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Terpene mixture (gallstone dissolution / dyspepsia) Pregnancy: Although no teratogenic effects have been reported, ROWACHOL should not be given in the first trimester of pregnancy. Lactation: Although no evidence is available, ROWACHOL should not be given to lactating females.

Borneol with camphene, cineole, menthol, menthone and pinene

Brand names: Rowachol

This is a combination of plant-derived terpenes used to help dissolve or disperse cholesterol-rich gallstones and to relieve associated biliary symptoms.

Adult dose

Dose: Rowachol capsules (each capsule contains pinene [alpha + beta] 17.0 mg, camphene 5.0 mg, cineol BPC 1973 2.0 mg, menthone 6.0 mg, menthol BP 32.0 mg, borneol 5.0 mg), adjunct therapy for the dispersal (by dissolution and/or expulsion) of stones in the common bile duct, to be used in combination with chenodeoxycholic acid: 1-2 capsules three times daily, taken before meals; one capsule three times daily is recommended at the start of treatment
Route: Oral (oral administration only)
Frequency: Three times daily, taken before meals
INDICATION SCOPE: the SPC licenses only the bile-duct-stone adjunct use below; the page's 'dyspepsia' use does not appear in the SPC and is not dosed. §2 (verbatim): 'Each capsule contains the following: Pinene [α + β] 17.0 mg Camphene 5.0 mg Cineol BPC 1973 2.0 mg Menthone 6.0 mg Menthol BP 32.0 mg Borneol 5.0 mg'. §4.1 (verbatim): 'Adjunct therapy for the dispersal [by dissolution and/or expulsion] of stones in the common bile duct. To be used in combination with chenodeoxycholic acid. It has been demonstrated that if ROWACHOL is combined with either low or medium dose chenodeoxycholic acid, the gallstone dissolution rate is greater than if the same dose of chenodeoxycholic acid is used alone. Combined therapy enables a reduced dose of chenodeoxycholic acid to be used and there is therefore a lower incidence of side effects.' VERBATIM §4.2: 'For oral administration only. Adult Dose: 1-2 capsules three times daily, taken before meals. A dose of one capsule three times daily is recommended at the start of treatment. Children: There Is no recommended dose for children.' The SPC prints no maximum daily dose and no treatment duration, so no maxDose is written and no daily total is derived. §4.4 (verbatim): 'Conservative medical treatment for stones in the common bile duct should be initiated with the awareness that duct stones can give rise to clinical complications such as obstructive jaundice, ascending cholangitis, pancreatitis, etc. and the physician should be aware of the necessity of being properly informed [particularly in the case of elderly patients] so that appropriate measures can be taken. Keep out of the reach of children.' §4.8 (verbatim): 'Side effects are uncommon and minor. A small number of patients have noted eructation and a peppermint taste after meals. This can be reduced or avoided by administration of drug on an empty stomach thirty minutes before meals.' All sections 4.1 to 4.8 were retrieved without a truncation marker; the SPC document is dated 2021-04-01 per the MHRA Products listing.

Dose adjustments

Renal

No renal dose adjustment is printed in the SPC.

Hepatic

No hepatic dose adjustment is printed in the SPC. §4.5 advises caution in patients receiving oral anticoagulants or other agents metabolised by the liver where the dose is critical.

Dose independently re-sourced from UK Summary of Product Characteristics (SPC) via MHRA Products — clinician-reviewed. Always confirm against the product SmPC and your local formulary before prescribing.

Contraindications

  • §4.3: 'None known.'
  • Children: 'There Is no recommended dose for children' (§4.2)
  • Pregnancy: 'should not be given in the first trimester of pregnancy' (§4.6)
  • Lactation: 'should not be given to lactating females' (§4.6)

Side effects

  • 'Side effects are uncommon and minor.' A small number of patients have noted eructation and a peppermint taste after meals; this can be reduced or avoided by administration of the drug on an empty stomach thirty minutes before meals (§4.8)
  • An insignificant number of patients noted soreness of mouth and buccal ulceration, an effect which can be rapidly reverted by discontinuation of the drug (§4.8)

Interactions

  • Oral anticoagulants or other agents metabolised by the liver where the dose is critical: caution should be used (§4.5)
  • Chenodeoxycholic acid: used in combination; combined therapy enables a reduced dose of chenodeoxycholic acid (§4.1)
  • Reduced cholesterol intake in diet is advisable (§4.5)

Monitoring

  • Conservative medical treatment for common bile duct stones should be initiated with awareness that duct stones can give rise to obstructive jaundice, ascending cholangitis, pancreatitis etc.; the physician should be properly informed (particularly in the case of elderly patients) so that appropriate measures can be taken (§4.4)
  • Patients receiving oral anticoagulants or other agents metabolised by the liver where the dose is critical (§4.5)
  • Dietary cholesterol intake: reduced intake is advisable (§4.5)

Clinical monograph

How it works

The terpene constituents are thought to act on the biliary tract to promote dissolution of cholesterol gallstones and may have choleretic and spasmolytic effects.

Prescribing in practice

  • It is suitable only for selected patients with small, cholesterol-rich, radiolucent stones in a functioning gallbladder and is not appropriate for radio-opaque or pigment stones or biliary obstruction.
  • Treatment is typically prolonged and stones may recur after stopping, so confirm the indication and counsel on the expected duration.
  • Avoid in biliary obstruction or acute cholecystitis, where it is not appropriate and specialist surgical assessment is needed.

Monitoring

Monitor response with periodic imaging to assess stone dissolution and review for any signs of biliary complications.

Counselling the patient

  • This treatment aims to slowly dissolve certain gallstones and may take a long time to work.
  • Stones can come back after treatment stops.
  • Seek urgent advice if you develop severe abdominal pain, fever or jaundice.

Evidence & guidelines

Terpene preparations are an established non-surgical option for dissolving selected cholesterol-rich gallstones, with surgery remaining the definitive treatment for most patients.

Reference: BSG; SmPC; Confirm identity and dosing against the manufacturer SPC (eMC) and NICE. Verify against your local formulary and current prescribing references before prescribing. The structured dose values shown have been reviewed by a clinician. Monograph status: clinician-reviewed (2026-07-04).

Related

Curated clinical cross-links plus same-class fallbacks.

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