What is the recommended dose of sambong (Blumea balsamifera) for diuretic use or to aid in passing kidney stones?

Sambong (Blumea balsamifera) Dosing for Diuretic Use and Kidney Stones

For diuretic use or to aid in passing kidney stones, the recommended dose of sambong (Blumea balsamifera) is typically 3-5 grams of dried leaves daily, which can be prepared as a decoction or tea taken 2-3 times per day.

Dosage Forms and Administration

• Dried leaves: 3-5 grams daily, divided into 2-3 doses, prepared as a decoction by boiling in water for 15-20 minutes 1
• Commercial preparations: Follow manufacturer's instructions, typically standardized to flavonoid content 2
• Tea preparation: 1-2 grams of dried leaves steeped in hot water for 10-15 minutes, taken 2-3 times daily 1

Mechanism of Action for Kidney Stones and Diuresis

• Sambong contains flavonoids (including dihydroquercetin derivatives and quercetin) that demonstrate diuretic properties, helping to flush out the urinary system 2
• The plant contains borneol (23.3%), β-caryophyllene (20.9%), and camphor (11.8%) as major components that contribute to its medicinal properties 3
• Pharmacokinetic studies show significant absorption of key flavonoids after oral administration, with peak plasma concentrations (Cmax) reached within 1-4.7 hours 2

Clinical Evidence and Traditional Use

• Ethnomedicinal evidence supports the use of Blumea balsamifera specifically for kidney stones, as a diuretic, and for urinary tract conditions across Southeast Asia 1
• The diuretic effect helps increase urine output, potentially facilitating the passage of small kidney stones 1, 4
• Pharmacokinetic studies demonstrate bioavailability of the active flavonoids with half-lives ranging from 2.9 to 7.3 hours, supporting the multiple daily dosing regimen 2

Safety Considerations

• Generally recognized as safe when used at recommended doses 1
• No major adverse effects have been reported in the literature at therapeutic doses 5
• Should be used with caution in:
  • Patients with severe renal impairment (limited evidence on safety in this population) 1
  • Pregnant or breastfeeding women (insufficient safety data) 5

Monitoring and Duration of Treatment

• For kidney stones: Treatment typically continues for 2-4 weeks or until stones are passed 1
• Monitor for increased urination, which indicates the diuretic effect is working 1
• If symptoms persist beyond 2 weeks without improvement, medical evaluation is recommended 5

Potential Adjunctive Therapies

• Increased fluid intake (2-3 liters daily) is recommended to enhance the diuretic effect 4
• Other dietary plants with evidence for kidney stone prevention that may complement sambong therapy include green tea, pomegranate, and stinging nettle 4

Research Limitations

• While traditional use is well-documented, large-scale clinical trials specifically evaluating optimal dosing are limited 5
• Most evidence comes from ethnopharmacological studies, animal models, and small human studies 1, 2