Age Ayurveda Nighantu

Asthishrinkhala

Cissus quadrangularis L.

Asthishrinkhala (Cissus quadrangularis L.) is a plant used in Ayurveda, from the Vitaceae family. Not listed in WHO monographs on selected medicinal plants; recognized in Ayurvedic Pharmacopoeia of India as Asthishrinkhala/Hadjod; available as dietary supplement in US and European markets.

Key facts
Botanical nameCissus quadrangularis L.
FamilyVitaceae
OrderVitales
Pharmacopoeia statusNot listed in WHO monographs on selected medicinal plants; recognized in Ayurvedic Pharmacopoeia of India as Asthishrinkhala/Hadjod; available as dietary supplement in US and European markets
Taxon identifiersGBIF 7130673 · Wikidata Q2157164 · NCBI Taxonomy 165298

Names and identification

LanguageName
EnglishAsthishrinkhala
Latin/BotanicalCissus quadrangularis L.

Key Phytochemical Constituents

How does it work?

  • Osteogenic mechanism through MAPK pathway-dependent upregulation of alkaline phosphatase in osteoblasts, enhanced collagen synthesis, and accelerated calcium deposition at fracture sites
  • Anti-inflammatory and analgesic action mediated by quercetin and other flavonoids inhibiting COX-2 and pro-inflammatory cytokine cascades, reducing fracture-site inflammation
  • Antioxidant mechanism through resveratrol, piceatannol, and quadrangularin-A scavenging of reactive oxygen species, protecting osteoblasts from oxidative damage

Which traditional uses are supported by research?

  • Bone fracture healing acceleration validated through human clinical trials and meta-analysis showing significant improvement in bone biomarkers, confirming premier Ayurvedic use as Asthi Sandhanaka (bone setter)
  • Anti-obesity and metabolic benefits validated through clinical studies showing weight and body fat reduction with CQR-300 extract supplementation
  • Analgesic and anti-inflammatory properties validated through in vivo studies, confirming traditional use in pain management and musculoskeletal conditions

What do recent clinical trials show?

2 further claims previously listed here could not be traced to a published paper and have been removed. An absence here means we could not identify the source, not that no work exists.

Recent safety updates

  • 90-day subchronic toxicity study showed no adverse effects at doses up to 2500 mg/kg/day; in vitro and in vivo mutagenicity studies revealed no mutagenic potential; considered exceedingly safe at commonly used supplemental doses
  • Minor reported side effects include headache, intestinal gas, diarrhea, and dry mouth; should be used with caution in diabetic patients due to hypoglycemic potential and in those on anticoagulants due to potential interactions

Dosage forms and preparation

Dosage Forms: Churna (stem powder), Capsule, Tablet, Swarasa (fresh stem juice), Sandhi Bala Taila (medicated oil — external), Lepa (bone-setting paste), Ghana Vati

Standard Dosage: 3-6g stem powder twice daily; 500mg-1g extract capsule twice daily; 10-20ml fresh stem juice; external paste/oil as needed

Bioavailability: Good oral bioavailability for ketosteroids (particularly anabolic steroids like ketosterone). 3,3’-di-O-methylquercetin is a potent bioavailable flavonoid. Resveratrol and related stilbenes show moderate absorption (~20%). Calcium content in stems is bioavailable. Fresh stem juice has better bioavailability profile than dried preparations. Traditionally administered with milk (calcium + stem bioactives for synergistic bone healing).

Optimal Timing: With warm milk twice daily for fracture healing (continue for 6-8 weeks). Before meals for osteoporosis prevention. External paste application at fracture site.

Standardized Extract: Stem extract (10:1) standardized to minimum 3% 3,3’-di-O-methylquercetin and minimum 2.5% ketosterones. Calcium content minimum 4% (as eleite). Total flavonoid content minimum 5%.

Shelf Life: 2 days (fresh juice); 18 months (powder); 2 years (capsules/tablets); 3 years (medicated oil)

Storage: Fresh stems refrigerated, process within 48 hours. Dried powder in airtight containers below 25°C. Capsules with desiccant.

