The short answer
Punarnavadi Mandoor is an iron medicine. The official recipe cooks mandura, a purified iron slag, in cow's urine with punarnava and the other herbal ingredients, with pippali listed twice, and the formulary lists it first for pandu, usually read as anaemia. In two small Indian studies of people with iron-deficiency anaemia, blood counts rose. Neither had a placebo group, and one trial lost a third of its children before the end.
Mandura bhasma makes up two-thirds of the dry input weight, 1.920 kg out of 2.880 kg; that is not a measure of the elemental iron in the finished medicine. It also contains pippali (long pepper) twice; piperine, a compound from pepper, raised phenytoin levels in a small study. If you take iron tablets, phenytoin or other regular medicines, tell your doctor about this one too, and ask whether your haemoglobin and iron should be checked.
What is in it
The official recipe is in the Ayurvedic Formulary of India, Part I, formulation 19:1 (printed page 251).[1]
| Ingredient | Botanical name | Part used | Proportion |
|---|---|---|---|
| Punarnava (rakta punarnava) | Boerhaavia diffusa | Root | 48 g |
| Trivrit (nishoth) | Ipomoea turpethum | Root | 48 g |
| Shunthi (dry ginger, saunth) | Zingiber officinale | Rhizome | 48 g |
| Marica (black pepper) | Piper nigrum | Fruit | 48 g |
| Pippali (long pepper) | Piper longum | Fruit | 48 g |
| Vidanga (vaividang) | Embelia ribes | Fruit | 48 g |
| Daru (devadaru) | Cedrus deodara | Heartwood | 48 g |
| Citraka (chitrak) | Plumbago zeylanica | Root | 48 g |
| Kushtha (kuth) | Saussurea lappa | Root | 48 g |
| Haridra (haldi) | Curcuma longa | Rhizome | 48 g |
| Daruharidra | Berberis aristata | Stem | 48 g |
| Haritaki (harad) | Terminalia chebula | Fruit rind | 48 g |
| Bibhitaka (baheda) | Terminalia bellirica | Fruit rind | 48 g |
| Amalaki (amla) | Emblica officinalis | Fruit rind | 48 g |
| Danti | Baliospermum montanum | Root | 48 g |
| Cavya (chavya) | Piper chaba | Stem | 48 g |
| Kalingaka (kutaja seed, indrajau) | Holarrhena antidysenterica | Seed | 48 g |
| Pippali (long pepper), second listing | Piper longum | Fruit | 48 g |
| Pippali mula (long pepper root) | Piper longum | Root | 48 g |
| Musta (nagarmotha) | Cyperus rotundus | Rhizome | 48 g |
| Mandura bhasma (purified iron slag) | - | - | 1.920 kg |
| Gomutra (cow's urine) | - | - | 6.144 l |
Rows and amounts from the 2003 printed edition. Pippali appears twice because the verse names it twice, once inside vyosha (the three pungents) and once on its own. These are batch amounts for making the medicine, not doses.[1]
Classical source
The formulary takes the recipe from the Charaka Samhita, Chikitsa Sthana 16.93-95. The lines above name the herbs; the mandura bhasma is to weigh twice as much as the herbal powder, and it is cooked down in cow's urine. The formulary's weights follow this exactly: 1.920 kg of mandura bhasma against 960 g of herbs.[1]
What it is used for
- The formulary lists it for pandu roga (usually read as anaemia), grahani (a long-standing bowel disorder), shotha (swelling), pliha roga (spleen disease), vishama jvara (recurring fever), arsha (piles), kushtha (skin disease) and krimi (worms).[1]
- The 2023 amendment to the formulary adds Punarnava Mandura as another name for the same medicine.[2]
What the evidence says
RCTChildren aged 2 to 16 with iron-deficiency anaemia were randomised to Punarnavadi Mandura or another Ayurvedic tablet, Pandughni Vati, for 90 days, without blinding. Of 91 children enrolled, 60 finished, and only those 60 were analysed. The authors report the two tablets worked about equally well. There was no placebo or standard iron group, and the abstract gives no side-effect counts.[4]
