Borneol with camphene, cineole, menthol, menthone and pinene

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.