Arjun tree

Other Names

AarrumarutuAnjanAnjaniArjanArjhanArjunArjun GachhArjun SadadaArjunaArjunamAttumaruthuBilimaddiBilimattiCarambole marronChuncoa glabra Buch.-Ham. ex Wall.DevasalaDhanviDhanvinDhavalaEchte MyrobalaneErramaddiHanjalHolemattiIndradruIndradrumaKahuKahuaKakubhaKaravirakaKarvirakKohaKonkani Mathi RukKula maruthuKumbukMaddiMaiyokphaMalabar almondMarutham pattaiMarutuMathi RukMyrobalanus cuneata (B.Heyne ex Roth) KuntzeNadisarjaNeer mattiNeermaruduNeermaruthuNirmarutuNirmathiParthaPentaptera angustifolia Roxb.Pentaptera arjuna Roxb. ex DC.Pentaptera cuneata (Roth) DC.Pentaptera glabra Roxb.Pentaptera obovata DC.PhalgunaPoomarudhuRok faa khaaoSadadaSadadoSaduraSajadanSarpanaTella maddiTellamaddiTerminalia arjunaTerminalia arjuna (Roxb. ex DC.) Wight & Arn.Terminalia arjuna var. angustifolia (Roxb.) C.B.ClarkeTerminalia berryi Wight & Arn.Terminalia cuneata B.Heyne ex RothTerminalia glabra Wight & Arn.Terminalia ovalifolia RottlerTerminalia psidiifolia DelileTerminalia urjan RoyleToramattiTropical almondVeeravrikshaVeervrikshaVella maruduVellai maruthuVellamattaVellamatthiVenmarutuViravrikshaWhite marudahWhite murdhYerra maddi

Synopsis

Terminalia arjuna (Arjun Tree): A Comprehensive Reference

1. Identity, Botanical Classification, and Forms

Botanical name: Terminalia arjuna (Roxb. ex DC.) Wight & Arn. Family: Combretaceae. Common names: Vernacular names in Indian languages include white marudah, arjuna, arjunam, kakubha, and kahu. Additional synonyms include Indradru, Partha, and Veeravriksha.

Terminalia arjuna is a deciduous tree from the Combretaceae family, commonly found along rivers and streams in India's Indo-sub-Himalayan regions, including Delhi, Uttar Pradesh, Bihar, Madhya Pradesh, and the Deccan areas. This 60–80-foot-tall tree has been a foundation of traditional Indian medicine for centuries.

The genus Terminalia comprises a family, Combretaceae, that includes approximately 20 genera and 600 species, with the genus name referring to the terminal arrangement of leaves on many species in the group. T. arjuna is used primarily for its bark, while other Terminalia species are primarily used for their fruits.

Common Preparations and Forms

Arjuna powder is produced from the grinding and sieving of stem bark.
The ancient physician Chakradatta recommended it to be given as a decoction of bark with milk, or as a ghrita (a preparation with ghee or butter).
Standardized bark extracts (aqueous and alcoholic) have been used in clinical research, typically as encapsulated powder or proprietary preparations.
Traditional liquid preparations include Arjunarishta, a fermented decoction.

2. Traditional and Historical Use

T. arjuna has been a staple in Ayurvedic medicine for over 2,500 years, dating back to the Vedic period, and is extensively referenced in ancient Indian medical texts such as the Charaka Samhita, Sushruta Samhita, and Astanga Hridayam.

References to Terminalia arjuna date back over two millennia. The Charaka Samhita (1st–2nd century CE) mentions "Marudah" bark for balancing Vata and soothing the cardiac region. In the Sushruta Samhita, physicians praised Arjuna's bark decoction for stopping bleeding and accelerating healing of wounds.

An Indian physician named Vagbhata has been credited as the first to use this product for heart conditions in the seventh century A.D.

Terminalia arjuna is one kind of widely used medicinal plant used in various indigenous systems of medicine, including Ayurveda, Siddha, and Unani. Traditional Siddha practitioners in South India employed decoctions of Arjuna bark to fight infections, while Unani healers used its extracts for dropsy (edema).

