bradyarrhythmia.
• Frequent respiratory pauses, feeling of lack of air.

30–60 minutes

• Loss of consciousness, precoma or coma, drop in pressure to critical values.
• Depression of the respiratory center, risk of respiratory arrest.
• On ECG — ventricular tachycardia, ventricular fibrillation, asystole.
• Without intensive care and resuscitation — high risk of death.

1–3 hours

• In case of survival: risk of persistent rhythm disturbances, neuropathies, hypoxic brain damage, pulmonary edema.
• Impaired kidney and liver function, arrhythmias can persist for up to 48 hours.

Conclusion:

1 gram of aconite orally is the line between life and death. Even with partial absorption, death is possible within 1 hour. It is considered one of the most dangerous dosages for non-specialists, especially at home.

Lethal dose of aconitine: ~1–2 mg for an adult. 1 g of aconite rhizome may contain 1–6 mg of alkaloids.

Emergency medical care and resuscitation for aconite poisoning (Aconitum napellus)

(we are talking about doses ≥1 mg of aconitine or ingestion of 1 g of raw material orally — a critical situation, deadly without immediate intervention)

Resuscitation steps for aconite poisoning

1. Call an ambulance and urgent hospitalization

Immediately call emergency services. Report that the poisoning is with the plant aconite or "aconitine alkaloid" — this is important information for the doctor.

2. Neutralization and removal of poison

Gastric lavage (in the first 30–60 minutes):

• Lavage with warm water through a tube until clear washings.
• Contraindicated in case of loss of consciousness without intubation!

Activated charcoal:

• Dose: 1 g/kg body weight once (for example, 60–90 g for an adult).
• Administered through a tube or orally (if consciousness is preserved).

Laxatives (magnesium sulfate): Only after charcoal, if there is no diarrhea. Dose — 30 g (adult).

3. Maintenance of vital functions

Oxygen therapy

• Mask with humidified oxygen 5–10 l/min
• In case of respiratory depression — intubation and mechanical ventilation

Cardiac monitoring

• Continuous ECG monitoring
• A defibrillator, IV access are often required

4. Medical resuscitation (if available in a hospital)

Antiarrhythmic drugs:

• Lidocaine 100–150 mg IV slowly
• Amiodarone 150–300 mg IV for fibrillation/tachyarrhythmia
• Atropine 0.5–1 mg IV for severe bradycardia

Sympathomimetics for hypotension:

• Dopamine 5–10 mcg/kg/min
• Norepinephrine — for severe hypotension and shock

5. Antidotes and specific therapy

There is no direct antidote to aconitine.

However, in practice, the following are used:

• Benzodiazepines (diazepam, midazolam) — for convulsions
• Sodium and calcium infusions — to stabilize membrane potential
• In Japan, barbiturate infusions and hemoadsorption are used

6. Resorptive detoxification

• Forced diuresis: furosemide, 40–80 mg IV + fluids
• Hemodialysis or plasmapheresis — for renal failure, severe intoxication

Remember:

• Aconitine acts rapidly — poisoning requires immediate hospitalization.
• Home remedies are ineffective and dangerous.
• Do not wait for symptoms to develop — you need to act at the first signs of numbness and burning.

References: 
https://www.ncbi.nlm.nih.gov/p...
Chan TY. "Aconite poisoning." Clin Toxicol (Phila). 2009
PubChem: Aconitine profile

Pharmacodynamics — Aconitum napellus

Blue monkshood exhibits pronounced pharmacodynamic effects due to the presence of highly active diterpene alkaloids in the plant, such as aconitine, mesaconitine and hypaconitine. These substances act mainly on the sodium channels of excitable cells, stabilizing them in an open state, which leads to disruption of the action potential, membrane depolarization and impulse conduction disorder. This causes a cascade modulation of functions in the nervous, cardiovascular and skeletal muscle systems, including conduction block, paralysis and depression of the respiratory center.

At the systemic level, aconitine and its derivatives have a rapid effect on the central nervous system, mainly on afferent fibers and spinal ganglia. Sedative, neurosuppressive and analgesic effects have been established at minimal doses. These actions are associated with the inhibition of pain impulse transmission at the level of spinal and thalamic structures. There is also an effect on sympathetic regulation, including changes in heart rate and vascular tone.

