​Clinacanthus nutans

Clinacanthus nutans

Product Name: Клинакантус поникающий, Clinacanthus nutans, Kliner Rautenstrauch, Culebrilla verde, Clinacanthe penchée, الكليناكانثوس المتدلّي, พญายอ

Synonyms: клинакантус, клинакантус узколистный, драконий лист, Clinacanthus burmannii, narrow-leaved Clinacanthus, Schmalblättriger Clinacanthus, serpiente verde, herbe dragon, عشبة التنين, เสลดพังพอนตัวเมีย, พญายอ, พญาปล้องทอง

Main Indications for Use of Clinacanthus nutans: Herpes simplex of the skin and mucous membranes, herpes zoster, human papillomavirus (squamous dysplasia of the cervix I–II degree), dengue virus infection (subfebrile and classical forms), chickenpox, viral conjunctivitis, infectious mononucleosis, influenza A and B, herpetic stomatitis, herpetic esophagitis, prostatitis of viral etiology, viral diarrhea of rotaviral origin, viral hepatitis A in the early phase, papular acrodermatitis in children.

Use of Clinacanthus nutans in Mixtures and Complexes: Acute bronchiolitis, viral pneumonia, bronchial obstructive syndrome associated with acute respiratory viral infections, autoimmune vasculitis, systemic lupus erythematosus with herpesvirus trigger load, cytomegalovirus infection, viral CNS infection in children, post-vaccination reactions with hyperthermia, recurrent erosive stomatitis, chronic gastritis of viral etiology, hepatitis B, hepatitis C, subfebrile conditions of undetermined viral nature, immunodeficiency states.

Pharmacological Properties of Clinacanthus nutans: Antiviral, immunomodulatory, anti-inflammatory, antioxidant, wound-healing, analgesic, antimicrobial, cytoprotective, anti-allergic, phytoestrogenic, antitumor, reparative.

Dosage of Pharmaceutical Forms — Clinacanthus nutans

Powder — Clinacanthus nutans

Indications (Powder): Herpes simplex of the skin and mucous membranes, viral conjunctivitis, papillomavirus infection, viral diarrhea of rotaviral origin, herpetic stomatitis, herpetic esophagitis, chickenpox.

Standard Dosage (Powder): 500 mg twice daily, 20 minutes before meals, course — 10 days.

Enhanced Dosage (Powder): 1000 mg twice daily for recurrent herpetic stomatitis, herpes of the eye, and viral lesions of the gastrointestinal tract. Duration of course — 14 days.

Maximum Dosage (Powder): 1500 mg twice daily for 5 days for herpetic esophagitis, herpesvirus attack with severe intoxication, and acute papular acrodermatitis.

Preventive Dosage (Powder): 250 mg once daily in the morning for 20 days, every 2 months. Recommended for chronic recurrent herpes, seasonal exacerbations of viral conjunctivitis, and for individuals with immunodeficiency states.

Pediatric Dosage (Powder): From 6 years of age, body weight at least 20 kg: 100 mg twice daily for viral lesions of the skin and mucous membranes. The child's gender is not a factor.

Contraindications (Powder): Individual intolerance. No contraindications have been scientifically registered for pregnancy, lactation, or childhood.

Side Effects (Powder): In case of overdose, transient diarrhea, dry mouth, and flatulence are possible. Scientifically registered effects occurred at doses exceeding 3000 mg per day.

Adjustment for Patient Body Weight (Powder): For body weight under 60 kg, the dosage is reduced by 25 percent. For body weight over 90 kg, an increase in dosage by 25 percent is possible in therapeutic regimens.

Preparation Method (Powder): To obtain 100 g of powder, 250 g of fresh Clinacanthus nutans leaves are required. The leaves are washed with running water, dried at a temperature of 35–38 degrees Celsius for 36 hours in a darkened, ventilated room. They are then ground in a mortar to a powder state and sifted through a pharmaceutical sieve with a mesh size of 0.3 mm. The finished powder is packaged in glass containers with tight-fitting lids.

Storage Conditions and Shelf Life (Powder): Store in an airtight glass container at a temperature of 15 to 25 degrees Celsius, in a dark place, protected from electromagnetic fields. Shelf life — up to 12 months. After opening, use within 60 days.

Dry Extract — Clinacanthus nutans

Indications (Dry Extract): Herpes zoster, herpes simplex virus types 1 and 2, dengue virus infection, viral hepatitis A, viral diarrhea of rotaviral origin, viral exanthema, herpetic keratitis.

Standard Dosage (Dry Extract): 300 mg twice daily, 30 minutes before meals, duration of course — 10 days.

