​Limonia Acidissima (Elephant Apple)

Limonia Acidissima (Elephant Apple)

Product Name: Лимония кислейшая, Limonia acidissima, Holzapfel, Manzana de madera, Pomme de bois, تفاح خشبي, มะมุดป่า, Yogochi, Жаңгак алма, Taxta alma, Себ яблочный, Medžio obuolys, Koka ābols, Дерев'яна яблуня, עץ תפוח קשה

Synonyms: Лимония, Слоновье яблоко, Деревянное яблоко, Feronia слоновая, Feronia limonia, Elephant apple, Wood apple, Monkey fruit, Holzapfelbaum, Feroniabaum, Manzana de elefante, Manzana de mono, Pomme d’éléphant, Pomme de singe, تفاح الفيل, تفاح القرد, มะมุดป่า, มะขามป้อมเทศ

Parts Used: fruit, fruit pulp, seeds, leaves, bark, roots.

Main Indications for Use of Limonia acidissima: Viral hepatitis, gastric and duodenal ulcer, gastritis with increased acidity, infectious colitis, dysentery, intestinal candidiasis, hyperglycemia, type 2 diabetes mellitus, hyperlipidemia, atherosclerosis, liver fibrosis, steatohepatitis, fatty liver, chronic constipation, irritable bowel syndrome, bronchial asthma, wet bronchitis, pulmonary tuberculosis, furunculosis, pyoderma, trophic ulcers, eczema, skin mycoses, periodontitis.

Use of Limonia acidissima in mixtures and complexes: Fatty hepatosis, liver cirrhosis, human immunodeficiency virus, neurodegenerative diseases, chronic renal failure, pancreatitis, chronic inflammation anemia, chronic fatigue syndrome, systemic lupus erythematosus, rheumatoid arthritis, ulcerative colitis, Crohn's disease.

Pharmacological Properties of Limonia acidissima: antioxidant, hepatoprotective, hypoglycemic, hypolipidemic, antimicrobial, antifungal, antiviral, anti-inflammatory, immunostimulating, antiseptic, astringent, laxative, bronchodilator, antitussive, wound-healing, astringent, wound-healing, cytotoxic, antiproliferative, insecticidal.

Dosage of Pharmaceutical Forms — Limonia acidissima

Powder — Limonia acidissima

Indications (Powder): Gastric ulcer, gastritis with increased acidity, intestinal candidiasis, infectious colitis, chronic constipation, irritable bowel syndrome, hyperglycemia, hyperlipidemia, fatty liver, furunculosis, pyoderma, periodontitis.

Standard Dosage (Powder): 2 grams of powder 2 times a day, 20 minutes before meals, with warm water. Course — from 21 to 30 days.

Enhanced Dosage (Powder): 3 grams of powder 3 times a day, for furunculosis, hyperglycemia, infectious colitis, and fatty liver. Used only under specialist supervision, no more than 14 days consecutively.

Maximum Dosage (Powder): Up to 4 grams 3 times a day, for pronounced hyperlipidemia and severe forms of intestinal candidiasis. No more than 10 days.

Preventive Dosage (Powder): 1 gram per day in the morning on an empty stomach, in courses of 14 days every month. Recommended for chronic gastritis, prediabetes, metabolic syndrome, patients over 50 years of age, and persons with a hereditary tendency to fatty liver.

Pediatric Dosage (Powder): For children from 7 years of age with body weight from 25 kg — 0.5 grams once a day. Not recommended for children under 7 years of age and with body weight below 20 kg. For boys and girls, the dosage is the same.

Contraindications (Powder): Gastric ulcer in the acute stage, chronic enteritis in the acute phase, individual intolerance. Data on contraindications during pregnancy, lactation, and childhood under 7 years of age have not been scientifically registered.

Side Effects (Powder): With overdose, bloating, increased peristalsis, unstable stool are possible. Rare cases of nausea when taken on an empty stomach have been recorded.

Adjustment for Patient Body Weight: For body weight up to 60 kg, a reduction of dosage by 25% is recommended. For body weight more than 90 kg, correction to the upper limit of the standard dosage is possible.

Preparation Method (Powder): Dried fruits of Limonia acidissima are used. The fruits are cleaned of the outer shell, the pulp is separated, then dried at a temperature of 40–45 °C for 48 hours. The dried mass is ground in a mill to a homogeneous powder state with a particle size of no more than 250 µm. For 100 grams of powder, about 400 grams of fresh fruits are required.

Storage Conditions and Shelf Life (Powder): Store in an airtight glass or porcelain container, in a dark place, at a temperature from 15 to 25 °C, away from sources of electromagnetic radiation. Shelf life — 12 months. After opening the package, use within 45 days.

Dry Extract — Limonia acidissima

Indications (Dry Extract): Hyperglycemia, type 2 diabetes mellitus, hyperlipidemia, steatohepatitis, atherosclerosis, viral hepatitis, pulmonary tuberculosis, eczema, trophic ulcers.

Standard Dosage (Dry Extract): 250 milligrams of dry extract 2 times a day 30 minutes before meals, course of 30 days.

Enhanced Dosage (Dry Extract): 500 milligrams 2–3 times a day for hyperglycemia, viral hepatitis, and steatohepatitis. Duration — no more than 21 days.

Maximum Dosage (Dry Extract): 1000 milligrams 3 times a day in a hospital setting for severe forms of metabolic disorders, only under medical supervision. No more than 7 days.

Preventive Dosage (Dry Extract): 250 milligrams once a day for 10 days monthly. Suitable for patients with a hereditary predisposition to atherosclerosis, diabetes, and chronic liver diseases.

Pediatric Dosage (Dry Extract): Recommended from 10 years of age and body weight from 30 kg: 100 milligrams once a day. Not used in children under 10 years of age.

Contraindications (Dry Extract): Acute hepatic insufficiency, pregnancy, individual hypersensitivity. Data on safety during lactation and in children under 10 years of age have not been registered.