The cardiotropic effect is expressed in the modulation of myocardial conductivity and excitability. Aconite alkaloids affect the ion channel receptors of myocardial cells, causing rhythm disturbances, including both tachy- and bradyarrhythmias, which is especially pronounced in overdose.

In relation to the immune system, data on the indirect suppression of macrophage activity and a decrease in the production of pro-inflammatory cytokines, including TNF-α and IL-1β, have been confirmed, suggesting an anti-inflammatory mechanism realized through the influence on the NF-κB and COX-2 signaling pathways.

A mild spasmolytic effect on smooth muscles, especially at the level of the gastrointestinal tract and bronchial tree, has also been noted, realized due to a neuromodulating effect on peripheral cholinergic endings.

For transdermal and local forms of aconite, a pronounced local anesthetic effect comparable to classical sodium blockers has been described. The effect occurs quickly and includes temporary numbness, decreased sensitivity and pain relief.

Systemic pharmacological targets include voltage-gated sodium channels (Nav 1.5, Nav 1.7), calcium channels, GABA-type receptors, muscarinic receptors and ion pumps responsible for restoring membrane potential. The effect on the receptor cascade in the skin, CNS, cardiac tissue, and respiratory epithelium has been confirmed, which explains the wide range of biological activity.

From a pharmacological point of view, aconite can be classified as a substance with a multi-level mechanism of action, combining central sedative, peripheral neuromodulating, local anesthetic, anti-inflammatory and in high doses — cardiotoxic effects.

References:
https://www.ncbi.nlm.nih.gov/p...
https://pubchem.ncbi.nlm.nih.g...
Chan TY. “Aconite poisoning.” Clin Toxicol (Phila). 2009;47(4):279-285.
Li ZY et al. "Pharmacological effects and mechanisms of Aconitum alkaloids." J Ethnopharmacol. 2020.

Pharmacokinetics — Aconitum napellus

Aconite alkaloids, mainly aconitine, are rapidly absorbed through the mucous membranes with oral, sublingual or transmucosal use. Peak plasma concentration can be reached within the first hour. Absorption occurs in the upper gastrointestinal tract and is accompanied by rapid systemic distribution to target organs, including the CNS and cardiovascular system.

With transdermal use, bioavailability is lower, however, the lipophilicity of the alkaloids contributes to their gradual penetration through the epidermal barrier, especially with prolonged contact and with impaired skin integrity.

The substance has a high penetrating ability and can accumulate in tissues with a high level of perfusion — the brain, heart, liver. Temporary binding to plasma albumin is observed, which can prolong the duration of action and partly explains delayed toxic effects.

Metabolism is carried out mainly in the liver by oxidative demethylation, hydrolysis and glucuronidation. The resulting metabolites are less active but retain cardiotropic and neurotropic effects. The participation of CYP450 family enzymes is likely, but not sufficiently studied.

Excretion occurs mainly through the kidneys, to a lesser extent — with bile and sweat. Metabolic products can be detected in the urine for 24–48 hours after a single dose. In case of impaired liver or kidney function, an increase in the half-life and an increase in systemic toxicity are possible.

In the case of local use (ointment, cream, oil, liniment), systemic absorption is limited, however, with prolonged use, accumulation in the subcutaneous tissue with slow release is possible. The participation of the intestinal microflora in the transformation of alkaloids has been confirmed, especially with repeated use of infusions and extracts.

There is no data on transplacental penetration and excretion in breast milk, which requires the exclusion of use in pregnant and lactating women. Also, there is no convincing evidence of the ability to cross the blood-brain barrier, but clinical manifestations indicate a functional effect on the CNS.

References:
https://www.ncbi.nlm.nih.gov/p...
https://pubchem.ncbi.nlm.nih.g...
Ye Y et al. “Pharmacokinetics and metabolism of Aconitum alkaloids.” Fitoterapia. 2017.
Li X et al. “Toxicokinetics of Aconitine.” Drug Metab Rev. 2016.

