The Pharmaceutical Journal
Vol 269 No 7206 pp53-57
13 July 2002

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  Repeat dispensing
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Letters to the Editor

ADR reporting

How to increase reports on herbal medicines

From Dr R. Woodward, MRPharmS

Dr Edmund Major (PDF 50K) (PJ, July 6, p25) appears puzzled as to why so few adverse reaction reports relating to herbal medicines are received by the Committee on Safety of Medicines from pharmacists. I offer him a possible explanation.

Community pharmacists are trained modern health professionals. Their shelves are therefore not likely to be overflowing with a huge variety of unlicensed herbal medicines because most do not believe they have the depth of knowledge confidently to recommend such products to their customers. They would rather stick with senna, dandelion, valerian, passiflora etc. Most of these products will have licences going back 30 years. Items such as garlic, ginger, evening primrose and ginseng may be unlicensed but are well known as being generally safe. Adverse reactions from all these are likely to be few.

Suspect herbal medicines tend come to consumers by mail order, health stores, the internet, and Chinese/Ayurvedic medicine practices. Indeed, I see mail order companies still offering kava-kava quite openly. Consumers are unlikely to visit a pharmacy with a reaction to a product which they purchased from one of those sources. If Dr Major really wants ADRs on herbal medicines then reporting should be widened to include these distributors.

Robert Woodward
Liss, Hampshire

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