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Introduction: Karvira (Nerium indicum Linn.; Syn. Nerium oleander L.), belonging to the family Apocynaceae, is an important medicinal plant widely referenced in classical Ayurvedic literature. Described across the Brihattrayi and major Nighantus, it has been traditionally employed in the management of Kushtha (skin disorders), Vrana (wounds), Kandu (pruritus), and Visha (poisoning). Despite its extensive classical documentation, a consolidated review integrating the Ayurvedic Rasapanchaka, Samhita-kala references, Nighantu descriptions, and contemporary pharmacological evidence has been lacking.

Methods: A comprehensive review was conducted by systematically examining classical Ayurvedic texts including Charaka Samhita, Sushruta Samhita, Ashtanga Sangraha, Ashtanga Hridayam, and seven major Nighantus (Dhanvantari, Raj, Bhavaprakasha, Kaiyadeva, Madanapala, Nighantu Adarsha, and Shaligrama Nighantu). Modern literature was searched through PubMed, Google Scholar, and the AYUSH Research Portal using the terms “Nerium indicum,” “Nerium oleander,” “Karvira,” and “pharmacological activity” for publications between 2000 and 2025. A total of 68 sources were screened and 30 met the criteria for inclusion in this qualitative synthesis.

Results: Classical texts consistently describe Karvira as Katu-Tikta-Kashaya in Rasa, Ushna in Virya, and Katu in Vipaka, with Kapha-Vatahara action. Its primary indications include Kushtha, Vrana Shodhana and Ropana, Kandu, Krimighna action, and Shirovirechana. Raj Nighantu classifies four varieties (Shweta, Rakta, Pita, and Krishna), while Shaligrama Nighantu provides the maximum forty-seven synonyms. Modern pharmacological studies have validated its antibacterial, antifungal, anti-inflammatory, analgesic, antidiabetic, antioxidant, hepatoprotective, cardiotonic, and anticancer activities. Key phytoconstituents include cardiac glycosides (oleandrin, neriine, odoroside), plumericin, kaempferol, and beta-sitosterol.

Discussion: The convergence between classical Ayurvedic indications and modern pharmacological findings substantiates the therapeutic rationale of Karvira documented by ancient Acharyas. The Kushthaghna and Vranapratisarana properties align with demonstrated antibacterial and wound-healing activities, while the Hridya action corresponds to cardiotonic glycoside pharmacology. The predominantly external usage recommended in Ayurveda is consistent with the known systemic toxicity of oleandrin. This review consolidates the ethno-pharmacological profile of Karvira and identifies opportunities for further standardised clinical investigation.

Keywords: Antibacterial; Apocynaceae; Ayurveda; Cardiac glycosides; Karvira; Kushtha; Nerium indicum; Nighantu; Oleandrin; Pharmacognosy; Rasapanchaka; Vrana