Engov: Why doesn’t the label say it cures hangovers? – 01/09/2023 – Balance and Health
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For decades, the phrase “an Engov before, another after” was a mantra among people who would consume alcohol and wanted to relieve the symptoms of a hangover – that unpleasant feeling of nausea, migraine and indisposition that appears the next day.
Medication is even one of the most frequent components of the so-called “hangover kit” available in bars and clubs, alongside solutions against heartburn or burning and liver protectors.
However, on the label, this product is only indicated to treat headaches and allergies — and, as you will see throughout this article, there is no pharmacological treatment with proven effectiveness to deal with the effects of heavy drinking.
And, contrary to popular belief, taking Engov together with alcohol can even be harmful to health.
To understand this story, it is first necessary to know the path that drinks take through the digestive system.
Hepatologist Raymundo Paraná, professor at the Faculty of Medicine at the Federal University of Bahia, explains that alcohol begins to be metabolized in the stomach and small intestine.
“In the liver, it goes through a second stage of metabolism. There, acetaldehyde is formed, a toxic substance that is related to hangover symptoms”, he says.
“This molecule dilates blood vessels, which causes redness in the skin, headache and other common symptoms”, he exemplifies.
In addition to the discomfort mentioned by the doctor, some hangover victims also suffer from nausea, vomiting, indisposition and sensitivity to light.
Drinks still promote two other actions in the body that reverberate in the morning after. First, they stimulate diuresis (the urge to go to the bathroom to pee). That’s why the person wakes up dehydrated and very thirsty.
Second, there is a loss of glycogen reserves in the liver, a kind of energy reserve that we have in this organ. “And that makes the individual also wake up hungry and want to eat sweets”, adds Paraná.
It is precisely to avoid all these unpleasant sensations that many people resort to supposed preventive strategies – and, among them, Engov is among the most popular pharmacological options.
unusual history
In the book “Vaudeville – Memórias”, journalist and businessman Ricardo Amaral brings a curious account of how Engov was invented.
He says he was taking a trip to Angra dos Reis, in Rio de Janeiro, on a sailboat that belonged to Dirceu Fontoura, the owner of the pharmaceutical laboratory that manufactured the famous biotonic that bears the same surname. This would have happened in the mid-1960s.
“That’s where all the international artists who painted in Rio passed by”, highlights the writer.
“It was there that I witnessed a historic moment for porristas in Brazil. Dr. Albert Sabin, the famous inventor of the vaccine against infantile paralysis […]seeing the whole group drinking respectable amounts of alcohol, wrote a formula and presented it to the host.”
“Engov was born there, created by the fantastic scientist. Things from this country”, concludes Amaral.
The description of the origins of the product, however, does not appear in other historical sources – and Hypera Pharma, the current manufacturer of Engov, did not respond to questions from BBC News Brasil until the publication of this report.
But there is one fact that certainly contributed to the fame of this drug until today: the telenovela “Beto Rockefeller”, broadcast on TV Tupi between 1968 and 1969.
Actor Luiz Gustavo, the protagonist of the plot, said in several interviews that he did not receive “a penny” from the television channel, which was going through a financial crisis. Therefore, he created, somewhat unintentionally, what is called “merchandising” today.
“I invented the thing together with the Fontoura laboratory”, reported Gustavo, in a report by Sheet published in 1994.
“They promised to pay a ‘xis’, I don’t remember how much, every time Beto [Rockfeller] quote Engov medicine on the air.”
He then began to mention the name of the medicine up to six times in each chapter of the soap opera.
“Nobody understood anything. The rest of the cast and the directors of Tupi kept asking me why I mentioned Engov so much. I, of course, stayed in the thicket, never opened the game”, recalled the actor, who died in 2021.
The management of TV Tupi called Gustavo for a conversation and warned him that one of Beto Rockefeller’s sponsors —another pharmaceutical company— was upset. After all, they also had a medicine that promised to cure hangovers, called Alka Seltzer.