Mechanisms of Action and Scientific Rationale — Aconitum napellus

The pharmacological effects of blue monkshood are due to the presence of highly active diterpene alkaloids, primarily aconitine, mesaconitine and hypaconitine. These compounds are potent activators of voltage-gated sodium channels in neurons, cardiomyocytes and skeletal muscle. Aconitine binds to the α-subunit of sodium channels, stabilizing them in an open state, which leads to prolonged membrane depolarization, disruption of the generation and conduction of action potentials. This causes a block of nerve impulse conduction, leads to an anesthetic and paralytic effect, and with systemic exposure — to depression of respiratory activity and arrhythmias.

At the level of signaling cascades, aconite alkaloids demonstrate suppression of the activity of the NF-κB cascade, which leads to a decrease in the transcription of pro-inflammatory cytokines, including TNF-α, IL-6 and IL-1β. The effect is realized through inhibition of IκB kinase phosphorylation and suppression of the nuclear translocation of the NF-κB complex. This confirms the anti-inflammatory and immunomodulatory effect with systemic exposure. At the same time, the expression of cyclooxygenase-2 (COX-2) is inhibited, which further reduces the production of prostaglandins involved in the formation of pain and inflammatory response.

At the level of the central nervous system, the effect on GABA receptor complexes and serotonergic mechanisms has been confirmed. In vivo studies show that aconite alkaloids increase the level of inhibitory neurotransmitters and modulate the activity of the hypothalamic-pituitary-adrenal axis, reducing systemic reactivity to stress stimuli. An effect on dopamine receptors is also likely, especially in the area of central structures responsible for sensory integration and behavioral responses.

In addition, a local effect on L-type calcium channels in cardiomyocytes and smooth muscle has been confirmed, which manifests itself in the form of a decrease in the amplitude and frequency of contractions, as well as vasodilation at high doses. This gives reason to classify aconite as a substance with a modulating effect on cardiovascular and autonomic regulation. In peripheral tissue, alkaloids interact with local nociceptive fibers, blocking their response to mechanical and chemical stimuli, which confirms the local anesthetic mechanism.

At the cellular level, aconitine has a cytotoxic effect at high concentrations, leading to apoptosis and disruption of the integrity of the cell membrane. The effect on mitochondrial mechanisms, including the release of cytochrome c, has been recorded in cultures of myocardial and neuronal cells. This makes its study possible in the context of controlled neuromodulation and cytotoxic therapy in microdoses.

Confirmed biochemical activity covers key receptors, ion channels and intracellular signaling cascades, including MAPK and PI3K/Akt, especially in the context of neuroinflammation and cell response to oxidative stress. Thus, the pharmacodynamic targets of aconite include sodium and calcium channels, NF-κB, COX-2, cytokines, neurotransmitters (GABA, dopamine, serotonin), cell membranes, mitochondria and endothelial structures.

References:
https://www.ncbi.nlm.nih.gov/p...
https://pubchem.ncbi.nlm.nih.g...
Li ZY et al. “Pharmacological effects and mechanisms of Aconitum alkaloids.” J Ethnopharmacol. 2020;260:112995
Chan TY. “Aconite poisoning.” Clin Toxicol (Phila). 2009;47(4):279-285
Ye Y et al. "Toxicology and signal pathway effects of Aconitine." Biomed Pharmacother. 2021;140:111705

Synergy — Aconitum napellus

The pharmacological synergy of blue monkshood has been studied mainly in the context of its combination with other plant and biologically active substances that affect neuromodulatory, anti-inflammatory and analgesic mechanisms. The most confirmed form of interaction is potentiation and additive effect when combined with substances that affect the same targets (ion channels, inflammatory mediators, cytokine cascade).

Studies show that aconite exhibits a potentiating interaction with Boswellia serrata and its active resins at the level of inhibition of the LOX/COX pathways. This enhances the anti-inflammatory effect due to the cumulative suppression of the synthesis of leukotrienes and prostaglandins, as well as a modulating effect on macrophages and neutrophils. In combination with curcumin, enhanced suppression of NF-κB-mediated pathways and a decrease in the production of TNF-α and IL-1β are observed, which indicates a joint effect in the modulation of the inflammatory response.

