Sufaud
July 03, 2004 The Times (London)
Alert over fatal mix of herbal pills and medicines By Sam
Lister, Health Correspondent
Doctors warn that thousands are at risk
THOUSANDS of people are risking their lives by mixing herbal
remedies with common prescription drugs.
Of the 10,000 deaths caused by adverse reactions to
prescription drugs every year, a "significant number" were
likely to have been caused by patients mixing their
treatments with complementary medicines, doctors' leaders
said yesterday.
Research has shown that more than 90 per cent of people
prescribed drugs such as warfarin, a powerful anti-
coagulant taken to stop the build-up of lethal blood clots,
were not asked by their GPs if they were taking any
complementary medicines.
Popular substances such as St John's wort, a plant extract
taken for mild depression, have been found to react
dangerously with warfarin and other prescription drugs,
preventing the treatments from working.
In the study, published in the British Journal of General
Practice (BJGP), one in five patients on warfarin was found
to be taking complementary medicines also.
Lindsay Smith, the lead author of the report, said that the
findings raised serious concerns about the lack of
communication between doctors and patients about herbal
remedies. Current software used by GPs to compile patient
records does not include a facility to record data on
alternative medications.
"What was really striking was that one in five people is
taking something and nine out of ten are not discussing it
with their doctor," Dr Smith, a GP in Somerset, said.
"If complementary medicines were perfectly safe and had been
thoroughly tested, there wouldn't be a problem. But most of
these medications remain untested and unresearched. This is
potentially very dangerous."
In the research carried out by Dr Smith, 1,360 patients
taking warfarin from 35 different practices were surveyed
about herbal remedy use. Almost 300 were found to be taking
a listed complementary medicine, of which 25 were taking at
least one reported to react with warfarin, such as St John's
wort, ginseng or gingko biloba, a tree leaf extract believed
to improve blood flow to the brain. A further 200 patients
were on other unidentified alternative medicines. Dr Smith
said that problems arise from the lack of medical knowledge
of interactions between prescription and alternative
medicines. His group is to undertake further research into
gingko and garlic pills.
It is estimated that at least 12 million Britons regularly
use herbal remedies, while more than 500,000 take warfarin.
The overlap, which remains undocumented, is likely to be
high among the elderly, who often rely on multiple
medications for different ailments, health experts said.
The report follows the publication yesterday of research
from scientists at the University of Liverpool which
estimates that more than 10,000 patients may be dying every
year because of reactions to common medications such as
aspirin, anticoagulants and antidepressants.
Researchers said that while most cases had been attributed
to conventional drug reactions — with patients and GPs asked
about St John's wort usage — other herbal remedies were
likely to have contributed to the high death rate.Concerns
have been raised about the effects of echinacea, a popular
anti-viral supplement, on the liver when combined with other
drugs, and garlic supplements on some anti-HIV treatments
Jim Kennedy, the Royal College of General Practitioners
spokesman on prescribing, said that adverse reactions
triggered by herbal remedies would be high.
"It is going to be a factor in a significant number of those
deaths — certainly in the hundreds," he said.
Edzard Ernst, director of the Department of Complementary
Medicine at the University of Exeter and an adviser on the
BJGP report, said that many British GPs " know absolutely
nothing about complementary medicine".
"But they have a moral duty to advise patients responsibly
on all matters of healthcare. To exclude a whole strain of
healthcare and say it's got nothing to do with us because we
didn't learn it at medical school is not responsible."
He added: "With a drug like warfarin the therapeutic window
is very narrow. Underdosing you can have a blood clot, and
overdosing can lead to extensive bleeding and, in worst -
case scenarios, brain haemorrhages. You are dead as a church
mouse. Any interference with herbal medicines is potentially
life-threatening."
http://www.timesonline.co.uk/article/0,,2-1166505,00.html
Alert over fatal mix of herbal pills and medicines By Sam
Lister, Health Correspondent
Doctors warn that thousands are at risk
THOUSANDS of people are risking their lives by mixing herbal
remedies with common prescription drugs.
Of the 10,000 deaths caused by adverse reactions to
prescription drugs every year, a "significant number" were
likely to have been caused by patients mixing their
treatments with complementary medicines, doctors' leaders
said yesterday.
Research has shown that more than 90 per cent of people
prescribed drugs such as warfarin, a powerful anti-
coagulant taken to stop the build-up of lethal blood clots,
were not asked by their GPs if they were taking any
complementary medicines.
Popular substances such as St John's wort, a plant extract
taken for mild depression, have been found to react
dangerously with warfarin and other prescription drugs,
preventing the treatments from working.
In the study, published in the British Journal of General
Practice (BJGP), one in five patients on warfarin was found
to be taking complementary medicines also.
Lindsay Smith, the lead author of the report, said that the
findings raised serious concerns about the lack of
communication between doctors and patients about herbal
remedies. Current software used by GPs to compile patient
records does not include a facility to record data on
alternative medications.
"What was really striking was that one in five people is
taking something and nine out of ten are not discussing it
with their doctor," Dr Smith, a GP in Somerset, said.
"If complementary medicines were perfectly safe and had been
thoroughly tested, there wouldn't be a problem. But most of
these medications remain untested and unresearched. This is
potentially very dangerous."
In the research carried out by Dr Smith, 1,360 patients
taking warfarin from 35 different practices were surveyed
about herbal remedy use. Almost 300 were found to be taking
a listed complementary medicine, of which 25 were taking at
least one reported to react with warfarin, such as St John's
wort, ginseng or gingko biloba, a tree leaf extract believed
to improve blood flow to the brain. A further 200 patients
were on other unidentified alternative medicines. Dr Smith
said that problems arise from the lack of medical knowledge
of interactions between prescription and alternative
medicines. His group is to undertake further research into
gingko and garlic pills.
It is estimated that at least 12 million Britons regularly
use herbal remedies, while more than 500,000 take warfarin.
The overlap, which remains undocumented, is likely to be
high among the elderly, who often rely on multiple
medications for different ailments, health experts said.
The report follows the publication yesterday of research
from scientists at the University of Liverpool which
estimates that more than 10,000 patients may be dying every
year because of reactions to common medications such as
aspirin, anticoagulants and antidepressants.
Researchers said that while most cases had been attributed
to conventional drug reactions — with patients and GPs asked
about St John's wort usage — other herbal remedies were
likely to have contributed to the high death rate.Concerns
have been raised about the effects of echinacea, a popular
anti-viral supplement, on the liver when combined with other
drugs, and garlic supplements on some anti-HIV treatments
Jim Kennedy, the Royal College of General Practitioners
spokesman on prescribing, said that adverse reactions
triggered by herbal remedies would be high.
"It is going to be a factor in a significant number of those
deaths — certainly in the hundreds," he said.
Edzard Ernst, director of the Department of Complementary
Medicine at the University of Exeter and an adviser on the
BJGP report, said that many British GPs " know absolutely
nothing about complementary medicine".
"But they have a moral duty to advise patients responsibly
on all matters of healthcare. To exclude a whole strain of
healthcare and say it's got nothing to do with us because we
didn't learn it at medical school is not responsible."
He added: "With a drug like warfarin the therapeutic window
is very narrow. Underdosing you can have a blood clot, and
overdosing can lead to extensive bleeding and, in worst -
case scenarios, brain haemorrhages. You are dead as a church
mouse. Any interference with herbal medicines is potentially
life-threatening."
http://www.timesonline.co.uk/article/0,,2-1166505,00.html
