Federal agency for medicines and health products JUSTIFICATON OF HOMEOPATHIC USE – SUB WORKING GROUP August 28th 2012 Marie-Anne Mouyart – Belgium, Unit Homeo-Phyto HMPWG Gdańsk – October 23th 2012 Available and already compiled data ECH pilot list 20 stocks HMPWG List of most commons stocks HMA Job1 (Materia Medica) HMA Job3 (Old Provings) Preparation of the subgroup: compilation of 2 drafted lists of stocks (differences in the raw materials description in bold characters) Draft Green list HMPWG Gdańsk famhp/Unit Homeo-Phyto Draft Yellow list October 23th 2012 2 Discussion within the sub working group case by case 28.08.2012 - Decision Draft Green list Draft Yellow list Positive advice Pending advice Light* yellow list Stocks put on hold Light *green list Pink and orange colored stocks Final Yellow list Final Green list * Same raw material, small differences in the degree of precision of the description HMPWG Gdańsk famhp/Unit Homeo-Phyto Positive advice after discussion case by case need to send a signal to the Pharmacopoeias authorities October 23th 2012 3 LIGHT* GREEN LIST (1/2) *Non significative difference concerning the description of the raw materials Starting material Pharmacopoeia Definition of the raw material Atropa belladonna GHP Belladonna Strychnos Nux vomica FP GHP Whole fresh plants of Atropa bella-donna L., without woody lower stem sections, collected at the end of flowering Whole fresh blooming plant Dried ripe seeds of Strychnos nux-vomica L. Nux vomica Thuja occidentalis FP GHP Thuya occidentalis FP HMPWG Gdańsk famhp/Unit Homeo-Phyto Dried seed of strychnos nux vomica L. Fresh, leafy, one-year-old twigs of Thuja occidentalis L. Fresh leafy branch of Thuya occidentalis harvested during spring October 23th 2012 4 LIGHT* GREEN LIST (2/2) *Non significative difference concerning the description of the raw materials Lachesis (mutus) GHP Gently dried venom of Lachesis melano-cephala Solorzano and Cerdas, Lachesis stenophrys Cope or Lachesis muta (L.) Bryonia cretica GHP Fresh root of Bryonia cretica L. ssp. dioica (Jacq.) Tutin or Bryonia alba L., harvested before the plant comes into flower Bryonia FP Fresh underground parts of Bryonia cretica L. subsp. dioica (Jacq.) Tutin or Bryonia alba L. HMPWG Gdańsk famhp/Unit Homeo-Phyto October 23th 2012 5 Light* yellow List (1/2) *Non significative difference concerning the description of the raw materials Starting material Pharmacopoeia Definition of the raw material Berberis vulgaris GHP Berberis vulgaris FP Cinchona pubescens GHP (China) China rubra FP +Ph. Eur. Selenicereus GHP grandiflorus (Cactus) Cactus grandiflorus FP HMPWG Gdańsk famhp/Unit Homeo-Phyto Dried bark of aerial and underground parts of Berberis vulgaris L. Dried bark of underground parts of Berberis vulgaris L. Dried bark of the trunk and twigs of Cinchona pubescens Vahl (Cinchona succirubra Pav.), of Cinchona calisaya Wedd., of Cinchona ledgeriana Moens ex Trimen, or of their varieties or hybrids Whole or cut dried bark of Cinchona pubescens Vahl of Cinchona calisaya Wedd.,of Cinchona ledgeriana Moens ex trimen or of their varieties or hybrids. Fresh young stem and flowers of Selenicereus grandiflorus (L.) Britt. et Rose Fresh young stem with or without flowers of Selenicereus grandiflorus (L.) Britt. Et Rose October 23th 2012 6 Light* yellow List (2/2) *Non significative difference concerning the description of the raw materials Strychnos ignatii GHP Dried ripe seeds of Strychnos ignatii Bergius Ignatia amara FP Dried seeds of Strychnos ignatii Bergius Solanum dulcamara (Dulc.) GHP Fresh shoots of Solanum dulcamara L., collected prior to flowering Dulcamara FP Viscum album GHP Fresh young blooming leafy-stem of solanum dulcamara L. Fresh leafy shoots and fruits of Viscum album L see monograph coniferous and deciduous trees Viscum album FP Fresh aerial fructiferous part of Viscum album collected on the apple tree Carbo vegetabilis FP Carbonisation of plants HMPWG Gdańsk famhp/Unit Homeo-Phyto October 23th 2012 7 Final green list (1/1): same description of the raw material Starting material Pharmacopoeia