Alchemilla vulgaris (Common Lady's Mantle)

Alchemilla vulgaris (Common Lady's Mantle)

Product Name: манжетка обыкновенная, Alchemilla vulgaris, Gewöhnlicher Frauenmantel, Manto de dama común, Alchémille commune, كمالية عادية, หญ้าฝรั่นตัวเมีย

Synonyms: манжетка, женская мантия, травка от женских болезней, alchemilla, common lady’s mantle, Frauenmantelkraut, hierba del manto de dama, herbe des femmes, عباءة السيدة, หญ้าฝรั่นตัวเมีย

Parts Used: leaves, herb, flowers.

Main Indications for Use of Alchemilla vulgaris: Dysfunctional uterine bleeding, hyperestrogenism, premenstrual syndrome, algodysmenorrhea, anovulatory infertility, cystitis, urethritis, bacterial vaginosis, varicose veins of the lower extremities, trophic ulcers, collagenoses, chronic gastritis with reduced secretion, functional diarrhea, gastric ulcer, inflammatory bowel diseases, gingivitis, periodontosis, chronic tonsillitis, acne, seborrheic dermatitis, atopic dermatitis.

Use of Alchemilla vulgaris in mixtures and complexes: Fibrocystic mastopathy, chronic endometritis, polycystic ovary syndrome, infertility of mixed origin, iron deficiency anemia, gout, rheumatoid arthritis, chronic pancreatitis, biliary dyskinesia, uterine hypotonia in the postpartum period, chronic bronchitis, pyelonephritis, cystopyelitis, obesity, dyslipidemia.

Pharmacological Properties of Alchemilla vulgaris: astringent, anti-inflammatory, hemostatic, antiseptic, phytoestrogenic, antioxidant, capillary-protective, vascular-strengthening, analgesic, healing, gastroprotective, immunostimulating, diuretic, antifungal, antibacterial, anticarcinogenic, mucolytic, antihistamine.

Dosage of Pharmaceutical Forms — Alchemilla vulgaris

Powder — Alchemilla vulgaris

Indications (Powder): Dysfunctional uterine bleeding, hyperestrogenism, premenstrual syndrome, algodysmenorrhea, varicose veins, chronic gastritis with reduced secretion, gastric ulcer, acne, seborrheic dermatitis, periodontosis, gingivitis.

Standard Dosage (Powder): 1 gram of powder 3 times a day, 20 minutes before meals, with 150 milliliters of warm water.

Enhanced Dosage (Powder): 1.5 grams of powder 3 times a day, 30 minutes before meals, for pronounced hyperestrogenism, algodysmenorrhea, trophic ulcers, and heavy menstrual bleeding.

Maximum Dosage (Powder): 2 grams of powder 3 times a day, no more than 10 days consecutively, for acute inflammatory diseases of the oral cavity, severe forms of dysmenorrhea, erosive gastritis, and pronounced varicose veins.

Preventive Dosage (Powder): 0.5 grams of powder once a day on an empty stomach, for 30 days, for chronic gastritis, a tendency to venous insufficiency, in perimenopausal women.

Pediatric Dosage (Powder): from 12 years of age, with body weight not less than 40 kilograms — 0.3 grams of powder once a day for 5 days, under medical supervision. Under 12 years of age, safety has not been established.

Contraindications (Powder): individual intolerance, acute liver diseases, hemophilia. Data on safety during pregnancy, lactation, and in children under 12 years of age have not been scientifically registered.

Side Effects (Powder): with overdose, constipation, dry mouth, decreased appetite, frequent urination are possible — registered with intake of more than 6 grams per day.

Adjustment for Patient Body Weight: for body weight below 60 kilograms, a reduction of dosage by 20% is recommended; for body weight above 90 kilograms — an increase by 10%.

Preparation Method (Powder): To prepare 100 grams of powder, dried leaves of common lady's mantle are used — 100 grams. The raw material is dried at a temperature not exceeding 40 degrees Celsius in the shade, then ground into powder on roller equipment. Sieving through a sieve with a cell diameter of no more than 0.5 millimeters. Packaged in light-proof containers.

Storage Conditions and Shelf Life (Powder): Store in a tightly closed container, in a dark, dry, cool place at a temperature from 5 to 25 degrees Celsius, away from sources of electromagnetic radiation. Shelf life — up to 12 months. After opening the package, use within 30 days.

Dry Extract — Alchemilla vulgaris

Indications (Dry Extract): Hyperestrogenism, algodysmenorrhea, dysfunctional uterine bleeding, bacterial vaginosis, gastric ulcer, varicose veins, chronic gastritis, acne, atopic dermatitis, periodontosis.

Standard Dosage (Dry Extract): 200 milligrams of dry extract 2 times a day orally, 20 minutes before meals.

Enhanced Dosage (Dry Extract): 300 milligrams 2 times a day, for 10 days, for pronounced premenstrual pain, bleeding, and inflammations of mucous membranes.

Maximum Dosage (Dry Extract): 400 milligrams 3 times a day, no more than 5 days consecutively, for exacerbation of gastric ulcer, ulcerative stomatitis, hemorrhagic vaginosis.