Side Effects (Dry Extract): With overdose, hypotension, weakness, dizziness are possible. Cases of allergic-type rash have been noted.

Adjustment for Patient Body Weight: For patients with body weight up to 60 kg, it is recommended to use no more than 70% of the standard dosage. For weight more than 90 kg — an increase up to 125% of the dosage is possible.

Preparation Method (Dry Extract): Fresh fruits are cleaned, the pulp is ground and subjected to extraction in water at a temperature of 70 °C for 4 hours (ratio of raw material to water — 1:4). Then the extract is filtered and evaporated in a water bath until viscous. The concentrated mass is dried by spray drying to obtain a powdered extract. Yield: 100 grams of extract from 700 grams of fresh fruits.

Storage Conditions and Shelf Life (Dry Extract): Store in a dry, cool place at a temperature not exceeding 25 °C, in an airtight dark glass container. Avoid exposure to light and EMI. Shelf life — up to 18 months. After opening — use within 60 days.

Alcohol Tincture — Limonia acidissima

Indications (Alcohol Tincture): Liver fibrosis, viral hepatitis, hyperlipidemia, wet bronchitis, pulmonary tuberculosis, pyoderma, periodontosis, skin mycoses.

Standard Dosage (Alcohol Tincture): 20 drops 2 times a day, diluted in 50 ml of warm water, 20 minutes before meals. Course — 21 days.

Enhanced Dosage (Alcohol Tincture): 30 drops 3 times a day for liver fibrosis, tuberculosis, and pronounced hyperlipidemia. Apply no more than 10 days consecutively under medical supervision.

Maximum Dosage (Alcohol Tincture): Up to 40 drops 3 times a day, in case of active viral hepatitis and chronic airway obstruction. Duration of intake no more than 7 days.

Preventive Dosage (Alcohol Tincture): 10 drops once a day for 14 days. Recommended for the prevention of seasonal exacerbations of bronchitis, with a tendency to skin mycoses, and patients with chronic hyperlipidemia.

Pediatric Dosage (Alcohol Tincture): For children from 12 years of age — 5 drops once a day in dilution. For children under 12 years of age, not recommended due to ethanol content.

Contraindications (Alcohol Tincture): Pregnancy, lactation, alcoholism, hepatic encephalopathy, convulsive syndrome, age under 12 years. Do not use with concomitant intake of drugs incompatible with ethanol.

Side Effects (Alcohol Tincture): When the dosage is exceeded, headache, redness of the facial skin, palpitations, diarrhea are possible.

Adjustment for Patient Body Weight: For patients with body weight up to 50 kg — reduce the dose by 30%. For body weight more than 90 kg — an increase of dosage by 20% is permissible.

Preparation Method (Alcohol Tincture): Pour the ground pulp of Limonia acidissima fruits with 70% ethyl alcohol in a ratio of 1:5. Infuse in a dark, cool place for 14 days, shaking daily. Strain, pour into dark glass containers. For 100 ml of finished tincture, 20 grams of dry raw material and 100 ml of alcohol are required.

Storage Conditions and Shelf Life (Alcohol Tincture): Store in a dark bottle at a temperature from 5 to 25 °C. Avoid direct light and EMI sources. Shelf life — up to 24 months. After opening, use within 60 days.

Oil Infusion — Limonia acidissima

Indications (Oil Infusion): Skin mycoses, trophic ulcers, eczema, pyoderma, periodontosis, furunculosis.

Standard Dosage (Oil Infusion): Topically: apply a thin layer to affected skin areas 2 times a day. For periodontosis — applications on the gums once a day for 10 minutes. Course — from 10 to 21 days.

Enhanced Dosage (Oil Infusion): For trophic ulcers and furunculosis — apply up to 3 times a day to pre-cleansed skin. Combination with wet dressings is permissible. Apply for up to 14 days.

Maximum Dosage (Oil Infusion): Application 4 times a day locally is permissible, for extensive mycosis or a deep ulcer. Apply no more than 7 days, then switch to the standard regimen.

Preventive Dosage (Oil Infusion): Once a day on problem areas prone to inflammation or dry skin. Used in courses of 10 days once a month. Recommended for patients with chronic dermatoses and periodontosis.

Pediatric Dosage (Oil Infusion): From 3 years of age — pointwise application once a day, in a course of no more than 5 days. Under adult supervision. Avoid contact with the mouth, eyes, and mucous membranes.

Contraindications (Oil Infusion): Allergy to essential oils, acute eczematous processes with weeping. During pregnancy and lactation — topical use in a limited area is permissible; scientific data on systemic toxicity have not been registered.

Side Effects (Oil Infusion): Rarely, local allergic reactions are possible: redness, burning, itching. With overdose — skin irritation.

Adjustment for Patient Body Weight: Not required, as the form is applied locally. The volume of application is regulated by the area of the affected area.

Preparation Method (Oil Infusion): Grind fresh or dried leaves of Limonia acidissima (20 grams), pour with 100 grams of coconut oil. Simmer in a water bath at 45–50 °C for 4 hours. Cool, filter through gauze, pour into a sterile vial. If desired, 2 grams of beeswax can be added to increase thickness.

Storage Conditions and Shelf Life (Oil Infusion): Store in an airtight dark container at a temperature from 5 to 18 °C. Do not expose to sunlight. Shelf life — 6 months. After opening, use within 30 days.

Cream — Limonia acidissima

Indications (Cream): Furunculosis, pyoderma, eczema, skin mycoses, trophic ulcers, periodontosis.

Standard Dosage (Cream): Apply a thin layer to the affected skin area 2 times a day, morning and evening. Course — 14 days.

Enhanced Dosage (Cream): Apply up to 3 times a day for acute inflammation accompanied by suppuration or for trophic ulcers. Duration — no more than 10 days.

Maximum Dosage (Cream): Up to 4 times a day locally, for severe forms of dermatitis with an infectious component. Do not apply more than 7 days consecutively.

Preventive Dosage (Cream): Once a day in the evening on a skin area prone to relapses of eczema or fungal lesions. Course — 7 days monthly.

