Medicinal Plants in Dosage Forms

October 17’ 2006
Draft No. 2
This is a feature article I wrote for my development journalism classes.

It is midnight and you’re suddenly attacked by a bad cough. The only remedy you have is a lagundi plant growing in your backyard. Before it becomes a cough medicine that you can use, you must prepare it into a simple mixture, which takes more than boiling-in-water.

Why take the effort when you can just pop a tablet of the same lagundi remedy into your mouth and flush it down with water?

Plant-shelf

According to the Philippine Institute of Traditional and Alternative Health Care (PITAHC), there are 10 herbs which were scientifically proven to have medicinal qualities. In their informational campaign booklet on preparing herbal medicines, “Gabay sa Paggamit ng 10 Halamang Gamot”, PITAHC has identified the following plants:

ü Lagundi for cough

ü Yerba Buena for pain relief

ü Tsaang Gubat for stomach aches

ü Niyug-Niyogan for stomach worms

ü Bayabas for cleaning wounds, mouth infections

ü Akapulko for ring worm infection, athletes foot

ü Ulasimang Bato for rheumatism and gout

ü Bawang (garlic) for lowering cholesterol

ü Ampalaya for diabetes

Among these, only the technologies for making prescription forms for Sambong (tablet), Lagundi (tablet and syrup) and Akapulko (ointment) have been completed and sold to local pharmaceutical companies making these prescription forms already out in the market.

Rap Padua, a pharmacist, enumerates these prescriptions sold along with other herbal medicines in tea forms.

There is Ascof (Lagundi) which is available in 350mg and 600mg tablets and 80mL and 120mL syrup. The tablets cost around P3.75 to P4.50, while the syrup prices range form P80 to P115. A play on the adjective relief, Re-Leaf is the Pascual Laboratories Inc. brand name for the Sambong tablet. This comes in 250mg and 600mg tablets ranging at a price of P3.50 to P7. Also available is the Charantia brand of Ampalaya tea and capsule, Gourmet brand of Banaba, Pito-Pito (a combination of 7 herbs) and Sambong teas, Rita Ritz brand of Banaba and Pito-Pito tea ranging form P65-70 per box.

Rodora Loares, manager of a pharmacy, notes that older people buy herbal medicines more than younger people, like students. She reasons this reflects that most herbal remedies are for older people, however lagundi, she says, is available in both tablet and syrup forms which could also be used for children. She observes that in general a lot of people still buy and use herbal remedies.

Herb-oloarios?

While herbolarios are the society’s traditional medicine men, a group of researchers at the National Institute for Research and Promotion of Medicinal Plants (NIRPROMP) are not exactly the herb-olarios you would usually think of. They are the researchers developing the technology for these dosage forms – tablet, syrup, ointment etc. The research team is composed of the Departments of Health, Education, Agriculture, the National Institute of Science and Technology, as well as the Agriculture, Medicine, Science and Pharmacy Colleges of the University of the Philippines.

Prof. Ernesta G. Quintana, Adjunct Research Professor at the Post-harvest Research Center, is part of the NIRPROMP research team. At the College of Agriculture (CA), University of the Philippines Los Baños (UPLB), they are doing research on the first step of making traditional herbs into dosage forms: the plants of course.

“I take care of the growing and post-harvest handling,” Prof. Quintana clarifies. Among their mandates are developing the fastest way to get the raw materials needed. “Halimbawa, kung dahon ng lagundi, papaano mo ipropagate at papaano mo aalagaan para mabilis mo makuha yung mga dahon? Kung niyug-niyogan naman na fruits, paano’ng gagawin mo para mamunga kaagad?”

Second step in their research is when the harvested leaves are then brought to the College of Pharmacy to be processed, but first tested. Prof. Quintana enumerates the tests done: “Leaves of lagundi will have to undergo a series of tests to be sure hindi siya:

· mutagenic, meaning hindi nakakacause ng changes sa chromosomes ng tao;

· teretogenic, hindi siya nakakacause ng deformity sa fetus;

· wala siyang pesticide residue,

· wala siyang aflatoxin,

· ang microbial count niya ay di lalagpas ng 100,000 microbial colony forming units etc.;

· at ’saka wala siyang amounts ng heavy metals katulad ng lead, cadmium, arsenic, mercury na lalampas sa amounts allowed by WHO (World Health Organization).”

