European Union herbal monograph on Ricinus communis L., oleum

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7 July 2015 EMA/HMPC/572974/2014 Committee on Herbal Medicinal Products (HMPC) European Union herbal monograph on Ricinus communis L., oleum Draft Discussion in Working Party on European Union monographs and list September 2014 (MLWP) November 2014 March 2015 May 2015 Adoption by Committee on Herbal Medicinal Products (HMPC) for release 7 July 2015 for consultation Start of public consultation 22 July 2015 End of consultation (deadline for comments). Comments should be 31 October 2015 provided using this template to hmpc.secretariat@ema.europa.eu Rediscussion in MLWP Adoption by HMPC Keywords Herbal medicinal products; HMPC; European Union herbal monographs; well established medicinal use; Ricinus communis L., oleum; Ricini oleum, Castor oil BG (bulgarski): Рициново масло CS (čeština): ricinový olej DA (dansk): Ricinusolie DE (Deutsch): Natives Rizinusöl EL (elliniká): Έλαιο κρότωνος (κικινέλαιο - ρετσινόλαδο) EN (English): Castor oil ES (español): Aceite de ricino ET (eesti keel): riitsinusõli FI (suomi): risiiniöljy FR (français): Ricin (huile de) HR (hrvatski): ricinusovo ulje HU (magyar): Ricinusolaj IT (italiano): Ricino olio LT (lietuvių kalba): Ricinų aliejus LV (latviešu valoda): Rīcineļļa MT (Malti): żejt ir-riġnu NL (Nederlands): Wonderolie, ricinusolie PL (polski): olej rycynowy PT (português): Óleo-de-rícino RO (română): ulei de ricin SK (slovenčina): Ricínový olej SL (slovenščina): ricinusovo olje SV (svenska): Ricinolja IS (íslenska): NO (norsk): Ricinusolje 30 Churchill Place Canary Wharf London E14 5EU United Kingdom Telephone +44 (0)20 3660 6000 Facsimile +44 (0)20 3660 5555 Send a question via our website www.ema.europa.eu/contact An agency of the European Union European Medicines Agency, 2015. Reproduction is authorised provided the source is acknowledged.

European Union herbal monograph on Ricini communis L., oleum 1. Name of the medicinal product To be specified for the individual finished product. 2. Qualitative and quantitative composition 1,2 With regard to the marketing authorisation application of Article 10a of Directive 2001/83/EC as amended Ricinus communis L., oleum (castor oil) i) Herbal substance Not applicable. ii) Herbal preparation Fatty oil obtained from seeds of Ricinus communis L. by cold expression 3. Pharmaceutical form Herbal preparations in liquid or solid dosage forms for oral use. The pharmaceutical form should be described by the European Pharmacopoeia full standard term. 4. Clinical particulars 4.1. Therapeutic indications Laxative for short term use in cases of occasional constipation.. 1 The declaration of the active substance(s) for an individual finished product should be in accordance with relevant herbal quality guidance. 2 The material complies with the Ph. Eur. monograph (Ricini oleum virginale (ref.: 0051) or Ricini oleum raffinatum (ref.: 2367)) EMA/HMPC/572974/2014 Page 2/6

4.2. Posology and method of administration Posology Adults and elderly Daily dose: 2-5 g (2.1-5.3 ml) as a single dose Normally it is sufficient to take this medicinal product up to 2-3 times a week. The use in children and adolescents under 18 years of age is not recommended (see section 4.4 special warnings and precautions for use ). Duration of use Use for more than 1 week requires medical supervision. If the symptoms persist during the use of the medicinal product, a doctor or a pharmacist should be consulted. Method of administration Oral use The onset time of defecation varies between 2-6 hours. 4.3. Contraindications Hypersensitivity to the active substance. Cases of intestinal obstructions and stenosis, atony, appendicitis, inflammatory colon diseases (e.g. Crohn s disease, ulcerative colitis), abdominal pain of unknown origin, severe dehydration state with water and electrolyte depletion. Pregnancy and lactation (See section 5.3) EMA/HMPC/572974/2014 Page 3/6

4.4. Special warnings and precautions for use Long-term use of laxatives should be avoided. If laxatives are needed every day the cause of constipation should be investigated. If stimulant laxatives are taken for longer than a brief period, this may lead to impaired function of the intestine. Castor oil should only be used if a therapeutic effect cannot be achieved by a change of diet or the administration of bulk forming agents. The use in children and adolescents under 18 years of age has not been established due to lack of adequate data on safety and efficacy. If the symptoms worsen during the use of the medicinal product, a doctor or a pharmacist should be consulted. 4.5. Interactions with other medicinal products and other forms of interaction Hypokalaemia (resulting from long-term laxative abuse) potentiates the action of cardiac glycosides and interacts with antiarrhythmic medicinal products. Concomitant use with diuretics, adrenal corticosteroids and liquorice root may enhance loss of potassium. Concomitant use of antihistamines may reduce the laxative action of castor oil. 4.6. Fertility, pregnancy and lactation The use during pregnancy is contraindicated because castor oil can influence the labour (see 5.3). The use during lactation is contraindicated because may pass into breast milk (see section 4.3 Contraindication"). EMA/HMPC/572974/2014 Page 4/6

No fertility data available. 4.7. Effects on ability to drive and use machines No studies on the effect on the ability to drive and use machines have been performed. 4.8. Undesirable effects Nausea, vomiting, abdominal pain and severe diarrhoea may occur. The frequency is not known. In such cases dose reduction is necessary. If other adverse reactions not mentioned above occur, a doctor or a pharmacist should be consulted. 4.9. Overdose The major symptoms of overdose are gastric irritation with nausea, vomiting, colic and severe diarrhoea, loss of water and electrolytes. Treatment should be supportive with generous amount of fluid and correction of electrolytes. A specific antidote is not available. 5. Pharmacological properties 5.1. Pharmacodynamic properties Pharmacotherapeutic group: contact laxatives Proposed ATC code: A 06 AB05 Ricinoleic acid, the active metabolite, like other anionic surfactants, reduces net absorption of fluid and electrolytes, and stimulates intestinal peristalsis. EMA/HMPC/572974/2014 Page 5/6

5.2. Pharmacokinetic properties The absorption is inversely related to the administered dose. Small doses of castor oil (4 g) are completely absorbed while 11.4% of a dose of 10 g and 86% of a dose of 44.4 g appeared in the faeces within 24 hours. The castor oil is hydrolysed in the small intestine by pancreatic enzymes, leading to the release of glycerol and ricinoleic acid. Ricinoleic acid is then metabolised to epoxydicarboxylic acids (3.6-epoxyoctanedioic acid, 3.6-epoxydecanedioic acid and 3.6 epoxydodecanedioic acid) which are excreted via urine. 5.3. Preclinical safety data Castor oil (2 ml/daily) administered by gavage on days 18, 19 and 20 of gestation induced the initiation of labour and shortened the course of the delivery in pregnant rats. Adequate tests on genotoxicity and carcinogenicity have not been performed. 6. Pharmaceutical particulars Not applicable. 7. Date of compilation/last revision 7 July 2015 EMA/HMPC/572974/2014 Page 6/6