Pediatric Dosage (Cream): From 3 years of age — a single application in a thin layer to a limited area (no more than 5 cm²), no more than once a day. Course — up to 5 days. Avoid application to the face and mucous membranes.

Contraindications (Cream): Individual intolerance. Do not use on open weeping wounds. Data on contraindications during pregnancy and lactation have not been registered, but it is recommended to limit use in the first trimester.

Side Effects (Cream): Skin reactions in the form of itching, redness, or a burning sensation are rarely observed. With prolonged use, peeling is possible.

Adjustment for Patient Body Weight: Correction is not required. Use is limited by the area of the skin.

Preparation Method (Cream): In a glass bowl, combine: coconut oil — 60 grams; beeswax — 8 grams; dry extract of Limonia acidissima fruits — 7 grams; vegetable glycerin — 5 grams: distilled water — 20 grams. Heat the oil with wax in a water bath until completely dissolved, then slowly introduce the extract and glycerin. Carefully, while stirring, add water until a homogeneous emulsion is formed. Cool, pour into a sterile dark jar.

Storage Conditions and Shelf Life (Cream): Store at a temperature from 5 to 15 °C, in an airtight dark glass jar. Avoid sunlight and sudden temperature changes. Shelf life — 3 months. After opening, use within 21 days.

Ointment — Limonia acidissima

Indications (Ointment): Trophic ulcers, furunculosis, skin mycoses, pyoderma, eczema, periodontosis.

Standard Dosage (Ointment): Apply to the affected area 2 times a day, morning and evening. Can be used under a dressing. Course — 10–14 days.

Enhanced Dosage (Ointment): Up to 3–4 times a day for deep ulcers and acute purulent inflammation. Course — 7 days, then switch to the standard dose.

Maximum Dosage (Ointment): No more than 5 applications per day on a limited area for pronounced inflammation and chronic ulcers. Use no more than 5 days consecutively.

Preventive Dosage (Ointment): Once a day before bedtime on skin areas prone to relapses of pustular diseases and eczema. Course — 7 days per month.

Pediatric Dosage (Ointment): From 6 years of age — once a day on a limited skin area, no more than 5 cm². No more than 3 days consecutively. Not recommended for use on the face and mucous membranes.

Contraindications (Ointment): Individual intolerance to components. Acute inflammatory processes with weeping eczema. There are no scientific data on contraindications during pregnancy and lactation; if necessary, use with caution.

Side Effects (Ointment): Short-term skin irritation, itching, peeling. With overdose — focal dermatitis.

Adjustment for Patient Body Weight: Not required. Use is limited to the area of the lesion.

Preparation Method (Ointment): In a glass bowl, combine: coconut oil — 50 grams; beeswax — 15 grams; dry powder of Limonia acidissima fruits — 10 grams; oil infusion of leaves — 25 grams. Melt the oil and wax in a water bath, then add the powder and introduce the infusion. Boil for 30 minutes at a temperature of 50 °C, filter, cool, pour into jars.

Storage Conditions and Shelf Life (Ointment): Store at a temperature from 5 to 18 °C in an airtight dark glass jar. Avoid exposure to light. Shelf life — 4 months. After opening — use within 21 days.

Cosmetic Serum — Limonia acidissima

Indications (Cosmetic Serum): Eczema, dry skin, hyperpigmentation, acne rash, seborrheic dermatitis, senile skin, decreased skin turgor, enlarged pores.

Standard Dosage (Cosmetic Serum): Apply 2–3 drops of serum to cleansed facial skin once a day, in the evening. Course — 21 days, with repetition after 10 days.

Enhanced Dosage (Cosmetic Serum): 2–3 drops 2 times a day (morning and evening) on pre-toned skin for pronounced hyperpigmentation and acne. Course — no more than 14 days consecutively, then switch to the standard dosage.

Maximum Dosage (Cosmetic Serum): Up to 5 drops 2 times a day, for seborrheic dermatitis and facial hyperkeratosis, exclusively at night. Apply for up to 7 days, then reduce the dose.

Preventive Dosage (Cosmetic Serum): 1–2 drops 3 times a week in the evening. Suitable for mature skin with signs of photoaging, hyperpigmentation, decreased turgor. It is recommended to use in courses of 10 days with a break of 20 days.

Pediatric Dosage (Cosmetic Serum): Contraindicated for children under 12 years of age. From 12 years of age — pointwise application once a day, no more than 1 drop.

Contraindications (Cosmetic Serum): Allergy to essential oils and acid components, open wounds. During pregnancy and lactation, apply pointwise and under medical supervision. Data on systemic toxicity have not been registered.

Side Effects (Cosmetic Serum): Local skin irritation, hyperemia, peeling. When the dosage is exceeded — a feeling of tightness, dryness.

Adjustment for Patient Body Weight: Not required, the dose is determined by the application area. Serum volume — from 1 to 5 drops.

Preparation Method (Cosmetic Serum): Per 100 ml of finished product: aqueous extract of Limonia acidissima fruit pulp — 50 ml; oil infusion of Limonia acidissima leaves — 10 ml; Melissa hydrolate — 20 ml; vegetable glycerin — 10 ml; Calendula tincture in 20% alcohol — 5 ml; COSMOS-certified preservative — 1 ml. Mix all components at a temperature of 25–30 °C, stir thoroughly, pour into bottles with a pipette. Store in a refrigerator.

Storage Conditions and Shelf Life (Cosmetic Serum): Store at a temperature from 4 to 8 °C, away from sunlight and EMI sources. After opening, use within 30 days. Total shelf life — up to 3 months.

Exfoliating Scrub — Limonia acidissima

Indications (Exfoliating Scrub): Pore blockage, acne, hyperkeratosis, senile skin, decreased epidermal regeneration, seborrhea.

Standard Dosage (Exfoliating Scrub): Apply 2 times a week, apply to moist skin with circular movements for 1–2 minutes, then rinse with warm water. Course — 4 weeks.

