Not the same thing as "drugs have cockroaches"

On April 22, "A woman found cockroaches to be the ingredient after drinking a traditional Chinese medicine for a week" becomes hot news on the Chinese social media platform "Weibo".

Images from Weibo 

The source revealed that a woman who took a traditional Chinese medicine found that the only ingredient was cockroaches, which was actually the extract of dried Periplaneta Americana.

People in the pharmaceutical industry would know that she was referring to KangFuXin Liquid. Unlike most drugs that can only be used for external use, oral administration, or injection, KangFuXin Liquid applies for oral administration and external use, making it a drug with multiple medication routes. 

There are four enterprises in China producing KangFuXin Liquid, i.e., Sichuan Gooddoctor Panxi Pharmaceuticals, KunMing SINOWAY Natural Pharmaceuticals, Hunan Kelun Pharmaceutical, and Inner Mongolia Jingxin Pharmaceutical. Among them, KunMing SINOWAY Natural Pharmaceuticals also has API projects. 

Cockroaches and Periplaneta Americana are different, of which cockroaches have a more extensive concept, similar to beef and beef from dairy cattle. In China, Periplaneta Americana can be seen in the south, while Blattella Germanica are mostly living in the north. Choosing Periplaneta Americana as a pharmaceutical ingredient is based on its potency and cost risk. We know that cockroaches are easier to survive. In Snowpiercer, a movie about surviving the end of the world, cockroaches are a food source for the poor. Their body can be as large as 29 to 40 mm. They are omnivorous, broad in diet, intolerant of dry environments, and have long starvation-endurance duration, that is, they can persist for five days without food if there is water. Therefore, its cost of breeding is far lower than that of other insects. With controllable risk and low cost, it is a way to greatly improve the cost-effectiveness of treatment. 

At present, records of Periplaneta Americana and its extract can only be found in Hunan traditional Chinese medicine standard and Sichuan traditional Chinese medicine materials standard (single page). It follows that not all regions can accept Periplaneta Americana as an ingredient. 

Other than KangFuXin Liquid, Ganlong capsules are also made from Periplaneta Americana. Ganlong capsules are an ethnic drug in Yunnan Province, where the Bai nationality (living in Yunnan province) has a history of using cockroaches to treat malignant sores. Currently, there is one reference number for Ganlong capsules, which is owned by KunMing SINOWAY Natural Pharmaceuticals. It should be noted that Yuganlong capsules, although a drug for liver diseases like Ganlong capsules, contain different raw materials, including virgate wormwood herb, Chinese thorowax root, barberry root, baical skullcap root, dandelion, and arnebia root. 

Among the above-mentioned companies, Kelun Pharmaceutical has its standard breeding site for Periplaneta Americana, and Jingxin Pharmaceutical also undertakes the breeding business. In 2022, the sales revenue of Jingxin Pharmaceutical reached RMB432 million, mostly from selling KangFuXin Liquid and Bacillus Licheniformis Capsules, Live. The phase II clinical enrollment of KangFuXin enteric capsules developed based on KangFuXin Liquid has been completed, which are mainly used for the treatment of mild to moderate ulcerative colitis. From liquid to capsules, KangFuXi is a true oral medicine taking into account the taste.

Periplaneta Americana is not the weirdest ingredient in drugs. People in the South are disgusted with it because they have never expected that cockroaches, a disgusting insect, can have a medical effect. In fact, after the processes, including extraction, ethanol recovery, extract static culture, and filtering, the extract has been completely separated from the cockroach body. The psychological resistance is from the emotional aversion to cockroaches. Lots of drug materials are weirder than cockroaches. Many botanical and mineral drugs have been produced, both in the East and the West, which are extracted from the natural environment due to a lack of chemical synthesis technology. 

As the process is optimized, many mixtures become purer. Aspirin, originally found in willow bark, has become a common preparation now after constant purification. Considering the lower cost and higher purity of the synthesis, the final process is no longer plant extraction. In China, there is a drug for diabetes with the raw material extracted from mulberry branches, for which mulberry trees are planted in large quantities. We are not clear whether it is based on the cost and difficulty of synthesis, but it is clear that all processes for making drugs are equal. It is the applicability that matters, after all, the fittest process survives. People's emotional preference for the source of an ingredient will never be the key point of the selection of processes.