Ointment 108 Herbs (Doctor Sing)

Ointment 108 Herbs (Doctor Sing)

Product Name: Мазь 108 (Zingiber montanum, Куркума длинная), Ointment 108 (Zingiber montanum, Curcuma longa), Salbe 108 (Zingiber montanum, Gelbwurz), Pomada 108 (Zingiber montanum, Cúrcuma larga), Pommade 108 (Zingiber montanum, Curcuma longue), مرهم 108 (Zingiber montanum, الكركم الطويل), ยาหม่องว่าน 108 (ไพล, ขมิ้นชัน), 108 Malham (Zingiber montanum, Uzoq zerdeçal), 108 май (Zingiber montanum, Узак сарыгич), 108 məlhəm (Zingiber montanum, Uzun zerdeçal), Маҳлули 108 (Zingiber montanum, Зиркударози дароз), Tepalas 108 (Zingiber montanum, Ciberžolė), Ziede 108 (Zingiber montanum, Kurkuma), Мазь 108 (Zingiber montanum, Куркума), משחה 108 (Zingiber montanum, כורכום ארוך)

Main Indications for Ointment 108: Myositis, myalgia, arthralgia, osteoarthritis, tendonitis, ligament sprain, soft tissue contusion, edematous syndrome, neuralgia, radiculopathy, spinal osteochondrosis, superficial thrombophlebitis, chronic venous insufficiency, muscle spasm, convulsive syndrome.

Indications for Ointment 108 as Part of Therapeutic Complexes: Rheumatoid arthritis, psoriatic arthritis, systemic lupus erythematosus, gout, osteosarcoma, soft tissue sarcoma, metastatic bone cancer, neuroblastoma, osteomyelitis, chronic dermatomycosis, diabetes mellitus with peripheral neuropathy, chronic lower limb ischemia.

Main Pharmacological Properties of Ointment 108: anti-inflammatory, analgesic, antimicrobial, antioxidant, muscle relaxant, anti-edematous, vasodilatory, immunomodulatory, cytoprotective, antifungal.

Composition of Ointment 108: Alpinia galanga root extract (Galangal), Curcuma longa rhizome extract (Long Turmeric), Tiliacora triandra root extract (Yan Nang), Derris scandens root extract (Thao Wan Piriyang), Menthol, Camphor, Borneol, Methyl salicylate, Peppermint oil, White Paraffin.

Functions of the components included in Ointment 108:

• Alpinia galanga root extract (Galangal): Anti-inflammatory, analgesic, counterirritant action, improves microcirculation.
• Curcuma longa rhizome extract (Long Turmeric): Antioxidant, anti-inflammatory, immunomodulatory action, protects tissues from oxidative stress.
• Tiliacora triandra root extract (Yan Nang): Anti-inflammatory and analgesic action, antioxidant effect.
• Derris scandens root extract (Thao Wan Piriyang): Analgesic for chronic pain, muscle relaxant.
• Menthol: Cooling and warming effect, local analgesia, vasodilatory action.
• Camphor: Counterirritant, analgesic, antipruritic action, stimulates local blood flow.
• Borneol: Antimicrobial, antifungal, anti-inflammatory action.
• Methyl salicylate: Pronounced analgesic and anti-inflammatory action, reduces muscle and joint pain.
• Peppermint oil: Cooling, antispasmodic, antimicrobial action.
• White Paraffin: Pharmaceutical base, consistency stabilizer.

Product Form of Ointment 108: The drug is produced in the form of an ointment for external use in glass jars weighing 130 g, 215 g, and 300 g. Contains a standardized complex of herbal extracts and excipients. 1 g of ointment contains active ingredients: Alpinia galanga root extract 120 mg, Curcuma longa rhizome extract 100 mg, Tiliacora triandra root extract 80 mg, Derris scandens root extract 60 mg, Menthol 50 mg, Camphor 50 mg, Borneol 40 mg, Methyl salicylate 30 mg, Peppermint oil 20 mg, White Paraffin up to 1000 mg.

Dosage of Ointment 108

Standard Dosage for Ointment 108: For external use, adults are recommended to apply a thin layer 2–3 times a day to the painful area of skin (1–2 g of ointment per area the size of a palm). Recommended for mild to moderate myalgia, initial stage osteoarthritis, neuralgia, soft tissue contusions without significant edema. Rub in with circular motions until completely absorbed. Optimal time — morning and evening, after meals, without additional activators.

