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There is a perception that herbal medicines are safer than prescription medicines. It is interesting to me then that a number of ‘herbals’ are containing actual prescription medications (though of course it does not say this on the bottle it just gives a list of herbs). The FDA has produced a number of warnings about this with particular products named, however unless an effort is made to search for these you might miss a particular announcement.
A patient came to me with some unusual symptoms that might have been worrying who was on a herbal diet pill. I had never heard of the name of this before but found it was in a list of 25 “herbal” medicines that contained an undeclared ingredient sibutramine, a controlled substance that can be sold only with a medical prescription and used under health care professional.
The reason for this is that sibutramine commonly causes increases in blood pressure and there were case reports that it can cause changes in electrolytes that can cause coma and seizures, changes to the ECG that can lead to fatal arrthymias and death.
That was not the scary part the scary part was this: “These tainted weight loss products pose a great risk to public health because they contain undeclared ingredients and, in some cases, contain prescription drugs in amounts that greatly exceed their maximum recommended dosages,” said Janet Woodcock, M.D., director, Center for Drug Evaluation and Research, FDA.
She also made the point that “Consumers have no way of knowing that these products contain powerful drugs that could cause serious health consequences” and might have reasonably added – and neither do her doctors.
If a doctor was going to start a patient on one of these medications ( I don’t think I ever have) they might reasonably ask them to come back to check their BP maybe check their electrolyes and maybe an ECG and be very careful prescribing other medications that might cause similar side effects and maybe warning them not to take any other non-prescriptions drugs – ie in a very controlled way and obviously a “safe” dosage.
The problem is ongoing and not just weight loss medications – a recent fda warning was for erectile dysfunction drugs and those for menopause. These were specifically marketed as being 100% herbal but the active ingredient was a prescription drug.
So be wary of the prescription drug hidden in herbals. Use your doctor, pharmacist and safe sources on the internet to try to find out more before buying or taking and always ask your doctor if you are already taking prescription medications. Some examples to avoid try this downloadable short pdf . One other way is to do a simple google search with the name of the herbal and then ‘fda’.