Its bark decoction has been used in the Indian subcontinent for anginal pain, hypertension, congestive heart failure, and dyslipidemia, based on the observations of ancient physicians for centuries.

The bark was also employed for a range of conditions beyond the heart. The bark was decocted and used to treat diarrhoea and dysentery, whilst the powdered bark was used for asthma. It was also recommended for poisonings and scorpion stings. In traditional Ayurvedic medicine, Terminalia arjuna has been used to balance the three "humors": kapha, pitta, and vata.

Young branches of Terminalia arjuna are used as toothbrushes to alleviate toothaches.

3. Key Constituents and Active Compounds

Terminalia's active constituents include tannins, cardenolide, triterpenoid saponins (arjunic acid, arjunolic acid, arjungenin, arjun glycosides), flavonoids (arjunone, arjunolone, luteolin), gallic acid, ellagic acid, oligomeric proanthocyanidins (OPCs), phytosterols, calcium, magnesium, zinc, and copper.

The plants contain arjunilic acid and triterpene glycosides including arjunetosides I, II, III, and IV, arjunine, and arjunetein. Additional identified compounds include arjungenin and arjunetin, the former being an aglycone similar to arjunic and arjunolic acids; arjunasides A–E (triterpenoid monoglycosides); arjunetoside; tannin structures (gallic and ellagic acids), 3-O-methylellagic acid 4′-O-α-L-rhamnopyranoside, casuarinin, and arjunin.

The three main triterpenoids (arjunic acid, arjunolic acid, arjungenin) are commonly regarded as the main active ingredients, with other named compounds (such as terminoside and arjunoside) tending to be glycosides of the three aglycones.

Mechanisms of Action

Triterpenoids are mainly responsible for cardiovascular properties. Tannins and flavonoids are responsible for its anticancer properties.

Cardioprotection: Arjunolic acid, an oleanane triterpenoid, exhibited cardiac protective action in isoproterenol-induced myocardial necrosis in rats by restoring levels of various antioxidant molecules. Arjunolic acid prevents heart injury by maintaining levels of cardiac antioxidants, reduced lipid peroxide, and MPO activity (myeloperoxidase, a marker of leukocyte accumulation).

Antioxidant activity: Arjunic acid and arjungenin, as well as their glycosides (arjunetin and arjunglucoside II), are able to scavenge free radicals without significantly influencing superoxide release from polymorphonuclear immune cells. Arjungenin and its glucoside exhibited a moderate free radical scavenging activity, while arjungenin also exhibited greater inhibitory action on hypochlorous acid production from human neutrophils.

Anti-ischemic and lipid effects: It has been extensively studied in animal models to demonstrate cardioprotective properties, ranging from positive inotropic, hypolipidemic, coronary vasodilatory, and antioxidant effects to induction of stress protein in the heart.

Antimicrobial effects: The major bioactive constituents, including tannins, flavonoids, and phenolic compounds, are known for their antimicrobial properties; these compounds interfere with bacterial cell walls, leading to cell lysis and death.

Antidiabetic activity: Several studies have confirmed that antihyperglycemic, analgesic, and antioxidant properties were due to flavonoids, while cardioprotective activity is attributed to triterpenoids.

4. Scientific Evidence by Area of Use

4.1 Cardiovascular Disease — Heart Failure

The earliest and most frequently cited clinical investigation was a small double-blind crossover study. Twelve patients with refractory chronic congestive heart failure (Class IV NYHA), related to idiopathic dilated cardiomyopathy (10 patients), previous myocardial infarction (1 patient), and peripartum cardiomyopathy (1 patient), received Terminalia Arjuna bark extract (500 mg every 8 hours) or matching placebo for 2 weeks each, separated by 2 weeks washout period, in a double-blind crossover design as an adjuvant to maximally tolerable conventional therapy. Terminalia arjuna, compared to placebo, was associated with improvement in symptoms and signs of heart failure, improvement in NYHA Class (Class III vs. Class IV), and decrease in echo-left ventricular end-diastolic dimensions.

