Complementary medicines sold in Australia are subject to regulation by the Therapeutic Goods Administration (TGA).
Unregulated complementary medicines, such as some traditional folk medicines, may not be manufactured to the same quality and standard as regulated medicines. Product labelling may be inaccurate, may include unproven claims, and/or may not be translated into English, with potential for undeclared and potentially harmful ingredients. No assurances can be given about the safety, quality or effectiveness of unregulated complementary medicines imported from other countries.
Traditional medicines, and other traditional products that are applied or ingested, may come in a variety of forms (eg. tablets, powders, pellets, creams) and may be used for a variety of purposes.
Reports of contamination
Some Ayurvedic medicines have been found to contain high levels of lead, with a number of reported cases in Victoria of elevated blood lead levels in patients taking Ayurvedic medications imported from India in recent years. Another example is that some types of traditional Burmese medicines, such as powders used for digestion and strength in babies, have been found to contain arsenic in NSW. Similar Burmese products in the USA have been identified as a source of lead exposure, as have 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.
Are your patients using traditional medicines?
Many people who use traditional medicines will not report this to their health care providers unless they are specifically asked about it.
It is important that health professionals ask about the use of traditional medicines, particularly in migrants and refugees who may use these medicines more frequently. Advise patients of the potential risks of using such traditional medicines, particularly those that are unregulated.
The National Health and Medical Research Council (HNMRC) provide a useful resource detailing how and what to ask patients about the use of complementary and traditional medicines, and how to discuss evidence and risks associated with their use.
In patients exposed to traditional medicines, consider the potential adverse effects on patient health and investigate if appropriate. As well as potentially leading to toxicity, side effects and/or drug interactions, traditional medicines can also have implications for health if used as a substitute for conventional medical therapy.
Specific clinical questions or concerns regarding toxicity should be discussed with the Victorian Poisons Information Centre 13 11 26.
Patients who are acutely unwell should be referred to the local emergency department.
Health professionals are strongly encouraged to report any adverse reactions associated with the use of medicines to the Therapeutic Goods Administration.