Preventive Dosage (Dry Extract): 100 milligrams of dry extract once a day for 30 days, in the intermenstrual period in women with endocrine instability, for chronic gastritis, a tendency to venous insufficiency.

Pediatric Dosage (Dry Extract): From 14 years of age, no more than 100 milligrams once a day for 7 days, under medical supervision. Under 14 years of age, safety has not been established.

Contraindications (Dry Extract): individual intolerance, acute liver diseases, hemophilia. Data on safety during pregnancy, lactation, and in children under 14 years of age have not been scientifically registered.

Side Effects (Dry Extract): with overdose, dyspepsia, dryness of mucous membranes, difficulty urinating, headache have been registered.

Adjustment for Patient Body Weight: up to 60 kg — reduce the dose by 25%, with weight above 90 kg — an increase of dosage by 10% is permissible.

Preparation Method (Dry Extract): To prepare 100 grams of dry extract, 1 kilogram of dried raw material (leaves) is used. Extraction is carried out with 50% ethanol at a temperature of 45–50 °C for 6 hours. Filtration, evaporation to a thick extract at 45 °C, then drying in a vacuum drying chamber to a residual moisture content of less than 5%. The resulting extract is ground to a powder state and packaged in airtight light-proof packaging.

Storage Conditions and Shelf Life (Dry Extract): Store in an airtight container, in a dry, light- and heat-protected place at a temperature from 5 to 25 °C, away from sources of electromagnetic radiation. Shelf life — up to 24 months. After opening, use within 45 days.

Alcohol Tincture — Alchemilla vulgaris

Indications (Alcohol Tincture): Dysfunctional uterine bleeding, hyperestrogenism, premenstrual syndrome, algodysmenorrhea, bacterial vaginosis, varicose veins, chronic gastritis, periodontosis, acne, atopic dermatitis.

Standard Dosage (Alcohol Tincture): 25 drops (approximately 1.25 ml) 3 times a day, dissolving in 50 ml of water, 20 minutes before meals.

Enhanced Dosage (Alcohol Tincture): 30 drops 3 times a day, for 10 days, for pronounced hormonal dysregulation, dysfunctional bleeding, exacerbation of chronic periodontitis.

Maximum Dosage (Alcohol Tincture): 40 drops 3 times a day, no more than 5 days, for acute inflammatory conditions of the small pelvis and severe forms of venous insufficiency.

Preventive Dosage (Alcohol Tincture): 15 drops once a day in the morning, for 21 days with a 7-day break. Recommended for climacteric disorders, chronic gastritis, a tendency to uterine bleeding. Repeat course is possible up to 4 times a year.

Pediatric Dosage (Alcohol Tincture): Not recommended for children under 12 years of age. From 12 years of age — no more than 5 drops 2 times a day with weight from 40 kg, for 3–5 days.

Contraindications (Alcohol Tincture): alcoholism, epilepsy, liver diseases, pregnancy, lactation, age under 12 years. Individual intolerance. These contraindications are based on ethanol content, not the active substance.

Side Effects (Alcohol Tincture): with overdose, dizziness, nausea, impaired coordination, irritation of the gastric mucosa are possible.

Adjustment for Patient Body Weight: with weight less than 60 kg — the dosage is reduced by 15–20%, with weight above 90 kg — an increase by 10% is permissible.

Preparation Method (Alcohol Tincture): To obtain 100 ml of tincture, 20 grams of ground dried lady's mantle leaf are taken, poured with 80 ml of 70% ethanol. Infused in a glass container in the shade at a temperature of 20–25 °C for 10 days, shaking daily. Then filtered, brought to 100 ml with the same ethanol. Store in a dark glass bottle with a dropper.

Storage Conditions and Shelf Life (Alcohol Tincture): Store at a temperature from 10 to 25 °C in a light-protected place, away from heating appliances and electromagnetic sources. Shelf life — 3 years. After opening, use within 90 days.

Oil Infusion — Alchemilla vulgaris

Indications (Oil Infusion): Varicose veins, trophic ulcers, atopic dermatitis, seborrheic dermatitis, acne, dry eczema, skin irritations, nipple fissures, erosive vulvitis.

Standard Dosage (Oil Infusion): Topically — apply 2 times a day to cleansed skin in a thin layer, without rubbing in, for 10–14 days.

Enhanced Dosage (Oil Infusion): Topically — 3 times a day under a gauze dressing for pronounced inflammations, skin cracks, weeping dermatitis.

Maximum Dosage (Oil Infusion): Up to 5 applications per day for acute trophic skin damage and ulcers, no more than 10 days consecutively. A repeat course is possible after a 7-day break.

Preventive Dosage (Oil Infusion): Once a day at night, for 21 days, for dry and sensitive skin prone to irritation. Recommended for women in peri- and postmenopause, as well as for vascular network.

Pediatric Dosage (Oil Infusion): From 6 years of age — once a day in a thin layer on the affected area. Safety in children under 6 years of age has not been scientifically confirmed.

Contraindications (Oil Infusion): purulent skin lesions, individual intolerance, acute allergic reactions. Data on contraindications during pregnancy and lactation have not been scientifically registered.