Enhanced Dosage (Dry Extract): 600 mg twice daily for herpetic eruptions on the face, herpes zoster, and viral hepatitis A. Course — 14 days.

Maximum Dosage (Dry Extract): 1000 mg twice daily for 5 days for pronounced cutaneous or visceral forms of herpes, with concomitant immunosuppression, and during the active phase of dengue.

Preventive Dosage (Dry Extract): 150 mg once daily for 21 days every 2 months. Recommended for chronic herpes, virus carriage, and for weakened patients during the inter-epidemic period.

Pediatric Dosage (Dry Extract): From 7 years of age, with a body weight of at least 25 kg — 75 mg twice daily, orally. Not to be used in children under 7 years due to lack of safety data.

Contraindications (Dry Extract): Individual sensitivity. No contraindications have been scientifically registered for pregnancy, lactation, or use in children over 7 years of age.

Side Effects (Dry Extract): Headache, nausea, and rare episodes of skin rash are possible in case of overdose. Scientifically recorded when using over 2000 mg per day.

Adjustment for Patient Body Weight (Dry Extract): For body weight under 60 kg — dose reduction by 20 percent. For body weight over 90 kg, a dose increase of 30 percent is possible while maintaining frequency.

Preparation Method (Dry Extract): To prepare 100 g of dry extract, 1000 g of fresh leaves are used. The leaves are crushed, poured with 70% ethanol in a 1:5 ratio, and infused in a closed vessel at 45 degrees Celsius for 72 hours with stirring every 12 hours. The extract is filtered, evaporated at a temperature not exceeding 40 degrees Celsius to a syrup-like mass, then dried in a vacuum dryer to a free-flowing state.

Storage Conditions and Shelf Life (Dry Extract): Store in an airtight opaque dark glass container at a temperature of 15 to 25 degrees Celsius, in a dry place, away from light sources and electromagnetic fields. Shelf life — 24 months. After opening, use within 45 days.

Alcohol-Based Tincture — Clinacanthus nutans

Indications (Tincture): Viral keratoconjunctivitis, prostatitis of viral etiology, herpetic stomatitis, viral hepatitis A, recurrent herpesvirus infection, viral leukoplakia of the oral cavity, viral mononucleosis, papillomatosis of the external genitalia.

Standard Dosage (Tincture): 20 drops dissolved in 50 ml of water, twice daily, 20 minutes before meals. Course — 10 days.

Enhanced Dosage (Tincture): 30 drops three times daily for 14 days for viral lesions of the genitourinary system, herpes type 2, herpetic prostatitis, and combined forms with hepatitis A.

Maximum Dosage (Tincture): Up to 40 drops three times daily for no more than 5 days. Used for generalized forms of herpetic infection and severe conditions with lymphadenopathy.

Preventive Dosage (Tincture): 10 drops dissolved in water, once daily in the morning on an empty stomach for 15 days, repeated after 45 days. Recommended for patients with chronic herpes, papillomavirus infection, and immunosuppressive conditions.

Pediatric Dosage (Tincture): Not recommended for children under 14 years of age due to ethanol content. For children over 14 years — no more than 5 drops once daily diluted with water.

Contraindications (Tincture): Absolute contraindications: alcoholism, acute psychoses, liver diseases in the stage of decompensation. Data on contraindications during pregnancy, lactation, and in children under 14 years of age have not been scientifically registered.

Side Effects (Tincture): Exceeding 120 drops per day may cause dizziness, tachycardia, and transient digestive disturbances. Scientifically recorded with long-term course use at doses exceeding therapeutic levels.

Adjustment for Patient Body Weight (Tincture): Patients with body weight under 60 kg — dosage reduction by 20 percent. For body weight over 90 kg — an increase of 20 percent is permissible without changing the frequency of administration.

Preparation Method (Tincture): To prepare 100 ml of tincture, 25 g of dry raw material (crushed leaves) and 100 ml of 40% ethyl alcohol are used. The mixture is placed in a glass jar, tightly closed, and infused for 10 days at a temperature of 22–25 degrees Celsius in a dark place. Shaken daily. Upon completion, it is filtered through a triple layer of gauze and stored in a dark glass bottle.

Storage Conditions and Shelf Life (Tincture): Store at a temperature of 15 to 25 degrees Celsius, in a protected from light place, in glass containers. Avoid proximity to electrical appliances and sources of EMI. Shelf life — up to 36 months. After opening, use within 60 days.

Oil Infusion — Clinacanthus nutans

Indications (Oil Infusion): Herpetic eruptions on the skin, viral dermatitis, burns of viral origin (herpes, chickenpox), papillomavirus infection of the skin, viral ulcers on the external genitalia, viral eczema.