Marker Compounds: Ketosterone, 3,3’-di-O-methylquercetin, Resveratrol, Piceatannol, Pallidol, Quadrangularin A-C, Beta-sitosterol, Calcium oxalate, Ascorbic acid, Beta-carotene

Extraction Methods

  • Fresh stem juice expression (Swarasa)
  • Hydroalcoholic extraction (70:30) for phytosteroid enrichment
  • Petroleum ether extraction for ketosteroid fraction
  • Aqueous decoction for mineral-rich extract
  • Sesame oil infusion for Taila preparation

Synergistic Combinations

  • With Laksha (lac) for fracture healing (classical Laksha + Asthishrinkhala combination)
  • With Ashwagandha for bone density and strength
  • With Arjuna for calcium metabolism
  • With Guduchi for anti-inflammatory support in fractures
  • With Shatavari and milk for comprehensive bone nourishment

Published research

Literature indexed in PubMed that concerns this subject, grouped by study type. A paper appearing here is a record of what has been published, not evidence that the subject works, and laboratory or animal results do not transfer to people. Study titles link to PubMed so you can read the source rather than take our word.

Systematic reviews and meta-analyses3

  1. Na Takuathung M, Aisara J, Sawong S and others. 2025. The effects of Cissus quadrangularis on bone-related biomarkers in humans: a systematic review and meta-analysisBMC complementary medicine and therapies. PMID 40707943 · doi:10.1186/s12906-025-04995-8
  2. Sawangjit R, Puttarak P, Saokaew S and others. 2017. Efficacy and Safety of Cissus quadrangularis L. in Clinical Use: A Systematic Review and Meta-analysis of Randomized Controlled TrialsPhytotherapy research : PTR. PMID 28165166 · doi:10.1002/ptr.5783
  3. Hasani-Ranjbar S, Nayebi N, Larijani B and others. 2009. A systematic review of the efficacy and safety of herbal medicines used in the treatment of obesityWorld journal of gastroenterology. PMID 19575486 · doi:10.3748/wjg.15.3073

Other clinical studies and reviews5

  1. Vinoth K, Kumar SR. 2025. Morphological, molecular, and pharmacological review of veldt grape (Cissus quadrangularis L.): an underutilized medicinal plantFrontiers in plant science. PMID 40551764 · doi:10.3389/fpls.2025.1586624
  2. Bafna PS, Patil PH, Maru SK and others. 2021. Cissus quadrangularis L: A comprehensive multidisciplinary reviewJournal of ethnopharmacology. PMID 34181958 · doi:10.1016/j.jep.2021.114355
  3. Kaur J, Sharma G, Mahajan A and others. 2021. Role of Cissus quadrangularis in the Management of Osteoporosis: An OverviewCritical reviews in therapeutic drug carrier systems. PMID 34375512 · doi:10.1615/CritRevTherDrugCarrierSyst.2021033808
  4. Lakshmanan DK, Ravichandran G, Elangovan A and others. 2020. Cissus quadrangularis (veldt grape) attenuates disease progression and anatomical changes in mono sodium iodoacetate (MIA)-induced knee osteoarthritis in the rat modelFood & function. PMID 32812575 · doi:10.1039/d0fo00992j
  5. Stohs SJ, Ray SD. 2013. A review and evaluation of the efficacy and safety of Cissus quadrangularis extractsPhytotherapy research : PTR. PMID 22976133 · doi:10.1002/ptr.4846

Laboratory and animal studies4

  1. R K, S M, Igk I and others. 2024. Analyzing the Antihyperglycemic Effect of Cissus quadrangularis and Bacopa monnieri on 3T3-L1 Cell LinesCureus. PMID 38380214 · doi:10.7759/cureus.52661
  2. Lee JJ, Lee J, Choi JS and others. 2024. Effects of Cissus quadrangularis L. Powder on Proximate Composition, Physicochemical and Textural Properties of TteokgalbiFood science of animal resources. PMID 38765287 · doi:10.5851/kosfa.2024.e11
  3. Syed AA, Reza MI, Shafiq M and others. 2022. Cissus quadrangularis extract mitigates diabetic cardiomyopathy by inhibiting RAAS activation, inflammation and oxidative stressBiomarkers : biochemical indicators of exposure, response, and susceptibility to chemicals. PMID 35896310 · doi:10.1080/1354750X.2022.2107703
  4. Barrella MV, Heringer OA, Cardoso PMM and others. 2017. Metals Content in Herbal SupplementsBiological trace element research. PMID 27344673 · doi:10.1007/s12011-016-0776-2

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