A more rigorously designed trial was subsequently conducted. In a double-blind, parallel, randomized, placebo-controlled add-on clinical trial, 100 patients of CHF of New York Heart Association (NYHA) functional class II on standard pharmacotherapy with echocardiographic left ventricular ejection fraction ≤40% were consecutively recruited and randomized 1:1 to Arjuna extract 750 mg or matching placebo twice daily. However, well-designed clinical trials exploring its efficacy and safety in chronic heart failure were acknowledged to be lacking at the outset of that trial.

Data for Terminalia arjuna are limited to a single product formulation evaluated in a small number of subjects. Additional well-controlled comparative trials are needed, and safety profiles must be established before its use can be recommended.

4.2 Chronic Stable Angina

Terminalia arjuna has been reported to have beneficial effects in patients with ischemic heart disease in a number of small, open studies. A double-blind, randomized, placebo-controlled study was conducted in which Terminalia arjuna bark extract (500 mg 8-hourly), given to patients with stable angina with provocable ischemia on treadmill exercise, led to improvement in clinical and treadmill exercise parameters compared to placebo therapy; these benefits were similar to those observed with isosorbide mononitrate.

Specifically, fifty-eight males with chronic stable angina (NYHA class II-III) with evidence of provocable ischemia on treadmill exercise test received Terminalia arjuna (500 mg 8-hourly), isosorbide mononitrate (40 mg/daily), or matching placebo for one week each, separated by a washout period of at least three days, in a randomized, double-blind, crossover design.

In an open-label trial, a 50% reduction in angina episodes was demonstrated along with a significant delay in the time to onset of angina on treadmill exercise test (TMT) and appearance of ST–T changes in ECG after arjuna therapy in stable angina patients. Significant lowering of systolic blood pressure and body mass index, with a marginal improvement in left ventricular ejection fraction and a slight increase in HDL levels, were also observed. In unstable angina patients, there was an insignificant reduction in anginal frequency.

A 2014 systematic review and meta-analysis (Kaur et al., Cardiology Research and Practice) concluded: the evidence is insufficient to draw any definite conclusions in favour of or against Terminalia arjuna in patients of chronic stable angina, and further well-controlled multicentric clinical trials need to be conducted in a large number of patients to explore its therapeutic potential.

4.3 Dyslipidemia and Cholesterol

To evaluate the antioxidant and hypocholesterolaemic effects of Terminalia arjuna tree bark (a popular cardiotonic substance in the Indian pharmacopoeia) and compare it with a known antioxidant, vitamin E, a randomized controlled trial was performed in 105 successive patients with coronary heart disease. Group I received placebo capsules; Group II received vitamin E capsules (400 units/day); and Group III received finely pulverized T. arjuna tree bark powder (500 mg) in capsules daily, with lipid and lipid peroxide levels determined at 30 days' follow-up. In the arjuna group, there was a significant decrease in total cholesterol (−9.7 ± 12.7%) and LDL cholesterol (−15.8 ± 25.6%). Lipid peroxide levels decreased significantly in both treatment groups; this decrease was more in the vitamin E group (−36.4 ± 17.7%) compared to the T. arjuna group (−29.3 ± 18.9%). Terminalia arjuna tree bark powder has significant antioxidant action that is comparable to vitamin E and also has a significant hypocholesterolaemic effect.

Animal studies (rats and hamsters) have provided supporting preclinical evidence for lipid-lowering effects: at doses of 250 mg/kg p.o., only the ethanolic fraction exerted significant lipid-lowering effect as assessed by reversal of plasma levels of total cholesterol, triglycerides, and phospholipids in hyperlipidemic rats. These findings are preliminary and from animal models.

