Punarnavasavam is a liquid Ayurvedic medicine useful in gastritis, edema, fiver and liver diseases. 
It is a fermented product and contains 5 – 10 % of self generated alcohol. 
This self generated alcohol and the water present in the product acts as a media to deliver water and alcohol soluble active herbal components to the body.  
Punarnavasavam dose: 
12 – 24 ml. one or two times a day, usually advised after food.
If needed, it can be mixed with equal quantity of water.
Punarnavasav uses – 
Punarnavasava is widely used as herbal anti inflammatory and anti oedema medicine. 
It reduces swelling, useful in liver and spleen conditions, and fever. Specially indicated for dropsy and anemia.
It is used for treating osteo arthritis, gout, rheumatoid arthritis. It helps to reduce the swelling and inflammation.
It is used in treating joint pains associated with elevated blood ESR levels.
It is used to reduce excess water collection in the body following intake of hormonal tablets and steroids.
Traditional uses:
Shotha – oedema, swelling, inflammatory conditions.
Udara – ascites,
Pleeha – splenomegaly
Amlapitta – gastritis, hyperacidity
Yakrut – liver disorders
Gulma – abdominal tumor, distension
Jvara – fever
Kruchra sadhya roga – chronic, difficult-to-treat disorders.
Doctors also prescribe Punarnavadyasav for treating:
Swelling induced due to continuous steroid medicine intake
Ankle swelling,
Puffy face, facial swelling
Fatty liver changes, Hepatic steatosis
Obesity, high cholesterol
Commonly prescribed combinations –
Along with Punarnavasav: Loha bhasma for anemia, jaundice, liver disorders etc.
Along with Rasna Erandadi Kashaya or Rasna Saptaka Kashaya for the treatment of rheumatoid arthritis.
Punarnavasavam side effects:
Punarnavasava in prescribed dosage is not having any side effects.
High dosage may cause temporary Blood pressure variations and gastric irritation.
People with diabetes and high BP should take this medicine only under medical supervision.
Punarnavasavam ingredients: 
Shunti – Ginger – Zingiber officinalis – Rhizome – 16 g
Pippali – Long pepper – Piper longum – Fruit – 16 g
Maricha – Pepper – Piper nigrum  -Fruit – 16 g
Haritaki – Terminalia chebula – Fruit rind – 16 g
Darvi – Berberis aristata – Stem – 16 g
Vibhitaki – Terminalia bellirica – Fruit rind – 16 g
Amla – Emblica officinalis – Fruit – 16 g
Gokshura –  Tribulus terrestris – Root / whole plant – 16 g
Kantakari –  Solanum xanthocarpum – Root / whole plant – 16 g
Brihati –  Solanum indicum – Root / whole plant – 16 g
Vasaka – Adhatoda vasica – Root – 16 g
Erandamoola Castor root – Ricinus communis – 16 g
katuki – Picrorrhiza kurroa – Root – 16 g
Punarnava – Boerhaavia diffusa – Root – 16 g
Gajapippali  Scindapsus officinalis – Fruit – 16 g
Pichumarda – Neem – Azadirachta indica – Stem bark – 16 g
Guduchi – Giloya – Tinospora cordifolia – Stem – 16 g
Patola – Trichosanthes dioica – leaf – 16 g
Shushka Mulaka – Dry Radish –  Raphanus sativus – root – 16 g
Duralabha – Fagonia cretica – Root – 16 g
Dhataki –  Woodfordia fruticosa – Flower – 256 g
Sita – sugar – 1.6 kg
Draksha – Dry grapes – Vitis vinifera – Fruit – 320 g
Madhu – Honey – 800 g
water – 8.19 liters