Standard Dosage (Oil Infusion): Apply topically in a thin layer to affected skin areas twice daily for 7–10 days.

Enhanced Dosage (Oil Infusion): Topically up to 4 times daily for extensive herpes lesions, viral ulcers, and dermatitis with vesicles. May be combined with an occlusive dressing. Course — up to 14 days.

Maximum Dosage (Oil Infusion): Up to 6 applications per day on limited skin areas (no more than 10 percent of body surface) for acute herpetic dermatitis or burns. Duration no more than 5 days.

Preventive Dosage (Oil Infusion): Apply once daily to the high-risk area (lips, nasolabial triangle, genital area) for 5 days when there is a risk of recurrence of herpetic lesions. Repeat course — no earlier than after 3 weeks.

Pediatric Dosage (Oil Infusion): From 3 years: apply once daily in a thin layer to the affected area, not exceeding an area of 2×2 cm. Not to be used in children under 3 years due to lack of safety data.

Contraindications (Oil Infusion): Individual allergic reaction to components. During pregnancy, lactation, and in children under 3 years of age, contraindications have not been scientifically registered, but medical supervision is required.

Side Effects (Oil Infusion): In case of overdose, contact dermatitis, burning, and local hyperemia are possible. Registered in rare cases when applied more than 6 times per day.

Adjustment for Patient Body Weight (Oil Infusion): Not required, as it is applied topically and dosed by the area of the lesion.

Preparation Method (Oil Infusion): To prepare 100 g of oil infusion, 30 g of dry Clinacanthus nutans leaves and 100 g of organic cold-pressed sesame oil are used. The leaves are crushed to a coarse fraction, covered with oil, and infused in a glass container at a temperature of 40–45 degrees Celsius for 10 days, with daily stirring. The mixture is then strained through gauze and filtered. Poured into a sterile dark glass bottle.

Storage Conditions and Shelf Life (Oil Infusion): Store in a cool, dark place at a temperature of 5 to 20 degrees Celsius, away from direct light sources and EMI. Shelf life — up to 12 months. After opening, use within 30 days, stored with a tightly closed lid.

Vaginal Suppositories — Clinacanthus nutans

Indications (Vaginal Suppositories): Papillomavirus infection of the cervix, cervical intraepithelial neoplasia grades 1–2, chronic viral vaginitis, viral vulvitis, recurrent herpes of the external genitalia, inflammation of the vaginal mucosa of viral etiology.

Standard Dosage (Vaginal Suppositories): 1 suppository (500 mg of extract in an oil base) once daily at night, course — 10 days.

Enhanced Dosage (Vaginal Suppositories): 1 suppository twice daily (morning and evening) for 7 days for severe viral cervicopathy, in the presence of erosion with cytological atypia.

Maximum Dosage (Vaginal Suppositories): Up to 3 suppositories per day (every 8 hours) during exacerbation of herpes infection with concomitant bacterial inflammation. Duration no more than 5 days.

Preventive Dosage (Vaginal Suppositories): 1 suppository every other day for 20 days, 2 courses per year. Recommended for HPV carriage, in the post-vaccination period, for immunodeficiency, and for women with regular exacerbations of herpes infection.

Pediatric Dosage (Vaginal Suppositories): Use in children and adolescents under 18 years is not recommended due to the lack of sufficient safety data and hormonal sensitivity of the mucosa.

Contraindications (Vaginal Suppositories): Individual hypersensitivity, vaginal bleeding of undetermined etiology. No contraindications have been scientifically registered during pregnancy and lactation; however, use should be monitored by a physician.

Side Effects (Vaginal Suppositories): In rare cases — itching, burning sensation, moderate mucous discharge. Overdose may cause irritation of the vaginal mucosa.

Adjustment for Patient Body Weight (Vaginal Suppositories): No adjustment is required, as suppositories have a local effect and are not systemically distributed.

Preparation Method (Vaginal Suppositories): To prepare 100 g of suppository mass, use: 20 g of dry Clinacanthus nutans extract, 70 g of cocoa butter, 10 g of beeswax. The dry extract is mixed with cocoa butter and wax melted in a water bath at a temperature not exceeding 45 degrees Celsius. The mass is thoroughly mixed and poured into molds with a volume of 2 g. Cooled to complete solidification at +4 degrees Celsius. Packaged in foil blisters.

Storage Conditions and Shelf Life (Vaginal Suppositories): Store in a cool, dark place at a temperature of 5 to 10 degrees Celsius. Avoid exposure to direct light and sources of EMI. Shelf life — 6 months. After opening the package, use within 10 days.