4.4 Antidiabetic / Antihyperglycemic Effects

A 3-month randomized clinical trial enrolled 60 type-2 diabetes mellitus patients. The study analyzed bark of T. arjuna for its antihyperglycemic effects alongside safety; one group received T. arjuna 1 g with metformin 500 mg twice daily, and the comparator group received sitagliptin 100 mg once daily with metformin 500 mg twice daily. Fasting blood sugar and HbA1c showed significant reduction in both groups; reduction in FBS at 12 weeks in the sitagliptin/metformin vs. the arjuna/metformin group was comparable (HbA1c −0.90 ± 0.34 vs. −0.89 ± 0.29), a non-significant difference. No side effects were observed in the arjuna group, while the sitagliptin group reported minor adverse effects in a small number of patients. This is a single, small trial and evidence in this domain is considered preliminary.

4.5 Atherosclerosis and Endothelial Function

A number of clinical studies have reported beneficial effects of arjuna in patients of chronic stable angina, endothelial dysfunction, heart failure, and even ischemic mitral regurgitation. A study published in the Journal of Cardiovascular Translational Research (2015, PMID: 25827448) assessed short-term adjuvant therapy with Terminalia arjuna in stable coronary artery disease patients, providing evidence of attenuation of ongoing inflammation and immune imbalance. Most studies, both experimental and clinical, have suggested that the crude drug possesses anti-ischemic, antioxidant, hypolipidemic, and antiatherogenic activities.

4.6 Antimicrobial and Periodontal Applications

In vitro work has shown that both aqueous and ethanolic extracts had very good antimicrobial activity against Staphylococcus aureus, Pseudomonas species, and Escherichia coli. The aqueous extract showed higher anti-inflammatory activity than the ethanolic extract. Bioactive compounds such as flavonoids and tannins have demonstrated efficacy in controlling bacterial colonization and reducing inflammation in periodontal pockets, making T. arjuna a promising candidate for inclusion in herbal-based local drug delivery systems. Most evidence in this area remains in vitro or in early proof-of-concept studies rather than large-scale randomized human clinical trials.

4.7 Anti-inflammatory Effects

Both alcoholic and aqueous extracts of the bark attenuated H₂O₂-mediated reactive oxygen species generation in human monocytic cells by promoting catalase and glutathione peroxidase (GPO) activities and by sustaining cellular reducing power. Anti-inflammatory activity has also been evaluated via the egg albumin denaturation assay in vitro, though human clinical data specifically for inflammatory conditions beyond cardiovascular disease are sparse.

4.8 Anticancer Potential

Arjunic acid isolated from the bark of T. arjuna was cytotoxic against human oral (KB), ovarian (PA 1), and liver (HepG2 and WRL-68) cancer cell lines. An aqueous extract of T. arjuna bark reduced buccal pouch carcinomas in hamsters, decreased lipid peroxidation, and increased antioxidant levels. These findings are preclinical (cell lines and animal models); no human clinical trials have established anticancer efficacy.

Overall Evidence Assessment

Most of the studies, both experimental and clinical, have suggested that the crude drug possesses anti-ischemic, antioxidant, hypolipidemic, and antiatherogenic activities. However, Terminalia species have been evaluated to a limited extent for potential hepatoprotective, cardiovascular, cholesterol-reducing, dermatologic, antimicrobial, antioxidant, and urate-lowering effects; however, clinical trial data are lacking to recommend use for any indication. The overall body of clinical evidence must be regarded as preliminary due to small sample sizes, methodological heterogeneity, and limited number of controlled trials.

5. Body Systems and Health Areas of Association

Cardiovascular system: Cardiac tonic, anti-ischemic, antihypertensive, positive inotropic, hypolipidemic, antithrombotic, and coronary vasodilatory effects.
Metabolic / endocrine: Antihyperglycemic, antidyslipidemic.
Immune / inflammatory: Antioxidant, anti-inflammatory, immunomodulatory.
Oral health: Antimicrobial against periodontal pathogens; potential local drug delivery agent for chronic periodontitis.
Gastrointestinal: Gastroprotective; traditional use for diarrhoea and dysentery.
Integumentary / wound healing: Astringent and antimicrobial properties supporting wound healing.
Oncology (preclinical only): Cytotoxicity against certain cancer cell lines in vitro; antimutagenic activity in laboratory models.

