Ayurveda management of Paracetamol-induced liver injury in an elderly female

Paracetamol is widely accessible; however, it is relatively more toxic compared to other over-the-counter analgesics. Chronic overdose of paracetamol can lead to liver injury, including hepatocellular jaundice. When the liver is impaired, bilirubin, a waste material, accumulates in the body. Clinical signs of jaundice appear when serum bilirubin levels exceed 2.5–3 mg/dL. In Ayurveda, jaundice is described under the spectrum of Kamala , a condition characterized by noticeable loss of interest in performing daily activities. The term “ Kama” refers to various bodily and mental desires, particularly those related to diet and physical activity, which are significantly diminished in Kamala . The patient discussed in this paper was diagnosed with Paracetamol-induced liver injury with markedly elevated liver enzymes [Aspartate Aminotransferase (AST), Alanine Aminotransferase (ALT)] and bilirubin levels, for which she was admitted to the Inpatient department of Kayachikitsa. She was treated with Shamana chikitsa (~pacifying treatment) comprising a combination of Bhunimbadi kwatha , Arogyavardhini vati , Avipattikara churn a, Kamadudha rasa , Pravalpanchamrita rasa , and Sutashekhara rasa . These Ayurvedic formulations alleviated symptoms of Daurbalya (~weakness), Kshudha mandya (~appetite loss), Peetamutrata (~yellow urine), Hrillasa (~nausea), and Udarshoola (~abdominal pain) along with the improvement of biochemical parameters. These outcomes underscore the potential of hepatoprotective herbal formulations in treating severe drug-induced liver injury, necessitating future clinical trials.