Amritarishtam, also known as Amritarishta or Amrutharishtam, is a classical Ayurvedic fermented liquid medicine (Arishta) traditionally used to manage fevers. It is described in Bhaishajya Ratnavali (Jwara Chikitsa), and the classical verse praises it as Sarva Jwara Kulantaka, the destroyer of all families of fever. Since Ayurveda often uses “Jwara” as a synonym for disease itself, this praise also points to its wide role as a general remedy. Its main ingredient is the Guduchi plant (Tinospora cordifolia), better known as Giloy, which gives the medicine its name: Amrita is a Sanskrit name for this herb.
Ingredients of Amritarishtam
Amritarishtam is prepared by a traditional process of decoction, sweetening and fermentation. It is composed of the following ingredients:
Kwatha Dravya (decoction base):
- Tinospora cordifolia (Amrita / Guduchi / Giloy, Chittamruthu) – stem, peeled
Dashamula or Dashmool (ten roots):
- Aegle marmelos (Bilva)
- Premna mucronata (Agnimantha)
- Oroxylum indicum (Shyonaka)
- Gmelina arborea (Gambhari)
- Stereospermum suaveolens (Patala)
- Solanum indicum (Brihati)
- Solanum xanthocarpum (Kantakari)
- Desmodium gangeticum (Shalaparni)
- Uraria picta (Prishnaparni)
- Tribulus terrestris (Gokshura)
Madhura Dravya (sweetener):
- Guda (old jaggery)
Prakshepa Dravya (additives):
- Trachyspermum ammi (Ajamoda, Ayamodakam)
- Oldenlandia corymbosa (Parpataka, Parpadakappullu)
- Alstonia scholaris (Saptaparna, Ezhilampala) – bark
- Zingiber officinale (Shunthi, ginger, Chukku)
- Piper nigrum (Maricha, black pepper, Kurumulaku)
- Piper longum (Pippali, long pepper, Thippali)
- Cyperus rotundus (Musta, Muthanga)
- Mesua ferrea (Nagakesara, Cheru Naagapoovu)
- Picrorhiza kurroa (Katuka or Kutki, Kadukurohini)
- Aconitum heterophyllum (Ativisha, Athividayam)
- Holarrhena antidysenterica (Indrayava, Kudakappala Arishi) – seed
Sandhana Dravya (fermentation aid):
- Woodfordia fruticosa (Dhataki, Thathiripoo) – flowers. It helps the fermentation go smoothly and prevents Vidaha (excessive sourness) in the Arishta.
The Giloy and Dashmool are boiled in water and the decoction is reduced, jaggery is dissolved in it, and the powdered additives and Dhataki flowers are added before the vessel is sealed for natural fermentation, traditionally for about a month. The clear liquid is then filtered and stored.
Ayurvedic properties of Amritarishtam
In Ayurveda, Amritarishtam is known for its balancing action on all three doshas and its fever-relieving, digestive, and strengthening effects.
- Action over Doshas: Tridoshahara (balances Vata, Pitta and Kapha), Vatanulomana (promotes the downward movement of Vata)
- Action over Tissues: Rasa-Rakta Dosha Hara (purifies Rasa and Rakta dhatus), Balya (promotes strength)
- Action over Metabolism: Pachana (digests Ama, the toxins left by improper digestion), Deepana (improves appetite and digestive fire), Malanulomana (supports regular bowel movement)
- Action over Organs: Strengthens the liver and spleen (Yakrit and Pleeha)
- Other Actions: Shophahara (anti-inflammatory, reduces swelling), Shulaprashamana (soothes pain), Pakahara (helps manage the inflammatory, suppurative process)
The bitter and pungent herbs digest Ama and support Agni, while the jaggery and the fermentation process make the medicine palatable and quick to act.