Controlled trialSix groups of 20 people with iron-deficiency anaemia each took a different Ayurvedic iron preparation, Punarnavadi Mandura among them, at 250 mg twice a day for 30 days. A seventh group took an iron and vitamin capsule (Irex-12). Haemoglobin and iron measures rose in every group, and the authors tied each result to the iron content of the preparation. The abstract gives no separate figure for Punarnavadi Mandura and does not say how people were put into groups.[5]
Systematic reviewA 2016 systematic review looked at Ayurvedic preparations for iron-deficiency anaemia. We have not yet checked what it found for Punarnavadi Mandura, so we do not summarise it here.[6]
Safety notes
- It is an iron medicine: the formulary identifies mandura as dross iron. Tell your doctor if you also take iron tablets.[3]
- Mandura bhasma makes up two-thirds of the dry input weight: 1.920 kg out of 2.880 kg. This is not a measurement of elemental iron in the finished medicine.[1]
- Contains pippali (long pepper) and marica (black pepper). In a small study of people with epilepsy, a single dose of piperine raised blood levels of phenytoin. That study used isolated piperine, not this medicine. See Pippali and phenytoin.[7]
- Punarnava, the herb the medicine is named after, has its own pages on diuretics and blood pressure medicines.
- We have not verified complete numerical side-effect reporting for these studies. That is not evidence that side effects do not occur.[4]
Who makes it
Sold in India by makers including Patanjali (Divya), Baidyanath, AVP, IMPCL. We list names so you can match your bottle to this page. We do not recommend or sell any brand.
Withheld until review
Questions people ask
Is Punarnavadi Mandoor the same as an iron tablet from the chemist?
No. The iron comes from processed iron slag (mandura), not the ferrous salts in most iron tablets, and it is mixed with 20 herbal portions, including pippali twice. In the 2007 study, how well each Ayurvedic preparation raised haemoglobin tracked how much iron it contained.[3][5]
Related
Pippali, black pepper and phenytoin
Piperine, the compound in pippali and black pepper, raised phenytoin blood levels in two small Indian studies. Phenytoin has a narrow safe range.
InteractionPunarnava and diuretics (water tablets)
Not studied in people. Punarnava increased urine output in rats, so it could add to a water tablet. Nobody has measured whether it does.
InteractionPunarnava and blood pressure medicines
Not studied in people. Lab and animal work suggests punarnava acts on urine flow and blood vessels, which could add to BP medicines.
FormulationTriphala Churna
Three fruits in one powder, best known as a laxative. Human trials are few and small; most research is in the lab or in animals.
Sources
- Ayurvedic Formulary of India, Part I, 2nd revised English edition, 2003. Punarnavadi Mandura, 19:1, printed pages 251-252.
- Pharmacopoeia Commission for Indian Medicine & Homoeopathy. Amendment List-1 (2023) to the Ayurvedic Formulary of India, Parts I to III, item 11 (adds the synonym Punarnava Mandura).
- Ayurvedic Formulary of India, Part I. List of single drugs of mineral origin: Mandura, dross iron or sludge iron.
- Kori VK, Patel KS. Efficacy of Pandughni Vati and Punarnavadi Mandura Vati in the management of Pandu w.s.r. iron deficiency anemia in children: an open labelled comparative clinical trial. Ayu. 2020;41(4):218-224. PMID 35813360.
- Sharma DC, Chandiramani D, Riyat M, Sharma P. Scientific evaluation of some Ayurvedic preparations for correction of iron deficiency and anemia. Indian J Clin Biochem. 2007;22(2):123-128. PMID 23105698.
- Samal J. Ayurvedic preparations for the management of iron deficiency anemia: a systematic review. Ayu. 2016;37(3-4):163-169. PMID 29491667.
- Pattanaik S, Hota D, Prabhakar S, Kharbanda P, Pandhi P. Effect of piperine on the steady-state pharmacokinetics of phenytoin in patients with epilepsy. Phytother Res. 2006;20(8):683-686. PMID 16767797.
Updated 4 November 2026
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