Home Europe European Commission Commission Implementing Decision (EU) 2016/1659 of 13 Septem...
Date: 2016-09-15 Category: Not Applicable State: Union Government Country: Europe

Commission Implementing Decision (EU) 2016/1659 of 13 September 2016 amending Decision 2008/911/EC establishing a list of herbal substances, preparations and combinations thereof for use in traditional herbal medicinal products (notified under document C(2016) 5748) (Text with EEA relevance)

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Executive Summary & Key Takeaways

Executive Summary: This Commission Implementing Decision (EU) 2016/1659 amends Decision 2008/911/EC to include *Melaleuca alternifolia* Maiden and Betch Cheel, *M. linariifolia* Smith, *M. dissitiflora* F. Mueller and/or other species of *Melaleuca*, aetheroleum (Tea tree oil) in the list of herbal substances, preparations, and combinations for use in traditional herbal medicinal products. The decision was adopted on 13 September 2016, and is addressed to the Member States. It reflects the opinion of the European Medicines Agency. Key Points / Main Content: * **Amendment to Decision 2008/911/EC:** * Annex I of Decision 2008/911/EC is amended to include *Melaleuca alternifolia* Maiden and Betch Cheel, *M. linariifolia* Smith, *M. dissitiflora* F. Mueller and/or other species of *Melaleuca*, aetheroleum after *Hamamelis virginiana* L. * Annex II of Decision 2008/911/EC is amended to include a Union list entry on *Melaleuca alternifolia* Maiden and Betch Cheel, *M. linariifolia* Smith, *M. dissitiflora* F. Mueller and/or other species of *Melaleuca*, aetheroleum after the entry for *Hamamelis virginiana* L. * **Details of Union List Entry for *Melaleuca alternifolia*:** * Botanical family: Myrtaceae * Common names in all EU official languages are listed. * Herbal preparation: Essential oil * European Pharmacopoeia monograph reference: 01/2008:1837 * **Indications:** * Indication a: Treatment of small superficial wounds and insect bites. * Indication b: Treatment of small boils/furuncles and mild acne. * Indication c: Relief of itching and irritation in cases of mild athlete's foot. * Indication d: Symptomatic treatment of minor inflammation of the oral mucosa. * Type of tradition: European * **Specified Posology:** * Detailed dosage instructions are provided for each indication (a, b, c, d) for adolescents, adults, and the elderly, including single doses, frequency of application, and methods of application. * Use in children under 12 years of age is not recommended for Indication d. * **Route of Administration:** * Indications a, b, and c: Cutaneous use. * Indication d: Oromucosal use. * **Duration of Use and Restrictions:** * Specific guidance on when to consult a doctor or qualified healthcare practitioner if symptoms persist. * Indication b and c: Not to be used for more than 1 month. * **Contraindications:** * Hypersensitivity to the active substance or to colophony. * **Special Warnings and Precautions for Use:** * General warnings against oral or inhalation use, and use in eyes or ears. * Specific warnings for each indication, including when to consult a doctor. * **Interactions:** * None reported. * **Fertility, Pregnancy, and Lactation:** * Use not recommended due to a lack of sufficient safety data. * **Undesirable Effects:** * Lists potential adverse skin reactions. * **Overdose:** * Details symptoms and treatment for cutaneous and oromucosal use, with specific warnings for children. * **Pharmaceutical Particulars:** * Storage instructions to avoid oxidation. Impact Analysis: Member States: * Impact: Required to incorporate the changes outlined in this Decision into their national regulations and practices regarding traditional herbal medicinal products. * Action Required: Implement the inclusion of *Melaleuca alternifolia* and related species into the list of herbal substances for traditional medicinal products, as per the amended Annexes I and II of Decision 2008/911/EC. Manufacturers and Suppliers of Herbal Medicinal Products: * Impact: Can now include *Melaleuca alternifolia* (Tea tree oil) in traditional herbal medicinal products, provided they adhere to the specified indications, posology, and safety guidelines. * Action Required: Update product formulations, labeling, and usage instructions to comply with the new regulations for products containing *Melaleuca alternifolia*. Ensure adherence to storage and handling requirements to minimize oxidation. European Medicines Agency (EMA): * Impact: The Committee for Herbal Medicinal Products' opinion has been implemented, expanding the list of approved herbal substances. * Action Required: Continue to monitor the safety and efficacy of *Melaleuca alternifolia*-based products and update guidance as necessary. Healthcare Professionals: * Impact: Have an additional treatment option for the specified indications, but must be aware of the correct usage, contraindications, and potential adverse effects. * Action Required: Familiarize themselves with the new guidelines for *Melaleuca alternifolia* and advise patients accordingly, particularly regarding dosage, duration of use, and potential risks. Patients/Consumers: * Impact: Have access to traditional herbal medicinal products containing *Melaleuca alternifolia* for the treatment of minor ailments. * Action Required: Follow the instructions on product labels carefully, consult with a healthcare professional if symptoms persist or worsen, and be aware of potential allergic reactions and contraindications.