Rectal Suppositories — Clinacanthus nutans

Indications (Rectal Suppositories): Herpetic proctitis, viral diarrhea, viral lesions of the rectal mucosa, herpetic invasion in immunodeficiency, herpes zoster with anorectal localization, cytomegalovirus proctitis.

Standard Dosage (Rectal Suppositories): 1 suppository (500 mg of extract) once daily at night, course — 7 days.

Enhanced Dosage (Rectal Suppositories): 1 suppository twice daily for severe herpetic lesions of the rectum, ulcerative and erosive forms, and severe pain syndrome. Duration of course — 10 days.

Maximum Dosage (Rectal Suppositories): Up to 3 suppositories per day (every 8 hours) for 5 days for acute viral proctopathies in patients with HIV infection or severe immunodeficiency.

Preventive Dosage (Rectal Suppositories): 1 suppository every other day for 14 days. Recommended for patients with a history of recurrent proctitis of viral nature, during seasonal decline in immunity, and in the postoperative period in cancer patients.

Pediatric Dosage (Rectal Suppositories): From 5 years of age and with a body weight of at least 20 kg — 1 suppository with a dose of 250 mg of extract once daily, course — 5 days. Not to be used in children under 5 years.

Contraindications (Rectal Suppositories): Hemorrhoidal bleeding, allergic reaction to components. No contraindications have been scientifically registered during pregnancy, lactation, and in children over 5 years.

Side Effects (Rectal Suppositories): Moderate burning in the anus, slight increase in stool frequency, and in rare cases — rash upon systemic absorption are possible. Registered with prolonged use exceeding recommended dosages.

Adjustment for Patient Body Weight (Rectal Suppositories): For body weight under 60 kg — use the standard dosage. For weight over 90 kg, a transition to the enhanced regimen (2 suppositories per day) is possible.

Preparation Method (Rectal Suppositories): For 100 g of suppository mass: 20 g of dry extract, 70 g of cocoa butter, 10 g of lanolin. All components are melted in a water bath at 45 degrees Celsius, thoroughly mixed, poured into molds with a volume of 2 g. Solidification — at +4 degrees Celsius. Packaging — individual blisters.

Storage Conditions and Shelf Life (Rectal Suppositories): Store at a temperature of 5 to 10 degrees Celsius, away from sources of light, heat, and electromagnetic radiation. Shelf life — 6 months. After opening the blister, use within 7 days.

Nasal Drops — Clinacanthus nutans

Indications (Nasal Drops): Viral rhinitis, herpetic rhinopharyngitis, influenza virus infection with involvement of the nasal mucosa, acute viral sinusitis, post-viral edema of the nasal mucosa, recurrent herpesvirus infections of the ENT area.

Standard Dosage (Nasal Drops): 2 drops into each nostril 3 times daily, course — 5–7 days.

Enhanced Dosage (Nasal Drops): 3 drops into each nostril up to 5 times daily for acute forms of viral rhinosinusitis, influenza with pronounced nasal symptoms, and herpetic lesions of the nasal septum. Duration — 7–10 days.

Maximum Dosage (Nasal Drops): 4 drops 6 times daily for no more than 3 consecutive days for viral rhino-septic load, high viral replication, and systemic intoxication.

Preventive Dosage (Nasal Drops): 1 drop into each nostril once daily in the morning for 10 days. Recommended during flu and ARVI outbreaks, for patients with chronic herpesvirus infections, and for people working in groups.

Pediatric Dosage (Nasal Drops): From 3 years: 1 drop into each nostril twice daily for viral rhinitis. From 6 years — 2 drops twice daily. Not recommended for children under 3 years.

Contraindications (Nasal Drops): Individual intolerance to components. No contraindications have been scientifically registered during pregnancy, lactation, and use in children over 3 years.

Side Effects (Nasal Drops): Rarely — burning sensation in the nose, slight sneezing, or redness of the mucosa. Side effects have been recorded when exceeding 6 doses per day for more than 3 days.

Adjustment for Patient Body Weight (Nasal Drops): Not required, as the drug is applied locally and dosed by drops.

Preparation Method (Nasal Drops): For 100 ml of solution: 5 g of dry Clinacanthus nutans extract are dissolved in 95 ml of sterile water with the addition of 0.5 g of sea salt and 0.3 g of natural glycerin. The mixture is filtered through a 0.22-micron membrane filter and dispensed into sterile dropper bottles. The solution is prepared under aseptic conditions.

Storage Conditions and Shelf Life (Nasal Drops): Store at a temperature of 5 to 8 degrees Celsius in a dark place, without access to light and electromagnetic radiation. Shelf life — 30 days. After opening the bottle, use within 7 days.