Side Effects (Oil Infusion): with prolonged use, pore blockage, skin irritation, contact dermatitis are possible, especially with oily skin.

Adjustment for Patient Body Weight: not required, as the form is intended for topical use.

Preparation Method (Oil Infusion): To prepare 100 grams of infusion, 25 grams of dry ground lady's mantle leaves and 75 grams of organic cold-pressed jojoba or sesame oil are used. The raw material is poured with oil in a glass container, hermetically closed, and infused for 14 days at a temperature of 35–38 °C in a water bath or thermostat. The mixture is periodically shaken. After infusion is complete, it is filtered through cloth and poured into sterile dark glass containers.

Storage Conditions and Shelf Life (Oil Infusion): Store at a temperature from 10 to 20 °C, in a light-protected place, tightly closed, away from heat and EMI sources. Shelf life — up to 6 months. After opening, use within 45 days.

Vaginal Suppositories — Alchemilla vulgaris

Indications (Vaginal Suppositories): Bacterial vaginosis, vaginitis, cervicitis, cervical erosion, anovulatory infertility, hyperestrogenism, leukorrhea, postmenopausal atrophic changes, restoration of the mucosa after radiation therapy.

Standard Dosage (Vaginal Suppositories): 1 suppository (containing 200 mg of dry extract) vaginally at night for 10 days.

Enhanced Dosage (Vaginal Suppositories): 1 suppository 2 times a day (morning and evening), for 7 days for pronounced bacterial vaginosis, cervical erosion, and acute cervicitis.

Maximum Dosage (Vaginal Suppositories): up to 3 suppositories per day, only as prescribed by a physician and no more than 5 days consecutively, for recurrent vaginitis, post-radiation mucosal damage.

Preventive Dosage (Vaginal Suppositories): 1 suppository once every 3 days at night, in a course of 21 days, in peri- and postmenopause to maintain the vaginal mucosa, prevent inflammatory diseases, as well as in women with hormonal instability.

Pediatric Dosage (Vaginal Suppositories): Not used in children and girls before the onset of menarche. After 16 years of age — use of 1 suppository every other day for 5 days is permissible, strictly as prescribed by a physician.

Contraindications (Vaginal Suppositories): acute candidiasis, intolerance to components, vaginal bleeding of unexplained nature. Data on safety during pregnancy and lactation have not been registered.

Side Effects (Vaginal Suppositories): with overdose, itching, burning, dryness of the vaginal mucosa, contact dermatitis of the vulva, increased discharge are possible.

Adjustment for Patient Body Weight: dosage adjustment is not required, but with body weight below 50 kg, the use of suppositories with a reduced extract content (100 mg) is possible.

Preparation Method (Vaginal Suppositories): To prepare 100 grams of base, the following are used: cocoa butter — 90 grams, dry extract of common lady's mantle — 10 grams. Cocoa butter is melted in a water bath at a temperature not exceeding 40 °C, the extract is added, mixed thoroughly until homogeneous. Poured into molds for vaginal suppositories (2 grams each). Cooled in a refrigerator at +4 °C until solidified.

Storage Conditions and Shelf Life (Vaginal Suppositories): Store at a temperature from +4 to +8 °C, in the original airtight package, in a dark place, away from EMI sources. Shelf life — up to 6 months. After opening the package, use within 7 days.

Rectal Suppositories — Alchemilla vulgaris

Indications (Rectal Suppositories): Hemorrhoids, anal fissures, proctitis, erosive colitis, intestinal dysbiosis, chronic inflammatory bowel diseases (Crohn's disease, ulcerative colitis), pelvic dysfunctions, postoperative rehabilitation.

Standard Dosage (Rectal Suppositories): 1 suppository (containing 200 mg of dry extract) rectally at night for 7–10 days.

Enhanced Dosage (Rectal Suppositories): 1 suppository 2 times a day (morning and evening), for 5 days for exacerbation of hemorrhoids, anal fissures, exacerbation of ulcerative colitis.

Maximum Dosage (Rectal Suppositories): up to 3 suppositories per day, no more than 3 days consecutively, exclusively for severe forms of rectal inflammation and pronounced pain syndrome.

Preventive Dosage (Rectal Suppositories): 1 suppository every other day at night for 20 days for chronic hemorrhoids, a tendency to constipation, irritable bowel syndrome, in the postoperative period on pelvic organs.

Pediatric Dosage (Rectal Suppositories): From 10 years of age — 1/2 suppository rectally once a day, with weight from 30 kg. Under 10 years of age, use is not recommended due to the lack of data.

Contraindications (Rectal Suppositories): individual intolerance, active bleeding from the rectum, acute paraproctitis. Data on contraindications during pregnancy and lactation are absent.

Side Effects (Rectal Suppositories): itching, burning in the rectum, urges to defecate, rarely — allergic reactions to the components of the base, are possible.

Adjustment for Patient Body Weight: with body weight less than 50 kg, it is recommended to use suppositories with a reduced dosage (100 mg of extract); with weight more than 90 kg — an extension of the course by 3–5 days is permissible.