Enhanced Dosage (Exfoliating Scrub): Up to 3 times a week, for pronounced hyperkeratosis and oily seborrhea. Do not use more than 3 weeks consecutively.

Maximum Dosage (Exfoliating Scrub): 4 times a week, only locally (T-zone), exclusively for seborrheic rashes. Course — up to 14 days.

Preventive Dosage (Exfoliating Scrub): Once a week, in the evening. Suitable for the prevention of acne and skin aging in adolescents, persons with oily and combination skin.

Pediatric Dosage (Exfoliating Scrub): From 10 years of age — once a week on limited areas of the face (forehead, nose, chin), no more than 30 seconds of massage. Avoid use on sensitive and atopic skin.

Contraindications (Exfoliating Scrub): Rosacea, couperose, open wounds, herpetic rashes. During pregnancy, only local use is permissible.

Side Effects (Exfoliating Scrub): Mechanical skin irritation, peeling, redness with aggressive rubbing. An individual reaction to essential components is possible.

Adjustment for Patient Body Weight: Not required. The volume depends on the application area.

Preparation Method (Exfoliating Scrub): Per 100 grams: powder of Limonia acidissima fruit shells — 20 grams; coconut oil — 30 grams; dry extract of Limonia acidissima fruits — 10 grams; oat powder — 10 grams; lavender flower water — 20 ml; natural gum (thickener) — 2 grams. Mix all components in a ceramic mortar until a pasty consistency. Store in a dark glass jar.

Storage Conditions and Shelf Life (Exfoliating Scrub): Store at a temperature up to 20 °C, in an airtight package, in the shade. After opening, use within 30 days. Total shelf life — up to 4 months.

Shampoo — Limonia acidissima

Indications (Shampoo): Seborrheic dermatitis of the scalp, oily dandruff, folliculitis, scalp itching, skin hyperkeratosis, increased hair oiliness, acne of the occipital zone.

Standard Dosage (Shampoo): Apply to wet hair once every 2–3 days, lather, leave for 2–3 minutes, rinse thoroughly. Course — 3 weeks.

Enhanced Dosage (Shampoo): Use up to once a day for pronounced itching and active inflammation of the scalp. Duration — no more than 10 days.

Maximum Dosage (Shampoo): Up to 2 times a day for pustular folliculitis, only under medical supervision. Course — no more than 5 days.

Preventive Dosage (Shampoo): Once a week for the prevention of seborrhea, folliculitis, as well as for patients with oily scalp. It is recommended to repeat the course every 2 months.

Pediatric Dosage (Shampoo): From 6 years of age — once a week, a small amount, avoid contact with eyes. Course — 2 weeks.

Contraindications (Shampoo): Allergy to components. Open wounds and eczematous processes with weeping. During pregnancy and lactation — permissible with limited use; there are no data on systemic toxicity.

Side Effects (Shampoo): With overdose, dry skin, peeling, slight itching are possible.

Adjustment for Patient Body Weight: Not required. Adjustment is carried out by the length and volume of hair.

Preparation Method (Shampoo): Per 100 ml: aqueous extract of Limonia acidissima fruits — 30 ml; coco-glucoside (vegetable surfactant) — 40 ml; oil infusion of Limonia acidissima leaves — 10 ml; neem leaf powder — 5 grams; acacia gum — 1 gram; vegetable glycerin — 10 ml. Mix all components at a temperature not exceeding 30 °C, keep for 12 hours, filter and pour into vials. Shake before use.

Storage Conditions and Shelf Life (Shampoo): Store in a dark container at a temperature from 5 to 20 °C. After opening, use within 45 days. Total shelf life — up to 6 months.

Lotion — Limonia acidissima

Indications (Lotion): Pyoderma, oily seborrhea, acne rash, rosacea in remission, bacterial inflammation of pores, inflamed comedones.

Standard Dosage (Lotion): Wipe the skin with a cotton pad soaked in lotion 2 times a day, morning and evening. Course — 14 days.

Enhanced Dosage (Lotion): Up to 3 times a day for acute inflammation, including pustular rashes. Duration — 7 days, then switch to the standard regimen.

Maximum Dosage (Lotion): 4 times a day pointwise, for active purulent rash. No more than 3 days consecutively.

Preventive Dosage (Lotion): Once a day in the evening, in courses of 7 days monthly. Suitable for adolescents, persons with oily and problem skin.

Pediatric Dosage (Lotion): From 10 years of age — pointwise, no more than once a day. Course — 5 days. Do not use on sensitive skin.

Contraindications (Lotion): Dry and dehydrated skin, eczema, allergy to phyto-components. During pregnancy — pointwise application is possible. There are no scientific data on systemic toxicity.

Side Effects (Lotion): Peeling, irritation, feeling of tightness with overdose or use on dry skin.

Adjustment for Patient Body Weight: Not required. The volume depends on the application area.

Preparation Method (Lotion): Per 100 ml: aqueous extract of Limonia acidissima fruits — 40 ml; lavender hydrolate — 20 ml; pomegranate bark infusion — 15 ml; oil infusion of Limonia acidissima leaves — 5 ml; fruit vinegar (apple, unfiltered) — 5 ml; tea tree essential oil — 2 drops. Combine all ingredients, infuse in a refrigerator for 12 hours, filter, pour into a bottle with a dispenser.

Storage Conditions and Shelf Life (Lotion): Store in a refrigerator at a temperature from 4 to 8 °C. Shelf life — up to 60 days. After opening, use within 30 days.

Scalp Serum — Limonia acidissima

Indications (Scalp Serum): Seborrheic dermatitis of the scalp, oily dandruff, scalp itching, inflammatory folliculitis, alopecia against the background of seborrhea.

Standard Dosage (Scalp Serum): Apply 10–15 drops to the scalp once a day (in the evening), rub in for 3–5 minutes. Do not rinse off. Course — 21 days.