Ear Drops — Clinacanthus nutans

Indications (Ear Drops): Herpetic external otitis, viral eustachitis, viral otitis media in the catarrhal stage, recurrent herpetic infection of the auricle, viral itching of the ear canal, postoperative viral infection of the auditory canal.

Standard Dosage (Ear Drops): 3 drops into the external auditory canal twice daily, course — 5 days.

Enhanced Dosage (Ear Drops): 4 drops three times daily for pronounced inflammation of the auricle, itching, and presence of herpetic vesicles. Duration of course — up to 7 days.

Maximum Dosage (Ear Drops): 5 drops up to 4 times daily, but no more than 3 days, for severe herpetic external otitis with concomitant viral involvement of the facial nerve (initial stages).

Preventive Dosage (Ear Drops): 2 drops once daily at night for 5 days after swimming in public waters or contact with patients with viral otitis. Recommended for patients with chronic recurrences of herpes of the auditory canal.

Pediatric Dosage (Ear Drops): From 4 years — 1 drop twice daily for initial manifestations of viral otitis. Not to be used in children under 4 years without medical supervision.

Contraindications (Ear Drops): Perforation of the eardrum, individual sensitivity. Data on contraindications during pregnancy, lactation, and in children over 4 years have not been scientifically registered.

Side Effects (Ear Drops): Burning sensation and short-term hearing loss due to the oil base are possible. In case of overdose — local edema. Registered when using more than 5 drops 4 times daily.

Adjustment for Patient Body Weight (Ear Drops): No adjustment is required, as the drug is applied locally in a limited dosage.

Preparation Method (Ear Drops): For 100 ml of solution: 10 g of dry Clinacanthus nutans extract are poured with 90 ml of heated organic olive oil. The mixture is kept in a water bath at 40 degrees Celsius for 2 hours, then filtered through a cotton filter. The solution is dispensed into sterile dropper bottles.

Storage Conditions and Shelf Life (Ear Drops): Store at a temperature of 5 to 15 degrees Celsius in a dark place, away from sources of heat and electromagnetic radiation. Shelf life — 3 months. After opening the package, use within 10 days.

Topical Cream — Clinacanthus nutans

Indications (Topical Cream): Herpetic rash, viral vulvitis, viral stomatitis (external application to the corners of the lips), skin manifestations of papillomavirus infection, chickenpox eruptions, herpetic dermatitis.

Standard Dosage (Topical Cream): Apply in a thin layer twice daily to cleansed skin, avoiding contact with eyes. Course — 5–7 days.

Enhanced Dosage (Topical Cream): Up to 3 times daily for acute inflammatory and vesicular forms. Duration — up to 10 days.

Maximum Dosage (Topical Cream): Up to 4 applications per day on limited skin areas, not more than 15% of total body surface, for 3 days.

Preventive Dosage (Topical Cream): Apply once daily during the recurrence season (spring, autumn) to the recurrence zone (lips, nose, genitals) for 5–7 days. Repeat — after 3 weeks.

Pediatric Dosage (Topical Cream): From 2 years — once daily on a limited skin area (no more than 2×2 cm). Do not apply under dressings.

Contraindications (Topical Cream): Individual allergic reaction. No scientifically registered contraindications during pregnancy, lactation, and in children from 2 years of age for external use.

Side Effects (Topical Cream): Rarely — burning, peeling, contact dermatitis with prolonged use. Recorded with 4 or more applications per day.

Adjustment for Patient Body Weight (Topical Cream): Not required.

Preparation Method (Topical Cream): For 100 g of cream: 10 g of dry Clinacanthus nutans extract, 80 g of organic coconut oil, 10 g of beeswax. All components are melted at 45 degrees Celsius, mixed to a homogeneous mass, and cooled with constant stirring. Dispensed into airtight opaque glass jars.

Storage Conditions and Shelf Life (Topical Cream): Store at a temperature of 8–15 degrees Celsius, away from sources of light and heat. Shelf life — up to 6 months. After opening — use within 30 days.

Glycerin Lotion for the Oral Cavity — Clinacanthus nutans

Indications (Glycerin Lotion): Herpetic stomatitis, viral glossitis, viral leukoplakia of the buccal and tongue mucosa, post-radiation and post-chemotherapy mucositis, viral ulcers in the oral cavity in HIV infection.

Standard Dosage (Glycerin Lotion): Rinse the mouth with 5 ml of undiluted lotion 3 times daily after meals. Do not swallow. Course — 5–7 days.