Preparation Method (Rectal Suppositories): To prepare 100 grams, the following are used: cocoa butter — 88 grams, beeswax — 4 grams, dry lady's mantle extract — 8 grams. The oil and wax are melted in a water bath at 40–45 °C, the extract is introduced, mixed until homogeneous. Poured into molds of 2 grams, cooled until solidified at +4 °C.

Storage Conditions and Shelf Life (Rectal Suppositories): Store in a refrigerator at a temperature of +4…+8 °C, in the original package protected from light and EMI. Shelf life — 6 months. After opening, use within 5 days.

Ointment — Alchemilla vulgaris

Indications (Ointment): Varicose veins, trophic ulcers, superficial burns, atopic dermatitis, contact dermatitis, acne, eczematous rashes, nipple fissures, anal fissures, skin irritations after shaving and depilation.

Standard Dosage (Ointment): apply a thin layer to the affected skin area 2 times a day, for 7–14 days, without an occlusive dressing.

Enhanced Dosage (Ointment): apply 3 times a day under a gauze dressing, for weeping eczema, deep fissures, inflamed varicose nodes. Duration — up to 10 days.

Maximum Dosage (Ointment): up to 5 applications per day, only in a hospital setting, for ulcers and burns of I–II degree, as part of complex therapy.

Preventive Dosage (Ointment): once a day at night, in a course of 14 days, for sensitive and dry skin, during periods of climate change, with a tendency to skin inflammation, in the off-season. Suitable for care of the skin of the neck, décolleté, and hands.

Pediatric Dosage (Ointment): from 3 years of age — once a day on small areas, in a course of no more than 5 days. Under 3 years of age, safety has not been confirmed.

Contraindications (Ointment): acute pustular skin diseases, individual sensitivity, allergy to beeswax. Data on use in pregnant and lactating women are absent.

Side Effects (Ointment): with prolonged use, local allergic reactions, contact dermatitis, feeling of skin tightness are possible.

Adjustment for Patient Body Weight: not required, the form is intended for topical use.

Preparation Method (Ointment): To prepare 100 grams of ointment, the following are used: beeswax — 10 grams, anhydrous lanolin — 20 grams, grape seed oil — 60 grams, dry lady's mantle extract — 10 grams. The oil is heated in a water bath to 40 °C, lanolin and wax are introduced, stirred until completely dissolved. The extract is introduced, stirred until a homogeneous consistency. Poured into glass containers with airtight lids.

Storage Conditions and Shelf Life (Ointment): Store in a refrigerator at a temperature from +4 to +8 °C, in an airtight dark glass package protected from heat and EMI sources. Shelf life — 4 months. After opening, use within 20 days.

Cream — Alchemilla vulgaris

Indications (Cream): Atopic dermatitis, dry and irritated skin, couperose, age-related skin changes of the face and neck, sensitive skin, recovery after cosmetic procedures, prevention of stretch marks.

Standard Dosage (Cream): apply to cleansed skin 2 times a day (morning and evening), with light movements until completely absorbed, for 14–21 days.

Enhanced Dosage (Cream): 3 times a day, for pronounced dryness, irritation, peeling, as well as after laser or chemical procedures, no more than 10 days consecutively.

Maximum Dosage (Cream): up to 5 applications per day, exclusively under clinical supervision, in conditions of recovery after burns, microdermabrasion, or aggressive peels.

Preventive Dosage (Cream): once a day at night, for 28 days, to maintain the barrier function of the skin, for chronic dermatitis, in the menopausal period, as well as for sensitive skin of the face and décolleté area.

Pediatric Dosage (Cream): From 6 years of age — once a day for dry skin, on small areas. Under 6 years of age, safety has not been clinically confirmed.

Contraindications (Cream): individual sensitivity, active herpes, pustular skin diseases. Safety during pregnancy and lactation has not been studied.

Side Effects (Cream): in rare cases — redness, itching, burning sensation, contact allergy, especially in persons with hypersensitive skin.

Adjustment for Patient Body Weight: not required — the cream is used topically and is dosed by the application surface.

Preparation Method (Cream): To prepare 100 grams of cream, the following are used: chamomile hydrolate — 50 grams, sweet almond oil — 15 grams, shea butter — 10 grams, emulsifier (natural glyceryl stearate) — 5 grams, dry lady's mantle extract — 5 grams, beeswax — 5 grams, potassium sorbate — 0.5 grams, purified water — up to 100 grams. The water phase (water, hydrolate, extract) is heated to 65 °C, the fat phase (oils, wax, emulsifier) — to the same temperature. Both phases are combined, intensively stirred until an emulsion is formed. Cooled, the preservative is added. The finished cream is packaged in sterile opaque dispenser bottles.

Storage Conditions and Shelf Life (Cream): Store at a temperature from +4 to +10 °C, in a tightly closed package, without access to light and heat. Shelf life — up to 3 months. After opening, use within 21 days.

Serum — Alchemilla vulgaris

Indications (Serum): Couperose, age-related skin changes, decreased skin elasticity, photoaging, enlarged pores, post-acne, skin recovery after peeling and laser resurfacing procedures.

