Buyer beware? : does the information provided with herbal products available over the counter enable safe use?
Raynor, David K., Dickinson, Rebecca, Knapp, Peter, Long, Andrew F. and Nicolson, Donald J.. (2011) Buyer beware? : does the information provided with herbal products available over the counter enable safe use? BMC Medicine, Vol.9 (No.1). p. 94. ISSN 1741-7015
WRAP_Nicolson_1741-7015-9-94.pdf - Published Version - Requires a PDF viewer such as GSview, Xpdf or Adobe Acrobat Reader
Official URL: http://dx.doi.org/10.1186/1741-7015-9-94
Background: Herbal products obtained over the counter are commonly used in Europe, North America and Australia.
Although there is concern about a lack of information provided to consumers to allow the safe use of these products,
there has been no published research to confirm these fears. In this study, we evaluated written information provided
with commonly used herbal products in the UK in advance of a European Union Directive issued in April 2011 that
tightened regulations for some herbal products, including requirements to provide safety information.
Methods: Five commonly used herbal products were purchased from pharmacies, health food shops and
supermarkets: St John’s wort, Asian ginseng, echinacea, garlic and ginkgo. Written information provided with the
products (on the package or on a leaflet contained in the package) was evaluated for inclusion of each of the key
safety messages included in the monographs of the US National Center for Complementary and Alternative
Medicine. Specifically, we looked for information on precautions (such as Asian ginseng not being suitable for
people with diabetes), interactions with conventional medicines (such as St John’s wort with the contraceptive pill
and warfarin) and side effects (such as ginkgo and allergic reactions).
Results: Our analysis showed that, overall, 51 (75%) of 68 products contained none of the key safety messages.
This included 4 of 12 St John’s wort products, 12 of 12 ginkgo products, 6 of 7 Asian ginseng products, 20 of 21
garlic products and 9 of 13 echinacea products. The two products purchased that are registered under the new
European Union regulations (for St John’s wort) contained at least 85% of the safety messages.
Conclusions: Most of the herbal medicine products studied did not provide key safety information which
consumers need for their safe use. The new European Union legislation should ensure that St John’s wort and
echinacea products will include the previously missing information in due course. The legislation does not apply to
existing stock. Depending on therapeutic claims made by manufacturers, garlic, ginkgo and Asian ginseng products
may not be covered by the legislation and can continue to be bought without the safety information. Also,
consumers will still be able to buy products over the internet from locations outside European Union jurisdiction.
Potential purchasers need to know, in both the short term and the long term, how to purchase herbal products
which provide the information they need for the safe use of these products.
|Item Type:||Journal Article|
|Subjects:||R Medicine > RM Therapeutics. Pharmacology|
|Divisions:||Faculty of Medicine > Warwick Medical School|
|Library of Congress Subject Headings (LCSH):||Herbs -- Therapeutic use -- Safety regulations|
|Journal or Publication Title:||BMC Medicine|
|Publisher:||BioMed Central Ltd.|
|Official Date:||9 August 2011|
|Page Range:||p. 94|
|Access rights to Published version:||Open Access|
|Funder:||University of Leeds|
1. Public Perceptions of Herbal Medicines. [http://www.ipsos-mori.com/
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