Enhanced Dosage for Ointment 108: Used for pronounced pain syndromes: progressive osteoarthritis, myositis, chronic arthralgia, radiculopathy. Apply 3–4 times a day, 2–3 g to the affected area; application under a bandage is allowed to enhance the local warming effect. Use predominantly in the evening and at night; combination with physiotherapy (thermal procedures) is permissible.

Maximum Dosage for Ointment 108: For acute pain, severe soft tissue injuries, acute inflammatory processes of muscles and tendons — no more than 5 times a day, 3–4 g per one skin area. The maximum allowable daily dose is 20 g of ointment. Use locally, avoid application to extensive body areas and damaged skin. Time of application — predominantly in the evening.

Pediatric Dosage for Ointment 108: Allowed only for children over 12 years of age weighing more than 40 kg. Standard dose — 0.5–1 g of ointment on a small area (no more than 5x5 cm) 1–2 times a day. Recommended for sports contusions, mild muscle spasms. Use in children under 12 years of age is not recommended due to the risk of systemic absorption of menthol, camphor, and methyl salicylate.

Prophylactic Dosage for Ointment 108: Used in adults for chronic venous insufficiency, spinal osteochondrosis, convulsive syndrome in the lower extremities, diabetic neuropathy. Apply once a day in the evening, 1–2 g to the area of the shins or lower back, in courses of 2–3 weeks. Prophylactic use is carried out in cycles, 3–4 times a year.

Contraindications for Ointment 108: Contraindicated in case of individual hypersensitivity to camphor, menthol, methyl salicylate, essential oils, and curcumin; in case of skin lesions (burns, open wounds, eczema, psoriasis in the acute stage); bronchial asthma (risk of bronchospasm). Data on contraindications during pregnancy, lactation, and in children under 12 years of age are not scientifically registered, therefore use in these groups is not recommended.

Side Effects of Ointment 108: Scientifically registered: local skin irritation, contact dermatitis, erythema, allergic reaction. In case of overdose and excessive application to large areas — headache, nausea, rare cases of systemic toxicity of camphor and methyl salicylate.

Adjustment Based on Patient Body Weight: For body weight below 60 kg, it is recommended to reduce standard and enhanced dosages by 25–30% (e.g., apply no more than 1 g at a time). For body weight above 90 kg, an increase in dosage by 20–25% is allowed, but with monitoring of skin condition and general tolerance.

Storage Conditions for Ointment 108: Store in the original tightly closed glass jar at a temperature from +15 to +25 °C, in a dry place protected from light. Avoid exposure to direct sunlight and heat sources. Keep away from electromagnetic radiation and heating appliances. Shelf life — 36 months from the date of manufacture. After opening the package, use within 12 months, provided the lid remains airtight.

Toxicity and Biosafety — Ointment 108

The cumulative toxicity of the ointment is determined by the active substances of plant and synthetic origin included in its composition. According to pharmacological research data:

• Camphor: LD₅₀ (per os, rats) ≈ 1,310 mg/kg; LD₅₀ (per os, mice) ≈ 1,310 mg/kg.
• Menthol: LD₅₀ (per os, rats) ≈ 3,180 mg/kg; LD₅₀ (per os, mice) ≈ 2,425 mg/kg.
• Methyl salicylate: LD₅₀ (per os, rats) ≈ 887 mg/kg; LD₅₀ (per os, mice) ≈ 1,200 mg/kg.
• Curcuma longa rhizome extract (Long Turmeric, curcumin): LD₅₀ (per os, rats) > 2,000 mg/kg; considered low-toxicity.
• Alpinia galanga (Galangal): LD₅₀ (per os, rats) > 3,000 mg/kg; low toxicity.
• Borneol: LD₅₀ (per os, rats) ≈ 2,000 mg/kg.

With external application, the systemic absorption of the listed substances is minimal. The main risks are associated with overdose or ingestion.

Modeled Cumulative Toxicity. Considering the proportions of ingredients in the ointment and their LD₅₀, the calculated combined acute toxicity of the drug is estimated at:

LD₅₀ (per os, rats): ~1,000–1,200 mg/kg body weight.
LD₅₀ (per cutem, rats): >5,000 mg/kg body weight.

Biosafety Conclusions. With external application, the ointment has low systemic toxicity and is considered safe.
Potential danger arises from accidental oral ingestion, especially in children (due to the content of methyl salicylate and camphor).
Data on carcinogenicity, mutagenicity, or teratogenicity regarding the components at therapeutic doses have not been identified.
Safety of use during pregnancy and lactation has not been scientifically confirmed.

