Crataeva

The drug is varuna, the stem bark, taken as a decoction or a powder.

Its central use is for urinary stones, described in Ayurveda under the heading ashmari ^{4Reference 4Agarwal et al. · 2010AnimalUrolithic property of Varuna (Crataeva nurvala): an experimental study — animal modelView study →}. The bark is used to break down stones and gravel, to prevent their return, and as a diuretic, and it is also given to protect the kidneys ^{20Reference 20Choucry et al. · 2018AnimalProtective action of Crateva nurvala extracts against renal ischaemia-reperfusion injury — animal modelView study →}.

It is prescribed for painful or difficult urination, urinary retention and urinary tract infection.

The bark is bitter and astringent. It is also used as a digestive, as an anti-inflammatory, and on the skin for abscesses, boils and swellings.

Across South Asia the plant is used for inflammation, rheumatic fever, gastric irritation and constipation ^{26Reference 26Moniruzzaman et al. · 2018AnimalLeaves of Crataeva nurvala modulate locomotor and anxiety behaviours possibly through the GABAergic system — animal modelView study →}. Other recorded uses include fever, as a laxative, as a tonic and as a contraceptive ^{24Reference 24Moniruzzaman et al. · 2014AnimalAntinociceptive effect of methanolic extract of Crataeva nurvala leaves — animal modelView study →}. In folk practice the stem bark is also used for urinary stones and for memory problems ^{25Reference 25Bhattacharjee et al. · 2015AnimalNootropic activity of Crataeva nurvala against scopolamine-induced cognitive impairment — animal modelView study →}.

The stem-bark decoction studied here is the traditional preparation. In rats, the decoction lowered the liver enzyme glycolate oxidase, which makes oxalate, and reduced stone-forming deposits in the kidney ^{1Reference 1Varalakshmi et al. · 1990AnimalEffect of Crataeva nurvala in experimental urolithiasis — animal modelView study →}. It also lowered small-intestinal Na⁺/K⁺-ATPase activity ^{5Reference 5Varalakshmi et al. · 1991AnimalEffect of Crataeva nurvala on the biochemistry of the small intestinal tract of normal and stone-forming rats — animal modelView study →}.

Oral lupeol, the bark’s marker triterpene, at 25 mg/kg reduced urinary oxalate and markers of kidney tubule damage in rats given ammonium oxalate for 15 days ^{2Reference 2Malini et al. · 1995AnimalEffect of lupeol, a pentacyclic triterpene, on urinary enzymes in hyperoxaluric rats — animal modelView study →}.

In a bladder-stone model, lupeol and the related triterpene betulin equally reduced crystal-induced oxidative damage in the kidney and bladder. Both restored superoxide dismutase, catalase and glutathione peroxidase ^{3Reference 3Malini et al. · 2000AnimalProtective effect of triterpenes on calcium oxalate crystal-induced peroxidative changes in experimental urolithiasis — animal modelView study →}. The authors proposed that inhibiting crystal aggregation is part of the mechanism ^{3Reference 3Malini et al. · 2000AnimalProtective effect of triterpenes on calcium oxalate crystal-induced peroxidative changes in experimental urolithiasis — animal modelView study →}.

A rat model with a stone surgically implanted in the bladder also responded to the decoction ^{4Reference 4Agarwal et al. · 2010AnimalUrolithic property of Varuna (Crataeva nurvala): an experimental study — animal modelView study →}.

In a double-blind trial of 77 patients, an Ayurvedic product of varuna plus banana stem reduced the size of 5–10 mm stones by 33%, against a 5% increase on placebo, and lowered pain scores ^{6Reference 6Patankar et al. · 2008RCTA prospective, randomized, controlled study of the Ayurvedic formulation “varuna and banana stem” in urinary stones — randomised controlled trialView study →}. A review places lupeol among the pentacyclic triterpenes with potential against kidney stones ^{7Reference 7Lobine et al. · 2020ReviewAntiurolithiatic effects of pentacyclic triterpenes — reviewView study →}.

