SUPSALVS NOT ADMITTED TO N. N. R.

Report of the Council on Pharmacy and Chemistry

The Council has authorized publication of the following report declaring Supsalvs (Anglo-French Drug Company) inadmissible to New and Non­official Remedies.

W. A. Puckner, Secretary.

Supsalvs are advertised by the Anglo-French Drug Company as “stable suppositories of ‘606’ (of French manufacture)” with the claim that by the rectal administration of these suppositories the effects of arsphen­amine may be obtained. The asserted efficacy of Supsalvs medication is based in part on the claim that for these suppositories an excipient was found which mixes with the cocoa butter base “to form an assimilable emulsion.”

“The active principle and the vehicle being bound to one another, the mucous membrane is able to absorb both simultaneously and progressively in the form of an organic emulsion.”

As no information was furnished the Council by the Anglo-French Drug Company on the origin or quality of the arsphen­amine used in the preparation of Supsalvs or the character of the vehicle which was “bound” to the arsphen­amine in such a way as to permit the absorption of this combination in the form of an “organic emulsion,” the firm was requested to furnish: (1) Evidence that the arsphen­amine used in Supsalvs complies with the N. N. R. standards and that deterioration of it does not occur in the preparation of the suppositories or on keeping. (2) The identity of the ingredients composing the suppository.

The Anglo-French Drug Company did not supply the requested evidence and consequently the Council judged the preparation on the basis of the information received from the company, and that contained in the available advertising and circulars. It found Supsalvs inadmissible to New and Non­official Remedies, first because the quality of the medicament contained in the suppositories has not been established, and second because the claimed efficacy of this preparation as a means of securing the effects of arsphen­amine lacks substantiating proof.

During the past few years some French physicians have reported favorably on the intrarectal administration of arsphen­amine. Boyd and Joseph at Panama published (The Journal, Aug. 17, 1918, p. 521) an enthusiastic report on intrarectal injection of arsphen­amine but did not refer to its use in the form of suppositories. In a comprehensive report, on the “Treatment of Syphilis” (Quarterly Journal of Medicine, July, 1917) L. W. Harrison stated that arsphen­amine (Salvarsan) in the shape of an enema is definitely less effective than intravenously and that “Neisser and the vast majority of workers can see no value in the rectal method.” Schamberg and Hirschler (A Safe and Efficient Intensive Method of Treating Syphilis, Therapeutic Gazette, November, 1919, p. 761) have given a rather thorough trial of this method; the results were most disappointing: “A certain or rather uncertain amount of arsphen­amine is absorbed into the blood, but the quantity is obviously too small to be at all comparable in its effect with the intravenous administration. Our conclusions are that the rectal administration of arsphen­amine or neo­arsphen­amine is an extremely feeble method of administering these drugs.”

The report of the Special Committee on the Manufacture, Biological History and Clinical Administration of Salvarsan and Other Substances of the British National Health Insurance Medical Research Committee contains the following: “The rectal method of administration, either in the form of solution or as suppositories, has been advocated by a few observers mainly for cases in which there is difficulty in the adoption of the intravenous method. The experiments made by Mills at Rochester Row show that three enemata of ‘606’ (0.6 Gm. in each) on successive days failed to produce any effect on the spironemes in the lesions. The general opinion of experienced workers is that the rectal method is ineffective, and in this view the Committee concur.”—(From The Journal A. M. A., Oct. 30, 1920.)