Key Entities Referenced

European Commission: The executive branch of the European Union, responsible for proposing legislation, implementing decisions, and managing the EU's day-to-day operations. Directive 2001/83/EC: Directive of the European Parliament and of the Council on the Community code relating to medicinal products for human use. European Medicines Agency: A European Union agency responsible for the scientific evaluation, supervision and safety monitoring of medicines in the EU. Committee for Herbal Medicinal Products: A committee within the European Medicines Agency responsible for scientific opinions on herbal medicinal products. Commission Decision 2008/911/EC: Commission Decision establishing a list of herbal substances, preparations and combinations thereof for use in traditional herbal medicinal products. Melaleuca alternifolia Maiden and Betch Cheel: A herbal substance, specifically tea tree oil, used in traditional herbal medicinal products. Brussels: City in Belgium, where the Commission Implementing Decision was adopted. European Union: Political and economic union of member states located primarily in Europe.
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L 247/22 EN Official Journal of the European Union 15.9.2016 COMMISSION IMPLEMENTING DECISION (EU) 2016/1659 of 13 September 2016 amending Decision 2008/911/EC establishing a list of herbal substances, preparations and combinations thereof for use in traditional herbal medicinal products (notified under document C(2016) 5748) (Text with EEA relevance) THE EUROPEAN COMMISSION, Having regard to the Treaty on the Functioning of the European Union, Having regard to Directive 2001/83/EC of the European Parliament and of the Council of 6 November 2001 on the Community code relating to medicinal products for human use (1), and in particular Article 16f thereof, Having regard to the opinion of the European Medicines Agency, formulated on 24 November 2014 by the Committee for Herbal Medicinal Products, Whereas: (1) Melaleuca alternifolia (Maiden and Betch) Cheel, M. linariifolia Smith, M. dissitiflora F. Mueller and/or other species of Melaleuca, aetheroleum can be considered as a herbal substance, a herbal preparation or a combination thereof within the meaning of Directive 2001/83/EC and it complies with the requirements set out in that Directive. (2) It is therefore appropriate to include Melaleuca alternifolia (Maiden and Betch) Cheel, M. linariifolia Smith, M. dissitiflora F. Mueller and other species of Melaleuca, aetheroleum in the list of herbal substances, preparations and combinations thereof for use in traditional herbal medicinal products established by Commission Decision 2008/911/EC (2). (3) Decision 2008/911/EC should therefore be amended accordingly. (4) The measures provided for in this Decision are in accordance with the opinion of the Standing Committee on Medicinal Products for Human Use, HAS ADOPTED THIS DECISION: Article 1 Annexes I and II to Decision 2008/911/EC are amended in accordance with the Annex to this Decision. Article 2 This Decision is addressed to the Member States. Done at Brussels, 13 September 2016. For the Commission Vytenis ANDRIUKAITIS Member of the Commission (1) OJ L 311, 28.11.2001, p. 67. (2) Commission Decision 2008/911/EC of 21 November 2008 establishing of a list of herbal substances, preparations and combinations thereof for use in traditional herbal medicinal products (OJ L 328, 6.12.2008, p. 42).15.9.2016 EN Official Journal of the European Union L 247/23 ANNEX Decision 2008/911/EC is amended as follows: (1) In Annex I, the following substance is inserted after Hamamelis virginiana L.: ‘Melaleuca alternifolia (Maiden and Betch) Cheel, M. linariifolia Smith, M. dissitiflora F. Mueller and/or other species of Melaleuca, aetheroleum’; (2) In Annex II, the following is inserted after the entry Hamamelis virginiana L.: ‘UNION LIST ENTRY ON MELALEUCA ALTERNIFOLIA (MAIDEN AND BETCH) CHEEL, M. LINARIIFOLIA SMITH, M. DISSITIFLORA F. MUELLER AND/OR OTHER SPECIES OF MELALEUCA, AETHEROLEUM Scientific name of the plant Melaleuca alternifolia (Maiden and Betch) Cheel, M. linariifolia Smith, M. dissitiflora F. Mueller and other species of Melaleuca Botanical family Myrtaceae Common name in all EU official languages of herbal preparation BG (bălgarski): Чаено дърво, масло IT (italiano): Melaleuca essenza CS (čeština): silice kajeputu střídavolistého LT (lietuvių kalba): Arbatmedžių eterinis aliejus DA (dansk): Tetræolie LV (latviešu valoda): Tējaskoka ēteriskā eļļa DE (Deutsch): Teebaumöl MT (Malti): Żejt tal-Melaleucae EL (elliniká): Μελαλεύκης αιθέριο έλαιο NL (Nederlands): Theeboomolie EN (English): Tea tree oil PL (polski): Olejek eteryczny drzewa herbacianego ES (español): Melaleuca alternifolia, aceite esencial de PT (português): Óleo esencial de melaleuca ET (eesti keel): teepuuõli RO (română): Melaleuca (arbore de ceai) (ulei esențial) FI (suomi): teepuuöljy SK (slovenčina): Silica melaleuky FR (français): Mélaleuca (arbre à thé) (huile essentielle de) SL (slovenščina): eterično olje melalevke HR (hrvatska): eteričnog ulje australijskog čajevca SV (svenska): Teträdsolja HU (magyar): Teafa-olaj NO (norsk): Tetreolje Herbal preparation Essential oil European Pharmacopoeia monograph reference 01/2008:1837 Indications Indication (a) Traditional herbal medicinal product for treatment of small superficial wounds and insect bites. Indication (b) Traditional herbal medicinal