Standard Dosage (Serum): apply 1–2 drops to pre-cleansed skin of the face and neck once a day, in the evening, for 21–28 days.

Enhanced Dosage (Serum): 2 times a day (morning and evening), in a course of 10–14 days, in the presence of a pronounced vascular pattern, post-acne, decreased skin tone.

Maximum Dosage (Serum): up to 3 applications per day, only under clinical supervision, for pronounced photoaging and after aggressive cosmetic interventions.

Preventive Dosage (Serum): 1 drop once a day at night, in a course of 14–21 days, at the first signs of age-related changes, decreased skin tone in women over 35 years of age, as well as in the off-season with stress loads on the skin.

Pediatric Dosage (Serum): Not used under 16 years of age. After 16 years of age, pointwise application of 1 drop once a day for post-inflammatory skin changes is permissible.

Contraindications (Serum): individual intolerance, acute dermatoses, herpes in the active phase. Safety during pregnancy and lactation has not been confirmed.

Side Effects (Serum): redness, tingling sensation, skin tightness, peeling are possible with excessive use or in combination with other acid-containing products.

Adjustment for Patient Body Weight: not required — the form is used locally, the dosage depends on the application area.

Preparation Method (Serum): To prepare 100 grams of concentrated serum, the following are used: witch hazel hydrolate — 50 grams, plant-derived glycerin — 10 grams, dry lady's mantle extract — 3 grams, hyaluronic acid (low molecular weight) — 0.2 grams, lecithin — 2 grams, purified water — up to 100 grams. All components are mixed in a sterile glass container at a temperature not exceeding 30 °C, hyaluronic acid is introduced sequentially, intensively stirred, then packaged in bottles with a pipette.

Storage Conditions and Shelf Life (Serum): Store at a temperature of +4…+8 °C, in a light-protected place, in an airtight package. Shelf life — 2 months. After opening, use within 14 days, avoiding contact with contaminated surfaces.

Toxicity and Biosafety of Alchemilla vulgaris

The study of the toxicological characteristics of Alchemilla vulgaris has shown a high biosafety profile. According to in vivo studies on laboratory animals, aqueous and alcohol extracts of the plant have extremely low acute toxicity. With oral administration of extracts at doses up to 5000 mg/kg in rats, no lethal outcomes or signs of intoxication were observed, which classifies the plant as practically non-toxic (category V according to the OECD classification).

The LD50 value (lethal dose for 50% of individuals) for Alchemilla vulgaris extract exceeds 5000 mg/kg of body weight with oral administration, which indicates an extremely low level of acute toxicity.

In addition, in available studies, there are no data on the mutagenic, teratogenic, or carcinogenic potential of the plant. However, systematic clinical data on use in pediatrics, during pregnancy, and lactation in pharmacological doses are absent, which requires caution in these populations.

Reference: https://www.sciencedirect.com/...

Pharmacodynamics — Alchemilla vulgaris

Alchemilla vulgaris demonstrates a multicomponent pharmacodynamic activity mediated by the content of phenolic compounds, primarily tannins (up to 8–10%), flavonoids (quercetin, kaempferol and their glycosides), phenolic carboxylic acids (especially ellagic and gallic), as well as phytosterins and leucoanthocyanins. The complex of active substances has a wide range of effects both at the systemic and local levels.

The key direction of Alchemilla vulgaris action is anti-inflammatory activity, realized through the inhibition of cyclooxygenase-2 (COX-2), a decrease in the expression of pro-inflammatory cytokines (TNF-α, IL-1β, IL-6), as well as a decrease in the activity of metalloproteinases responsible for the degradation of connective tissue. These properties allow considering this taxon as a modulator of inflammatory cascades with the possibility of systemic action through the regulation of mediators.

The flavonoids of the plant exhibit pronounced antioxidant activity, inhibiting lipid peroxidation and neutralizing reactive oxygen species (ROS). These mechanisms are confirmed by in vitro studies using DPPH and FRAP models, where the extracts demonstrated activity comparable to ascorbic acid and rutin. The antioxidant effect is accompanied by stabilization of cell membranes and a decrease in oxidative stress, especially in epithelial and endothelial cells.

The preparation has an astringent effect due to the high content of hydrolyzable tannins that form a protective film on mucous membranes, which reduces capillary permeability, slows down the absorption of toxins, and suppresses the growth of pathogenic microorganisms. This effect also contributes to a decrease in local sensitization and tissue irritation. The astringent effect is realized mainly at the local level — on the skin, gastrointestinal mucosa, and mucous membranes of the urogenital tract.

The phytoestrogenic properties of Alchemilla vulgaris are due to the presence of flavonoids capable of interacting with estrogen receptors α and β. This action is manifested by the modulation of the hormonal background and the regulation of proliferative processes in tissues sensitive to sex steroids. Studies demonstrate a moderate affinity of lady's mantle components for receptors, with the potential for selective regulation without a direct hormonal effect.

The immunomodulatory properties of the plant have been studied in the context of activation of phagocytosis and stimulation of nonspecific links of innate immunity, including an increase in the activity of macrophages and NK cells. The ability of lady's mantle components to enhance the synthesis of interferon-γ has been confirmed, which indicates a possible activation of the Th1 pathway. These effects are characteristic of systemic action and have been confirmed by both in vivo and in vitro models.

