Rowachol Mechanism of Action

Pharmacology: Pharmacodynamics: Rowachol increases biliary secretion, relieves spasm of the bile ducts, enhances metabolic liver function by reducing biliary stasis. By inhibiting HMGCoA reductase, endogenous cholesterol production is reduced, maintaining the bile above saturation level, assisting the dissolution of gallstones and preventing precipitation of further stones. The choleresis produced by Rowachol increases insulin production, assisting in the control of diabetic states.
Pharmacokinetics: The several ingredients are well absorbed, metabolised in the liver and excreted in bile and urine. Studies were performed on some of the terpenes contained in Rowachol. There are a few pharmacokinetic studies on menthol, one of the major constituents of Rowachol. A major route of metabolism of terpenes e.g. menthol or borneol is via their glucuronides. Bioavailability studies demonstrate rapid oral absorption, e.g. menthol is rapidly absorbed, metabolised in the liver and excreted in the urine and bile as glucuronides. Absorption half-life T2-ß 0.373 + 0.081 hours; peak plasma concentration - conjugates 2.467 + 0.663 mg - L; elimination half-life T-2-ß - 0.861 + 0.148 [mean hr + SEM].
In comparative study on bioavailability of Rowachol in capsule and liquid form in volunteers, menthol was used as marker component. Blood samples were assayed for menthol by GLC after enzymatic treatment to liberate menthol by glucuronide - the main metabolite. Rowachol was subject to rapid first pass metabolism, the conjugate appearing in blood after about 15 minutes.
Glucuronic acid can solubilise calcium salts, an ability enhanced if it is conjugated. Menthyl glucuronide provide an effective solution for calcium salts e.g. addition of 2.5 ml of an 0.8 M ammonium menthyl glucuronide solution will dissolve the precipitate of calcium carbonate formed by mixing 0.25 ml each of 0.1 M CaCl₂ and 0.1 M Na₂CO₃.
Rowachol can bring about the dissolution of cholesterol gallstones in the gallbladder and common bile duct. In combination with low or medium dose chenodeoxycholic acid 7.0 - 10.5 ml/kg daily can bring about dissolution of cholesterol stones in the gallbladder.