product for treatment of small boils (furuncles and mild acne).L 247/24 EN Official Journal of the European Union 15.9.2016 Indication (c) Traditional herbal medicinal product for the relief of itching and irritation in cases of mild athlete's foot. Indication (d) Traditional herbal medicinal product for symptomatic treatment of minor inflammation of the oral mucosa. The product is a traditional herbal medicinal product for use in specified indication exclusively based upon long- standing use. Type of tradition European. Specified strength Please see ‘Specified posology’. Specified posology Indication (a) Adolescents, adults and elderly Single dose 0,03-0,07 ml of undiluted essential oil to be applied to the affected area using a cotton bud 1-3 times daily. Liquid preparations containing 0,5 % to 10 % of essential oil to be applied to the affected area 1-3 times daily. Indication (b) Adolescents, adults and elderly Single dose Oily liquid or semi-solid preparations containing 10 % of essential oil to be applied to the affected area 1-3 times daily, or 0,7-1 ml of essential oil stirred into 100 ml of lukewarm water to be applied as an impregnated dressing to the affected areas of skin. Undiluted essential oil to be applied to the boil using a cotton bud 2-3 times daily. Indication (c) Adolescents, adults and elderly Single dose Oily liquid or semi-solid preparations containing 10 % of essential oil to be applied on the affected area 1-3 times daily. 0,17-0,33 ml of essential oil in an appropriate volume of warm water to cover the feet. Soak feet for 5-10 minutes daily. Undiluted essential oil to be applied to the affected area using a cotton bud 2-3 times daily. Indication (d) Adolescents, adults and elderly 0,17-0,33 ml of essential oil to be mixed in 100 ml of water for rinse or gargle several times daily. The use in children under 12 years of age is not recommended (see section ‘Special warnings and precautions for use’).15.9.2016 EN Official Journal of the European Union L 247/25 Route of administration Indications (a), (b) and (c) Cutaneous use Indication (d) Oromucosal use. Duration of use or any restrictions on the duration of use Indication (a) If the symptoms persist longer than 1 week during the use of the medicinal product, a doctor or a qualified health care practitioner should be consulted. Indications (b) and (c) Not to be used for more than 1 month. If the symptoms persist during the use of the medicinal product, a doctor or a qualified health care practitioner should be consulted. Indication (d) If the symptoms persist longer than 5 days during the use of the medicinal product, a doctor or a qualified health care practitioner should be consulted. Any other information necessary for the safe use Contraindications Hypersensitivity to the active substance or to colophony. Special warnings and precautions for use The use in children under 12 years of age has not been established due to lack of adequate data. If a rash develops, discontinue use. Not to be used orally or as inhalation. Not to be used in eyes or ears. If the symptoms worsen during the use of the medicinal product, a doctor or a qualified health care practitioner should be consulted. Indication (a) If fever or signs of exacerbating skin infection are observed, a doctor or a qualified health care practitioner should be consulted. Indication (b) In cases of severe acne a doctor or a qualified health care practitioner shall be consulted. Indication (c) For the eradication of fungal infection a doctor or a qualified health care practitioner shall be consulted.L 247/26 EN Official Journal of the European Union 15.9.2016 Indication (d) Not to be swallowed. Interactions with other medicinal products and other forms of interaction None reported. Fertility, pregnancy and lactation Safety during pregnancy and lactation has not been established. In the absence of sufficient data, the use during pregnancy and lactation is not recommended. No fertility data available. Effects on ability to drive and use machines No studies on the effect on the ability to drive and use machines have been performed. Undesirable effects Adverse skin reactions including smarting pain, mild pruritus, burning sensation, irritation, itching, stinging, erythema, oedema (contact dermatitis) or other allergic reactions have been reported. The frequency is not known. Burn-like skin reactions have been reported. The frequency is rare (< 1/1 000). If other adverse reactions not mentioned occur, a doctor or a qualified health care practitioner should be consulted. Overdose Cutaneous use: None reported. Oromucosal use: Accidental overdose may cause central nervous system depression and muscle weakness. However, in adults these symptoms generally resolve within 36 hours. If ingestion occurs, the patient should be monitored and standard supportive treatment applied as required. In children, ingestion of tea tree oil is a medical emergency requiring immediate hospital treatment and respiratory support. Pharmaceutical particulars (if necessary) Store in air-tight containers, protected from light and heat. Proper storage and handling are needed to avoid the formation of oxidation products which have greater potential for skin sensitisation. Pharmacological effects or efficacy plausible on the basis of long-standing use and experience (if necessary for the safe use of the product) Not applicable.’

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