Definition of the raw material Acidum arsenicosum (Ars.alb.) GHP/FP Ph eur arsenii trioxidum Arsenious trioxide according to Ph. Eur. monograph Sulfur GHP/FP Sublimed sulfur Lycopodium clavatum GHP/FP Dried ripe spores of Lycopodium clavatum L. Pulsatilla pratensis GHP Rhus toxicodendron GHP Rhus toxicodendron FP Lachesis mutus FP Whole fresh flowering plants of Pulsatilla pratensis (L.) Mill. Fresh, young, not yet lignified shoots of Rhus toxicodendron L., with leaves Fresh leafy branch of Rhus toxicodendron harvested at the end of summer. Dried venom of Lachesis muta L. Phosphorus GHP White phosphorus Calcium carbonicum Hahnemanni GHP Inner parts of broken shells of the oyster Ostrea edulis L., Calcarea carbonica ostrearum HMPWG Gdańsk Sepia officinalis FP Inner parts of broken shells of the oyster Ostrea edulis L., GHP/FP Dried secretion from the ink gland ofOctober Sepia23th officinalis L 2012 famhp/Unit Homeo-Phyto 8 Final yellow list (1/4): same description of the raw material Starting material Pharmacopoeia Definition of the raw material Arnica montana e planta tota GHP whole fresh blooming plant ARNICA MONTANA FP whole fresh blooming plant Aconitum napellus GHP Fresh whole plants of Aconitum napellus L., collected at the start of flowering Aconitum napellus FP Whole fresh flowering plant of Aconitum napellus Apis mellifica GHP Live worker honey bee (Apis mellifera L.). according to Ph. Eur. monograph Apis mellifica Ph. Eur. Apis mellifera(2024) Live worker honey bee (Apis mellifera L.) Matricaria recutita (Chamomilla) GHP Whole fresh flowering plants of Matricaria recutita (L.) Chamomilla vulgaris FP Whole fresh blooming plants of Chamomilla recutita (L.)Rauschert ( Matricaria recutitaL.,M;chamomilla L; Citrullus colocynthis GHP Dried, peeled, deseeded fruits of Citrullus colocynthis (L.) Schrad. or pieces thereof Colocynthis FP Dried pulp of deseeded fruit of Citrullus colocynthis (L.) HMPWG Gdańsk famhp/Unit Homeo-Phyto October 23th 2012 9 Final yellow list (2/4): same description of the raw material Psychotria ipecacuanha (Cephaelis ipecacuanha) GHP Dried underground organs of Psychotria ipecacuanha (Brot.) Stokes IPECA Carduus marianus (Silybum marianum) FP +Ph eur Ipecacuanha root (094) GHP Carduus marianus FP +Milk Thistle(1860) Conium maculatum GHP Fragmented and dried underground organs of Cephaelis ipecacuanha(Brot) Mature fruit, devoid of the pappus, of Silybum marianum L. Gaertner Mature fruit,devoid of the pappus of Silybum marianumLGaertner Fresh, aerial parts of flowering, but not yet fruiting specimens of Conium maculatum L. Conium maculatum FP Fresh flowering aerial parts of Conium maculatum L., harvested at the end of the blooming season. Calcium fluoratum GHP Calcium fluoride according to DAB monograph Clacarea fluorica Ca F2 Hydrastis canadensis no FP Monograph, to be checked in Ph. Eur GHP Hydrastis FP +Hydrastis Ph E (1831) Hepar sulfuris GHP Hepar sulfur no monograph in FP Whole or cut dried rhizome and root of Hydrastis canadensis L. Substance obtained by calcining a mixture of Calcium carbonicum Hahnemanni and Sulfur Substance obtained by calcining a mixture of Calcium carbonicum Hahnemanni and Sulfur HMPWG Gdańsk famhp/Unit Homeo-Phyto Dried underground parts of Hydrastis canadensis L. October 23th 2012 10 Final yellow list(3/4): same description of the raw material Secale cornutum GHP Secale cornutum no monograph in FP Anamirta cocculus (Cocc.) check ph eur new GHP monograph Cocculus indicus check ph eur new FP monograph Kalium jodatum GHP +FP + Ph. Eur. Argentum nitricum GHP +FP+ Ph. Eur. Hypericum Ph,Eur Hypericum perforatum (hypericum) GHP Lytta vesicatoria (Canth.) GHP Cantharis no monograph in FP HMPWG Gdańsk famhp/Unit Homeo-Phyto Sclerotium of Claviceps purpurea (Fries) Tulasne, grown on rye plants (Secale cereale L.) and dried at a temperature not exceeding 40°C. Sclerotium of Claviceps purpurea (Fries)Tulasne Ripe, dried fruits of Anamirta cocculus Wight et Arn. Ripe, dried fruits of Anamirta cocculus Wight et Arn. Potassium iodide according to Ph. Eur. monograph Silver nitrate according to