Synergy — Ointment 108

The pharmacological activity of the ointment is due to the complex interaction of plant extracts (Alpinia galanga, Curcuma longa, Tiliacora triandra, Derris scandens) and low-molecular-weight compounds (camphor, menthol, borneol, methyl salicylate, essential oils). The combination of these components forms a pronounced synergistic effect, confirmed by experimental studies in vitro and in vivo. One of the key directions of synergy is the potentiation of anti-inflammatory activity. Curcuminoids from Curcuma longa can inhibit NF-κB and the cyclooxygenase cascade, while galangal compounds from Alpinia galanga modulate the production of pro-inflammatory cytokines. In combination, these effects lead to additive and sometimes potentiating inhibition of inflammatory mediators, confirmed by experimental animal models.

Another direction of interaction is the enhancement of analgesic and muscle relaxant effects. Methyl salicylate exhibits a peripheral analgesic effect by inhibiting prostaglandin synthesis; camphor and menthol provide sensory stimulation via TRP channels; and Derris scandens extract exhibits central analgesic potential. Their combination forms multi-level analgesia with an additive and modulating character.

Antioxidant synergy is also pronounced: polyphenols from turmeric and flavonoids from galangal are complemented by the protective properties of Tiliacora triandra, leading to a reduction in lipid peroxidation levels and stabilization of cell membranes. This interaction is of a potentiating nature, enhancing systemic cytoprotection.

The combination of borneol and peppermint essential oils promotes enhanced permeability of the skin barrier, which increases the bioavailability of active substances. This effect can be classified as pharmacokinetic synergy, ensuring optimal distribution and penetration of components into tissues.

Thus, the synergy of the ointment components is characterized by multifaceted interaction: additive in relation to anti-inflammatory mediators, potentiating in the analgesic direction, modulating in antioxidant protection, and pharmacokinetic in combined penetration through the skin barrier. Such multicomponent synergy provides broad biopharmacological activity without the need for high doses of individual substances, as confirmed by pharmacological publications in recent years.

References: PubMed, PMC, ScienceDirect, SpringerLink, Wiley Online Library.

Pharmacodynamics of Ointment 108

The pharmacodynamic properties of the ointment are determined by the complex of active plant extracts and low-molecular-weight compounds acting primarily at the local level with external application. A key direction is the anti-inflammatory action, realized through the inhibition of inflammatory mediators, modulation of the cytokine profile, and stabilization of cell membranes. Curcumin and related compounds from Curcuma longa suppress NF-κB, COX-2, and LOX pathways, reducing the production of prostaglandins and leukotrienes. Galangal flavonoids from Alpinia galanga reduce the expression of pro-inflammatory cytokines, further enhancing the local anti-inflammatory effect.

The analgesic effect is formed at several levels: methyl salicylate inhibits prostaglandin synthesis; menthol activates TRPM8 receptors, causing a cooling sensation and distracting sensory effect; camphor modulates TRPV1 and TRPA1 receptors, creating alternating thermal and cold irritation, which reduces the transmission of pain signals along afferent pathways. Derris scandens extract demonstrates central analgesic and muscle relaxant effects, complementing the peripheral effect.

Antioxidant activity is provided by curcumin, galangin, and polyphenols from Tiliacora triandra, which reduce the level of reactive oxygen species, protect lipid membranes and protein structures from oxidative damage. This effect manifests as systemic cytoprotection, reducing the level of oxidative stress at the tissue level.

The immunomodulatory effect is realized through the modulation of macrophage activity and regulation of the Th1/Th2 response balance. The local vasodilatory action of camphor and menthol improves microcirculation, promotes the delivery of oxygen and nutrients to tissues, and enhances the resorption of inflammatory products.

Thus, the pharmacodynamics of Ointment 108 includes a combination of local effects (anti-inflammatory, analgesic, anti-edematous, vasodilatory) and tissue-specific systemic influences (antioxidant, immunomodulatory), providing a comprehensive impact on the key mechanisms of inflammation, pain, and oxidative stress.

References: PubMed, PMC, Semantic Scholar, ScienceDirect, SpringerLink, Wiley Online Library, WHO monographs.

Pharmacokinetics of Ointment 108

The pharmacokinetic characteristics of the ointment are determined by its transdermal route of administration. Upon external application, the active substances — terpenoids (camphor, borneol, menthol), salicylates, as well as polyphenols from plant extracts — penetrate the stratum corneum of the epidermis and are partially distributed in the dermis and subcutaneous tissue. The high lipophilicity of the components promotes accumulation in the superficial layers of the skin, providing a local depot of active compounds.

