1 TRENKA Chem. pharm. Fabrik Ges.m.b.H EUCARBON a product of Trenka Ges.m.b.H. Vienna P.P. Presentation Eucarbon (classic) doc. Vers. English Date: (MHK) 30 p. Grafic: Mai 2013 (MHK) Vers. 4 2 TRENKA Chem. pharm. Fabrik Ges.m.b.H Contents 1.Basics - EUCARBON and the Intestine 2.Ingredients of EUCARBON 3.Application & Effects of EUCARBON 4.Major Indications 5.FAQ 6.Interesting Facts 7.Contra-indications 8.Guidelines for Professionals 3 1. Basics developed in 1909 by Mag. F. Trenka & Prof. Pauli proven, unchanged formulation EUCARBON proven for more than 100 years TRENKA Chem. pharm. Fabrik Ges.m.b.H 4 2. Components Function Classification according to the functions of the ingredients Adsorbent:Finely-pulverized vegetable charcoal Laxative:Senna leaves Rhubarb roots Purified Sulfur Carminative & Spasmolytic: Essential mint oil Essential fennel oil 5 TRENKA Chem. pharm. Fabrik Ges.m.b.H 2. Components Types of Charcoal Vegetable charcoal: carbonisation Finely-pulverised vegetable charcoal (EUCARBON ): carbonisation + pulverisation Activated charcoal: carbonisation + activation The difference lies in the adsorption power. 6 TRENKA Chem. pharm. Fabrik Ges.m.b.H 2. Components Activated charcoal / vegetable charcoal Activated charcoal has an adsorption power which is times higher than vegetable charcoal (acc. to Non-clinical overview, Module 2.4., dated 4/2011) 7 TRENKA Chem. pharm. Fabrik Ges.m.b.H 2. Components Types of Charcoal Activated charcoal: Inhibits the effect of other drugs and causes constipation Resolves one problem, but creates another 8 TRENKA Chem. pharm. Fabrik Ges.m.b.H 2. Components Senna & Rhubarb Active substances in senna & rhubarb: anthraquinone glycosides (AG) stimulate intestinal peristalsis reduce water adsorption in the intestine 9 TRENKA Chem. pharm. Fabrik Ges.m.b.H 2. Components Anthraquinone Glycosides Each EUCARBON tablet contains 5 mg AG The average treshold for a laxative effect by AG is 30 mg / day To achieve a laxative effect with EUCARBON , an average of 5 tablets / day is required 10 TRENKA Chem. pharm. Fabrik Ges.m.b.H 2. Components Purified Sulphur Therapeutic usage and efficacy - I Yellow solid substance, which appears in nature in pure form Essential for living cells, exists in different biological variants in all tissues Has no importance for human nutrition, thus there are no studies nor scientific data Pure sulphur is insoluble in water and therefore cannot be absorbed in the intestine Per oral applications of elemental sulphur play practically no role in pharmacotherapy Used in balneotherapy since long times 11 TRENKA Chem. pharm. Fabrik Ges.m.b.H 2. Components Purified Sulphur Effect of Sulphur in EUCARBON : Releases hydrogen sulphide bubbles in the small intestine These hydrogen sulphide bubbles stimulate intestinal peristalsis 12 TRENKA Chem. pharm. Fabrik Ges.m.b.H 2. Components Mint & Fennel Mint & fennel stimulate evacuation of intestinal gases reduce painful contractions relieve cramps of the unstriated intestinal muscles relieve the feeling of painful tension stop the development of bacteria which cause fermentations essential mint oils stimulate bile secretion. Bile is necessary for lipolysis 13 TRENKA Chem. pharm. Fabrik Ges.m.b.H 3. Application & Effects of EUCARBON How to use EUCARBON to achieve one effect/ a combination of effects? Simply change dosage and/or duration of treatment 14 TRENKA Chem. pharm. Fabrik Ges.m.b.H 3. Application & Effects of EUCARBON Effects: At low doses, from 1 to 3 tablets daily, EUCARBON has an adsorbent effect At higher doses, from 4 to 6 tablets daily, EUCARBON has both, an adsorbent and a laxative effect 15 TRENKA Chem. pharm. Fabrik Ges.m.b.H 3. Application & Effects of EUCARBON Duration of treatment: Mid to long-term treatment ( weeks): EUCARBON becomes an intestinal regulator WEEKS 16 TRENKA Chem. pharm. Fabrik Ges.m.b.H 4. Major Indications Dyspepsia Bloating Flatulence Meteorism Indigestion All types of constipation Slow bowel Hemorrhoids Anal fissures 1 3 tablets/day (adsorbing effect) 4 6 tablets/day (laxative and absorbing effect) 17 TRENKA Chem. pharm. Fabrik Ges.m.b.H 5. FAQ Pain at the moment of defecation Reflex constipation due to fear of pain Why