Gill Stannard

Tuesday, April 11, 2006

more on legal drugs

Pharmaceutical drugs are a $450 billion industry worldwide. Recent studies have shown that over 10% of visits to GPs in Australia are due to drug side effects alone. But this figure is known to be the tip of the iceberg, as many adverse drug events go unreported. Even when patients feed the information back to their GP, the majority of mild to moderate adverse reactions are not passed back to the company or the regulatory body. In fact “post market surveillance” of drugs is very poorly monitored in this country.

More alarmingly, problems with drugs – which may include incorrect dosage, inappropriate prescriptions or interactions with other medication, account for up to 150,000 hospital admissions annually. Deaths in Australia alone, are in the thousands.

As many drugs are life saving, this may justify the trade off between unpleasant side effects and the benefit of the medicine. However, this may not always be the case.

It is important to tell all your health care providers what orthodox or complementary medicines you are taking.

Some known potential herb-drug interactions.
In most cases this may mean you may not get the prescribed amount of the drug when you take a herb at the same time, perhaps rendering it less effective. In cases such as taking St John’s Wort with anti-rejection drugs after an organ replacement, the consequences could be very serious. But keep in mind the majority of interactions are hypothetical.

Complementary medicines are not always ‘harmless’ but are viewed by the Therapeutic Goods Administration as “low risk and a low propensity to cause adverse reactions”. Every case of serious reaction is widely reported in the media (unlike the thousands of adverse events with orthodox medicines). Interestingly, the Pan Pharmaceuticals fiasco in 2003,which muddied the name of complementary medicines at the time, was due to a laboratory not following the code of good manufacturing practice and the event that bought this to the fore was one involving a pharmaceutical medicine. Coincidentally the lab happened to manufacture 75% of all Australian complementary medicines.

Of the rare serious cases in Australia regarding western herbal medicine, herb misidentification and substitution with a toxic herb is often the case.

It is important to buy any herbal products with a TGA “L” or “R” number, to assure they have been quality assessed by the country’s regulatory body. There have been numerous cases of traditional Chinese herbs imported into the country being adulterated with drugs such as steroids, and ayuvedic herbals tainted with heavy metals.

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