Medine.co.uk

Draft Community Herbal Monograph On Juniperus Communis L., Pseudo-Fructus

European Medicines Agency Evaluation of Medicines for Human Use


London, 14 January 2009 Doc. Ref.: EMEA/HMPC/441929/2008


COMMITTEE ON HERBAL MEDICINAL PRODUCTS

(HMPC)


DRAFT


COMMUNITY HERBAL MONOGRAPH ON JUNIPERUS COMMUNIS L.,

PSEUDO-FRUCTUS


DISCUSSION IN WORKING PARTY ON COMMUNITY MONOGRAPHS AND COMMUNITY LIST (MLWP)

September 2008 November 2008 January 2009

ADOPTION BY HMPC FOR RELEASE FOR CONSULTATION

14 January 2009

END OF CONSULTATION (DEADLINE FOR COMMENTS)

15 May 2009

REDISCUSSION IN WORKING PARTY ON COMMUNITY MONOGRAPHS AND COMMUNITY LIST (MLWP)

ADOPTION BY HMPC


Comments should be provided using this template to hmpc.secretariat@,emea.europa.eu Fax: +44 20 75 23 70 51


KEYWORDS

Herbal medicinal products; HMPC; Community herbal monographs;

traditional use; Juniperus communis L.; Juniperi pseudo-fructus; juniper

berry


7 Westferry Circus, Canary Wharf, London, E14 4HB, UK Tel. (44-20) 74 18 84 00 Fax (44-20) 75 23 70 51 E-mail: mail@emea.europa.eu http://www.emea.europa.eu © European Medicines Agency, 2009. Reproduction is authorised provided the source is acknowledged


COMMUNITY HERBAL MONOGRAPH ON JUNIPERUS COMMUNIS L.,

PSEUDO-FRUCTUS


1.    Name of the medicinal product

To be specified for the individual finished product.

2.    Qualitative and quantitative composition1,2

Well-established use

Traditional use

With regard to the registration application of Article 16d(1) of Directive 2001/83/EC as amended

Juniperus communis L., pseudo-fructus (juniper berry)

i) Herbal substance Cone berries

ii) Herbal preparations

Comminuted cone berries

Liquid extract with 25% ethanol (1:1 V/V)

Tincture with 45% ethanol (1:5 V/V)

3. PHARMACEUTICAL FORM

Well-established use

Traditional use

Herbal substance or herbal preparations in solid or liquid dosage forms or as herbal tea for oral use.

The pharmaceutical form should be described by the European Pharmacopoeia full standard term.

1    The material complies with the Eur. Ph. monograph (ref. 01/2008:1532)

2    The declaration of the active substance(s) for an individual finished product should be in accordance with relevant herbal quality guidance

4.1. Therapeutic indications

Well-established use

Traditional use

a)    Traditional herbal medicinal product to increase the amount of urine to achieve flushing of the urinary tract as an adjuvant in minor urinary tract complaints.

b)    Traditional herbal medicinal product for symptomatic relief of digestive disorders such as dyspepsia and flatulence

The product is a traditional herbal medicinal product for use in specified indications exclusively based upon long-standing use.

4.2. Posology and method of administration

Well-established use

Traditional use Posology

i)    Herbal substance Indication a)

Cone berries:

To start on day 1 with 5 cone berries, increasing the number every day by 1 coneberry (well chewed) up to 15 cone berries, then decrease the number (1 per day less) until 5 coneberries. So the duration of the therapy is 21 days, the maximum daily dose 15 cone berries.

ii)    Herbal preparations Indications a) and b)

Infusion:

2    g crushed or comminuted herbal substance for tea preparation with boiling water, infusion time 10 minutes: 2-3 times a day

Liquid extract (1:1 in 25% ethanol): 2-4 ml

3    times daily

Tincture (1:5 in ethanol 45%): 1-2 ml 3 times daily

Not to be used in children and adolescents under 18 years of age (see section 4.4 ‘Special warnings and precautions for use’).

Duration of use

Not to be used for more than 3 weeks without consulting a doctor or a qualified health care practitioner.

Method of administration

Oral use.

Indication a)

For preparations other than tea preparations, ensure appropriate fluid intake.

4.3. Contraindications

Well-established use

Traditional use

Hypersensitivity to the active substance.

Severe renal disease including infectious interstitial nephritis, pyelitis and pyelonephritis.

Indication a)

Conditions where reduced fluid intake is recommended (e.g. severe cardiac diseases).

4.4. Special warnings and precautions for use

Well-established use

Traditional use

Not to be used in children and adolescents under 18 years of age since no data on the safe use in children and adolescents are available.

Appropriate fluid intake is recommended.

If complaints of symptoms such as fever, dysuria, spasms or blood in the urine occur during the use of the medicinal product, a doctor or a qualified health care professional should be consulted.

Concomitant treatment with synthetic diuretics is not recommended.

For preparations containing ethanol the appropriate labelling for ethanol, taken from the ‘Guideline on excipients in the label and package leaflet of medicinal products for human use’, must be included.

4.5. Interactions with other medicinal products and other forms of interaction

Well-established use

Traditional use None reported.

4.6. Pregnancy and lactation

Well-established use

Traditional use

Safety during pregnancy and lactation has not been established.

In the absence of sufficient data, the use during pregnancy and lactation is not recommended.

4.7. Effects on ability to drive and use machines

Well-established use

Traditional use

No studies on the effect on the ability to drive and use machines have been performed.

4.8. Undesirable effects

Well-established use

Traditional use

Allergic skin reactions have been reported. The frequency is not known.

If other adverse reactions not mentioned above occur, a doctor or a qualified health care practitioner should be consulted.

4.9. Overdose

Well-established use

Traditional use

Seizures and kidney damage have been reported in individuals who took more than 10 g of Juniper per day or who took high doses of Juniper for longer than 4 weeks.

In case of prolonged use and overdose, urine will smell of violets. There may be renal irritation and pain in and near the kidney, strong diuresis, albuminuria, haematuria, purplish urine, gastrointestinal upsets, accelerated heartbeat and blood pressure. Rarely symptoms of central stimulation like convulsions occur as well as metrorrhagia and abortion.

5.1. Pharmacodynamic properties

Well-established use

Traditional use

Not required as per Article 16c(1)(a)(iii) of Directive 2001/83/EC as amended.

There is limited evidence from preclinical studies that Juniper may influence glucose levels in diabetes.

5.2. Pharmacokinetic properties

Well-established use

Traditional use

Not required as per Article 16c(1)(a)(iii) of Directive 2001/83/EC as amended.

5.3. Preclinical safety data

Well-established use

Traditional use

Not required as per Article 16c(1)(a)(iii) of Directive 2001/83/EC as amended, unless necessary for the safe use of the product.

Based on the results of preclinical investigations it can be concluded that Juniperus communis extract has anti-fertility and abortifacient effects in rats.

As no specific investigations were done on the foetuses, there are no data on genotoxicity, reproductive toxicity or carcinogenicity available for Juniperus communis or its preparations.

6.    PHARMACEUTICAL PARTICULARS

Well-established use

Traditional use Not applicable.

7.    DATE OF COMPILATION/LAST REVISION

14 January 2009

© EMEA 2009 6/6