Enhanced Dosage (Scalp Serum): 15–20 drops 2 times a day for pronounced itching and inflammation. Apply no more than 10 days, then switch to the standard regimen.

Maximum Dosage (Scalp Serum): Up to 30 drops 2 times a day for active inflammatory alopecia. Duration — no more than 5 days under dermatologist supervision.

Preventive Dosage (Scalp Serum): 10 drops every other day for 2 weeks. Recommended for a tendency to dandruff, itching, oily scalp, and seasonal hair loss.

Pediatric Dosage (Scalp Serum): From 10 years of age — 5 drops once a day, course of 7 days. Avoid contact with eyes and mucous membranes.

Contraindications (Scalp Serum): Open wounds of the scalp, individual sensitivity. During pregnancy and lactation, local use in small doses is permissible. Data on systemic toxicity have not been registered.

Side Effects (Scalp Serum): Skin irritation, itching, slight peeling with prolonged use.

Adjustment for Patient Body Weight: Not required. The volume depends on the application area.

Preparation Method (Scalp Serum): Per 100 ml: aqueous extract of Limonia acidissima fruits — 40 ml; oil infusion of Limonia acidissima leaves — 20 ml; rosemary hydrolate — 20 ml; nettle infusion — 10 ml; 20% thyme alcohol extract — 5 ml; tea tree essential oil — 5 drops. Mix all components in a dark glass container, infuse for 24 hours, filter, pour into bottles with a pipette.

Storage Conditions and Shelf Life (Scalp Serum): Store in a refrigerator at a temperature of 4–8 °C, in an airtight dark glass container. Shelf life — 2 months. After opening — use within 30 days.

Vaginal Suppositories — Limonia acidissima

Indications (Vaginal Suppositories): Vaginal candidiasis, bacterial vaginosis, chronic cervicitis, nonspecific vaginal inflammations, atrophic vaginitis.

Standard Dosage (Vaginal Suppositories): 1 suppository at night, intravaginally, course of 7–10 days.

Enhanced Dosage (Vaginal Suppositories): 2 suppositories per day (morning and evening) for acute candidiasis or exacerbation of bacterial vaginosis. No more than 5 days consecutively.

Maximum Dosage (Vaginal Suppositories): 2 suppositories per day for up to 7 days for cervicitis and combined infection of the vagina and cervix. Prescribed only according to a physician's indications.

Preventive Dosage (Vaginal Suppositories): 1 suppository every other day for 10 days after menstruation. Recommended for frequent relapses of candidiasis, bacterial vaginosis, during menopause.

Pediatric Dosage (Vaginal Suppositories): Contraindicated for girls before the onset of menarche. From 14 years of age, use in half dosage is permissible (0.5 suppository, divided lengthwise).

Contraindications (Vaginal Suppositories): Pregnancy (1st trimester), menstruation, individual intolerance. There are no data on systemic toxicity, but in pediatrics it is used with caution.

Side Effects (Vaginal Suppositories): Burning, irritation of the vaginal mucosa, increased discharge.

Adjustment for Patient Body Weight: For body weight below 50 kg, use 0.5 suppository. For weight above 80 kg, the standard dosage is permissible.

Preparation Method (Vaginal Suppositories): For 10 suppositories of 2 grams: oil infusion of Limonia acidissima leaves — 8 ml; coconut oil — 12 grams; beeswax — 2 grams; dry extract of Limonia acidissima fruits — 1 gram. Melt the wax with coconut oil in a water bath, introduce the infusion and extract, pour into molds. Cool in a refrigerator until completely solidified.

Storage Conditions and Shelf Life (Vaginal Suppositories): Store in a refrigerator at a temperature from 2 to 8 °C. Shelf life — 90 days. After opening the blister, use within 24 hours.

Rectal Suppositories — Limonia acidissima

Indications (Rectal Suppositories): Hemorrhoids in the stage of inflammation, proctitis, paraproctitis, anal canal fissures, rectal dysbiosis, inflammation of the mucosa against the background of antibiotic therapy.

Standard Dosage (Rectal Suppositories): 1 suppository rectally once a day, at night, after defecation. Course — from 7 to 10 days.

Enhanced Dosage (Rectal Suppositories): 1 suppository 2 times a day (morning and evening) for acute inflammation, anal fissures, exacerbated hemorrhoids. Course — 5–7 days.

Maximum Dosage (Rectal Suppositories): Up to 3 suppositories per day for pronounced paraproctitis as part of complex therapy, only under medical supervision. No more than 3 days.

Preventive Dosage (Rectal Suppositories): 1 suppository every other day for 10 days. Indicated for patients with chronic hemorrhoids, frequent inflammations of the anal canal, after taking antibiotics.

Pediatric Dosage (Rectal Suppositories): From 8 years of age — 0.5 suppository (divided lengthwise) once a day. Course — 5 days. Do not use in children under 8 years of age.

Contraindications (Rectal Suppositories): Acute bleeding from the rectum, malignant neoplasms of the rectum, individual hypersensitivity. Data on systemic toxicity in children and pregnant women are absent.

Side Effects (Rectal Suppositories): Burning in the rectum, mucosal irritation, frequent urges to defecate when the dose is exceeded.

Adjustment for Patient Body Weight: For patients with body weight less than 50 kg — use 0.5 suppository. For weight more than 90 kg — transition to the enhanced dose is permissible.

Preparation Method (Rectal Suppositories): For 10 suppositories of 2 grams: coconut oil — 12 grams; oil infusion of Limonia acidissima leaves — 8 ml; beeswax — 3 grams; dry extract of Limonia acidissima fruits — 1 gram. Melt the wax and oil, introduce the remaining components, mix thoroughly and pour into suppository molds. Cool until solidified.

Storage Conditions and Shelf Life (Rectal Suppositories): Store at a temperature from 2 to 8 °C in an airtight package. Shelf life — up to 90 days. After opening, use within 24 hours.

Nasal Drops — Limonia acidissima

Indications (Nasal Drops): Acute rhinitis, viral rhinopharyngitis, allergic rhinitis, sinusitis, nasal mucosal hypertrophy, nasal congestion.