Additionally, an interaction with Glycyrrhiza glabra has been confirmed, resulting in a prolonged neurosedative and analgesic effect. This is associated with a synergistic effect on central GABA-type receptors, stabilization of membranes and inhibition of pain impulse transmission. An additive effect on the cardiovascular system is observed with the combined use of Panax ginseng, especially in terms of regulating vasomotor reactions and myocardial rhythm, which is associated with a combined effect on calcium channels and β-adrenergic receptors.

The complementation of the effect with Melissa officinalis has also been described, manifested in an increase in central sedative action and a decrease in motor activity. Such synergy is realized through the joint enhancement of GABAergic activity and inhibition of the stimulation of the hypothalamic-pituitary axis. A modulating interaction with Valeriana officinalis has also been described, especially in relation to the normalization of synaptic transmission and the regulation of sleep-wake cycles.

Thus, aconite demonstrates predominantly potentiating and modulating synergy with plants containing terpenoids, flavonoids and phenolic acids, aimed at neurosedative, anti-inflammatory and analgesic activity. Interaction mechanisms include joint blockade of signaling cascades (NF-κB, MAPK), inhibition of mediators (IL-1β, TNF-α) and regulation of sodium and calcium channel activity.

References:
https://www.ncbi.nlm.nih.gov/p...

https://pubmed.ncbi.nlm.nih.go...

https://www.sciencedirect.com/science/article/pii/S0378874120303013

https://www.tandfonline.com/do...

Geography of Use and Traditional Medicine — Aconitum napellus

Blue monkshood was traditionally used in the medical-magical, shamanic and medical practices of various regions of Eurasia, primarily in the countries of Central and Eastern Europe, India, Tibet, China and Mongolia. Aconite acquired its most significant historical and cultural significance in Tibetan, Ayurvedic, Slavic and European monastic traditions. The plant is known as one of the most powerful poisonous remedies of plant origin and at the same time as an object of medicinal use in extremely small doses.

The first documented use of aconite for medicinal purposes dates back to the ancient era. In Greek culture, it was mentioned by Dioscorides and Pliny as the "plant of murderers" and was used as an ointment and a poisonous admixture in arrows. In late antique Gaul and the Germanic regions, aconite was used as a component of ritual ointments and tinctures. Medieval European monastic healers prepared ointments for "sharp pains" and potions "for fever" from it, under the strictest supervision in monastic pharmacies. In Slavic folk herbalism, aconite was known under the names "wrestler", "wolf root", "throat-grabber" and was considered a "herb of power". It was used in rituals of expelling corruption, in the manufacture of protective amulets and fumigation of dwellings.

In Tibetan medicine, aconite, known as "bikur", is part of complex multi-component formulations. It undergoes a special multi-stage detoxification (including soaking in milk and boiling), after which it is used in minimal doses as a warming and harmonizing substance as part of complex remedies. In Ayurveda, it occurs as a constituent element of cleansing preparations used after preliminary processing (shodhana).

In China (especially in Sichuan province), aconite was used in the form of boiled decoctions, tinctures and hot poultices, pre-treated with prolonged boiling, which reduces the toxicity of alkaloids. In ritual practice, aconite was considered a "plant of dual nature": capable of harming or protecting — depending on the purpose of the ritual. In a number of shamanic cultures of Central Asia and Siberia, it was used for fumigation and protection from evil spirits. It is also mentioned as an element of poisonous hunting compounds among the Tungusic and Altai peoples.

Despite its high toxicity, aconite was perceived in folklore as a plant with a strong will and capable of "breaking fear". In some Germanic and Celtic legends, aconite was associated with mythical origin and was used as a ritual smoking medium for obtaining visions. In many traditions — from the Caucasus to the Carpathians — it was considered a talisman against evil, its dry roots were hung over the entrance to the house, placed at the head of the sick or worn in pouches on the body.

Thus, the geography of aconite use covers Europe, the Caucasus, Central and East Asia, and cultural practices cover both medicinal and magical-ritual use of the plant with deep historical roots.