Kathillaka (Punarnava, Rakta Punarnava)

Kathillaka, also known as Punarnava (Boerhavia diffusa), is a rejuvenative herb widely used in Ayurveda for its diuretic, anti-inflammatory, and hepatoprotective properties. It is beneficial in managing hypertension and kidney disorders.

Botanical name: Boerhavia diffusa. Also known as: Spreading Hogweed, Hogweed, Pigweed, Vishakhapara, Pathari, Satodi, Sharunai, Galizeru, Sabuni, Rakta punarnava, Vishakapra, Kathillaka, Punarnava, Shilatika, Varhsabhu, Jatila, Shivatika, Vruscheera, Shophaghni, Shothaghni, Bhauma, Krishnakhya, Krura, Lohita, Mandalpatrika, Nava, Navya, Nila, Nilapunarnava, Nilavarshabhu, Nilini, Pravrishenya, Punarbhava, Raktakanda, Raktapatrika, Raktapunarnava, Raktapushpa, Raktapushpika, Raktavarshabu, Sarini, Shilatika, Shonapatra, Shophagni, Shothagni, Shyma, Swatapunarnava, Vaishakhi, Varshabhava, Varshabhu, Varshaketu, Vikasvara, Vishaghni, Vishakarpara.

Properties

Diuretic activity, Anti-inflammatory action, Hepatoprotective effects, Antioxidant properties

Dosage

The typical adult dosage of Punarnava powder (churna) is 3–6 grams twice daily. Swarasa (Fresh juice): 5-10 ml. Bija Churna (Seed powder): 1-3 grams. Decoction (Kwatha): 50-100 ml. Some preparations recommend 12-24 ml before food, twice daily. Tablets: If using standardized extract tablets (250 mg), the usual dose is 2 tablets twice daily. Syrup: 10-20 ml with water after meals. It is recommended to start with lower doses (1-3 grams daily) and assess tolerance before increasing. Always consult with a qualified Ayurvedic practitioner before starting any new herbal treatment.

Classical attributes

Rasa: Tikta (Bitter), Kashaya (Astringent)
Virya: ["Ushna (Heating)"]
Vipaka: ["Katu (Pungent)"]

Benefits

Shothahara (Anti-inflammatory)
Mutrala (Diuretic)
Rasayana (Rejuvenative)
Yakrit Vikara (Liver disorders)

Traditional uses

Edema
Ascites
Renal disorders
Liver disorders
Hypertension
Inflammation

Dosha effects

vata: balancing
kapha: decreasing
pitta: balancing

Preparation methods

Swarasa (Fresh Juice): Fresh plant parts are crushed to extract the juice.
Churna (Powder): The plant is dried and ground into a powder.
Kwatha (Decoction): Fresh or dried herbs are boiled in water until the water is reduced to a quarter of the original amount. The general principle involves using fresh herbs cut into small pieces or dry herbs ground to a coarse powder, soaking them in water overnight, and then boiling the mixture on slow flame with continuous stirring.
Paste: Fresh drugs are taken and a fine paste is made.

Contraindications

Pregnancy: Avoid use during pregnancy, especially beyond the first trimester, due to potential uterine stimulation.
Breastfeeding: Use should be avoided during lactation.
Hypotension: Use with caution in individuals with low blood pressure, as it can further lower blood pressure.
Diuretic Interactions: Exercise caution when using Punarnava concurrently with potent diuretics (like furosemide) due to the risk of excessive fluid loss.
Drug Interactions: Punarnava may interfere with diuretic and hypertensive drugs, so it should be used under medical supervision.
Skin Sensitivity: For external applications, it is best to use Punarnava with coconut oil or water, especially if you have hypersensitive skin.
Electrolyte Imbalance: High doses (over 5g/day of root powder) may cause electrolyte imbalance, particularly sodium depletion. Monitor salt intake if taking high doses.

Side effects

Due to its diuretic properties, it may cause increased urination, dehydration, and electrolyte imbalance. Use with caution in individuals with high blood pressure or kidney disorders.
May cause dizziness or lightheadedness, especially in individuals with already low blood pressure.
Some people may experience stomach upset or nausea.
Rash or itching.
Medical supervision is required during pregnancy. Pregnant women should avoid high doses.

Interactions

As Punarnava acts as a diuretic, it may enhance the effects of other diuretic drugs, potentially leading to excessive fluid loss and electrolyte imbalance.
It may interact with hypertensive medications.
Cardiac medications that treat diuresis, vasodilation, and ACE inhibitors.
Salacia, which has similar properties to Punarnava, may lower blood sugar levels. Taking salacia along with diabetes medications might cause blood sugar to drop too low.
It may increase the activity of anxiolytics.

Clinical evidence

Meta-analyses of up to 5 RCTs and databases tracking 10+ clinical trials show that Boerhavia diffusa (Kathillaka) has potential benefits in reducing blood pressure and improving kidney function. Studies also indicate antibacterial, antiviral, antidiabetic, and antiestrogenic activities.

Ayurvedic karmas

Shothahara (Anti-inflammatory)
Mutrala (Diuretic)
Rasayana (Rejuvenative)
Yakrit Vikara (Liver disorders)

Classical clinical indications

Edema
Ascites
Renal disorders
Liver disorders
Hypertension
Inflammation