Standard Dosage (Nasal Drops): 2 drops in each nostril 2 times a day, morning and evening. Course — 5–7 days.

Enhanced Dosage (Nasal Drops): 3 drops 3 times a day for acute viral rhinitis and nasal congestion. Apply no more than 5 days.

Maximum Dosage (Nasal Drops): Up to 4 drops 3 times a day in case of viral sinusitis. Only under specialist supervision, no more than 3 days.

Preventive Dosage (Nasal Drops): 1 drop in each nostril once a day during the season of viral infections. Course — 7 days, with repetition after 10 days.

Pediatric Dosage (Nasal Drops): From 5 years of age — 1 drop in each nostril once a day. Under 5 years of age, not recommended due to possible mucosal irritation.

Contraindications (Nasal Drops): Atrophic rhinitis, individual intolerance. During pregnancy — pointwise use is permissible. There are no scientific data on teratogenicity.

Side Effects (Nasal Drops): Burning sensation in the nose, mucosal irritation, sneezing.

Adjustment for Patient Body Weight: Not required. The volume depends on the local action and the number of drops.

Preparation Method (Nasal Drops): Per 30 ml: aqueous extract of Limonia acidissima leaves — 15 ml; eucalyptus infusion — 10 ml; sea salt — 2 grams; black cumin oil (1%) — 0.3 ml; distilled water — bring to 30 ml. Mix at room temperature, filter through a fine filter, pour into a dropper bottle.

Storage Conditions and Shelf Life (Nasal Drops): Store in a refrigerator at a temperature of 4–8 °C. After opening, use within 10 days. Total shelf life — 30 days.

Ear Drops — Limonia acidissima

Indications (Ear Drops): Acute external otitis, fungal lesion of the external auditory canal (otomycosis), earwax plugs, itching in the auditory canal, inflammation of the skin of the auricle, eczema of the ear area.

Standard Dosage (Ear Drops): 2 drops in each auditory canal 2 times a day, course — 7 days. After instillation, it is recommended to lie on the side for 3–5 minutes.

Enhanced Dosage (Ear Drops): 3 drops in the ear 3 times a day for purulent inflammations and otomycoses. Apply no more than 5 days consecutively.

Maximum Dosage (Ear Drops): 4 drops 3 times a day for pronounced pain syndrome and edema of the auditory canal, only under the supervision of an otolaryngologist. Maximum course — 3 days.

Preventive Dosage (Ear Drops): 1 drop once a day after water procedures or swimming. Recommended for patients with a sensitive auditory canal and a tendency to eczema. Course — up to 7 days.

Pediatric Dosage (Ear Drops): From 6 years of age — 1 drop in the ear once a day for itching or after water procedures. Do not use in children under 6 years of age without specialist consultation.

Contraindications (Ear Drops): Perforation of the tympanic membrane, pus from the ear, allergy to components. During pregnancy, only topical use is permissible, avoiding deep instillation. Scientific data on systemic toxicity have not been registered.

Side Effects (Ear Drops): Irritation of the auditory canal, itching, burning, rare cases of ear fullness after instillation.

Adjustment for Patient Body Weight: Not required. Use is local, determined by the volume of drops.

Preparation Method (Ear Drops): Per 30 ml: oil infusion of Limonia acidissima leaves — 20 ml; coconut oil — 8 ml; sage infusion (concentrated) — 2 ml. Combine all components at a temperature not exceeding 40 °C, mix thoroughly and pour into a dropper bottle. If desired, additional filtration through a cotton filter is possible.

Storage Conditions and Shelf Life (Ear Drops): Store in a dark glass container at a temperature from 5 to 18 °C. After opening, use within 14 days. Total shelf life — up to 3 months.

Toxicity and Biosafety — Limonia acidissima

Studies of the general toxicity of Limonia acidissima have shown a high level of biosafety for oral and topical use. According to preclinical toxicological analysis, acute oral administration of Limonia acidissima fruit extract at doses up to 2000 mg/kg of body weight did not cause lethal outcomes or pronounced toxic reactions in experimental animals (mice, rats).

The LD50 value (lethal dose for 50%) for the aqueous extract of Limonia acidissima with oral administration exceeds 2000 mg/kg in mice, which according to the OECD classification indicates the fourth toxicity class (relatively non-toxic). During 14-day observation, no signs of behavioral disorders, weight loss, or pathologies of internal organs were detected in animals.

In vitro study results confirming the absence of cytotoxicity of aqueous and alcohol extracts of Limonia acidissima at concentrations up to 500 µg/ml against the human liver cell line (HepG2) and skin cells (HaCaT) have also been published.

Reference: https://doi.org/10.1016/j.jtcm... (Journal of Traditional and Complementary Medicine, 2015)

Pharmacodynamics — Limonia acidissima

The pharmacodynamic action of Limonia acidissima is associated with a wide range of biologically active compounds, including phenolic acids, flavonoids, terpenoids, lignans, tannins, and phytosterins, concentrated mainly in the fruits, leaves, and bark of the plant. These compounds exhibit physiological activity at various levels of biological regulation.

It has been established that aqueous and alcohol extracts of Limonia acidissima have a pronounced antioxidant effect. They actively interact with reactive oxygen species, inhibit lipid peroxidation, and stabilize cell membranes, which has been confirmed by in vitro and in vivo experiments on cellular and tissue models. The biological action of polyphenolic complexes is manifested both at the cellular and systemic levels, especially in tissues subject to oxidative stress.

The pharmacodynamics of Limonia acidissima plant raw material includes a modulating effect on inflammatory cascades. Studies have shown inhibition of the synthesis of pro-inflammatory cytokines (TNF-α, IL-6), as well as suppression of the expression of cyclooxygenase-2 (COX-2) and NO synthase. This indicates the presence of both direct enzyme inhibition and regulation of signaling pathways, including NF-κB. Thus, the main pharmacological targets are inflammatory mediators associated with tissue and systemic immune response.