should EUCARBON be used for treatment of hemorrhoids and anal fissures? Serious problem of these two pathologies: Thats why soft stool is essential in these two pathologies 18 TRENKA Chem. pharm. Fabrik Ges.m.b.H 5. FAQ Why does EUCARBON provide soft stool? Anthraquinone glycosides are hydrophilic. Once in the colon, they soak up water and thus provide soft stool. Conclusio: The more fluid we want a faecal bolus to be, the higher the dosage of EUCARBON should be. 19 TRENKA Chem. pharm. Fabrik Ges.m.b.H 6. Interesting Facts EUCARBON is an intestinal transit regulator. Treatment of the irritable bowel syndrome (IBS) = EUCARBON Idea that should guide our activity ! 20 TRENKA Chem. pharm. Fabrik Ges.m.b.H 6. Interesting Facts Irritable Bowel Syndrome A brief overview of the irritable bowel syndrome: Patients complain about a certain number of symptoms in the gastro-intestinal tract. Diagnosis takes place through elimination. The physician carries out the required investigations if there is no organic cause / explanation, and if the symptoms persist the diagnosis is irritable bowel syndrome 21 TRENKA Chem. pharm. Fabrik Ges.m.b.H 6. Interesting Facts IBS, Symptomatic Treatment against flatulence against diarrhoea against constipation against pain Additional prescription of an anxiolytic adsorbent antidiarrhoeal laxative antispasmodic 22 TRENKA Chem. pharm. Fabrik Ges.m.b.H 6. Interesting Facts IBS, Treatment with EUCARBON Adsorbent Laxative Antispasmodic at low doses EUCARBON is an adsorbent at high doses EUCARBON is also a laxative essential mint & fennel oil in EUCARBON have a spasmolytic & carminative effect Moreover, EUCARBON yields a reduction of abdominal distension by adsorption and elimination of gases, considerably reducing pain 23 TRENKA Chem. pharm. Fabrik Ges.m.b.H 6. Interesting Facts IBS, Treatment with EUCARBON Treating the IBS with EUCARBON to achieve regulation of the intestinal transit, 2 conditions should be observed: 1. Duration of treatment 2. Dose reduction in function of intestinal transit improvement 24 TRENKA Chem. pharm. Fabrik Ges.m.b.H 6. Interesting Facts IBS, Duration of Treatment The average duration of treatment with EUCARBON until achieving intestinal transit regulation is weeks WEEKS If the patient stops treatment before intestinal transit regulation is achieved, treatment should be started anew! 25 TRENKA Chem. pharm. Fabrik Ges.m.b.H 6. Interesting Facts IBS, Dose Reduction Criterion for reduction of the dose: faecal bolus As soon as the faecal bolus becomes softer or as soon as there are signs of diarrhoea, it can be concluded that intestinal transit has improved and dose should be reduced, until achieving regulation of digestion 26 TRENKA Chem. pharm. Fabrik Ges.m.b.H 6. Interesting Facts Ultrasonography & Radiology EUCARBON before ultrasonography and radiology: To prepare patients for: x-ray examinations of the kidneys, the gallbladder, the liver and the spleen Abdominal ultrasonography Objectives: To obtain clear radiographs, we need an adsorbing and laxative effect total elimination of gases intensive cleaning of the digestive tract 27 TRENKA Chem. pharm. Fabrik Ges.m.b.H 6. Interesting Facts Ultrasonography & Radiology Three possible preparation patterns: 3 days before examination: 2 tablets 3x per day 1 day before examination: 4 tablets in the morning and 4 tablets in the evening In urgent cases: 6 8 tablets in the evening in one single intake before going to sleep The shorter the preparation time, the higher the dosage must be 28 TRENKA Chem. pharm. Fabrik Ges.m.b.H 7. Contra-indications Like all other laxatives, EUCARBON may not be taken in case of: appendicitis intestinal obstruction surgery emergencies Other contra-indications: progressing gastro-intestinal ulcers an ulcer is an open wound which triggers pain when getting in contact with sulphur. In case of healed ulcers EUCARBON may be taken safely. 29 TRENKA Chem. pharm. Fabrik Ges.m.b.H 8. Guidelines for Professionals Each physician should advise the patient of the laxative effect of EUCARBON and as for any other laxative it should be used with precaution, in order to avoid diarrhoea! 30 TRENKA Chem. pharm. Fabrik Ges.m.b.H Thank you for your attention!