Herbal and dietary products are chemicals that have druglike effects in people. Unfortunately, their effects are largely unknown and may be dangerous for some people because there is little reliable information about them. For most products, little research has been done to determine either their benefits or their adverse effects.
The safety and effectiveness of these products are not documented or regulated by laws designed to protect consumers, as are pharmaceutical drugs. As a result, the types and amounts of ingredients may not be standardized or even identified on the product label. In fact, most products contain several active ingredients and it is often not known which ingredient has the desired pharmacologic effect. In addition, components and active ingredients of plants can vary considerably, depending on the soil, water, and climate where the plants are grown.
These products can be used more safely if they are manufactured by a reputable company that states the ingredients are standardized (meaning that the dose of medicine in each tablet or capsule is the same).
The product label should also state specific percentages, amounts, and strengths of active ingredients. With herbal medicines especially, different brands of the same herb vary in the amounts of active ingredients per recommended dose. Dosing is also difficult because a particular herb may be available in several different dosage forms (eg, tablet, capsule, tea, extract) with different amounts of active ingredients.
These products are often advertised as "natural". Many people interpret this to mean the products are safe and better than synthetic or man-made products. This is not true; "natural" does not mean safe, especially when taken concurrently with other herbals, dietary supplements, or drugs.
When taking herbal or dietary supplements, follow the instructions on the product label. Inappropriate use or taking excessive amounts may cause dangerous side effects.
Inform health care providers when taking any kind of herbal or dietary supplement, to reduce risks of severe adverse effects or drug-supplement interactions.
Most herbal and dietary supplements should be avoided during pregnancy or lactation and in young children.
The American Society of Anesthesiologists recommends that all herbal products be discontinued 2-3 weeks before any surgical procedure. Some products (eg, echinacea, ephedra, feverfew, garlic, gingko, ginseng, kava, valerian and St. John's wort) can interfere with or increase the effects of some drugs, affect blood pressure or heart rhythm, or increase risks of bleeding; some have unknown effects when combined with anesthetics, other perioperative medications, and surgical procedures.
Store herbal and dietary supplements out of the reach of children.
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