To please the advertiser, the television channel’s management added a line in the soap opera script, which was said by the character Carlucho, played by Rodrigo Santiago:
– Wow, what a hangover! I had too much to drink at the party last night. But now I’m going to get better. I just had an Alka Seltzer.
As reported by Sheet, Luiz Gustavo didn’t miss the cue. He said on stage: “You’re stupid, Carlucho. You should follow my example. I had an Engov before the party, another one after, and today I’m clean.”
The soap opera chapters were recorded a few hours after the broadcast, so TV Tupi did not have time to edit the dialogue before it aired, details the article.
One pill, four substances
According to the label and the leaflet, Engov is composed of four substances, and each of them has a different function.
Mepyramine maleate (15 milligrams) is an antihistamine and works against allergies. Aluminum hydroxide (150 mg) decreases stomach acidity and relieves heartburn and nausea. Acetylsalicylic acid (150 mg) —the same active ingredient in aspirin— acts against headaches, among other functions. Finally, caffeine (50 mg) is a stimulant, which can also help reduce migraines.
Officially, Engov is indicated for “relief of symptoms of headaches and allergies”—and there is nothing in the package insert that directly mentions preventing or improving hangovers.
“That is, we are talking here about an association of substances that, in the public perception, form a medicine against hangovers, or against ‘pe na jackfruit’, so to speak”, evaluates pharmacist André Bacchi, professor at the Federal University of Rondonópolis, in Mato Grosso.
“However, the most that this product promotes is the relief of some specific symptoms”, adds the expert.
In Bacchi’s view, the popular view of Engov may even be harmful. “By seeing it as a hangover solution, people end up drinking more because they feel protected by the drug’s effect”, he warns.
Taking this drug together with alcohol as a strategy to prevent hangovers, by the way, is something discouraged in the leaflet itself.
“This drug is contraindicated for patients with a history of chronic alcoholism, [ou que ingerem] other substances that depress the central nervous system or alcoholic beverages”, says the text.
This recommendation has to do with two main reasons. First, because “some effects of acetylsalicylic acid in the gastrointestinal tract can be potentiated by alcohol”, according to the package leaflet.
And this, in turn, can attack the stomach and lead to gastritis.
Second, the association of alcohol with the antihistamine in the formula (mepyramine maleate) potentiates the sedative effect related to both substances.
That is: that feeling of being oblivious to reality caused by drinking can be even stronger by mixing drinks with these pills.
As previously mentioned, BBC News Brasil contacted Hypera Pharma, so that the laboratory could position itself on the issues raised, but no responses were sent until the publication of this report.
Asked about sales figures for the medication, the National Health Surveillance Agency (Anvisa) said that “Engov is registered by only one manufacturer, and therefore, for reasons of business secrecy, it is not possible to pass on commercial information about it”.
What to do?
According to experts, the only really proven way to avoid a hangover is not to drink — or at least moderate consumption.
“There is no magic formula”, attests psychiatrist Olivia Pozzolo, a researcher at the Information Center on Health and Alcohol (Cisa), in São Paulo.
“It’s worth trying to drink as little as possible and adopt some basic strategies, such as drinking water between one dose and another, eating something so that your stomach is full, spacing the time between one glass and another…”, lists the specialist.
Although the World Health Organization (WHO) currently argues that there is no safe amount of alcohol, moderate consumption is classified as one dose for women and two for men per day —there is a difference in the way this substance is metabolized in the male body and feminine.
What about Engov? Can it be taken the next day, when the hangover symptoms show up?
“Perhaps the person using this medication can even feel some effect and become more sedated or improve from heartburn”, replies Bacchi.
However, according to the pharmacist, the most appropriate thing in these cases would be for the individual to assess exactly what the discomfort they are feeling and seek specific medications to alleviate them.
“For the headache, it is possible to take a specific analgesic, such as dipyrone. If there is a lot of nausea, an antiemetic reduces the feeling of vomiting. And so on”, he exemplifies.
Paraná also recalls the importance of other non-pharmacological measures in those 12 to 24 hours when the hangover persists in plaguing the body.
“It is important to hydrate well to replace liquids, eat light foods and rest”, concludes the hepatologist.
Text was originally published here.
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