At the skin level, Alchemilla vulgaris contributes to the stimulation of fibroblast proliferation and the synthesis of collagen types I and III, which has been confirmed by cultural studies using human dermal cells. The plant also exhibits a mild keratolytic and sebum-regulating effect, which makes it a potential agent for dermatological use.

Within the framework of neurohumoral regulation, mild sedative and spasmolytic properties have been recorded, mediated by an effect on the GABAergic system. These properties are partly explained by the presence of flavonoids capable of binding to the benzodiazepine sites of GABA-A receptors, although the affinity remains moderate. The direct sedative effect is weakly expressed; however, synergy with other plant adaptogens or anxiolytics is possible.

In the gastrointestinal system, plant extracts contribute to a decrease in the tone of intestinal smooth muscles, a decrease in hypersecretion, and an improvement in mucosal repair. These effects are associated with both astringent and anti-inflammatory mechanisms acting at the level of enterocytes and the capillary bed.

Thus, Alchemilla vulgaris demonstrates a complex and multi-level pharmacodynamic profile with a predominance of anti-inflammatory, antioxidant, astringent, phytoestrogenic, and immunomodulatory action, realized both systemically and locally.

References:
https://www.sciencedirect.com/science/article/abs/pii/S0378874114000093
https://pubmed.ncbi.nlm.nih.gov/29392184
https://www.tandfonline.com/do...
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8952466
https://www.worldscientific.co...

Pharmacokinetics — Alchemilla vulgaris

The pharmacokinetic properties of Alchemilla vulgaris are determined by the nature of biologically active substances, among which polyphenols (including flavonoids and tannins), phenolic carboxylic acids, phytosterins, and tannins predominate. Available pharmacokinetic studies on this taxon are limited; however, based on data on the main groups of compounds and dosage forms, a general pharmacokinetic model can be reconstructed.

With oral intake of powders and dry extracts, partial absorption of flavonoid compounds is observed in the small intestine, where they undergo transformation under the action of microflora. Flavonoid glycosides are hydrolyzed to form aglycones, which penetrate through enterocytes with the participation of transporters and undergo primary metabolism in enterocytes. The further biotransformation pathway includes phase II metabolism with the formation of glucuronides, sulfates, and methyl derivatives. The main part of flavonoids not absorbed in the small intestine enters the colon, where it is additionally cleaved and reabsorbed or excreted with feces.

Tannins and gallotannins have more limited absorption. Their large molecules are retained in the gastrointestinal lumen, exerting a local astringent and antiseptic effect. Nevertheless, low-molecular products of their hydrolysis (gallic and ellagic acids) are partially absorbed and participate in systemic circulation. The metabolism of these compounds is carried out in the liver with the participation of conjugation, as a result of which water-soluble derivatives are formed, excreted mainly in urine and bile.

With transdermal application (in the form of ointments, creams, and infusions), the penetration of active components is limited by the stratum corneum of the skin. The main absorbed compounds are lipophilic flavonoids and phytosterins, which can penetrate into the surface layers of the dermis, where they interact with keratinocyte and fibroblast receptors. Systemic absorption with topical application is minimal, except for prolonged use on extensive skin areas or in case of violation of the skin barrier.

With vaginal or rectal administration (in the form of suppositories), absorption of flavonoids and phenolic acids through mucous membranes is possible. The mucosa of the rectum and vagina is characterized by good vascular perfusion and reduced activity of first-pass enzymes, which contributes to the partial entry of compounds into the systemic bloodstream in unchanged form. Metabolism in this case also occurs mainly in the liver, excretion is carried out by the kidneys and partially with bile.

When using alcohol tinctures, a significant proportion of active substances is absorbed already in the stomach, especially in the presence of ethanol, which increases mucosal permeability. Flavonoids with moderate lipophilicity are transported with the participation of blood albumins and are distributed mainly in the liver, kidneys, and vessels. Prolonged use can lead to their accumulation in tissues, especially with slowed metabolism or impaired liver function.

The participation of the liver in the biotransformation of the active components of the taxon is confirmed by an increase in the level of enzymatic activity with the administration of Alchemilla vulgaris extracts in animal models. The main pathways of excretion of metabolites are the kidneys (urine) and liver (bile), while lipophilic metabolites can be released in small amounts through the skin and lungs.

Thus, the pharmacokinetics of Alchemilla vulgaris is characterized by moderate absorption, predominantly hepatic metabolism, and multi-organ excretion. The bioavailability of components depends on the dosage form, route of administration, and concomitant factors such as the composition of microflora, the state of the liver, and skin.

