Controlled document PF-011A
TLO DUO Phase 1 Master Formula
TemplateDocumented
Record identification
- Document ID
- PF-011A
- Document type
- Template
- Status
- Documented
- Source
- Standardisation & Production of SIRIAM Products
Overview
PF-011A
PRODUCT FORMULA CARD
SIRIAM TLO DUO – PHASE 1 (VISCERO-FASCIAL RELEASE)
DOCUMENT CONTROL
Field
Product ID
Formula ID
Document
Product
Anatomical Region
Therapeutic Phase
Product Type
Standard Batch
Version
Status
Internal QR
| Value |
|---|
| SIR-TLO-001 |
| MF-011 |
| PF-011A |
| TLO DUO – Phase 1 |
| T10–L2 |
| Viscero-Fascial Release |
| Topical Magistral Cream |
| 100 g |
| 2.0 |
| 🔒 LOCKED |
| ☐ |
ValueSIR-TLO-001
ValueMF-011
ValuePF-011A
ValueTLO DUO – Phase 1
ValueT10–L2
ValueViscero-Fascial Release
ValueTopical Magistral Cream
Value100 g
Value2.0
Value🔒 LOCKED
Value☐
1. PRODUCT PURPOSE
Field
Clinical Objective
Anatomical Region
Primary Biological Target
Therapeutic Phase
Product Type
| Description |
|---|
| Viscero-fascial and neurovegetative modulation |
| T10–L2 |
| Psoas and visceral release with autonomic unloading |
| Phase 1 – Release |
| Topical Magistral Cream |
DescriptionViscero-fascial and neurovegetative modulation
DescriptionT10–L2
DescriptionPsoas and visceral release with autonomic unloading
DescriptionPhase 1 – Release
DescriptionTopical Magistral Cream
2. MASTER FORMULA
The ingredient quantities follow the uploaded Phase 1 magistral fiche, with the agreed SQMS standardisation.
| Code |
|---|
| Official Ingredient |
| Supplier |
| Master Qty |
| Unit |
| Phase |
| PC-001 |
| Lanette Cream FNA |
| Fagron |
| 65.00 |
| g |
| B |
| PC-002 |
| Aqua Purificata |
| Fagron |
| 18.00 |
| g |
| W |
| SC-001 |
| Magnesium Chloride |
| Fagron |
| 4.00 |
| g |
| W |
| SC-002 |
| MSM |
| — |
| 2.50 |
| g |
| W |
| OC-001 |
| Castor Oil |
| Natural Heroes |
| 4.00 |
| g |
| L |
| OC-002 |
| Jojoba Oil |
| Natural Heroes |
| 2.00 |
| g |
| L |
| SC-003 |
| D-Panthenol |
| Natural Heroes |
| 0.50 |
| g |
| W |
| SC-004 |
| Vitamin E Full Spectrum |
| Natural Heroes |
| 0.50 |
| g |
| L |
| BE-013 |
| Solidago virgaurea (A.Vogel) |
| A.Vogel |
| 0.70 |
| mL |
| C |
| BE-014 |
| Berberis vulgaris (Aromedica) |
| Aromedica |
| 0.30 |
| mL |
| C |
| BE-009 |
| Ruta graveolens |
| — |
| 0.40 |
| mL |
| C |
| BE-002 |
| Copaiba Oil |
| Aroma-Zone |
| 0.30 |
| mL |
| C |
| SC-005 |
| Silicea Gel (+1 drop Silicea D8) |
| — |
| 1.50 |
| g |
| C |
| CL-001 |
| Sea Buckthorn Oil (optional) |
| — |
| 1 |
| drop |
| C |
| PR-001 |
| Cosgard 221 |
| Aromantic |
| 0.70 |
| g |
| C |
CodeOfficial Ingredient
CodeSupplier
CodeMaster Qty
CodeUnit
CodePhase
CodePC-001
CodeLanette Cream FNA
CodeFagron
Code65.00
Codeg
CodeB
CodePC-002
CodeAqua Purificata
CodeFagron
Code18.00
Codeg
CodeW
CodeSC-001
CodeMagnesium Chloride
CodeFagron
Code4.00
Codeg
CodeW
CodeSC-002
CodeMSM
Code—
Code2.50
Codeg
CodeW
CodeOC-001
CodeCastor Oil
CodeNatural Heroes
Code4.00
Codeg
CodeL
CodeOC-002
CodeJojoba Oil
CodeNatural Heroes
Code2.00
Codeg
CodeL
CodeSC-003
CodeD-Panthenol
CodeNatural Heroes
Code0.50
Codeg
CodeW
CodeSC-004
CodeVitamin E Full Spectrum
CodeNatural Heroes
Code0.50
Codeg
CodeL
CodeBE-013
CodeSolidago virgaurea (A.Vogel)
CodeA.Vogel
Code0.70
CodemL
CodeC
CodeBE-014
CodeBerberis vulgaris (Aromedica)
CodeAromedica
Code0.30
CodemL
CodeC
CodeBE-009
CodeRuta graveolens
Code—
Code0.40
CodemL
CodeC
CodeBE-002
CodeCopaiba Oil
CodeAroma-Zone
Code0.30
CodemL
CodeC
CodeSC-005
CodeSilicea Gel (+1 drop Silicea D8)
Code—
Code1.50
Codeg
CodeC
CodeCL-001
CodeSea Buckthorn Oil (optional)
Code—
Code1
Codedrop
CodeC
CodePR-001
CodeCosgard 221
CodeAromantic
Code0.70
Codeg
CodeC
3. MANUFACTURING WORKFLOW
Step
1
2
3
4
5
6
7
8
9
10
Prepared according to the Lanette protocol in the magistral fiche.
| Action |
|---|
| ✓ |
| Verify raw materials |
| □ |
| Prepare water phase |
| □ |
| Prepare oil phase |
| □ |
| Emulsification |
| □ |
| Cool below 40°C |
| □ |
| Add botanical extracts |
| □ |
| Add Copaiba and Silicea Gel (+1 drop Silicea D8) |
| □ |
| Quality Control |
| □ |
| Fill airless dispensers |
| □ |
| Batch Release |
| □ |
Action✓
ActionVerify raw materials
Action□
ActionPrepare water phase
Action□
ActionPrepare oil phase
Action□
ActionEmulsification
Action□
ActionCool below 40°C
Action□
ActionAdd botanical extracts
Action□
ActionAdd Copaiba and Silicea Gel (+1 drop Silicea D8)
Action□
ActionQuality Control
Action□
ActionFill airless dispensers
Action□
ActionBatch Release
Action□
4. QUALITY CONTROL
Standard SQMS Quality Control
Appearance
Colour
Odour
Homogeneity
pH (5.2–5.5)
Viscosity
Packaging
Net Weight
5. BATCH RELEASE
Standard SQMS Batch Release
6. CLINICAL APPLICATION
Field
Anatomical Region
Primary Zone
Secondary Zone
Additional Zone
Additional Projection
Frequency
Treatment Phase
Application zones follow the magistral protocol.
| Value |
|---|
| T10–L2 |
| Lower abdomen |
| Flanks |
| Paravertebral T10–L2 |
| Iliac crest |
| 1–2× daily |
| Weeks 1–2 |
ValueT10–L2
ValueLower abdomen
ValueFlanks
ValueParavertebral T10–L2
ValueIliac crest
Value1–2× daily
ValueWeeks 1–2
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