PILES-FIL 5%W/W , 1%W/W , 5%W/W GEL

Indications

• Chronic venous insufficiency
• Varicose veins
• Hemorrhoids
• Edema

Dosage

Children: Refer to the BNF for Children for appropriate dosing information.

Adults: Refer to the BNF for appropriate dosing information.

Mechanism of action

Aesculus contains aescin, which acts by stabilizing capillary walls and enhancing venous tone. It demonstrates anti-inflammatory effects by inhibiting the release of inflammatory mediators and reducing vascular permeability, thus contributing to its use in managing conditions associated with poor venous circulation.

Pharmacodynamics

The pharmacodynamic effects of aescin include the reduction of edema and inflammation, improved venous return, and increased capillary resistance. These effects are particularly beneficial in conditions such as chronic venous insufficiency, where venous tone is compromised.

Pharmacokinetics

The pharmacokinetics of aesculus have not been extensively studied. However, it is known that aescin is absorbed in the gastrointestinal tract and metabolized in the liver. Its bioavailability, half-life, and elimination pathways require further research for a comprehensive understanding.

Pregnancy

Safety in pregnancy has not been established. Use with caution.

Breast-feeding

Safety during breastfeeding has not been established. Use with caution.

Storage

Store in a cool, dry place away from direct sunlight.

Indications

• Calcium deficiency
• Osteoporosis prevention and treatment
• Hypoparathyroidism
• Rickets
• Acid indigestion
• Heartburn

Dosage

Adults: For calcium supplementation, the typical adult dose is 1,000 to 1,200 mg of elemental calcium per day, divided into two or three doses. For use as an antacid, 500 to 1

Mechanism of action

Calcarea primarily acts by supplementing calcium levels in the body, which is vital for several biological processes. Calcium ions are essential for the normal functioning of muscles and nerves and play a pivotal role in blood coagulation. In the gastrointestinal tract, calcium carbonate acts as an antacid by neutralizing stomach acid, thus providing relief from symptoms of heartburn and indigestion. The mechanism involves the reaction of calcium carbonate with hydrochloric acid in the stomach to form calcium chloride, water, and carbon dioxide.

Pharmacodynamics

The pharmacodynamic effects of calcarea are largely related to its calcium content. Through its role in maintaining calcium homeostasis, it supports bone mineralization, prevents bone resorption, and contributes to the overall health of the skeletal system. Additionally, by acting as an antacid, it alleviates symptoms of gastric acidity and promotes comfort in patients suffering from gastroesophageal reflux disease (GERD) and peptic ulcer disease.

Pharmacokinetics

Calcarea is absorbed in the gastrointestinal tract, with absorption being influenced by factors such as the presence of food and the pH of the stomach. Peak plasma concentrations of calcium usually occur within 1 to 4 hours after ingestion. The bioavailability of calcium carbonate can vary, but it is generally higher when taken with meals. Calcium is primarily excreted by the kidneys, with a small amount excreted in the feces. The half-life of calcium in the body is not well defined due to its extensive physiological roles and regulatory mechanisms.

Pregnancy

Calcarea is often considered safe during pregnancy; however, clinical evidence is limited. Consultation with a healthcare provider is recommended.

Breast-feeding

It is generally deemed safe to use Calcarea while breastfeeding, but caution is advised and it is best to consult a healthcare provider.

Storage

Store in a cool, dry place away from direct sunlight and moisture. Keep out of reach of children.

Indications

• Nutritional source for energy
• Culinary applications in baking and cooking
• Thickening agent in sauces and gravies

Dosage

Children: Refer to specific dietary guidelines; no specific dosing established.

Adults: Refer to specific dietary guidelines; no specific dosing established.

Mechanism of action

Flour primarily serves as a source of carbohydrates, which are broken down into glucose to provide energy. In the case of wheat flour, the gluten proteins form a network that traps air bubbles during baking, leading to the rise and structure of baked goods.

Pharmacodynamics

Flour itself is not a pharmacologically active substance but provides essential nutrients, including carbohydrates, proteins, vitamins, and minerals. The breakdown of starches in flour through digestion releases glucose, influencing blood sugar levels and providing energy for cellular functions.

Pharmacokinetics

The gastrointestinal absorption of carbohydrates from flour occurs primarily in the small intestine, where enzymes break down starches into monosaccharides, such as glucose. The absorption rate can vary based on the type of flour and its processing. The metabolic fate of glucose includes utilization for energy, storage as glycogen in the liver and muscles, or conversion to fat when in excess.