These activities — antimicrobial, anticancer, cardioprotective, antifungal, antidiabetic, antioxidant, anti-inflammatory, hypolipidemic, anthelmintic, insecticidal, wound healing, antiacne, and gastroprotective — have been reported in phytochemical and pharmacological studies of T. arjuna.

6. Dosage Forms and Dosages Reported in Studies

T. arjuna bark extract 500 mg every 8 hours (reported treatment durations of 1 to 2 weeks) has been used in clinical studies evaluating effects on cardiovascular disorders.

Heart failure (crossover trial, Dwivedi et al.): Bark extract 500 mg every 8 hours for 2 weeks.
Stable angina (double-blind crossover, Bharani et al.): 500 mg of bark extract 8-hourly for one week per treatment arm.
Chronic heart failure (double-blind RCT, Maulik et al., 2016): 750 mg of aqueous stem bark extract or matching placebo twice daily.
Cholesterol/antioxidant RCT: Finely pulverized T. arjuna tree bark powder, 500 mg daily in capsules.
Antihyperglycemic trial: T. arjuna 1 g with metformin 500 mg twice daily for 3 months.

No standardized or officially recommended human dosage has been established by a major regulatory or pharmacopeial body for any specific indication.

7. Safety Considerations and Drug Interactions

Short-Term Safety

So far, no serious side effects have been reported with arjuna therapy. However, its long-term safety still remains to be elucidated.

Arjuna has been in use for long and is considered to be effective for angina with no major side effects in short-term studies. However, pharmacovigilance studies during long-term therapy have not been conducted.

Adverse reactions similar to those with placebo (constipation, headache, abdominal discomfort, body ache) have been described.

Potential Toxicity at High Doses

In rats, it was suggested that high amounts of T. arjuna extract could cause hepatotoxicity and hypothyroidism. This finding was from animal studies and has not been replicated in human clinical investigations.

Drug–Drug and Drug–Herb Interactions

CYP enzyme inhibition: Alcoholic and aqueous extracts of T. arjuna have been identified to possess strong inhibitory potential of CYP3A4, CYP2D6, and CYP2C9 enzymes in human liver microsomes, which are involved in the metabolism of many drugs. Alcoholic and aqueous bark extract of T. arjuna showed potent inhibition of all three enzymes in human liver microsomes with IC₅₀ values less than 50 μg/mL. Arjunic acid, arjunetin, and arjungenin did not show significant inhibition of CYP enzymes in human liver microsomes. Enzyme kinetics studies suggested that the extracts of arjuna showed reversible non-competitive inhibition of all three enzymes. These findings suggest strongly that arjuna extracts significantly inhibit the activity of CYP3A4, CYP2D6, and CYP2C9 enzymes, which is likely to cause clinically significant drug–drug interactions mediated via inhibition of these major CYP isozymes.

Anticoagulant/antiplatelet interactions: Terminalia arjuna might slow blood clotting; taking Terminalia arjuna along with medications that also slow blood clotting might increase the risk of bruising and bleeding. Experiments in rats administered arjunolic acid extracted from T. arjuna demonstrated an antiplatelet and anticoagulant action similar to that of acetylsalicylic acid.

Cardiac medications: The bark of the Terminalia arjuna tree contains chemicals that might stimulate the heart and may also have effects that lower cholesterol and blood pressure. Concurrent use with cardiac drugs requires attention given additive or potentiating cardiovascular effects.

Statin co-administration: Considering its anti-ischemic activity and its potential to correct dyslipidemia, reduce left ventricular mass, and increase left ventricular ejection fraction, it is essential to examine the molecular mechanism of its action. The proposition to administer Terminalia arjuna along with statins deserves to be explored in depth for defining its place in the overall management and prevention of coronary artery disease.

When taken by mouth, Terminalia arjuna is possibly safe when used for up to 3 months. The evidence base for safety beyond this period in controlled human studies is limited.

References

Health Conditions

Health conditions that Arjun tree may help support.

No conditions available.

Body Systems

Body systems that Arjun tree may help support.

No body systems available.