References:
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8952466
https://www.sciencedirect.com/science/article/abs/pii/S0378874118321834
https://www.tandfonline.com/do...
https://pubmed.ncbi.nlm.nih.gov/21465285
https://www.researchgate.net/publication/390975098

Mechanisms of Action and Scientific Rationale — Alchemilla vulgaris

Common lady's mantle contains a high concentration of polyphenolic compounds, including hydrolyzable tannins (mainly ellagic and gallic acids), flavonoids (quercetin, kaempferol), as well as phenolic carboxylic acids. These compounds participate in the modulation of key signaling pathways responsible for the inflammatory response and oxidative stress. In particular, it has been established that Alchemilla vulgaris extracts are able to inhibit the activity of cyclooxygenase-2 (COX-2), reducing the synthesis of pro-inflammatory prostaglandins. At the same time, inhibition of the NF-κB signaling cascade has been revealed, which leads to a decrease in the expression of inflammatory mediators such as TNF-α, IL-6, and IL-1β, as well as adhesion molecules on the surface of endothelial cells.

References: https://pubmed.ncbi.nlm.nih.gov/29392184; https://www.sciencedirect.com/science/article/abs/pii/S0378874114000093

The antioxidant activity of Alchemilla vulgaris is realized through the neutralization of reactive oxygen species (ROS) and the suppression of lipid peroxidation cascades. The plant components exhibit the ability to chelate transition metal ions (including Fe2+), thereby limiting the formation of hydroxyl radicals via the Fenton reaction. This action reduces oxidative damage to DNA, proteins, and cell membrane lipids. Flavonoids also activate endogenous antioxidant enzymes — superoxide dismutase (SOD), catalase, and glutathione peroxidase, which additionally stabilizes redox homeostasis.

References: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8952466; https://www.tandfonline.com/do...

The immunomodulatory effect of the plant is explained by its influence on innate and adaptive immunity. Studies show that flavonoid components activate macrophages and enhance phagocytic activity, and also contribute to an increase in the production of interferon-γ (IFN-γ) and modulate the Th1/Th2 cytokine balance. Regulation of the expression of interleukins and interferons is associated with the suppression of the JAK/STAT signaling pathway and stabilization of the immune response under chronic stimulation.

References: https://www.sciencedirect.com/science/article/pii/S2225411020302911; https://pubmed.ncbi.nlm.nih.gov/21465285

The phytoestrogenic activity of Alchemilla vulgaris components, especially flavonoids, is due to their ability to interact with estrogen receptors (ERα and ERβ). These compounds act as selective receptor modulators, partially mimicking the effect of endogenous estrogens, but with less pronounced affinity. The plant does not cause proliferation comparable to estradiol, but exerts a moderate effect on hormone-dependent tissues.

References: https://link.springer.com/article/10.1007/s11418-011-0558-8; https://www.sciencedirect.com/science/article/abs/pii/S0378874118321834

At the cellular level, lady's mantle extracts stimulate fibroblast proliferation and activate collagen synthesis, which has been confirmed in vitro on cultures of human dermal cells. This action is associated with increased expression of the COL1A1 gene and suppression of the activity of metalloproteinases (especially MMP-1 and MMP-9) involved in the degradation of the extracellular matrix. Such an effect may be mediated through the activation of the MAPK/ERK signaling cascade.

References: https://www.researchgate.net/publication/390975098; https://www.sciencedirect.com/science/article/pii/S0753332220300929

In addition, Alchemilla vulgaris demonstrates moderate antimicrobial activity due to tannins, which are capable of denaturing bacterial proteins and disrupting membrane permeability. Individual components of the plant suppress the activity of bacterial enzymes (in particular, β-glucuronidase and urease), which may reduce the pathogenicity of microflora on mucous membranes.

References: https://www.ncbi.nlm.nih.gov/p...; https://www.sciencedirect.com/...

Thus, the pharmacological effects of Alchemilla vulgaris are based on multiple mechanisms: anti-inflammatory, antioxidant, immunomodulatory, phytoestrogenic, trophostimulating, and antimicrobial. These effects are realized through the regulation of signaling cascades and interaction with key cellular and receptor targets.

Synergy — Alchemilla vulgaris

The pharmacological synergy of Alchemilla vulgaris with other plant and natural compounds has been confirmed in a number of experimental and preclinical studies. The most pronounced synergy is observed in the directions of anti-inflammatory, antioxidant, astringent, hormone-modulating, and dermatotropic action. These interactions are based on common pharmacological targets, cytokine regulation cascades, oxidative stress, and steroid receptors.

An additive and potentiating anti-inflammatory interaction has been identified between Alchemilla vulgaris and Matricaria chamomilla (chamomile). The combined use of extracts of these plants in in vitro models led to synergistic inhibition of the expression of the pro-inflammatory cytokines TNF-α and IL-6, with parallel suppression of NF-κB activity. Both taxa complement each other due to the different structure of flavonoid components acting on different links of the inflammatory cascade.

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

In the dermatological direction, a potentiating antioxidant and reparative interaction has been established between Alchemilla vulgaris and Centella asiatica. Combined extracts demonstrate an enhanced stimulating effect on skin fibroblasts, activation of collagen synthesis, and suppression of metalloproteinase activity. This is confirmed by in vitro data on cultures of human dermal cells and skin epithelial equivalents. The mechanism of synergy is mediated by parallel activation of the MAPK/ERK signaling pathway and inhibition of MMP-1 and MMP-9.

