Description

Astragalus (Injection) Solution

Composition

• Main active ingredient: Astragalus membranaceus extract (standardized polysaccharides).
• Inactive ingredients: Purified water, sodium chloride (solvent/stabilizer).

Pharmacological Action

Astragalus membranaceus is a traditional Chinese medicinal herb known for its broad spectrum of pharmacological actions, including immunostimulant, adaptogenic, anti-inflammatory, antioxidant, antiviral, and cardioprotective properties. It enhances T‑cell proliferation, increases macrophage and NK cell cytotoxic activity, modulates pro- and anti-inflammatory cytokines (e.g., IL‑2, IL‑6, TNF‑α, IFN‑γ), and regulates oxidative stress through upregulation of endogenous antioxidant enzymes like SOD and glutathione peroxidase. The key bioactive components responsible for these effects are Astragalus polysaccharides (APS), flavonoids, and saponins.

Indications

Astragalus injection is used as an adjunctive or supportive agent in the following conditions:

• Chronic fatigue syndrome and general physical exhaustion
• Cardiovascular disease, including viral myocarditis and heart failure
• Cancer immunotherapy to improve immune status and reduce chemotherapy-induced toxicity
• HIV/AIDS: to enhance immune function and reduce opportunistic infections
• Recurrent respiratory tract infections (upper and lower)
• Renal disorders including nephrotic syndrome (via podocyte protection)
• Adjunct to seasonal flu prevention and recovery

Contraindications

• Autoimmune diseases (e.g., lupus erythematosus, multiple sclerosis, rheumatoid arthritis), as immune stimulation could exacerbate symptoms.
• Pregnancy and breastfeeding – insufficient data on safety in these populations.
• Known hypersensitivity to Astragalus or any of the excipients.

Administration and Dosage

The dosage of Astragalus injection depends on the therapeutic goal and patient condition. Typical regimens include:

• Intramuscular injection: 2–4 ml once daily or every other day.
• Intravenous drip (diluted): 10–20 ml diluted in 250 ml normal saline, once daily for 10–20 days (commonly used in hospital settings for immunosuppression or myocarditis).

Treatment cycles may last 10–21 days, followed by rest periods.

Side Effects

Astragalus injection is generally well tolerated. However, possible side effects include:

• Mild gastrointestinal discomfort (e.g., nausea, bloating)
• Localized skin rash or allergic reaction at injection site
• Headache or dizziness (rare)
• Altered blood coagulation profiles in high doses or long-term use

Severe adverse events are rare and typically resolve upon discontinuation.

Drug Interactions

• May reduce the effectiveness of immunosuppressant medications (e.g., corticosteroids, cyclosporine).
• May enhance the effects of anticoagulants – monitor INR and bleeding risk.
• Can influence the outcomes of lab tests involving cytokine assays or immune parameters.

Overdose and Treatment

Signs of overdose include gastrointestinal distress, fatigue, hypotension, or immune overstimulation. Treatment includes cessation of therapy, monitoring of vitals, and supportive care.

Storage

• Store between 15–25°C (room temperature), away from sunlight and moisture.
• Do not freeze.
• Use immediately after opening the vial.
• Keep out of reach of children and pets.

Mechanism of Action

Astragalus polysaccharides (APS) are the main active constituents and exert immunomodulatory effects through:

• Stimulation of macrophage phagocytic activity
• Enhancement of lymphocyte proliferation and NK cell cytotoxicity
• Regulation of pro- and anti-inflammatory cytokines (e.g., suppression of TNF-α, IL-6 via NF-κB pathway inhibition)
• Antioxidant action through scavenging ROS and upregulating antioxidant enzymes
• Cardioprotective and renoprotective properties via regulation of oxidative stress and inflammation

Clinical Studies and Evidence

A 2025 meta-analysis of 14 randomized controlled trials demonstrated that Astragalus injection significantly improved clinical outcomes in patients with viral myocarditis, reducing cardiac enzyme markers (CK-MB, LDH) and improving ECG parameters. Qian et al., 2025

A systematic review published in the Journal of Traditional Chinese Medicine highlighted Astragalus as an effective adjunctive agent in cancer patients, improving immune profiles and reducing chemotherapy-induced leukopenia. Piao et al., 2014

Use in Special Populations and Sports

In sports medicine, Astragalus is gaining popularity due to its adaptogenic properties:

• Supports post-exercise recovery by reducing inflammation and oxidative stress
• May enhance endurance through mitochondrial support and fatigue resistance
• Useful in overtraining syndrome by stabilizing immune response and reducing cortisol impact

Note: While not on the WADA prohibited list, athletes should consult a sports physician prior to use, as some immunomodulators can alter biological passport data or raise doping concerns.

In elderly or immunocompromised populations, Astragalus can serve as a preventive immune booster, but dosage should be tailored individually.

Additional Applications

• Renal protection: Astragalus has been shown to protect renal tubular cells, reduce proteinuria, and improve creatinine clearance in early-stage nephropathy.
• Liver support: Some studies suggest hepatoprotective effects via antioxidant and anti-inflammatory mechanisms.
• Diabetes adjunct: May improve glucose tolerance and insulin sensitivity through AMPK activation and reduced oxidative stress.

Formulations and Availability

Astragalus injection is typically available in 2 ml, 5 ml, or 10 ml ampoules at 1–2 g crude drug equivalent per 10 ml. It is a prescription-grade preparation in China and parts of Asia and may be available via international pharmacies for integrative medical practices.

Summary

Astragalus (Injection) Solution is a scientifically supported herbal immunomodulator and adaptogen with wide-ranging benefits. From immune enhancement to organ protection and stress resilience, its bioactive constituents target multiple physiological systems. Clinical trials support its use in viral myocarditis, immune suppression, and fatigue-related conditions. Though generally safe, usage should be guided by trained medical professionals, especially in athletes or individuals with autoimmune conditions.

References

• Qian et al., 2025 – Meta-analysis on Astragalus in viral myocarditis
• Piao et al., 2014 – Review of Astragalus in integrative oncology