Use of Amritarishtam in Ayurvedic Treatment
Amritarishtam is a mainstay of Jwara Chikitsa (fever management) in Keraleeya Chikitsa paddhati, and most vaidyas prescribe it for fevers. It is used both to treat fever and, traditionally, to help prevent seasonal fevers. It is commonly used in:
- Acute and Jirna Jwara (chronic fever)
- Vishama Jwara (intermittent fever)
- Low-grade evening fever with no marked external symptoms
- Vatarakta, including forms with oozing lesions
- Amavata and joint pain (Sandhivedana)
- Tamaka Shwasa (bronchial asthma), Kasa (cough and cold) and Peenasa (chronic rhinitis and sinusitis)
- Tonsillitis, pharyngitis and adenoiditis
- Skin disorders accompanied by fever
How does Amritarishtam work
Amritarishtam works through the combined action of herbs that are Jwaraghna (antipyretic or fever-relieving), Pachana (Ama-digesting) and Balya (strength-promoting). Giloy, the main ingredient, is a well-known Rasayana with immunomodulatory and antioxidant properties that supports the body’s natural resistance to infections and helps in fever, joint pain and Vata-Rakta conditions. Dashamula pacifies the doshas, particularly Vata and Kapha, and helps relieve swelling and pain. Trikatu (the three pungent spices), Musta, Ajamoda and Nagakesara improve appetite and digestion and prevent Ama formation, while bitter herbs such as Katuka, Ativisha, Saptaparna and Indrayava help settle recurring and lingering fevers.
Fermentation with jaggery and Dhataki flowers produces a mild amount of self-generated alcohol. In the Ayurvedic view this acts as a carrier (Yogavahi), taking the herbal principles quickly into the tissues. Together, these actions restore Agni, clear Ama and its toxins, support the liver and spleen, and help the body recover from prolonged or recurring fever.
Conditions Amritarishtam helps to treat
- Fevers of all types, including seasonal fevers
- Chronic and intermittent fevers
- Low-grade evening fever
- Fever with indigestion and loss of appetite, after digestion has improved
- Debility, poor appetite and fatigue that remain after fever or an infection
- Vatarakta (gout-like conditions), including forms with oozing lesions
- Amavata (rheumatoid arthritis-like disorders) and joint pain
- Bronchial asthma, cough, cold and sinusitis
- Throat infections such as tonsillitis and pharyngitis, and adenoiditis
- Skin diseases with fever
- Autoimmune conditions such as SLE (as an adjuvant, under physician supervision)
Benefits of Amritarishtam
- Brings down fever and supports recovery from chronic and recurring fevers
- Restores appetite, improves digestion and clears Ama
- Strengthens the liver and spleen
- Builds the body’s natural resistance to recurring infections
- Helps reduce joint pain, swelling and inflammation
- Aids regular bowel movement
- Eases swelling and discomfort in respiratory and throat complaints when combined with suitable medicines
- Used in Ayurveda to help prevent fever
Unlike heavy, nourishing tonics, Amritarishtam is digestive in nature, so it is especially useful when Ama and fever are the main concerns.
Amritarishtam dosage and directions for use
Amritarishtam is taken orally. The recommended dosage is:
- Adults: 15–30 ml twice daily, mixed with an equal quantity of water, immediately after food.
- Children (5 years and above): 5–15 ml twice daily, diluted with an equal quantity of water, after food, or as directed by the physician.
- The best time to take it is soon after meals, in the morning and evening.
- It can be taken in the usual dose until the illness subsides.
- In evening low-grade fever without marked external symptoms, it is traditionally given continuously for up to three months, under a physician’s guidance.
- In fever due to indigestion (Agnimandya), starting Amritarishtam first may cause vomiting. It is best to begin after the digestive fire and appetite have improved.
Your physician may combine Amritarishtam with other Ayurvedic medicines for better results:
- In fever: with Chukku Tippalyadi Gulika, Vettumaran Gulika, Suryaprabha Gulika or Mukkamukkatuvadi Gulika, and with Dashamularishtam or Pippalyasavam
- In respiratory complaints (asthma, cough, sinusitis): with Dashamularishtam, to increase the Kapha-reducing action
- In skin diseases with fever: with Aragvadharishtam or Khadirarishtam, to address both the main disease and the associated complaints
- In pain, tonsillitis and pharyngitis: with Punarnavasavam and Vettumaran Gulika, to bring quicker relief
- In adenoiditis and SLE: with Vettumaran Gulika
All such combinations should be taken on the advice of a physician. Because Amritarishtam contains Guduchi and jaggery, and a mild amount of self-generated alcohol, patients taking anti-diabetic or immunosuppressant medicines should consult their doctor before taking Amritarishtam. It is advisable to keep a gap of about 30 minutes between Amritarishtam and other medicines.