Gap: both human trials used a multi-herb formula, so varuna’s own contribution is unproven and no standardised single-herb dose exists.

In rats with adjuvant arthritis, a model of rheumatoid inflammation, oral lupeol and its synthetic ester lupeol linoleate (50 mg/kg for 8 days) corrected lipid peroxidation and antioxidant enzyme changes ^{9Reference 9Geetha et al. · 1998AnimalEffect of triterpenes from Crataeva nurvala stem bark on lipid peroxidation in adjuvant-induced arthritis — animal modelView study →}. The ester worked better than lupeol ^{9Reference 9Geetha et al. · 1998AnimalEffect of triterpenes from Crataeva nurvala stem bark on lipid peroxidation in adjuvant-induced arthritis — animal modelView study →}. It also reduced paw thickness and complement activity more than both lupeol and indomethacin ^{10Reference 10Geetha et al. · 1999AnimalAnticomplement activity of triterpenes from Crataeva nurvala stem bark in adjuvant arthritis — animal modelView study →}.

In LPS-stimulated macrophages, an ethanol bark extract cut nitric oxide and IL-6, and lowered IL-1β gene expression ^{8Reference 8Cho et al. · 2015In vitroAnti-inflammatory effects of Crataeva nurvala are mediated via inactivation of ERK but not NF-κB — in vitroView study →}. The effect ran through reduced ERK activity, not NF-κB, and the extract did not suppress COX-2 or TNF-α ^{8Reference 8Cho et al. · 2015In vitroAnti-inflammatory effects of Crataeva nurvala are mediated via inactivation of ERK but not NF-κB — in vitroView study →}.

Computer and cell screens have found bark compounds that act on inflammatory pathways ^{11Reference 11Nithin Krishna et al. · 2024In vitroDevelopment of an anti-inflammatory drug from Crataeva nurvala — in silico and in vitroView study →}. A 2026 study of Crateva magna, the accepted name for this plant, reported anti-arthritic effects through TNF signalling in cells and in rats with adjuvant arthritis ^{12Reference 12Pattanaik et al. · 2026In vitroCrateva magna ameliorates rheumatoid arthritis via TNF-signalling — in silico, in vitro and in vivo (animal model)View study →}.

No human anti-inflammatory trial exists.

Among five Indian medicinal barks tested in vitro, crataeva bark had the highest phenolic and tannin content and the strongest superoxide dismutase-like activity ^{13Reference 13Kumari et al. · 2008In vitroScreening of antioxidant potential of selected barks of Indian medicinal plants — in vitroView study →}.

In rats, an ethanol bark extract (150 mg/kg) protected the prostate against oxidative damage from testosterone and a chemical carcinogen ^{14Reference 14Kumar et al. · 2012AnimalModulatory effects of Crataeva nurvala bark against testosterone- and NMU-induced oxidative damage in prostate — animal modelView study →}. Another ethanol bark extract (100 mg/kg for four weeks) lowered oxidative-stress markers and restored catalase and superoxide dismutase in the kidneys of rats with two-kidney, one-clip hypertension ^{15Reference 15Jahan et al. · 2023AnimalCrataeva nurvala bark extract modulates oxidative-stress gene expression and restores antioxidant enzymes in kidney and heart of 2K1C rats — animal modelView study →}.

Leaf and stem bark published as C. magna, the accepted name for this plant, showed antioxidant activity and inhibited α-glucosidase, an enzyme involved in blood-sugar control ^{16Reference 16Loganayaki et al. · 2012In vitroCrataeva magna: antioxidant activity and inhibition of key enzymes relevant to hyperglycemia — in vitroView study →}.

All of this is preclinical, with no human data.