It is because of these tests that the researchers stress the importance that the farmers not use pesticides on the medicinal plants in its growing stage.

After being made into the appropriate dosage from, depending on use, at the College of Pharmacy it goes to the College of Medicine to be tested for its efficacy. If the results are good, the product will eventually reach the market.

More than just plain old Herbal Medicine

The benefits of having herbal medicines in dosage forms are obvious for consumers: convenience and portability. As a consumer herself, Rodora Loares says “Mas madali kasi iinumin na lang. Di kagaya ng ‘pag yung dahon pa lang, kailangan pa pakuluan. e ito, iinumin na lang.” They are also portable in the sense you can bring the tablet anywhere, and take it anytime it is most needed.

Alyn Daileg, assistant branch manager of a local drug store, mentions that you don’t need a doctor’s prescription to avail of these medicines.

Another benefit is storage. Unlike the traditionally bottled concoctions, the foil tamper-proof packaging allows drug stores to stock the medicines making it available to consumers for longer periods of time.

Prof. Quintana stresses that one important benefit of this is standardized dosage. She says that in preparing medicines the herbolaio’s way, “Sasabihin niya kumuha ka ng isang dakot, iboil mo sa tubig. Di niya sasabihin kung gaano karaming tubig. Walang quantification iyon. Hit and miss ‘yun. And he will not even tell you gaano kadaming dakot para sa matanda at ‘saka sa bata. Tapos, yung kamay ng isang tao ay iba-iba.”

Another benefit is the lowered cost of health care. Compared to the chemical synthetic medicines widely produced, herbal medicines are cheaper by a well-saved few pesos. Prof. Quintana enumerates some herbal remedies equivalents in Western medicine:

ü Lagundi – Bromhexine Hcl (ex. Bisolvon)

ü Sambong – (ex. Lasix)

ü Akapulko – Tioconazine (ex. Trocyd)

Western Medicine in the Red Corner

Not many studies have actually been done on these herbal medicines’ efficacy versus western medicine. “Usually they are tested against placebo,” says Dr. Anthony Charles F. Dalmacio, M.D. of HealthServ at Crossing, Los Baños. That is, testing against something that doesn’t work. If the drug has the same effect as something that doesn’t work, it means it has no effect. “But if the response is different, if it is statistically significant, is the change enough to say that it is effective?” Dr. Dalmacio explains.

“I think it’s a practical alternative to the industrial medicines available commercially,” he says, debunking the idea that western medicine and traditional medicine aren’t friends. “The evil comes in marketing.” Dr. Dalmacio cites examples of herbal supplements being commercialized as wonder drugs. “There is nothing wrong with using herbal medicines; it is in the proper use of it as a patient and as a businessman.”

A whole new Industry

The demand for herbal medicine in tablet form has generated a new industry for producing herbal plants. “It has given jobs to farmers. Meron na silang alternative crop kung pumalpak ang kanilang main crop.”

In the article “Filipino Remedy” written by Susie Emmett for the New Agriculturalist Online, she features Bonifacio Navaroza,a farmer who manages the first lagundi farm at Palawan. He says the main advantage of having a medicinal plant for a crop is, “that it is not like other crops where you have to plant every season. This you plant once and then just keep harvesting it for years.” From plant to tablet is basically a process of harvesting, sorting (taking out damages and diseased rejects), drying, milling into fine powder, to be shipped off to Manila where pharmaceutical companies press it into tablets.

Many may no longer have a lagundi plant in their backyards, or have the time to prepare them as medicines in times of need. The tradition of herbal medicines has been around for centuries, but the past few years of research has provided ways for our traditions to catch up on the conveniences of our modern lifestyles.