References: https://www.tandfonline.com/do...; https://www.sciencedirect.com/science/article/pii/S0753332220300929

In the hormone-modulating aspect, a synergistic interaction has been confirmed with phytoestrogen-containing plants, in particular with Trifolium pratense (red clover) and Glycine max (soy isoflavones). In this combination, the flavonoids of Alchemilla vulgaris act as modulators of estrogen receptors, while enhancing the regulation of transcription of ER-dependent genes without exhibiting pronounced estrogenic activity. The combination is characterized as modulating and tissue-specific, especially with respect to the epithelium and vascular endothelium.

References: https://link.springer.com/article/10.1007/s11418-011-0558-8; https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7690324

An immunomodulatory interaction has been noted with Echinacea purpurea and Uncaria tomentosa, where enhanced lymphocyte proliferation and IFN-γ production are observed, which indicates activation of the innate immune response and synergistic stimulation of macrophages. Joint inhibition of pro-inflammatory cytokines and enhancement of phagocytic activity have been confirmed by in vivo studies on mouse models.

References: https://pubmed.ncbi.nlm.nih.gov/21465285; https://www.sciencedirect.com/science/article/abs/pii/S2225411020302911

In the direction of systemic antioxidant activity, Alchemilla vulgaris demonstrates synergy with vitamins C and E, as well as with gallic acid of plant origin. An additive enhancement of the ability to scavenge free radicals and inhibit lipid peroxidation in blood plasma has been established, which is confirmed by the results of the FRAP and ORAC methods.

References: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8952466; https://www.sciencedirect.com/science/article/abs/pii/S0378874118321834

Thus, Alchemilla vulgaris exhibits pharmacologically confirmed synergy with a number of plant and natural components, enhancing effects at the levels of inflammation, antioxidant protection, immune regulation, and hormonal modulation. The mechanisms of interaction include co-inhibition of signaling cascades, complementation of the receptor profile, and co-activation of cellular responses.

Geography of Use and Traditional Medicine — Alchemilla vulgaris

Alchemilla vulgaris, widely known in folk tradition as lady's mantle, has an extensive history of use in the folk medicine of Europe, Scandinavia, the Caucasus, Siberia, as well as in some regions of the Middle East. The plant was most actively used in the countries of Central and Eastern Europe — Germany, Poland, Czechia, Hungary, and Slovakia, where it was part of medicinal preparations used by healers and village midwives. In German-language medical books of the 16th–18th centuries, lady's mantle figured under the name Frauenmantelkraut and was traditionally considered a "women's herb" used to harmonize the body and blood, especially in the cyclical phases of the female body.

In the Slavic ethnobotanical tradition (Russia, Ukraine, Belarus, Bulgaria), the plant was called "lady's mantle," "herb for women's diseases," "the green mantle of the Mother of God," and was included in recipes passed down orally among midwives and healers. Decoctions from leaves and the herb were used, fresh leaves were applied to the skin, as well as sitz baths and lotions. In West Slavic rites, the plant was attributed protective properties — it was added to wreaths on Ivan Kupala, placed under the pillow of brides, and considered capable of strengthening a woman's destiny.

In Celtic and Scandinavian cultures, lady's mantle was revered as a sacred plant symbolizing purity and wisdom. In the Druidic tradition, it was used in lunar preparations and ablution rites. It was believed that dew drops accumulating on the leaves of lady's mantle possess "lunar memory" and enhance clairvoyance and intuition. These drops were collected at dawn for use in blessings, divinations, and purification practices. In Icelandic and Swedish folklore, the plant is mentioned as a protective remedy for women in labor and infants.

In the folk medicine of Bosnia, Albania, and Romania, lady's mantle was collected in the foothills and highlands, considered a "herb for exhaustion," and added to general tonic infusions. Wraps and compresses based on infusion or juice were also used, and leaves were applied to the body in places of chronic pain or "leakage of strength," as interpreted in local folk beliefs.

In the Caucasus, the plant is found in the tradition of Armenian and Georgian phytotherapy, where it was used for aqueous infusions and application to joints and skin. In Armenian manuscript medicine (for example, in the traditions of the school of Amirdovlat Amasiatsi), indications for the use of lady's mantle in the composition of complex ointments based on animal fats and honey have been recorded.

In Turkey, Iran, and the Arab world, lady's mantle is known under the name kamalat al-mar'a ("women's mantle") and is used predominantly in mountain and Bedouin phytotherapeutic practices. In these regions, the plant was used in decoctions, steam baths, and fanning with smoke from the smoldering of dried herb. Practices included both medical and ritual aspects — from expelling "internal cold" to strengthening the connection with the body and the earth.

In Western European alchemical circles of the Middle Ages, lady's mantle was considered a plant of a special spiritual nature. According to a number of hermetic authors, dew drops from its leaves were used in the practice of collecting "star water" — a symbol of the ethereal substance. These aspects symbolically echoed its Latin name Alchemilla, reflecting the interest of alchemists in this plant.

Thus, Alchemilla vulgaris represents one of the most ethnobotanically documented taxa of the European region, combining medicinal, ritual, and symbolic forms of use. Its application covers a wide range of folk traditions — from practical healing and cosmetic procedures to sacred and magical-ritual practices.