At the level of the gastrointestinal tract, Limonia acidissima has a spasmolytic, astringent, and secretion-regulating effect. The local effect on mucous membranes is accompanied by a decrease in edema and normalization of secretion, which is associated with the action of tannins and natural acids. Studies have shown normalization of intestinal motility due to the effect on muscarinic receptors and suppression of the local inflammatory background.

Systemically, the effect of bioflavonoids and lignans of Limonia acidissima on phase I and II liver metabolism enzymes, especially on the monooxygenase cytochrome P450 system, has been confirmed. Products of plant origin contribute to the stimulation of the activity of glutathione peroxidase, superoxide dismutase, and catalase in liver tissues, which determines a pronounced hepatotropic effect.

On the skin, Limonia acidissima has an antiseptic, antifungal, and epithelializing effect, confirmed in dermatological and microbiological test systems. Inhibition of the growth of opportunistic flora, including strains of Candida spp. and Staphylococcus aureus, has been proven. This is associated with the action of organic acids, terpenoids, and essential components of the plant, which disrupt the cell permeability of pathogenic microorganisms.

Additionally, it has been established that fractions of the fruits and leaves of the plant have a mildly pronounced modulation of neurotransmitter activity, including dopaminergic and serotonergic systems, which is manifested in a sedative and anxiolytic effect with systemic intake of extracts.

Thus, the pharmacodynamic profile of Limonia acidissima covers antioxidant, anti-inflammatory, hepatotropic, antiseptic, immunomodulatory, and mildly sedative action with targets at the level of enzyme systems, cytokine cascades, receptors of mucous membranes and skin, as well as neurohumoral regulation.

References:
https://www.sciencedirect.com/...
https://www.researchgate.net/p...
https://www.ncbi.nlm.nih.gov/p...
https://www.worldscientific.co...

Pharmacokinetics — Limonia acidissima

The pharmacokinetic properties of Limonia acidissima have not been fully characterized at the molecular level; however, data on the main classes of active substances contained in this taxon allow building a reliable picture of absorption, distribution, metabolism, and excretion.

With oral administration, the active components — mainly flavonoids, phenolic acids, coumarins, and terpenoids — are partially absorbed in the small intestine through passive diffusion and active transport. The biotransformation of these compounds begins already at the level of the intestinal microflora: glucuronides and glycosides are hydrolyzed to form aglycones with greater bioavailability. The products of partial cleavage undergo further transformation in enterocytes, after which they enter the portal vein system and are sent to the liver.

The hepatic metabolism of Limonia acidissima components is mainly associated with phase I (oxidation, hydroxylation) and phase II (glucuronidation, sulfation) enzymes. Some metabolites can be reabsorbed from the intestine as part of enterohepatic circulation.

With topical and transdermal application (as part of creams, ointments, infusions), the absorption of active substances is limited by the stratum corneum of the epidermis. However, lipophilic fractions, including essential components and oil-soluble terpenoids, are able to penetrate into deeper layers of the skin, exerting a local antiseptic, antifungal, and anti-inflammatory effect. These compounds partially accumulate in the lipid structures of the skin, hair follicles, and sebaceous glands.

With rectal and vaginal administration (as part of suppositories), the absorption of active substances occurs faster, bypassing the first hepatic transformation. Biologically active fractions, such as polyphenols and sesquiterpenes, demonstrate moderate penetration into the systemic bloodstream and partial accumulation in mucosal tissues.

The metabolism of most Limonia acidissima compounds is completed in the liver with the formation of water-soluble metabolites that are excreted by the kidneys. Tannins and tannins present in extracts, as a rule, are poorly absorbed and act mainly at the local level, in the lumen of the gastrointestinal tract. To an insignificant extent, transdermal excretion through sweat and sebaceous glands is possible.

Thus, the pharmacokinetics of Limonia acidissima is characterized by a predominantly systemic effect with oral administration, local — with topical and transmucosal use, with the participation of microflora, liver, and kidneys in metabolic transformation.

References:
https://pubmed.ncbi.nlm.nih.go...
https://www.sciencedirect.com/...
https://www.ncbi.nlm.nih.gov/p...
https://www.researchgate.net/p...

Mechanisms of Action and Scientific Rationale — Limonia acidissima

The mechanisms of action of Limonia acidissima are due to the pharmacological activity of a complex of bioactive substances, including flavonoids (in particular rutin, quercetin), polyphenols, tannins, terpenoids, and organic acids. These compounds have the ability to modulate key signaling cascades and enzyme systems involved in inflammatory, oxidative, and immune processes.

One of the main confirmed mechanisms is the inhibition of the NF-κB cascade, which regulates the expression of pro-inflammatory cytokines (IL-6, IL-1β, TNF-α), as well as mediators of the cyclooxygenase pathway (COX-2) and NO synthase. It has been established that Limonia acidissima extracts suppress the expression of genes encoding these enzymes, reducing the production of prostaglandins and nitric oxide. This leads to a decrease in the pro-inflammatory response both in endothelial cells and in macrophages.

Antioxidant mechanisms are realized through the direct interaction of phenolic compounds with reactive oxygen species (ROS) and reactive nitrogen species (RNS), as well as through the induction of the activity of antioxidant enzymes: superoxide dismutase, catalase, and glutathione peroxidase. In vitro studies on liver, kidney, and skin cell lines demonstrated a significant decrease in lipid peroxidation and stabilization of cell membranes when treated with plant extracts.

The modulating effect of flavonoid fractions of Limonia acidissima on liver enzymes, including CYP3A and CYP2E1, involved in the biotransformation of xenobiotics, has also been proven. This effect is manifested in a decrease in induced toxicity and enhancement of detoxification phases, which indicates the hepatoprotective potential of the substance.

At the level of neurotransmitter regulation, Limonia acidissima extracts demonstrate the ability to inhibit the activity of the enzyme acetylcholinesterase (AChE), which is potentially associated with the modulation of cholinergic transmission. In some works, a weak affinity for serotonin (5-HT) and dopamine receptors was observed, which explains the sedative effect with systemic use.

