Status:
Active
Health advisory:
170011
Date Issued:
23 Oct 2017
Issued by:
Professor Charles Guest, Chief Health Officer, Victoria
Issued to:
Health professionals and consumers

Key messages

  • Unregulated complementary medicines such as some traditional folk medicines, may not be manufactured to the same quality as regulated medicines and can therefore cause adverse health effects including toxicity and drug interactions.
  • Most complementary medicines sold in Australia are subject to regulation by the Therapeutic Goods Administration (TGA).
  • No assurance can be given about the safety or quality of unregulated imported complementary medicines.
  • Ask patients about their use of traditional medicines, particularly migrants who may use these medicines more frequently and consider testing for heavy metals, including lead, if exposure is suspected.
  • Advise patients of the potential risks of using traditional unregulated medicines.
  • Report any adverse reactions associated with the use of medicines to the Therapeutic Goods Administration.

What is the issue?

Traditional medicines come in a variety of forms (for example liquids, tablets, powders, creams) and may be applied or ingested for a variety of purposes.

Unregulated complementary medicines, such as some traditional folk medicines, may not be manufactured to the same quality as regulated medicines. Product labelling may be inaccurate, may include unproven claims, and may not be translated into English, with potential for undeclared and potentially harmful ingredients.

Some Ayurvedic medicines contain high levels of lead, with a number of reports in Victoria of elevated blood lead levels in patients taking Ayurvedic medications imported from India. In another example, some traditional Burmese medicines, such as powders used for 'digestion and strength' in babies, were found to contain arsenic in NSW. Similar Burmese products in the USA have been identified as a source of lead exposure, as has a range of other traditional medicines.

There have been no reported cases of toxicity associated with the use of Burmese powders in Victoria; however based on these reports, use of these products is not recommended as no assurance can be given about the safety or quality of unregulated complementary medicines imported from other countries.

The department is also aware of adverse reports from healing or purging rituals, for example kambo ceremonies, where secretions of exotic animals such as Amazonian tree frogs are applied to blistered skin.

Who is at risk?

Anyone who uses or consumes unregulated complementary medicines is at risk of an adverse health effect including toxicity and drug interactions. The use of traditional medicines can also have health implications if used as a substitute for conventional medicine.

Prevention / treatment

Many people will not report use of traditional medicines to their health care providers. These medicines may have been obtained directly from overseas through friends or relatives, or via the internet. It is important that health professionals ask patients about their use of traditional medicines, particularly migrants who may use these medicines more frequently.

Advise patients of the potential risks of using such traditional unregulated medicines. As well as potential toxicity, side effects and drug interactions, traditional medicines can also have health implications if used as a substitute for conventional medicine.  In patients exposed to traditional medicines, consider the potential adverse effects and investigate if appropriate.

Consider testing patients for heavy metals, including lead, if exposure is suspected, as symptoms may be non-specific.  Patients who are acutely unwell should be referred to the local emergency department.

More information

Clinical information

International reports regarding traditional (folk) medicines

Reporting adverse reactions to a medicine (TGA)

Talking with your patients about Complementary Medicine

Guide for health practitioners for managing individual exposure to lead in Australia

Clinical questions regarding toxicity - Victorian Poisons Information Centre, 13 11 26

Consumer information

Better Health Channel