Abstract
Narikelasava (Nalikerasavam) is a classical Ayurvedic Sandhana Kalpana (fermented preparation) described in the medieval text Gada Nigraha, valued for pleasant organoleptic properties, long shelf life, and self-generated alcohol that enhances the extraction and bioavailability of both water- and alcohol-soluble constituents. Traditionally regarded as Vajikarana (aphrodisiac) and Rasayana (rejuvenative), it is indicated for sexual health, longevity, skin quality, and restoration of vitality, and is increasingly considered for conditions requiring anti-inflammatory, immunomodulatory, hepatoprotective, antioxidant, and rejuvenative support. This review aimed to compile dispersed classical and modern evidence on Narikelasava, appraise the pharmacology of its ingredients, and contextualise its therapeutic potential for contemporary healthcare. Information was synthesised from classical sources (Gada Nigraha, Bharata Bhaishajya Ratnakara, Vaidya Chintamani) and English-language literature indexed in PUBMED, Google Scholar, ScienceDirect, Web of Science, and Scopus, searched up to 2025 using formulation- and ingredient-specific keywords (e.g., Cocos nucifera, Dashamoola, Woodfordia fruticosa/Dhataki, Bombax malabaricum/Shalmali, phytochemistry, pharmacological activity). Narikelasava is prepared by fermenting tender coconut water (Narikelodaka) with sugarcane juice, Dashamoola, Shalmali, Chaturjata, and other herbs in a ghee-smeared airtight container for one month, followed by filtration. Phytochemical evidence across ingredients indicates diverse bioactives including medium-chain fatty acids (lauric acid up to 52%, caprylic/capric acids), nuciferoic acid, phenolics, macrocyclic hydrolysable tannins (woodfordin C, oenothein B), flavonoids (kaempferol, quercetin), volatile oils, and sterols/triterpenes (β-sitosterol, lupeol), characterized using techniques such as HPLC, NMR, and MS. Pharmacological findings from in vitro, in vivo, and preliminary clinical studies support synergistic antiinflammatory actions (including NF-κB/IκB pathway modulation and prostaglandin synthesis inhibition), immunostimulation (e.g., macrophage activation, TLR engagement), hepatoprotection in toxin/drug-induced models with restoration of antioxidant status, and aphrodisiac benefits notably linked to Tribulus terrestris, complemented by sedative/anxiolytic contributions from Valeriana wallichii and mood/sexual health support from Crocus sativus. Collectively, the formulation’s ingredient synergy and fermentation-enabled extraction substantiate its traditional claims and justify its consideration as an adjunct in geriatric care and chronic inflammatory disorders, while highlighting the need for rigorous mechanistic studies and well-designed clinical trials to confirm safety and efficacy.