Abstract
Objective: The purpose of this study was to (1) characterize the pSopulation who uses and reports adverse events to the California Poison Control System (CPCS) related to herbal remedies (HR) and dietary supplements (DS), (2) to assess whether adverse drug reactions (ADRs) occur within the usual recommended dosing, and (3) to describe the nature of adverse events.
Methods: A retrospective search of HR and DS related calls was conducted between 1997 and June 1998. Data collection included the demographics of callers, types of exposures, substances involved, amounts ingested and severity.
Results: Of the 918 HR and DS calls received, 259 (28.2%) were drug information queries, 599 (65.3%) were exposures, and 60 (6.5%) were excluded. Exposures occurred most often in pediatric patients 324 (54.1%), but exposures resulting in ADRs occurred most often in adults at recommended doses. There were 233 ADRs, of which 67 (28.8%) occurred in children. The most common products involved in ADRs were zinc (38.2%), echinacea (7.7%), chromium picolinate (6.4%) and witch hazel (6%). Severity of ADRs required no treatment or was minor in a majority of cases, but may have contributed to hospitalization in three.
Conclusion: Children were involved in a majority of exposure calls to the CPCS involving HR and DS. Adults, however, were more likely to develop an ADR from these products due to intentional exposure. Overall, the ADRs caused by HR and DS were mild, could be managed at home and rarely resulted in a severe outcome or other sequelae. Products involved in ADRs were consistent with the most common HR and DS products used by adult U.S. consumers.
Additional information
Notes on contributors
Candy Tsourounis
F. U. Alakbarov is Head Scientific Officer, expert in the Oriental and Folk Medicine, Institute of Manuscripts of the Azerbaijan Academy of Sciences, 8 Istiglaliyat str., Baku, 370001, Azerbaijan.
At the time of writing Liya Davydov was PharmD candidate, College of Pharmacy and Allied Health Professions, St. John's University. Currently, she is Pharmacy Practice Resident, Mount Sinai Medical Center, New York, NY.
Ila Mehra Harris is Assistant Professor, Department of Pharmaceutical Care & Health Systems, College of Pharmacy, and Clinical Assistant Professor, Department of Family Practice & Community Health, Medical School, University of Minnesota, Minneapolis, MN.
Colin J. Briggs is Professor of Pharmacy, Faculty of Pharmacy, University of Manitoba. Recently he completed a secondment to Health Canada, as Senior Science Advisor in the Therapeutics Products Programme with special responsibility for complementary medicines.
Gemma Briggs is Research Assistant, IMPACT, The Injury Prevention Centre of Children's Hospital, 501G-715 John Buhler Research Centre, Winnipeg, MB, Canada.
Mary Chavezis Professor of Pharmacy Practice, Director of Complementary Medicine Education and Research, The Center for the Advancement of Pharmacy Practice, Midwestern University, College of Pharmacy Glendale, Glendale, AZ 85308.