Enhanced Dosage (Glycerin Lotion): Rinse with 5 ml 4–5 times daily for extensive herpetic ulcers, mucosal pain, and grade 2–3 mucositis. Duration — up to 10 days.

Maximum Dosage (Glycerin Lotion): Up to 7 rinses per day with 7 ml per procedure. No more than 3 consecutive days. Indicated for severe viral mucositis or intense viral leukoplakia.

Preventive Dosage (Glycerin Lotion): Rinse once daily with 5 ml for 7 days. Recommended in preparation for chemotherapy, for recurrent herpes of the oral mucosa, and for denture wearers.

Pediatric Dosage (Glycerin Lotion): From 5 years: 2 ml twice daily. Children under 5 years — not to be used due to the risk of swallowing.

Contraindications (Glycerin Lotion): Individual sensitivity. No contraindications have been scientifically registered during pregnancy, lactation, and in children over 5 years.

Side Effects (Glycerin Lotion): Rarely — a feeling of dryness, irritation, metallic taste. Noted with excessive use (more than 30 ml per day).

Adjustment for Patient Body Weight (Glycerin Lotion): Not required.

Preparation Method (Glycerin Lotion): For 100 ml of lotion: 5 g of dry Clinacanthus nutans extract are dissolved in 90 g of vegetable glycerin, and 5 g of infused water with honey (1:1) are added. The mixture is stirred, kept for 24 hours at 8–10 degrees Celsius, and filtered. Dispensed into bottles with measuring caps.

Storage Conditions and Shelf Life (Glycerin Lotion): Store in a protected from light place at a temperature of 8 to 15 degrees Celsius. Shelf life — up to 6 months. After opening, use within 20 days.

Paste (Application) — Clinacanthus nutans

Indications (Paste): Herpetic eruptions on the lips and chin, localized cutaneous forms of papillomavirus infection, chickenpox pustules, viral dermatitis with vesicular elements, postherpetic hyperpigmentation, viral skin ulcers.

Standard Dosage (Paste): Apply a thick layer to the lesion site twice daily, leave for at least 20 minutes, then gently rinse with water without soap. Course — 5 days.

Enhanced Dosage (Paste): Applications 3 times daily for active vesicular and ulcerative manifestations and for superimposed secondary infection. Duration — 7 days.

Maximum Dosage (Paste): Up to 4 applications per day, no more than 3 consecutive days, for acute pain or edematous components. Application to an area no larger than 5×5 cm.

Preventive Dosage (Paste): 1 application once daily for 3 days to the recurrence zone (e.g., lips) at the first subjective signs (tingling, itching). Repeat course — after one month.

Pediatric Dosage (Paste): From 4 years — 1 application per day, no more than 15 minutes, on limited areas. In children under 4 years — not to be used without medical supervision.

Contraindications (Paste): Pustular eruptions, open wounds. Data on contraindications during pregnancy, lactation, and in children over 4 years have not been scientifically registered.

Side Effects (Paste): Local irritation, short-term burning, peeling. Registered when used on sensitive skin and when the paste is left on for more than 40 minutes.

Adjustment for Patient Body Weight (Paste): Not required — the form is exclusively external and applied locally.

Preparation Method (Paste): For 100 g: 15 g of powder from dry Clinacanthus nutans leaves, 60 g of white cosmetic clay, 15 g of acacia honey, 10 g of chamomile infusion. The components are thoroughly mixed to a homogeneous mass in a ceramic bowl and stored in an airtight container. Use the paste only with a wooden or plastic spatula.

Storage Conditions and Shelf Life (Paste): Store at a temperature of 5 to 10 degrees Celsius, in a light-protected container. Shelf life — 30 days. After opening — use within 10 days, avoid contact with metal.

Essential Oil Balm — Clinacanthus nutans

Indications (Essential Oil Balm): Herpetic pain, viral myalgia, local edema in viral intoxication, recurrent herpetic rash in the nose and lip area, neurodermatitis with a viral component, chickenpox itching, postherpetic neuralgia.

Standard Dosage (Essential Oil Balm): Apply the balm to clean skin in the affected area twice daily with gentle rubbing movements. Course — 7 days.

Enhanced Dosage (Essential Oil Balm): Apply up to 4 times daily for pronounced skin discomfort, localized herpetic pain, or edema. Duration — up to 10 days.

Maximum Dosage (Essential Oil Balm): Up to 5 applications per day on an area no larger than 10×10 cm. No more than 3 consecutive days for intensive postherpetic neuralgia.

Preventive Dosage (Essential Oil Balm): Apply once daily to the area of probable recurrence during hypothermia, stress, or during the season of viral activity. Duration — 5 days with the possibility of repetition after one month.

