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**Total alkaloids of Sophora flavescens** is a botanical active pharmaceutical ingredient derived from the root of *Sophora flavescens* and used in Chinese medicinal products such as vaginal Kushen gel. It is a chemically variable mixture of quinolizidine alkaloids rather than a single defined INN molecule; matrine-type alkaloids, including oxymatrine, are important constituents, and a marketed gel is labeled using oxymatrine-equivalent total-alkaloid content. In preclinical aerobic-vaginitis models, intravaginal gel administration showed antibacterial activity, reduced vaginal mucosal injury and inflammatory findings, and was associated with increased vaginal *Lactobacillus* abundance. A registered Chinese trial evaluated the gel for aerobic vaginitis with bacterial vaginosis. ([yaozs.com](https://www.yaozs.com/z101828/))
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