1. Homeopathic Medicine “Like Cures Like”
Dr. Ujjaval J Pathak, Pharm D, Temple University School of Pharmacy

2. Objectives
Understand the evolution and major principles of homeopathic medicine
Differentiate homeopathic medications from conventional (allopathic) medications as well as dietary supplements
Discuss regulations and current issues involving the practice of homeopathic medicine
Recognize roles of healthcare professionals in homeopathic management
Copyright © Dr. Ujjaval J Pathak, Pharm D, Rph [2017]. All rights reserved

3. What is Homeopathy? 200 years old system of medicine
Introduced by German doctor Samuel Hahnemann opposing the state of medicine in 1800s
Dr. Hahnemann self-applied cinchona bark extract to induce malaria like symptoms
“like cures like”
Homeopathic medicines are made from plants, chemicals, minerals, or animal sources
Copyright © Dr. Ujjaval J Pathak, Pharm D, Rph [2017]. All rights reserved

4. Branches of Medicine HOMEOPATHY ALLOPATHY DIETARY/HERBAL SUPPLEMENTS
MECHANISM OF ACTION
Acts directly on immune system
Acts on the disease
Treated as a separate category of supplements for supporting the condition not treating it.
ADVERSE EFFECTS PROFILES
Least adverse effects
Potentially more adverse effects
Potential adverse effects
TREATMENT
Treats the symptoms that are usually produced by the medication in a healthy individual
Treats the disease which produce effects different from those produced by the disease under treatment
Helps as a supportive care but does not guarantee symptom or disease control
FDA REGULATIONS
Not-controlled by FDA though potential for stricter regulation exists
Controlled by FDA
Not-controlled by FDA
LABELING
Must have a therapeutic indication for self-diagnosing condition
**classified as “drugs” by FDA
Must have a therapeutic indication. Can make definitive claims to cure/treat
Cannot make claims for the diagnosis, relief, cure, of a given condition/illness
Copyright © Dr. Ujjaval J Pathak, Pharm D, Rph [2017]. All rights reserved

5. Homeopathy Utilization
Estimated $110 million in sales of homeopathic products in 2014.
Estimated 5 million adults and 1 million children used homeopathic medicine in 2011, according to National Center for Complementary and Integrative Health.
Copyright © Dr. Ujjaval J Pathak, Pharm D, Rph [2017]. All rights reserved

6. Prevalence of Use
High prevalence among patients with HIV/AIDS and cancer to fight emotional well being
CAM= Complementary and alternative medicine
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7. Central Principles
Law of Similar: Substance causing symptoms in a healthy individual will likely cure the ill presenting with the same symptoms; “like cures like.”
Law of Individualization: Characteristics of the chosen medicine should be as similar as possible to the characteristics of the illness in the patient.
Law of Minimum Dose: They are manufactured using a process combining serial dilution and vigorous shaking to make the ultra-molecular dilutions.
Copyright © Dr. Ujjaval J Pathak, Pharm D, Rph [2017]. All rights reserved

8. Dilutions 2 scales used for concentration
X scale and C scale refers to 10 and 100 respectively
X scale is used in the US
3X = 1 part in 103 parts or 1 in
Scale conversion: 1C = 2X
Homeopathic medicine: 24X homeopathic solution: pinch of salt in both the North and South Atlantic Oceans
i.e. 24X dilution is 1 part of active drug in 1,000,000,000,000,000,000,000,000 [or 1024] parts of water
Allopathic medicine: Tylenol syrup 325mg/15ml
i.e. 1 part of active drug in 50 parts of solvent
Copyright © Dr. Ujjaval J Pathak, Pharm D, Rph [2017]. All rights reserved

9. Significance of Water as a “Drug”
Water memory
Extreme dilutions do not leave any original substance in the final product
Considered to have pharmacologic effect in absence of the substance from water
Contains memory or vibration from the diluted substance.
Electromagnetic-treated water
Experiment with electromagnetic conditioned water on health of soybean
Suggested diverse biological effects on both animal and plant cells
Potential for further investigation
Copyright © Dr. Ujjaval J Pathak, Pharm D, Rph [2017]. All rights reserved

10. Common Treatments MOST COMMON CONDITIONS TREATED WITH HOMEOPATHY
MOST COMMON HOMEOPATHIC MEDICINES USED
Mental health conditions, such as depression, stress and anxiety
Hypericum (St. John's wort)
Ignatia (St. Ignatius bean)
Allergies
Allium cepa (onion)
Arthritis
Arnica (mountain daisy)
Dermatitis (an allergic skin condition)
Rhus tox (poison ivy)
Ear infections
Pulsatilla (windflower)
Digestive disorders
Nux vomica (poison nut),
General pain (spams, sprain)
Magnesia phosphorica (phosphate of magnesia)
Copyright © Dr. Ujjaval J Pathak, Pharm D, Rph [2017]. All rights reserved

11. Treatment Approach Get patient case history
Collect, evaluate, and characterize patient symptoms
Compare and select medications that produces similar symptoms in a healthy individual
Select potency, dose, and route of administration for particular medication
Counsel patient on diet, regimen, and management
Follow up
Copyright © Dr. Ujjaval J Pathak, Pharm D, Rph [2017]. All rights reserved

12. Homeopathic Practitioners
Homeopaths/Naturopathic physicians (requires board certified license from American Board of Homeotherapeutics)
Professionals practice homeopathic medicine under strong code of conduct and ethics with boards license in homeopathy
Other practitioners
Homeopathic pharmacists (
Homeopathic nurses (
Homeopathic vets (
Homeopathic dentists (
Site of Practice
Private practices
Hospitals
Clinics
Community health centers
Copyright © Dr. Ujjaval J Pathak, Pharm D, Rph [2017]. All rights reserved