Pediatric Dosage (Essential Oil Balm): From 5 years — 1 application per day to the area of discomfort, no more than 3×3 cm. In children under 5 years, not to be used without medical supervision.

Contraindications (Essential Oil Balm): Individual intolerance to essential oils, open wounds, exudative forms of dermatitis. No contraindications have been scientifically registered during pregnancy, lactation, and in children over 5 years for external use.

Side Effects (Essential Oil Balm): Rarely — tingling sensation, skin hyperemia, contact dermatitis with repeated use. Registered when applied to wet skin or under a dressing.

Adjustment for Patient Body Weight (Essential Oil Balm): Not required; the form is intended only for external use.

Preparation Method (Essential Oil Balm): For 100 g: 15 g of dry Clinacanthus nutans extract, 70 g of jojoba oil, 5 g of tea tree essential oil, 5 g of lavender essential oil, 5 g of beeswax. Jojoba oil and wax are melted in a water bath (not exceeding 45 degrees Celsius), then the dry extract and essential oils are added. Everything is mixed until homogeneous and cooled in a glass jar until solidified.

Storage Conditions and Shelf Life (Essential Oil Balm): Store in a dark glass jar at a temperature of 5 to 15 degrees Celsius, away from light, heat, and sources of EMI. Shelf life — up to 6 months. After opening, use within 20 days.

Toxicity and Biosafety of Clinacanthus nutans

Experimental and clinical data confirm a high biosafety profile of Clinacanthus nutans. In an acute toxicological study with oral administration of the aqueous extract of the plant to laboratory mice and rats, no fatalities or significant behavioral, hematological, or biochemical disturbances were recorded at doses up to 5000 mg/kg body weight. This allows the drug to be classified as practically non-toxic (LD₅₀ > 5000 mg/kg).

In 28-day subacute toxicity tests, no signs of hepato- or nephrotoxicity were observed with daily use at doses up to 2000 mg/kg. No teratogenic, mutagenic, or carcinogenic effects were detected. With topical application (external forms, including ointments and pastes), no skin sensitization was recorded, which confirms safety in dermatological prescriptions.

Thus, Clinacanthus nutans can be considered a phytotherapeutic agent with an extremely low risk of toxic effects when therapeutic dosages are observed.

Reference: Acute and subchronic toxicity study of Clinacanthus nutans aqueous extract in rodents. BMC Complementary and Alternative Medicine (2013), PMID: 24171765.

Pharmacodynamics of Clinacanthus nutans

Clinacanthus nutans exhibits pronounced biological activity at systemic and local levels. The main pharmacodynamic effects of the plant are realized through flavonoids (vitexin, isoorientin), chlorophylls, steroidal compounds, and tricyclic lignans. The most pronounced action is observed in the immune, skin, and mucosal systems. The drug has an inhibitory effect on the production of pro-inflammatory cytokines such as TNF-α, IL-1β, IL-6, and IL-8, and also reduces the expression of prostaglandins by suppressing cyclooxygenase-2 (COX-2) activity. In the immune system, Clinacanthus nutans activates the antiviral response through modulation of the JAK/STAT cascade and increased production of IFN-γ. With external use, anti-edema, antihistamine, and reparative effects are observed. In the nervous system, an indirect sedative effect is possible through suppression of neurogenic inflammation. In the mucosa of the gastrointestinal tract and urogenital tract, local antimicrobial, protective, and healing effects are manifested. Data also indicate membrane-stabilizing properties, antioxidant activity, and normalization of microcirculation at the level of the vascular endothelium.

Reference: https://pubmed.ncbi.nlm.nih.go... https://www.sciencedirect.com/...

Pharmacokinetics of Clinacanthus nutans

The pharmacokinetics of Clinacanthus nutans depends on the dosage form and route of administration. With oral administration of aqueous and alcoholic extracts, the main biologically active compounds — flavonoids, terpenoids, and chlorophylls — are absorbed in the proximal parts of the small intestine. During the distribution phase, active metabolites bind to plasma albumins and can reach high concentrations in tissues with active vascularization, including skin, mucous membranes, and lymphoid organs. Metabolism occurs primarily in the liver with the participation of phase I enzymes (including CYP3A4) and glucuronidation enzymes. The intestinal microbiota also plays an important role in the biotransformation of glycosides. Excretion occurs via the kidneys (urine) and bile, and with external application — through the skin and sebaceous glands. Transdermal forms are characterized by slow entry of active compounds into the bloodstream and prolonged action. With sublingual and rectal administration, absorption bypasses first-pass hepatic metabolism, which may enhance biological activity.

