Univestin (Scutellaria + Acacia catechu, UP446)

Univestin (UP446, Unigen) is a standardized blend of Scutellaria baicalensis root (baicalin) and Acacia/Senegalia catechu heartwood (catechins) marketed for joint comfort; the same botanical pairing was sold as the prescription 'medical food' flavocoxid (Limbrel). Mechanism is dual COX/5-LOX inhibition. Human evidence: a 12-week randomized double-blind trial (Levy 2010, n=220) found flavocoxid 500 mg twice daily non-inferior to naproxen 500 mg twice daily on WOMAC in knee OA; a 90-day placebo- and celecoxib-controlled pilot (Sampalis 2012, n=60, 15/arm) found significant WOMAC pain/stiffness/function improvements at 250 and 500 mg/day; a 1-week naproxen-comparator RCT (Arjmandi 2014, n=79) found reduced pain and improved range of motion at 500 mg/day. All trials were small or short and industry-linked (Unigen / Primus). ⚠️ SAFETY: the flavocoxid form has documented idiosyncratic liver injury — 4 cases of acute hepatitis in the US DILIN network (Chalasani 2012, Ann Intern Med), and Limbrel was withdrawn in 2017–2018 after FDA received ~200 adverse-event reports including liver injury and hypersensitivity pneumonitis. Trials of UP446 itself reported no liver-enzyme changes, but the ingredient pair is the same. Avoid in existing liver disease; discontinue if jaundice, dark urine, or unexplained fatigue occur.

Moderate clinical evidence. 3 RCTs (n=60–220, 1–12 wks) show benefit vs placebo and parity with naproxen at 250–1,000 mg/day, all industry-linked; identical flavocoxid combination carries documented liver-injury cases and a 2017 US withdrawal