arnica

Complementary/Alternative Medicine: This monograph describes a natural or herbal product that is not subject to FDA guidelines for medicines. Patients and clinicians are advised to read package labels carefully to ensure safe and efficacious use.

REMS

Topical treatment of insect bites, bruises, acne, boils, sprains, muscle, and joint pain

Action ⬆ ⬇

Polysaccharides in arnica may produce a slight anti-inflammatory and analgesic effect. Some antibacterial effects are seen, in addition to a counterirritant effect, which may aid in wound healing.

Therapeutic effects:

Decreased inflammation.
Pain relief.

Pharmacokinetics ⬆ ⬇

Absorption: Systemic absorption may occur following topical application to broken skin.

Distribution: Unknown.

Metabolism/Excretion: Unknown.

Half-Life: Unknown.

Time/Action Profile ⬆ ⬇

ROUTE	ONSET	PEAK	DURATION
Topical	unknown	unknown	unknown

Contraind./Precautions ⬆ ⬇

Contraindicated in:

Not for oral use (except in highly diluted homeopathic preparations);
Arnica allergy;
Avoid use on broken skin;
Infectious or inflammatory GI conditions;
OB: Pregnancy and lactation.

Use Cautiously in:

Infectious or inflammatory GI conditions;
Surgery (discontinue use 2 wk prior to procedure due to antiplatelet effects).

Adv. Reactions/Side Effects ⬆ ⬇

GI: abdominal pain, diarrhea (if taken orally), vomiting

Derm: edematous dermatitis with pustules (chronic treatment of damaged skin), eczema (prolonged use)

Misc: local allergic reactions

Interactions ⬆ ⬇

Natural-Drug Products:

Alcohol-containing preparations may interact with disulfiram and metronidazole.
May potentiate the effects of anticoagulants and antiplatelet agents, increasing the risk of bleeding.

Natural-Natural Products:

May increase risk of bleeding with clove, garlic, ginger, ginkgo, and ginseng.

Route/Dosage ⬆ ⬇

(Adults ): Topical: rub or massage arnica tincture, cream, or gel onto injured area 2–3 times a day. Do not apply to broken skin; Compress: dilute 1 tablespoon of arnica tincture in ½ L water. Wet a gauze pad with solution and apply to affected area for 15 min. For use in poultices, dilute tincture 3–10 times with water.

Availability ⬆ ⬇

Cream, tincture, salve, ointment, gel, and oil: ^OTC
Topical (preparations should contain not more than 20–25% arnica tincture or 15% arnica oil): ^OTC
Homeopathic preparations: ^OTC

Assessment ⬆ ⬇

Inspect skin for breaks prior to application to ensure arnica is applied only to an intact surface. Note the size, character, and location of affected area prior to application of arnica.
After application, monitor affected area for signs of allergic response.

Toxicity and Overdose:

Systemic absorption may result in nausea, vomiting, organ damage, hypertension, cardiotoxicity, arrhythmias, muscular weakness, collapse, vertigo, renal dysfunction, coma, and death. If ingested orally, induce emesis and gastric lavage to remove undigested contents. Supportive care may be necessary. Do not take orally or apply to non-intact skin to avoid systemic absorption.

Implementation ⬆ ⬇

Clean skin with a non-alcohol containing cleanser prior to applying arnica. Apply topically to affected area, or site of injury, ensuring skin is intact.
Do not take orally or apply to an open wound because of potential for systemic absorption with toxicity.

Patient/Family Teaching ⬆ ⬇

Teach patients to inspect the affected area for breaks in the skin and not to apply arnica to any areas where the skin is broken.
Warn patients that use on non-intact skin and oral ingestion may cause life-threatening toxicity.
Advise patients that arnica should only be used for short periods of time in the treatment of minor aches and pains associated with local muscle, joint, or skin pain. Prolonged use may cause allergic/hypersensitivity reactions to develop.
Instruct patients taking antihypertensive agents to avoid concurrent use of arnica.
Rep: Advise females of reproductive potential to notify health care professional if pregnancy is planned or suspected. Arnica should be avoided during pregnancy.

Evaluation/Desired Outcomes ⬆ ⬇

Relief of, or improvement in, minor aches and pains associated with muscle or joint overuse, or sprains and/or local skin irritation from insect bites, bruises, boils, or acne.

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Pronunciation ⬇

Classifications ⬆ ⬇

Indications ⬆ ⬇