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Kaloba: 30 Tablets

£9.9£99Clearance
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Goossens H, Ferech M, Vander Stichele R, Elseviers M. Outpatient antibiotic use in Europe and association with resistance: a cross-national database study. Lancet (London, England). 2005;365(9459):579–87. On theoretical grounds Kaloba should not be used where there is a likelihood of increased tendency to bleeding or use of coagulation-inhibiting drugs. film-coated tablet contains 20 mg of extract (as dry extract) from the roots of Pelargonium sidoides DC (1 : 8 – 10) (EPs® 7630) Extraction solvent 11% ethanol (w/w). Clarke A. Parental health beliefs and respiratory illness consultations at general practitioners, in multi-ethnic and multi-cultural areas: University of Leeds; 1989. A detailed statistical analysis plan was developed prior to the analysis. All analyses were conducted using STATA version 15 [ 35]. We aimed to present descriptive feasibility data rather than to test hypotheses and patients were analysed as randomised. Health economic methods

This is the first feasibility trial to be conducted on the use of a herbal medicine for acute bronchitis in UK primary care. A strength of this trial is the use of both quantitative and qualitative methods to explore several feasibility aspects. The trial was not powered to detect effectiveness, so we are unable to comment on the effectiveness of the herbal medicine. However, there was no evidence of any serious side-effects due to the intervention and the patient withdrawal rate was low. Although the study was only open for 9 months as opposed to the 12 months initially planned, we recruited at a faster rate than anticipated. Whitehead A, Simpson C, Willcox M, Webley F, Hay AD, Butler C, et al. HATRIC: a study of Pelargonium sidoides root extract EPs®7630 (Kaloba®) for the treatment of acute cough due to lower respiratory tract infection in adults—study protocol for a double blind, placebo-controlled randomised feasibility trial. Pilot and Feasibility Studies. 2019;5(1):98. Transcripts were analysed using inductive thematic analysis, following the framework approach [ 37]. The transcripts were compared within and between each other to search for themes, which were then reviewed, defined and named. The analysis followed three key steps: Signs indicating changes in liver function have been reported after taking Kaloba; however, the causal relationship between these effects and the use of the product has not been demonstrated. Several strategies have attempted to reduce inappropriate use of antibiotics. “Delayed” prescriptions (which patients are advised to take only if they are not starting to improve after a certain time) reduce consumption of antibiotics while maintaining patient satisfaction [ 9], but many patients would still like to take medication to relieve their symptoms because a moderately bad cough is known to persist for around three weeks on average [ 6, 10]. Commonly recommended treatments like steam and ibuprofen make little or no difference to symptom severity [ 11]. Other potential symptomatic treatments in adults (the expectorant guaifenesin, mucolytics and antihistamine-decongestant combinations) have not been shown to have consistent benefit in a recently updated Cochrane systematic review [ 7].

Before you take this product

Conrad A, Hansmann C, Engels I, Daschner FD, Frank U. Extract of Pelargonium sidoides (EPs 7630) improves phagocytosis, oxidative burst, and intracellular killing of human peripheral blood phagocytes in vitro. Phytomedicine. 2007;14(Suppl 6):46–51. NICE. NICE guideline NG 120. Cough (acute): antimicrobial prescribing: National Institute for Health and Care Excellence; 2019 [Available from: https://www.nice.org.uk/guidance/ng120/chapter/Recommendations. This formulation is not suitable for children under the age of 12 years. If you take too much of this product (overdose)

Tell your doctor or pharmacist if any of the above side-effects becomes serious or if you notice any other side-effects not listed above Reporting of side-effects

Kaloba contains Pelargonium sidoides, a member of the geranium family. It has long stalked leaves that are mildly aromatic, heart shaped and velvety. Kaloba is of pharmaceutical quality and has been manufactured to European Good Manufacturing Practice (GMP) Guidelines Of the 127 eligible patients not randomised, in 69 cases this was because the patient declined, and 51 of these gave a reason. Most frequent were concerns about the medication (21/51 patients: 5 didn’t want a placebo; 5 were concerned about potential side-effects; 4 didn’t want to take more medicines; 2 didn’t want a herbal medicine; 2 did not want the liquid preparation; 1 did not want the tablets; 2 wanted antibiotics). Second most frequent (12/51) were patients who were too busy to participate or had personal circumstances which would make it difficult (planned holiday, unwell family member). Nine patients felt either that they were too unwell to take part [ 6] or that they were improving and didn’t need to take anything [ 2] or that taking part would make them too anxious [ 1]. Three patients stated that they just didn’t want to be involved in research. Five patients specifically mentioned that they wouldn’t be good at completing the diary and one would have had to travel to another branch surgery of his GP practice to be recruited. Feasibility outcomes were: recruitment rate, withdrawal rate from the study, return rate of patient diaries, percentage of completion of patient diaries, compliance with medication according to diary data and returned medication, type of antibiotic prescription given (i.e. immediate/delayed/not given), percentage of patients who took antibiotics, time to antibiotic usage, mean symptom severity (at days 2–4), percentage of patients resolved, time to resolution of symptoms and duration of treatment with herbal medication. The minimum key outcome dataset from the diaries was considered to be [ 1] antibiotic use in the 28 days post randomisation, [ 2] no longer experiencing moderate symptoms for two consecutive days and [ 3] study medication use. A health economic study was a part of the feasibility study which aimed to develop the methods of data collection both for quality of life and for usage of key resources for the design of the future phase III trial.

Although patients only received one formulation (liquid or tablets) they were asked which they would prefer to receive. Six patients said that they would not mind either. Four patients said that they would prefer the liquid (because there is less pharmaceutical processing involved than in manufacturing tablets, and the liquid felt soothing for the throat). Fifteen said that they would prefer tablets, because they were already taking other tablets, tablets were easy to swallow, they were more convenient, one is less likely to take the wrong dose, there is no problem with spillage, they can be put in a weekly container and they are easier to carry out. The main reason for disliking the liquid was its taste. Several patients reported problems in measuring the liquid dose in drops and thought they may sometimes have taken the wrong dose; they would have preferred to measure the dose using a spoon. Two health professionals expressed similar concerns about dosing the liquid, but one reported that “ I perceived a problem but it wasn’t, it didn’t come to fruition actually… it’s to do with number of drops and things, isn’t it, but it wasn’t a problem” (HP02, GP). Study diaries hypersensitivity reactions, e.g. skin rash, nettle rash or itching of the skin and mucous membranesLittle P, Moore M, Kelly J, Williamson I, Leydon G, McDermott L, et al. Ibuprofen, paracetamol, and steam for patients with respiratory tract infections in primary care: pragmatic randomised factorial trial. BMJ: British Medical Journal. 2013;347:f6041. Ritchie J, Spencer L. Qualitative data analysis for applied policy research. In: Bryman A, Burgess R, editors. Analyzing qualitative data. London and New York: Routledge; 1994. p. 173–94. Tablet core: Maltodextrin, microcrystalline cellulose, lactose monohydrate, croscarmellose sodium, precipitated silica, magnesium stearate.

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