Ph. Eur. monograph Whole fresh plants according to Ph. Eur. monograph on Hypericum for homoeopathic preparations Whole fresh plants according to Ph. Eur. monograph on Hypericum for homoeopathic preparations Spanish flies (Lytta vesicatoria L.), as far as possible intact specimens, sacrificed and dried at a temperature not exceeding 40°C Dried Lytta vesicatoria October 23th 2012 11 Final yellow list(4/4): same description of the raw material Stibium sulfuratum nigrum (Ant. crud.) Antimonium crudum GHP Antimony(III) sulfide FP Sb2S3 Magnesium phosphoricum GHP Magnesia phosphorica FP Magnesium hydrogen phosphate trihydrate according to DAB monograph MgHPO4 3H2O Graphites GHP Naturally occurring mineral graphite Graphites FP Pulverized mineral graphite Carbo vegetabilis GHP Well carbonized charcoal obtained from beech or birch wood Acidum nitricum GHP + FP + Ph.Eur. Nitric acid according to Ph. Eur. monograph Kalium bichromicum GHP+FP Potassium dichromate HMPWG Gdańsk famhp/Unit Homeo-Phyto October 23th 2012 12 Conclusion of the subgroup A Proposal of a first final list of justified stocks Final Green Final Yellow Light yellow Light green Submission to the HMPWG members For approval and publication on the HMA website HMPWG Gdańsk famhp/Unit Homeo-Phyto October 23th 2012 13 Conclusion of the subgroup B Signal to the authorities in charge of Homeopathic Pharmacopoeias Light green list Light yellow list Ph. Eur. French Ph. G.H.P. In order to check the adapt level of precision of the description of the Raw Material (See bold characters) e.g. : End of flowering / blooming Dried Ripe seeds / Dried Seeds One year old twigs / harvested during spring Lightfied shoots / harvested at the end of summer HMPWG Gdańsk famhp/Unit Homeo-Phyto October 23th 2012 14 Conclusion of the subgroup C List of « negative »/pending advice / stocks put on hold, • Same Name / different compositions e.g. : Calcarea phos, Kalium phosphoricum, • Same description of the Raw Material / Poor available Homeopathic litterature e.g.: Avena sativa Check the MRP procedure HMPWG Gdańsk famhp/Unit Homeo-Phyto October 23th 2012 15 Pending advice: stocks put on hold Starting material Pharmacopoeia Calcium phosphoricum GHP + Ph. Eur. 0116 Calcium hydrogen phosphate dihydrate according to Ph. Eur. monograph Calcarea phosphorica FP+ Ph eur phosphate Mixture of Calcium phosphates tricalcique(1052) Kalium phosphoricum GHP + Ph.Eur. 920 Kalium phosphoricum FP+Ph.Eur. 1003 Pulsatilla pratensis GHP Whole fresh flowering plants of Pulsatilla pratensis (L.) Mill. Pulsatilla FP Whole fresh flowering plants of Pulsatilla vulgaris (L.) Mill. HMPWG Gdańsk famhp/Unit Homeo-Phyto Definition of the raw material Potassium dihydrogen phosphate according to Ph. Eur. monograph Dipotassium phosphate according to Ph.Eur. Monograph October 23th 2012 16 AVENA SATIVA: check MRP Starting material Pharmacopoeia Definition of the raw material Avena sativa GHP Fresh aerial parts of Avena sativa L., collected at flowering time. Avena sativa FP Fresh blooming aerial parts of Avena sativa L. ECH HMA job 1 MM ECH HMA Job 3 old provings nbr symptoms 2 pages 125-126 Boericke yes (-) Charette no HMPWG Gdańsk famhp/Unit Homeo-Phyto Nbr provers 1 Clarke yes Kent no Leeser no Mezger yes nbr ref 1 Stauffer yes page 18 Voisin yes (-) October 23th 2012 17 Next meeting of the subgroup Proposal of the next meeting on 26/03/2013 ? Same methodology Second list of Justified stocks For approval in Dublin (30/05/2013) HMPWG Gdańsk famhp/Unit Homeo-Phyto October 23th 2012 18 Interactions in order to increase harmonization In order to increase harmonisation and to facilitate MRP/DCP, a lot of interactions are/ should be induced by this project between - Prescribers (via ECH), HMA (via HMPWG and the HU sub working group), Pharmacopoeias authorities Companies (via the public consultation) Prescribers Homeopathic Litterature ECH Pharmacopoeias Authorities ECH Pilot List HMA Jobs HMPWG HMPWG List Public (consultation) HMPWG Gdańsk famhp/Unit Homeo-Phyto Sub working group FR, UK,DE,GR, ES, IRL, PT, BE (Rapporteur) Final lists October 23th 2012 19