13. Challenges to Homeopathy
The result of clinical research into the homeopathic medicine is not compelling
No good-quality evidence that homeopathic medicines are effective as a treatment for any health condition
Extensive risk of missing timely diagnosis and effective treatment of serious conditions
Copyright © Dr. Ujjaval J Pathak, Pharm D, Rph [2017]. All rights reserved

14. Safety & Effectiveness
Controversial safety
“Unlike some conventional drugs, homeopathic medicines are non-addictive and have no dangerous side-effects” per British Homeopathic Association.
“Homeopathic remedies may contain substances that are not safe, or that interfere with the action of other medicines” per National Health Service.
Homeopathic medicines are safe to use for babies, children and pregnant or breastfeeding women, who are under the supervision of a homeopathic doctor.
Copyright © Dr. Ujjaval J Pathak, Pharm D, Rph [2017]. All rights reserved

15. Safety & Effectiveness
Homeopathy effectiveness study by Leone and researchers suggests:
No statistically significant different between the homeopathic and placebo for rates of hospitalization due to progression of the disease.
“Proving” homeopathic procedure: determine the dose of a drug sufficient to produce symptoms
“There is no good quality evidence that homeopathy is an effective treatment for these or any other health conditions” per National Health Service.
Copyright © Dr. Ujjaval J Pathak, Pharm D, Rph [2017]. All rights reserved

16. Regulatory Affairs
Homeopathic medicines generally must meet the standards for strength, quality, and purity set forth in the Homeopathic Pharmacopeia.
HPCUS: The Homeopathic Pharmacopoeia Convention of the United States
Reviews homeopathic efficacy, toxicology, adverse effects, and clinical use for individual homeopathic ingredients marketed.
HPUS: The Homeopathic Pharmacopoeia of the United States
Listings of monographs for currently marketed homeopathic products.
Copyright © Dr. Ujjaval J Pathak, Pharm D, Rph [2017]. All rights reserved

17. Current Issue
FDA to rethink their policy for regulating homeopathic medication
Surveying general population for their perspective on current regulations for homeopathic remedies
FDA to reveal decision sometimes this year (2015)
Questions posed by the FDA include:
Consumer thought and attitude towards the use of homeopathic remedies over allopathic
Whether or not enough information is available for consumers to select certain products
Whether or not it is viable to disperse homeopathic remedies along with conventional medications
Copyright © Dr. Ujjaval J Pathak, Pharm D, Rph [2017]. All rights reserved

18. Ethical Dilemmas
Veterinary use of these medicines suggests that it is not viable to trial these medications even on animals when evidence suggests that they are not effective for treating a disease state.
Currently FDA/HPUS “does not establish that it has been shown by appropriate means to be safe, effective, and not misbranded for its intended use.”
UK pharmacies are advertising misleading information that does not specify that these products are biologically implausible to use.
Copyright © Dr. Ujjaval J Pathak, Pharm D, Rph [2017]. All rights reserved

19. Role of a Pharmacist
The pharmacist’s attitude with regard to homeopathy is still a dilemma. 
Pharmacists must keep their integrity by acting honestly, ethically, and with conscience, accepting responsibility for his actions and under no circumstances providing false information to the patient
Pharmacist counseling points:
Do not attempt to self-treat before undergoing a thorough medical evaluation
Always keep an updated list of all homeopathic medications that you are taking
Special population should never use homeopathic medications without first consulting their primary health care provider
Only use products by reputable manufacturers
Copyright © Dr. Ujjaval J Pathak, Pharm D, Rph [2017]. All rights reserved

20. Useful Resources RESOURCES FOR INFORMATION ON HOMEOPATHIC TREATMENTS
The National Center for Complementary and Alternative Medicine’s Time to Talk campaign:
The Homoeopathic Pharmacopoeia of the United States:
The American Association of Homeopathic Pharmacists website:
The National Center for Homeopathy website:
LEADING MANUFACTURERS OF HOMEOPATHIC MEDICATIONS
Boiron, USA
Hyland’s, Inc
Similasan, USA
Copyright © Dr. Ujjaval J Pathak, Pharm D, Rph [2017]. All rights reserved

21. Common Homeopathic Products
Copyright © Dr. Ujjaval J Pathak, Pharm D, Rph [2017]. All rights reserved

22. Patient Education
Important to know when to make changes especially when self-treating without medical supervision
Sufficient level of health literacy
Be able to recognize symptoms associated with the disease state
Counsel a healthcare professional before selecting a homeopathic medication
*** Important to educate patients that homeopathy does not replace conventional therapy
Copyright © Dr. Ujjaval J Pathak, Pharm D, Rph [2017]. All rights reserved

23. Conclusion Approach to an appropriate diagnosis and treatment
Symptoms can be different for each individual
Necessary to pick correct medicine as it relates to the symptoms
Consideration of safety and effectiveness is crucial
Failure to establish a use in disease state as a cure
Underdiagnoses and under-treatment
Keeping one self up-to-date for new research and new regulations
Copyright © Dr. Ujjaval J Pathak, Pharm D, Rph [2017]. All rights reserved

24. Conclusion General public acceptance across the nation
Non-supporters call it scientific illiteracy and a pseudoscience
Supporters think that they are absolutely effective if used appropriately to treat appropriate symptoms.
Potential for further research for these products for symptomatic treatment
Conventional wisdom of practitioners and patient education for risk and benefits of using proper remedy
Copyright © Dr. Ujjaval J Pathak, Pharm D, Rph [2017]. All rights reserved