The best human evidence for a urinary use comes from Urox®, a proprietary blend of crataeva stem bark, horsetail (Equisetum arvense) stem and Lindera aggregata root ^{17Reference 17Schoendorfer et al. · 2018RCTUrox (Crataeva nurvala stem bark, Equisetum arvense, Lindera aggregata) for overactive bladder and urinary incontinence — phase 2 randomised, double-blind, placebo-controlled trialView study →}. The crataeva extract is standardised to 1.5% lupeol ^{18Reference 18Schloss et al. · 2019RCTRandomised, double-blind, placebo-controlled trial protocol of a herbal combination for nocturnal enuresis in children — clinical trial protocolView study →}.

In a phase 2, randomised, double-blind, placebo-controlled trial of 150 adults over 8 weeks, the blend reduced daytime urinary frequency (7.7 against 11.0 a day on placebo), nocturia, urgency and incontinence ^{17Reference 17Schoendorfer et al. · 2018RCTUrox (Crataeva nurvala stem bark, Equisetum arvense, Lindera aggregata) for overactive bladder and urinary incontinence — phase 2 randomised, double-blind, placebo-controlled trialView study →}. The trial was funded by the product’s maker, and one author holds the patent ^{17Reference 17Schoendorfer et al. · 2018RCTUrox (Crataeva nurvala stem bark, Equisetum arvense, Lindera aggregata) for overactive bladder and urinary incontinence — phase 2 randomised, double-blind, placebo-controlled trialView study →}.

A trial protocol extends the same blend to bedwetting in children aged 6 to 14 ^{18Reference 18Schloss et al. · 2019RCTRandomised, double-blind, placebo-controlled trial protocol of a herbal combination for nocturnal enuresis in children — clinical trial protocolView study →}.

Gap: both trials tested a three-herb combination, so nothing here belongs to varuna specifically. No single-herb overactive-bladder study exists.

Lupeol isolated from the stem bark (40–80 mg/kg for 10 days) lowered blood urea nitrogen, creatinine and lipid peroxidation, and raised glutathione and catalase, in rats with cisplatin kidney damage ^{19Reference 19Shirwaikar et al. · 2004AnimalEffect of lupeol isolated from Crataeva nurvala stem bark against free-radical-induced nephrotoxicity in rats — animal modelView study →}.

Given before a one-hour block of blood flow to the kidney, both leaf and bark extracts reduced kidney damage, oxidative stress and inflammatory markers ^{20Reference 20Choucry et al. · 2018AnimalProtective action of Crateva nurvala extracts against renal ischaemia-reperfusion injury — animal modelView study →}. The bark and leaf extracts had similar chemical profiles, with flavonoids the main class ^{20Reference 20Choucry et al. · 2018AnimalProtective action of Crateva nurvala extracts against renal ischaemia-reperfusion injury — animal modelView study →}.

A bark extract also protected the kidneys in the two-kidney, one-clip hypertension model ^{15Reference 15Jahan et al. · 2023AnimalCrataeva nurvala bark extract modulates oxidative-stress gene expression and restores antioxidant enzymes in kidney and heart of 2K1C rats — animal modelView study →}.

Gap: all rodent, all short-term.

A single research group found that lupeol and lupeol linoleate (50 mg/kg for 10 days) offset cyclophosphamide heart toxicity in rats ^{21,22Reference 21Sudharsan et al. · 2005AnimalCardioprotective effect of lupeol and its ester on cyclophosphamide-induced oxidative stress — animal modelView study →Reference 22Sudharsan et al. · 2005AnimalRole of lupeol and its ester on cyclophosphamide-induced hyperlipidaemic cardiomyopathy in rats — animal modelView study →}. They normalised lactate dehydrogenase and creatine phosphokinase, reduced lipid peroxidation and corrected blood-lipid changes ^{21,22Reference 21Sudharsan et al. · 2005AnimalCardioprotective effect of lupeol and its ester on cyclophosphamide-induced oxidative stress — animal modelView study →Reference 22Sudharsan et al. · 2005AnimalRole of lupeol and its ester on cyclophosphamide-induced hyperlipidaemic cardiomyopathy in rats — animal modelView study →}.

The work is on the isolated constituent in one chemotherapy-toxicity model.