Pregnancy

Flour is generally considered safe for consumption during pregnancy. However, it is important to ensure that it is properly processed and free from contaminants.

Breast-feeding

Flour is safe to consume while breastfeeding, as long as it is part of a balanced diet and free from harmful additives.

Storage

Flour should be stored in a cool, dry place in an airtight container to prevent moisture absorption and pest infestation.

Formulations

• All-purpose flour
• Whole wheat flour
• Self-rising flour
• Cake flour
• Bread flour
• Gluten-free flour

Indications

• Skin irritations
• Hemorrhoids
• Minor wounds
• Itching
• Varicose veins
• Acne

Dosage

Children: Refer to BNF for Children for appropriate formulations and dosing guidelines.

Adults: For topical use, apply a small amount of hammamelis extract or ointment to the affected area up to three times daily, or as directed on the product label.

Mechanism of action

The active constituents of hammamelis include tannins, flavonoids, and essential oils, which contribute to its astringent and anti-inflammatory effects. Tannins precipitate proteins, leading to a protective barrier on the skin and mucous membranes. This mechanism helps reduce inflammation and promotes wound healing by forming a protective layer over damaged tissues.

Pharmacodynamics

Hammamelis exhibits astringent properties, which reduce secretions and can help in shrinking tissues. Its anti-inflammatory effects are attributed to its ability to inhibit the release of inflammatory mediators, providing symptomatic relief in conditions such as skin irritations and hemorrhoids. The flavonoids present in witch hazel may also exhibit antioxidant activity, further contributing to its therapeutic benefits.

Pharmacokinetics

When applied topically, hammamelis is minimally absorbed into systemic circulation. The astringent effects are localized to the site of application, allowing for targeted relief of symptoms. The onset of action is typically rapid, providing immediate soothing effects. The duration of action may vary based on formulation and individual skin characteristics.

Adverse effects

• Skin irritation
• Allergic reactions
• Digestive upset

Precautions

• Use with caution in patients with known allergies to hamamelis or its constituents
• Discontinue use if irritation or allergic reaction occurs

Pregnancy

Limited data available; consult healthcare provider before use.

Breast-feeding

Limited data available; consult healthcare provider before use.

Storage

Store in a cool, dry place away from direct sunlight.

Formulations

• Topical ointments
• Liquid extracts
• Witch hazel pads

Indications

• Metabolic disorders
• Urinary excretion abnormalities
• Detoxification of aromatic compounds

Dosage

Children: Refer to the BNF for Children for appropriate dosing recommendations based on age and weight.

Adults: Refer to specific guidelines in the BNF for appropriate dosing based on the clinical condition and patient factors.

Mechanism of action

Hippurate is formed from the conjugation of benzoic acid and glycine, facilitating its excretion via urine. This process enhances the solubility of benzoic acid, allowing for efficient renal clearance. The mechanism involves the activation of mitochondrial enzymes that facilitate the utilization of glycine in the liver, promoting the detoxification of aromatic compounds. Additionally, hippurate is implicated in the modulation of certain pathways related to amino acid metabolism.

Pharmacodynamics

Hippurate exhibits its effects primarily through the conjugation pathway, where it aids in the detoxification of potentially harmful metabolites. It plays a role in the excretion of aromatic substances, thus reducing their potential toxic effects in the body. The pharmacodynamic profile of hippurate reflects its ability to influence metabolic rates and detoxification processes, impacting the overall metabolic homeostasis.

Pharmacokinetics

Hippurate is rapidly absorbed and undergoes significant metabolism in the liver, where it is conjugated with glycine to form hippurate. It is then excreted in the urine, with renal clearance being the primary route of elimination. The half-life of hippurate is relatively short, necessitating frequent dosing in clinical settings. Pharmacokinetic parameters such as absorption, distribution, metabolism, and excretion are influenced by factors such as renal function and hepatic metabolism.

Pregnancy

There is limited data on the use of hipp during pregnancy. It should only be used if the potential benefit justifies the potential risk to the fetus.

Breast-feeding

It is not known whether hipp is excreted in human milk. Caution should be exercised when administering to nursing mothers.

Storage

Store in a cool, dry place, away from direct sunlight.