T h e r a p e u t i c I n d e x 232 Dosage 1 tablet twice daily. Treatment may be continued till the symptoms are relieved. Adverse Effects No adverse effects have been reported. Contraindications Not recommended in the first trimester of pregnancy. Special Precautions Pregnancy and lactation. Drug Interactions No clinically significant drug interactions have been reported. Presentation Box of 2 blister-pack strips of 30 tablets each. Pharmacological Actions of Principal Ingredients 1. Anti-inflammatory and analgesic actions: Boswellia serrata is a proven potent anti-inflammatory agent as it inhibits leukotriene (LT) biosynthesis. 11-keto-boswellic acids from Boswellia serrata prevents TNFα-induced expression and activity of matrix metalloproteinases (MMP-3, MMP-10, and MMP-12), thus exhibiting potent anti-inflammatory property both in vitro and in vivo. Alpinia galanga suppresses prostaglandin synthesis through the inhibition of COX-1 and COX-2, and thus provides anti-inflammatory action. Tribulus terrestris inhibits prostaglandin E2 and COX-2 activity, thus proving to be a potent anti-inflammatory agent. Tinospora cordifolia reduces IL-1β production and inhibits TNFα, and hence, is a potent anti-inflammatory agent. Vitex negundo is a strong anti-inflammatory and analgesic agent. Zingiber officinale is a potent inhibitor of the prostaglandin-biosynthesizing enzyme (PG synthetase) and arachidonate 5-lipoxygenase (an enzyme of LT biosynthesis), and inhibits biotransformation of arachidonic acid (AA) comparable to indomethacin. Zingiber officinale attenuates COX-1/TX synthase (thromboxane synthase) enzymatic activity, and has an inhibitory effect on COX-2 enzymes. COX-1 and 2 (regulated by the eukaryotic transcription factor NF-kappa B) are recognized as molecular targets for actions of Zingiber officinale. The gingerol in Zingiber officinale acts by interfering with intracellular signaling cascades, those involving NF-kappa B and mitogen-activated protein kinases. Zingiber officinale significantly inhibits prostaglandin E2 production. 2. Antioxidant action: Commiphora wightii causes inhibition of nitric oxide (NO) formation, and has a scavenging effect on 2,2-diphenyl-1-picrylhydrazyl (DPPH) radicals. Alpinia galanga inhibits lipid peroxidation. The glabridin from Glycyrrhiza glabra has potent antioxidant activity. Rumalaya® forte (tablet)
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