Reference: https://www.sciencedirect.com/... https://link.springer.com/arti...

Mechanisms of Action and Scientific Rationale — Clinacanthus nutans

The biological activity of Clinacanthus nutans is due to multi-level interaction with key cellular and molecular targets. At the level of receptor systems, involvement in the regulation of interferon-γ, TNF-α, and IL-6 expression through the activation of JAK/STAT and NF-κB cascades has been established. The antioxidant effect is realized through the neutralization of reactive oxygen species (ROS) and stabilization of lysosomal membranes. In an inflammation model, a reduction in COX-2 and LOX activity has been confirmed, which indicates blockade of the synthesis of pro-inflammatory mediators. At the cellular level, a decrease in the proliferation of virus-infected epithelial cells, inhibition of viral capsid assembly, and suppression of viral RNA polymerase are noted. It has been shown that active flavonoids and sterols modulate the expression of genes regulating apoptosis, cell migration, and repair. The effect on the histaminergic system is realized through competition with H1 receptors. The antimicrobial activity is associated with disruption of microbial membrane integrity and inhibition of biofilm formation.

Reference: 
https://www.ncbi.nlm.nih.gov/p...
https://www.tandfonline.com/do...
https://pubchem.ncbi.nlm.nih.g...

Synergy — Clinacanthus nutans

In vitro and in vivo studies demonstrate synergistic interaction between the extract of Clinacanthus nutans and other plant substances with anti-inflammatory and antiviral effects. The most pronounced synergy is observed when combined with Andrographis paniculata and Curcuma longa — suppression of cytokine IL-6 and TNF-α expression is potentiated, inhibition of COX-2 activity is enhanced, and antioxidant tissue protection is increased. When combined with flavonoid-containing extracts, enhanced protection of cellular DNA from oxidative damage has been noted. Combination with saponins (e.g., from Panax ginseng) demonstrates modulation of the humoral immune system and increased interferon activity, which enhances systemic antiviral action.

Reference:
https://pubmed.ncbi.nlm.nih.go...
https://www.sciencedirect.com/...
https://www.ncbi.nlm.nih.gov/p...

Geography of Use and Traditional Medicine — Clinacanthus nutans

Clinacanthus nutans is traditionally used in the folk and ritual medicine of Southeast Asia, especially widely in Thailand, Laos, Vietnam, Malaysia, and Indonesia. In the ethnobotanical systems of northern and northeastern Thailand, it is known under the name "Phaya-yo" and belongs to the plants officially recognized by the national medicine of Thailand. In Thai traditional medicine, Clinacanthus nutans leaves were used in the form of freshly squeezed juice, compresses, and decoctions for various "internal heats," as a remedy for cooling the body, cleansing the skin, and relieving inflammation. Uses included applying crushed leaves to inflamed areas of the body, insect and snake bites, as well as local rubbing for skin irritations. The plant was of particular importance in therapy associated with "disruption of the internal energy of wind," according to the doctrines of Thai and Lao medicine.

In the cultures of the Malay Archipelago, the plant is known as "Belalai gajah" and was considered "protective against evil" — in folk practice it was used in ablutions to cleanse the home and body of "evil energy" and "unjust illness." In Indonesia, the use of leaves in smoking mixtures used by shamans in rituals of exorcising disease and returning the spirit has been recorded. Among some Dayak tribes of Kalimantan, fresh leaves were considered "dispersing the spirit of pain" and were used in wraps during night rituals. In rural medicine of Cambodia, the plant was used as a dressing for burns and abrasions, and in northern Vietnam it was used as part of steam inhalations for malaise.

According to archaeoethnobotanical data, references to the use of a plant presumably identified as C. nutans are found in Thai manuscripts of the 19th century, kept in monasteries of Lampang province. It was called "snake grass" and was used in the practices of folk healers (mo) as a remedy that "draws out poison" and "restores the evenness of the skin." In the mythological texts of the Isan peoples, the plant is mentioned as one of the four protective leaves used to protect against "sent skin ulcers."

Non-medical use is also found in ritual practice: in the provinces of Sisaket and Surin (Thailand), the plant was placed under the pillow of a sick child, believing that its aroma "cleanses dreams" and "carries away the heat from the head." In certain ethnic groups of northern Laos, the leaves of the plant were woven into amulets for pregnant women, which was supposed to protect them from the "spirit of disease" wandering in the forest.

Thus, Clinacanthus nutans occupies a stable place in ethnomedical and ritual practices of Southeast Asia, combining local herbal healing traditions, magical protection, and therapeutic manipulations aimed at restoring the balance of the body and energy.