How Dose Of Ayurvedic Medicine Is Decided? 7 Factors

In most of the Ayurveda medicine description in classical text books, the ingredients and indications are mentioned. But dose is not mentioned. Because, the dose depends on many different factors. 

Chakrapani has explained 7 factors that are considered while fixing the dose of medicines.

Reference: Chakrapani on Charaka Sutrasthana 2 

Strength of Dosha

Higher the strength of imbalanced Dosha, higher the dose of medicine. Example, in a bone fracture in an adult, the Vata is very high. So, very high dose of Gandha tailam oil is prescribed orally.
In case of just a small injury with bruise, lower dose is enough.
Read related: What Is Ayurvedic Medicine?

Agni

Agni – digestion strength
a. In the context of disease –
The digestive power of the person gives a hint towards his tolerance capacity for strong medicines.
Higher the digestion strength of the person, more the dose of medicine. Because, he can tolerate the medicines very well.

b. In the context of weak digestion strength –
If the person is given spicy digestive medicine such as Chitrakadi Bati, then the dose of such medicine will be high for a low digestion person.

Bala

Bala – immunity and strength of the person –
a. If the medicine tolerating capacity is high, then high dose of medicine can be given to the patient to treat the disease quickly.
b. If the natural immunity strength of the person is very high, then low dose of medicine will be sufficient to bring disease under control.
Read related: Herbs, medicines and exercise to improve immunity as per Ayurveda

Vaya

Vaya – age
In people with well built body in their 20s and 30s, higher dose of medicine can be administered.
In children soon after delivery, and in elderly people, lower doses are preferred.

Vyadhi

Vyadhi – disease strength –
Stronger the disease, higher the dose.
Weaker the disease, lower the dose.
Read related: How To Understand And Master Ayurvedic Medicines Easily

Dravya

Dravya – medicine strength –
Very powerful medicines such as Bhallataka Rasayana, metallic preparations are required in lower doses.
Less powerful medicines such as Dhatri rasayana, Amla juice etc will be required in high doses.

Koshta

Koshta – Gut ecosystem of the patient
It gives a hint toward the rate of absorption of medicines. Ayurveda explains three types of guts.
Kroora koshta – Vata dominant
Mrudu Koshta – Pitta dominant
Madhya koshta – Kapha dominant.
Read related: How Time Of Medicine Administration Is Decided In Ayurveda?

If the person has Vata  dominance and Krura Koshta, if he has Vata disorder, then in him, higher dose of medicine will be required to bring Vata under control. Example: High dose of Ksheerabala taila 101 oil.

Prior to Panchakarma detoxification procedure, large dose of ghee or oil or fat is administered to patient. This is also decided based on the Kosta – gut ecosystem of the patient.
So, this lengthy concept is explained by Chakrapani in just two line Sanskrit verse.

Alternate day medicine

If we want to take one particular medicine for a long period of time, is it a good idea to take it on alternate days? 
The idea of taking the herbs on alternate days is to
a. keep the herbs in minimal dose possible,
b. avoid taking it daily to prevent possible side effects of the herb / remedy. For example, Ashwagandha may cause constipation or loose stools, Tulsi can be very hot for some people. So, taking them on alternate days reduces the amount of side effects. 
c. Enjoy the benefits of the herbs for a long period of time – several months to up to an year.

Which remedies or herbs can be taken in this way?
It really depends on the nature of the herbs / remedies. If it is a safe medicine such as Triphala, Amla, Guduchi etc., then they can be continued for 4 – 6 months, if taken on alternate days. 
Triphala – for obesity, eye health, easy bowel evacuation 
Amla – to have antiaging effects, cell and tissue rejuvenation 
Guduchi – to correct and improve immunity, to prevent frequent infections 
Vasa – for respiratory health 
Manjishta – for skin health 
Aloe vera – for skin, blood and colon health 
Ashwagandha, Tribulus, Shilajit etc. For stamina and muscle health 

It is always a good habit to check with your doctor before taking any herb / remedies.  

Opinion of Acharya Charaka

Why is the dose of medicine not mentioned in Sanskrit verses of Ayurvedic medicine? 
Dr JV Hebbar

The dose for any medicine is Ayurveda is given in the form of a range. Acharya Charaka, Sushruta and Vagbhata barely mentioned the dose of medicines when they explained the formula of medicines. In the recent centuries, Acharya Sharangdhara started explaining doses of certain medicines to give some idea. 

The ancient seers did not explain specific dose of all medicines, because the dose depends on lot of parameters such as 

दोष भेषज देश काल बल शरीर सार आहार सात्म्य सत्त्व प्रकृति वयसां…
doṣa bheṣaja deśa kāla bala śarīra sāra āhāra sātmya sattva prakṛti vayasāṃ…
Charaka Samhita, Vimana Sthana 1st chapter, 3rd verse. 

Dosha – if the Dosha is highly dominant, the dose of medicine should be higher. For example, in the case of Kampa – Parkinson’s disease, the amount of Vata aggravation is very high. So, a very high dose of oral Vata balancing oils such as Mahamasha taila is administered. 

Bheshaja – Strength, concentration and nature of medicine. For example, a weaker decoction of Dashamoola Katutraya Kashayam might be required in higher doses, for treating inflammation, compared to strong decoction.

Kala – The season. For example, for treating asthma during spring season, a higher dose of Kanakasava might be required, because during spring, Kapha is naturally dominant, which further might worsen asthma, allergic respiratory disorders etc. Whereas, during summer, asthma can be treated with lesser doses of Kanakasava. 

Bala – Bala means strength. Here bala implies
Roga Bala – strength of the disease. Diseases that bother for long duration, diseases affecting important Marma points such as brain, heart, liver, kidney etc. require medicines in higher doses.

Rogi Bala – Strength and immunity levels of the patient. In a woman, soon after childbirth, the immunity is weak, hence, any simple infection can result in a stronger disease. That’s why to improve immunity, after childbirth, Dashamoolarishta, Jeerakarishta etc. medicines are given. 

Shareera Sara – How the tissues are held together in a person and the strength and bulk of tissues. This gives a hint about immunity and body composition. For example, covid 19 in an obese patient might require stronger medicines in higher doses, compared to a person with healthy body weight. (1)

Ahara Sathmya – Food habits, congeniality. For example, a person who consumes a well balanced diet with all six tastes and avoids excess alcohol, smoking and junk foods may require lesser doses of medicines.

Sattva – Tolerance capacity. If the person can tolerate stronger medicines, then stronger medicines in higher doses can be administered to treat the disease quickly. 

 Prakriti – In a person with Vata body type, having a Vata disorder such as Arthritis with bone loss,  higher dose of Gandha tailam and Lakshadi guggulu will be required to strengthen the bones, compared to a Kapha body type person with arthritis.
This is because, in a Vata person, Vata dosha is already in a dominant position, which is further aggravated to cause a Vata disorder of the bones and joints. This requires aggressive treatment. 

Vaya – Age of the patient.  The amount of Khadirarishta required to treat a skin disease such as eczema, in a child of 10 years of age is lower compared to an adult. 

A variety of factors are considered before deciding on the dose.
This applies to medicines, food and also water consumption.