P.P. Presentation Biocarbon – Engl. Date: 12.01.2013 – 17 p. Grafik: 7 Juni 2013 MHK Presentation Tablets BIOCARBON® is a product from the company Trenka Ges.m.b.H. in Vienna, Austria

The active substance contained in BIOCARBON® is pure activated charcoal The terms 'activated charcoal', 'activated carbon', and 'active carbon' all occur in the literature and are generally used interchangeably. As activated charcoal is not absorbed, it acts in situ in the intestine. TRENKA Chem. pharm. Fabrik Ges.m.b.H 2

HISTORY Activated charcoal is a remedy with a well-established use dating back to as early as 1500 B.C.. At the time of Hippocrates charcoal was used to treat epilepsy, vertigo, chlorosis and anthrax. These practices were more and more abandoned but were still partially mentioned even in the 19th century. External application of charcoal was mentioned to gangrenous ulcers to remove bad odours. TRENKA Chem. pharm. Fabrik Ges.m.b.H 3

HISTORY Activated charcoal tablets are also a popular folk remedy used for simple conditions as bad breath: It can bind to some of the odor-producing sulfur compounds in foods and fluids. Today it is established for the treatment of diarrhoea, flatulence and related gastrointestinal disturbances as well as the use as emergency remedy in poisonings. TRENKA Chem. pharm. Fabrik Ges.m.b.H 4

Power of Adsorption Activated charcoal has an adsorption power which is 8 - 16 times higher than vegetable charcoal in Eucarbon (acc. to Non-clinical overview, Module 2.4., dated 4/2011) TRENKA Chem. pharm. Fabrik Ges.m.b.H 5

How does ACTIVE CHARCOAL act? TRENKA Chem. pharm. Fabrik Ges.m.b.H 6

MAJOR INDICATIONS Diarrhoea Adjuvant in intestinal infections Symptomatic treatment of diarrhoea Accumulated gases in the digestive tract Flatulence Meteorism TRENKA Chem. pharm. Fabrik Ges.m.b.H 7

DIARRHOE Very common clinical illness Defined as an abnormal frequency and liquidity of faecal discharges, having three or more loose or liquid bowel movements per day. Most common causes of acute diarrhoea are infectious agents viral and bacterial toxins, enterotoxin, cytotoxin. Common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhoea can cause dehydration and electrolyte imbalances. TRENKA Chem. pharm. Fabrik Ges.m.b.H 8

Treatment of Diarrhoea Symptomatic treatment may include: Rehydration therapy and correction of malnutrition Application of activated charcoal or titrated doses of codeine phosphate or loperamide, and occasionally both to control stool frequency. TRENKA Chem. pharm. Fabrik Ges.m.b.H 9

BIOCARBON® Summary The formulation is based on well-established knowledge. The active ingredient activated charcoal is well known. Main indications: symptomatic treatment of diarrhoea and other gastrointestinal disorders such as flatulence/flatus and meteorism. BIOCARBON® tablets are generally well tolerated. Higher dosage or long time administration may cause nausea and constipation requiring the administration of a laxative. No adverse reaction reports for BIOCARBON® tablets are received from worldwide reporting sources. TRENKA Chem. pharm. Fabrik Ges.m.b.H

Can reduce the effect of medicaments through ist high activity. Attention! Can reduce the effect of medicaments through ist high activity. The use of medicinal charcoal may reduce the reliabity of oral contraceptives /ovulation inhibitors so that it might be necessary to use an additional form of contraception after taking medicinal charcoal. TRENKA Chem. pharm. Fabrik Ges.m.b.H

Any other kind of medicine should be taken at Attention! In case of the oral anti-diabetic drug chlorpropamide (drug against diabetes) as well as of heart active glycosides, resorption from the bowel is inhibited in the order of up to 90 %. Therefore it is recommended to take these drugs 2 hours before taking BIOCARBON® tablets or with a time lag of several hours. Any other kind of medicine should be taken at least 1 hour before BIOCARBON® tablets are taken. TRENKA Chem. pharm. Fabrik Ges.m.b.H

Enterohepatic recirculation Some drugs and poisonous substances are secreted from the blood to the alimentary tract and are then reabsorbed back to the blood, thus undergoing a recirculation process. Activated charcoal may be very useful in accelerating the elimination of drugs and poisons by interrupting the enteroenteric and recirculation. This “gastrointestinal dialysis” is achieved by repeated doses of activated charcoal. TRENKA Chem. pharm. Fabrik Ges.m.b.H

What must the patient pay attention to? Symptomatic treatment may include: BIOCARBON® should be in every medicine cabinet and never be missing in any travel first aid kit. Should the complaints not disappear rapidly (within 1 - 3 days) after taking BIOCARBON®, medical assistance should be sought at all events. In the case of persistent diarrhoea, emergencies or increased abdominal pain, a doctor should be notified or consulted. TRENKA Chem. pharm. Fabrik Ges.m.b.H

Official Treatment Recommendations Activated charcoal is one of the essential medicines as listed in the essential medicines WHO model list as of March 2010. Furthermore included in the new version of the WHO model list of essential medicines for children (2010). With oral poisoning, if the patient is stabilised the administration of activated charcoal is recommended as a primary method of gastrointestinal decontamination (EMEA, 2003). It is recommended for the treatment of diarrhoea or acute drug intoxication in virtually every textbook or handbook. TRENKA Chem. pharm. Fabrik Ges.m.b.H

BIOCARBON® at a glance 1 tablet contains: Medicinal activated charcoal 0,25 g Forms of presentation: Box of 20, 30, 50, 1000 tabs TRENKA Chem. pharm. Fabrik Ges.m.b.H

Thank you for your attention! TRENKA Chem. pharm. Fabrik Ges.m.b.H 17