FWD 2 Expanded Commission E: Arnica flower

Herbal Medicine: Expanded Commission E

Arnica flower

Latin Name: Arnica montana or A.chamissonis subsp. foliosa
Pharmacopeial Name: Arnicae flos
Other Names: n/a

Overview

Arnica grows up to two feet in the mountainous regions of Europe and western North America (Foster, 1998; Grieve, 1979; Schulz et al., 1998). American arnica species include A. fulgens, A. sororia, and A. cordifolia. In Europe, A. chamissonis is cultivated in addition to A. montana to fill the demand for the estimated three hundred arnica-containing tinctures, ointments, and homeopathic remedies manufactured for the German market (Foster, 1998). Dried orange-yellow flower heads supply a therapeutic volatile oil, that contains fatty acids, aromatic terpenes, flavonoids, tannins, and sesquiterpenes of the helenalin type (Leung and Foster, 1996).

Arnica soothes sore muscles and reduces pain and inflammation. Europeans and Native Americans, who referred to arnica as mountain tobacco and leopard's bane, used it for sprains, bruises, and wounds (Grieve, 1979). Eclectic physicians, alternative medical practitioners of the late nineteenth and early twentieth centuries, recommended it for contusions and bruised muscles, mastalgia, and chronic sores or abscesses (Ellingwood, 1983). Rubbed on the head, arnica tincture was said to stimulate hair growth (Grieve, 1979). Some physicians recommended internal use for depression, dyspnea, typhoid, pneumonias, anemia, diarrhea, and cardiac weakness (Felter, 1922).

Contemporary studies demonstrate in vitro antimicrobial, anti-inflammatory, positive inotropic, respiratory-stimulating, and uterine activities (Schulz et al., 1998). Experimental trials suggest further potential uses. Arnica enhanced immune response in laboratory animals against Listeria monocytogenes and Salmonella typhimurium (Leung and Foster, 1996). One trial found that bile and liver enzyme levels improved when rats with carbon-tetrachloride-induced hepatic toxicity were administered phenols obtained from arnica (Marchishin, 1983). However, internal use of tinctures and fluidextracts is not recommended. Cardiac toxicity has been demonstrated, and arnica's effects on respiration and the uterus require further study. Oral administration of arnica is often accompanied by severe side effects. For this reason the monograph refers to the herb's external use only, in contrast to the comment section in the German Pharmacopoeia that refers to the internal use of a tea infusion of arnica for circulatory disorders of the heart and brain (DAB 8, 1978).

External use is also risky. Individuals sensitive to sesquiterpenes of the helenalin type may develop contact dermatitis from topical applications of arnica preparations. Edematous dermatosis and eczema have been reported following long-term use (Schulz et al., 1998). Arnica should not be applied to broken skin (McGuffin et al., 1997).

Arnica is a common homeopathic remedy. Arnica in a dilution of 6X is given to epileptics, and Arnica 3X may prevent seasickness (Grieve, 1979). However, its predominant place in homeopathy is now being questioned. A recent study determined that Arnica 30X was ineffective in reducing muscle soreness in long-distance runners (Vickers, 1998). Also, a literature review of available articles discussing applications of homeopathic arnica found no supportive evidence for use (Ernst, 1998).

Description

Arnica flower consists of the fresh or dried inflorescence of A. montana L. or A.chamissonis Less. subsp. foliosa (Nutt.) Maguiere [Fam. Asteraceae], as well as its preparations in effective dosage. It contains sesquiterpene lactones of the helenanolid type, predominantly ester derivatives of helenalin and 11,13-dihydrohelenalin. Additionally, the herb contains flavonoids (e.g., isoquercitrin, luteolin-7-glucoside, and astragalin), volatile oil (with thymol and its derivatives), phenol carbonic acid (chlorogenic acid, cynarin, caffeic acid), and coumarins (umbelliferone, scopoletin).

Chemistry and Pharmacology

The Commission E reports that when applied topically, arnica preparations have antiphlogistic (anti-inflammatory) activity. In cases of inflammation, arnica preparations also show analgesic and antiseptic activity. In animal studies, helenalin and dihydrohelenalin were found to have analgesic, antibiotic, antimicrobial and anti-inflammatory activity (Vanhaelen-Fastr, 1968; 1972; 1973). In vitro experiments concluded that helanalin also works as an immunostimulant (Leung and Foster, 1996).

Uses

The Commission E approved the external use of arnica flower for injuries and for consequences of accidents, e.g., hematoma, dislocations, contusions, edema due to fracture, rheumatic muscle and joint problems. It is also approved for use in inflammation of the oral and throat region, furunculosis, inflammation caused by insect bites, and superficial phlebitis.

Contraindications

Arnica allergy.

Side Effects

Prolonged treatment of damaged skin, e.g., use for injuries or ulcus cruris (indolent leg ulcers), often causes edematous dermatitis with the formation of pustules. Long use can also give rise to eczema. In treatment involving higher concentrations of the preparation, toxic skin reactions with formation of vesicles or even necroses may occur.

Use During Pregnancy and Lactation

No restrictions known.

Interactions with Other Drugs

None known.

Dosage and Administration

Unless otherwise prescribed:

Infusion: 2 g of herb per 100 ml of water.

Tincture: For cataplasm: 3-10 times dilution.

For mouth rinses: 10 times dilution.

As ointment: Not more than 20-25% tincture.