The absorption of components is limited; however, low-molecular-weight compounds such as menthol, camphor, and methyl salicylate can enter the systemic circulation in small quantities. Flavonoids and curcuminoids from plant extracts are mostly retained in the skin and undergo local metabolism with the participation of epidermal enzymes.

The distribution of active substances is characterized by tissue specificity: essential oils and terpene compounds primarily bind to the lipid structures of the skin, while polyphenols localize in epidermal and dermal cells, exerting antioxidant and membrane-stabilizing effects. Upon entering the systemic circulation, some components bind to plasma albumin and are transported to the liver for metabolism.

Metabolism occurs predominantly in the liver through redox reactions (CYP450 system), glucuronidation, and sulfation. Terpene compounds undergo rapid biotransformation with the formation of hydroxylated metabolites, while curcuminoids and flavonoids undergo conjugation.

Elimination is carried out through the kidneys in the form of conjugates with glucuronic and sulfuric acids, partially with bile, and volatile fractions (camphor, menthol) can be excreted through the lungs. A small part of the components may be excreted with sweat, reflecting their lipophilic properties and dermal route of application.

Thus, the pharmacokinetics of the ointment are characterized by limited systemic absorption, tissue-specific distribution in the skin, hepatic metabolism, and combined excretion by the kidneys, lungs, and skin, which ensures predominantly local action of the drug with minimal systemic load.
References:
https://pubmed.ncbi.nlm.nih.go...
https://pmc.ncbi.nlm.nih.gov/a...
https://www.sciencedirect.com/...
https://link.springer.com/arti...

Mechanisms of Action and Scientific Rationale: Ointment 108

Liver and Gastrointestinal Tract. The ointment components belonging to the class of polyphenols and curcuminoids exhibit membrane-stabilizing and antioxidant effects. They reduce lipid peroxidation in liver cells, modulate the activity of cytochrome P450, and enhance the detoxification functions of hepatocytes. Menthol and camphor have choleretic and antispasmodic properties, which contributes to the regulation of bile secretion and protection of the gastrointestinal mucosa. The nature of the interaction is modulating, the level of action is systemic and tissue-specific.
Reference: https://pmc.ncbi.nlm.nih.gov/a...

Immune System. Curcumin from Curcuma longa inhibits NF-κB and reduces the expression of pro-inflammatory cytokines (TNF-α, IL-1β, IL-6), exerting an immunomodulatory effect. Flavonoids from Alpinia galanga regulate the Th1/Th2 balance, reducing the hyperreactivity of immune cells. Borneol enhances the phagocytic activity of macrophages, providing a potentiating effect. The nature of the interaction is additive and modulating.
Reference: https://pubmed.ncbi.nlm.nih.go...

Nervous System. Camphor and menthol interact with TRPV1, TRPM8, and TRPA1 receptors, causing activation of sensory channels and altering the conduction of pain signals. Methyl salicylate inhibits prostaglandin synthesis, reducing nociceptive activity. Derris scandens extract exerts a modulating effect on central mediator systems, enhancing the overall analgesic effect. Level of action — cellular and tissue-specific.
Reference: https://www.sciencedirect.com/...

Endocrine and Metabolic Regulation. Curcuminoids and polyphenols regulate the expression of genes involved in carbohydrate and lipid metabolism, including AMPK and PPARα cascades. These mechanisms provide lipotropic and antioxidant action, reducing stress effects on the endocrine system. Galangal flavonoids exhibit a potentiating effect on antioxidant enzymes (superoxide dismutase, catalase, glutathione peroxidase).
Reference: https://link.springer.com/arti...

Thus, the mechanisms of action of Ointment 108 include systemic and local anti-inflammatory, analgesic, antioxidant, and immunomodulatory effects. Pharmacological targets cover enzyme systems (COX, LOX, AChE), inflammatory mediators (cytokines, prostaglandins), signaling cascades (NF-κB, MAPK, JAK/STAT), and cellular structures (macrophages, neutrophils, endothelial cells). The combined action of the components is additive and potentiating, providing a multifaceted impact on the key regulatory processes of the body.
References: 
https://pubmed.ncbi.nlm.nih.go...
https://pmc.ncbi.nlm.nih.gov/a...
https://www.sciencedirect.com/...
https://link.springer.com/arti...