Interaction with other medicines
Immunosuppressants and steroids (such as azathioprine, methotrexate, tacrolimus, cyclosporine, prednisolone): Guduchi has an immune-stimulating effect and may work against these medicines. This matters in organ transplant recipients and in autoimmune conditions such as SLE, rheumatoid arthritis and autoimmune hepatitis. Amritarishtam should be used in these cases only under supervision.
- Anti-diabetic medicines and insulin: Guduchi may lower blood sugar, while the jaggery base adds sugar. The blood glucose level should be monitored regularly.
Medicines that are hard on the liver (such as paracetamol in high or prolonged doses, methotrexate, anti-tuberculosis drugs): Rare cases of liver injury have been reported with Giloy preparations, so liver function should be monitored in people with liver disease or those taking such medicines.
Blood thinners and antiplatelet medicines (such as warfarin, clopidogrel, aspirin): Ginger and long pepper may mildly affect platelet function and clotting, so caution is advised.
Medicines with a narrow dosing range (such as phenytoin, theophylline, propranolol): Piperine in black pepper and long pepper may increase the absorption of some medicines, and this can raise their blood levels. Doses may need monitoring.
- Sedatives, sleep aids, anti-anxiety and anti-epileptic medicines: The alcohol content may add to drowsiness.
- Medicines that react with alcohol: Medicines such as metronidazole, tinidazole and disulfiram can react with even small amounts of alcohol, so Amritarishtam should be avoided during their use.
- Antibiotics, antimalarials and fever medicines: Amritarishtam is often used alongside these in fever and infections, but only under the guidance of a doctor. It should not replace medical evaluation of a persistent, high or recurring fever, which needs a proper diagnosis.
- Before surgery: Inform the surgeon and anaesthetist. Guduchi-containing medicines are usually stopped about two weeks before planned surgery because of their effect on blood sugar and immunity.
Side effects of Amritarishtam
Amritarishtam is generally safe when taken in the recommended dosage. Nausea or vomiting may occur if it is given at the start of a fever caused by indigestion, and mild acidity, stomach upset or loose stools may occur if it is taken on an empty stomach or in excess. Discontinue use and seek medical advice if any allergic reaction or persistent discomfort develops.
Who should avoid Amritarishtam
- People with liver diseases should strictly avoid this formulation
- People with autoimmune conditions or those on immunosuppressants, unless prescribed by a physician
- Individuals allergic to any of the ingredients
- People with diabetes, unless advised by a physician, as the preparation contains jaggery
- Women during pregnancy or breastfeeding, unless prescribed by a physician
- People who need to avoid alcohol for medical, religious or personal reasons, as Arishtas contain self-generated alcohol
How to store Amritarishtam
- Store in a cool, dry place away from direct sunlight
- Keep the glass bottle tightly closed after use
- Use a clean, dry measuring cup or spoon to avoid contamination
- Keep out of the reach of children. Although it looks like a sweet syrup, it is a fermented medicine.
- Some sediment at the bottom is normal for Arishtas.
FAQ
How to use Amritarishtam for fever?
Take 15–30 ml of Amritarishtam mixed with an equal quantity of water after food, twice a day, or as directed by your physician. It works well in chronic, recurring and intermittent fevers. If the fever is linked to indigestion and loss of appetite, it is best to start after your appetite and digestion have improved. A fever that lasts more than a few days, or is high or accompanied by severe symptoms, needs proper medical evaluation.
When to take Amritarishtam?
Amritarishtam is generally taken after food, in the morning and evening, mixed with an equal quantity of water. Taking it after meals supports digestion and helps avoid stomach discomfort or vomiting.
Can I use Amritarishtam for a long period?
The duration of use depends on the condition; Amritarishtam is usually taken until the illness subsides. In persistent low-grade evening fever with no marked external symptoms, it is given continuously for up to three months. Long-term use should always be under the supervision of an Ayurvedic practitioner.