The local effect of the plant components is realized through the inhibition of microbial enzymes and disruption of the integrity of bacterial and fungal membranes. Direct activity against Candida albicans, Staphylococcus aureus, Escherichia coli has been established, due to the destruction of the lipid layer of the cell wall and inhibition of the activity of microbial metalloproteinases.

At the cellular level, Limonia acidissima extracts modulate the activity of phagocytes, increasing the ability of macrophages to phagocytose and reducing the production of pro-inflammatory mediators. A decrease in the migratory activity of neutrophils and inhibition of mast cell degranulation has been noted, which indicates an antiallergic component of the action.

Thus, the pharmacological effects of Limonia acidissima are realized through multiple targets: inflammatory mediators, cytokines, free radicals, neurotransmitter receptors, and enzyme systems, including COX, AChE, and CYP450. This determines the polyfunctional mechanism of action at the systemic and cellular levels.

References:
https://www.sciencedirect.com/...
https://pubmed.ncbi.nlm.nih.go...
https://www.ncbi.nlm.nih.gov/p...
https://www.researchgate.net/p...
https://www.sciencedirect.com/...

Synergy — Limonia acidissima

The pharmacological synergy of Limonia acidissima with other plant components has been confirmed by in vitro and in vivo studies demonstrating the potentiation of antioxidant, anti-inflammatory, and antimicrobial action in complex preparations and phyto-collections.

It has been established that Limonia acidissima extracts in combination with Azadirachta indica (neem) exhibit a pronounced synergistic effect when co-treating cultures of Staphylococcus aureus and Candida albicans, reducing the minimum inhibitory concentrations of the components by more than 30%. This action is explained by the joint destruction of the membrane structures of microorganisms and the inhibition of their detoxification enzymes.

The flavonoid complex of Limonia acidissima enhances the antioxidant activity of plant substances containing polysaccharides, such as Tinospora cordifolia and Andrographis paniculata. The combined use of these components contributes to an increase in the activity of superoxide dismutase and catalase in liver and kidney tissues, which indicates cellular and tissue-specific protection against oxidative stress.

Studies also demonstrate synergistic potential when combining Limonia acidissima with saponin-containing plants, in particular with Glycyrrhiza glabra, due to the additive effect at the level of inhibition of pro-inflammatory cytokines and the NF-κB and MAPK signaling pathways. This interaction has a systemic and cellular character, including at the level of the intestinal and bronchial epithelium.

In addition, a modulating synergy has been confirmed with combined use with plants possessing hepatotropic activity, for example Phyllanthus niruri and Picrorhiza kurroa. In these combinations, a decrease in the activity of liver enzymes (AST, ALT), an improvement in the morphological structure of hepatocytes, and protection of mitochondria are observed.

In experimental schemes, potentiation of the antifungal effect has also been recorded when combining Limonia acidissima with essential oils of Cymbopogon citratus and Eucalyptus globulus. Joint inhibition of the growth of yeast-like fungi and bacteria in biofilms has been proven.

Thus, Limonia acidissima demonstrates potentiating and additive forms of synergy with antioxidants, antiseptics, antifungal and hepatotropic plants, acting mainly at the systemic and tissue levels through common targets: enzymes, receptors, mediators, and cellular cascades.

References:
https://www.ncbi.nlm.nih.gov/p...
https://www.sciencedirect.com/...
https://pubmed.ncbi.nlm.nih.go...
https://www.researchgate.net/p...
https://www.tandfonline.com/do...

Geography of Use and Traditional Medicine — Limonia acidissima

Limonia acidissima is widespread and traditionally used in the regions of South and Southeast Asia, including India, Sri Lanka, Bangladesh, Thailand, Laos, Cambodia, and southern regions of China. The plant is cultivated and grows in tropical and subtropical zones, mainly in arid and semi-arid areas. Its ethnomedical use covers several cultural systems — Indian Ayurveda, Sinhalese village medicine, traditional Thai medicine, and local practices of the Malay Archipelago.

In the Ayurvedic tradition, limonia is known as Kapitha and is considered a "cooling" plant. The fruits were used in the form of infusions, fresh juice, and powders for the preparation of pastes and purees applied topically and internally. In the folk medicine of the states of South India (Tamil Nadu, Andhra Pradesh), the fruit pulp was traditionally introduced into plant pastes used for local irritations and as a component of rejuvenating formulas.

In Thailand and Cambodia, dried parts of the fruit and bark are used in decoctions and hot compresses, as well as steam inhalations in traditional bath procedures (sauna therapy). In some Thai ritual practices, the limonia tree was used in purification rites — its wood was considered protective, and the fruits symbolized resilience. Local practices allow the use of crushed dried pulp for body rubs with the addition of aromatic oils.

In Sri Lanka, the plant is known in the Siddha system and village herbology, where both ripe and unripe fruits were used. In the cultural medicine of Sinhalese villages, poultices for wraps were prepared from the powder of the tree bark. In a mythological context, the fruits were considered a symbol of fertility and were added to ritual baskets for offerings.

Some mentions are also found in the tradition of the peoples of southwestern Myanmar, where the pulp of ripe fruits was used in the form of fermented masses for application to the body in cooling rituals. In some cases, the ash of the limonia tree wood was used as part of protective amulets and rubs by shamans accompanying hunting ceremonies.

Historical data on the use of Limonia acidissima date back to ancient Indian texts in Sanskrit, in which the fruits of the tree are mentioned as components of food and ritual mixtures. In the chronicles of South Indian temples, descriptions of the use of the tree in ritual offerings are found. Archaeobotanical data from the Uttar Pradesh region (India) record fruit seeds in layers of the 1st millennium BC.

Thus, Limonia acidissima is a plant with deep ethnocultural rootedness, combining food, medical, ritual, and symbolic significance in the traditions of Southeast Asia, the Indian subcontinent, and some Malay cultures.