'Arnica oil':

Extract of 1 part herb and 5 parts fatty oil.

Ointments with not more than 15% 'arnica oil.'

References

Deutsches Arzneibuch, 8th ed. (DAB 8). 1978. Stuttgart: Deutscher Apotheker Verlag.

Ellingwood, F. 1983. American Materia Medica, Therapeutics and Pharmacognosy. Portland, OR: Eclectic Medical Publications [reprint of 1919 original].

Ernst, E. 1998. Efficacy of homeopathic arnica: a systematic review of placebo-controlled clinical trials. Arch Surg 133(11):11871190.

Felter, H.W. 1922. The Eclectic Materia Medica, Pharmacology and Therapeutics. Portland, OR: Eclectic Medical Publications.

Foster, S. 1998. 101 Medicinal Herbs: An Illustrated Guide. Loveland: Interweave Press.

Grieve, M. 1979. A Modern Herbal. New York: Dover Publications, Inc.

Leung, A. and S. Foster. 1996. Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics. 2nd ed. New York: John Wiley & Sons, Inc.

Marchishin, S.M. 1983. [Efficacy of the phenol compounds of Arnica in toxic lesion of the liver] [In Russian]. Farmakol Toksikol 46(2):102106.

McGuffin, M., C. Hobbs, R. Upton, A. Goldberg. 1997. American Herbal Product Association's Botanical Safety Handbook. Boca Raton: CRC Press.

Schulz, V., R. Hansel., V. Tyler. 1998. Rational Phytotherapy: A Physician's Guide to Herbal Medicine. New York: Springer Verlag.

Vanhaelen-Fastr, R. 1968. Cnicus benedictus: Separation of antimicrobial constituents. Plant Med Phytother (2):294299.

———. 1972. [Antibiotic and cytotoxic activity of cnicin isolated from Cnicus benedictus L.] [In French]. J Pharm Belg 27(6):683688.

———. 1973. [Constitution and antibiotical properties of the essential oil of Cnicus benedictus] [In French]. Planta Med 24(2):165175.

Vickers, A.J. 1998. Homeopathic Arnica 30X is ineffective for muscle soreness after long-distance running: a randomized, double-blind, placebo-controlled trial. Clin J Pain 14(3):227231.

Additional Resources

Baillargeon, L., J. Drouin, L. Desjardins, D. Leroux, D. Audet. 1993. [The effects of Arnicamontana on blood coagulation. Randomized controlled trial] [In French]. Can Fam Physician (39):23622367.

Hausen, B.M. 1978. Identification of the allergens of Arnica montana L. Contact Dermatitis 4(5):308.

Kaziro, G.S. 1984. Metronidazole (Flagyl) and Arnica Montana in the prevention of post-surgical complications, a comparative placebo-controlled clinical trial. Br J Oral Maxillofac Surg 22(1):4249.

Rossetti, V., A. Lombard, P. Sancin, M. Buffa. 1987. Characterization of Arnica montana L. flowers. Boll Chim Farm 126(11):458461.

Rudzki, E. and Z. Grzywa. 1977. Dermatitis from Arnica montana.Contact Dermatitis 3(5):281282.

Schroder, H. et al. 1990. Helenalin and 11 alpha, 13-dihydrohelenalin, two constituents from Arnica montana L., inhibit human platelet function via thiol-dependent pathways. Thromb Res 57(6):839845.

Tveiten, D., S. Bruseth, C.F. Borchgrevink, K. Lohne. 1991. [Effect of Arnica D 30 during hard physical exertion. A double-blind randomized trial during the Oslo Marathon] [In Norwegian]. Tidsskr Nor Laegeforen 111(30):36303631.

Wagner, H. et al. 1991. [Immunologic studies of plant combination preparations. In-vitro and in-vivo studies on the stimulation of phagocytosis] [In German]. Arzneimforsch 41(10):10721076.

Wagner, H., S. Bladt, E.M. Zgainski. 1983. Plant Drug Analysis. Berlin-Heidelberg: Springer Verlag.

This material was adapted from The Complete German Commission E Monographs—Therapeutic Guide to Herbal Medicines. M. Blumenthal, W.R. Busse, A. Goldberg, J. Gruenwald, T. Hall, C.W. Riggins, R.S. Rister (eds.) S. Klein and R.S. Rister (trans.). 1998. Austin: American Botanical Council; Boston: Integrative Medicine Communications.

1) The Overview section is new information.

2) Description, Chemistry and Pharmacology, Uses, Contraindications, Side Effects, Interactions with Other Drugs, and Dosage sections have been drawn from the original work. Additional information has been added in some or all of these sections, as noted with references.

3) The dosage for equivalent preparations (tea infusion, fluidextract, and tincture) have been provided based on the following example:

  • Unless otherwise prescribed: 2 g per day of [powdered, crushed, cut or whole] [plant part]
  • Infusion: 2 g in 150 ml of water
  • Fluidextract 1:1 (g/ml): 2 ml
  • Tincture 1:5 (g/ml): 10 ml

4) The References and Additional Resources sections are new sections. Additional Resources are not cited in the monograph but are included for research purposes.

This monograph, published by the Commission E in 1994, was modified based on new scientific research. It contains more extensive pharmacological and therapeutic information taken directly from the Commission E.

Excerpt from Herbal Medicine: Expanded Commission E Monographs
Copyright 2000 American Botanical Council
Published by Integrative Medicine Communications
Available from the American Botanical Council.