Lupeol (100 mg/kg for 7 days) reduced aflatoxin B1 liver damage in rats and restored liver antioxidant status, about as well as silymarin at the same dose ^{23Reference 23Preetha et al. · 2006AnimalLupeol ameliorates aflatoxin-B1-induced peroxidative hepatic damage in rats — animal modelView study →}.

This is a single animal study of the isolated constituent, with no whole-bark or human data.

A methanol extract of crataeva leaves (50–200 mg/kg) relieved pain in mice in hot-plate, tail-immersion and acetic-acid writhing tests, with up to about 66% inhibition of writhing ^{24Reference 24Moniruzzaman et al. · 2014AnimalAntinociceptive effect of methanolic extract of Crataeva nurvala leaves — animal modelView study →}. Naloxone reversed part of the effect, pointing to opioid involvement ^{24Reference 24Moniruzzaman et al. · 2014AnimalAntinociceptive effect of methanolic extract of Crataeva nurvala leaves — animal modelView study →}.

Gap: one study, using leaf extract rather than the stem bark the herb is actually taken as — so it says nothing about the traditional preparation.

An ethanol stem-bark extract improved learning and memory in rats with scopolamine-induced amnesia on elevated-plus-maze and Y-maze tasks ^{25Reference 25Bhattacharjee et al. · 2015AnimalNootropic activity of Crataeva nurvala against scopolamine-induced cognitive impairment — animal modelView study →}. It lowered brain acetylcholinesterase activity in a dose-dependent way, comparable to piracetam ^{25Reference 25Bhattacharjee et al. · 2015AnimalNootropic activity of Crataeva nurvala against scopolamine-induced cognitive impairment — animal modelView study →}.

A single rodent study, unreplicated, with no human cognitive data.

Methanol leaf extracts reduced movement and showed anxiety-reducing behaviour in mice across open-field, hole-cross, elevated-plus-maze and light-dark tests ^{26,27Reference 26Moniruzzaman et al. · 2018AnimalLeaves of Crataeva nurvala modulate locomotor and anxiety behaviours possibly through the GABAergic system — animal modelView study →Reference 27Ali et al. · 2014AnimalIn vivo sedative and cytotoxic activities of methanol extract of Crataeva nurvala leaves — animal modelView study →}. One study linked the effect to the GABA system, because the extract lengthened thiopental sleep ^{26Reference 26Moniruzzaman et al. · 2018AnimalLeaves of Crataeva nurvala modulate locomotor and anxiety behaviours possibly through the GABAergic system — animal modelView study →}.

Both studies used leaf extract rather than the medicinal bark. One also reported toxicity in a brine-shrimp assay ^{27Reference 27Ali et al. · 2014AnimalIn vivo sedative and cytotoxic activities of methanol extract of Crataeva nurvala leaves — animal modelView study →}.

Chemical work on the stem bark yielded two new compounds, the quinolone alkaloid crataemine and the steroidal glycoside crataenoside. Both were toxic to HeLa, PC-3 and MCF-7 cancer cells and blocked migration and colony formation in HeLa and PC-3 cells ^{28Reference 28Sinha et al. · 2013In vitroA new cytotoxic quinolone alkaloid and a pentacyclic steroidal glycoside from Crataeva nurvala stem bark — in vitroView study →}.

This is in-vitro work on isolated constituents only, with no whole-extract or animal tumour data.

Tolerance. In the 8-week trial of the Urox® blend in 150 adults, no significant side effects led anyone to withdraw ^{17Reference 17Schoendorfer et al. · 2018RCTUrox (Crataeva nurvala stem bark, Equisetum arvense, Lindera aggregata) for overactive bladder and urinary incontinence — phase 2 randomised, double-blind, placebo-controlled trialView study →}.

Kidney disease. Caution is advised in established kidney disease.

Stones and prostate. A kidney stone causing fever, severe pain or blocked urine flow is an emergency. Prostate symptoms should be diagnosed before they are self-treated.

Research gaps. No formal human toxicology or drug-interaction studies have been done on the bark.