Natural Health Product Adverse Reactions (SONAR): Active Surveillance of Adverse Events Following Concurrent Natural Health Product and Prescription Drug Use in Community Pharmacies

Recent national surveys in North America, Australia and Europe suggest that more than half of the population uses dietary supplements, also known as natural health products (NHPs) or complementary medicines, including herbs, vitamins, minerals and other supplements. [1][6]In developing countries, use is even higher; in Africa for example, 80% of the population uses African Traditional Medicine, 90% of which is plant-based. [5].

 Reported also within the above captioned PubMed article is the following:

NHPs are generally considered to be safe by the public, despite the growing evidence that this is not always the case. [1], [7][11] Particular caution is warranted when NHPs are used in combination with prescription medications due to the potential for interactions. [1] Of note, NHPs are frequently used by patients with chronic or recurrent conditions; these patients are also the most likely to be prescribed conventional medications. [12][14] Since the likelihood of an adverse event (AE), including drug interactions, increases with the number of medicinal products used, it is hypothesized that patients who concurrently use prescription medications and NHPs are therefore at greater risk for an AE than if they were using either product alone and represent a population of particular interest with respect to exploring the safety of NHPs.[10].

The many Canadians who take natural health products as well as prescription drugs are six times as likely to suffer unwanted side effects. What does this mean?

Research shows that natural health products through historical use, traditional use, scientific evaluation and clinical outcomes studies have properties often that prove substantially beneficial in treating or managing conditions at source or cause. Rx or prescription medication indicated for a condition also must undergo rigorous, labourious testing. Whether it be Rx, OTC, or NHP each individual category or product is studied separately for outcomes, and in Canada under the NNHPD are evaluated (NHP or natural products) for safety and efficacy much like an OTC. To mix therapies, drugs, treatments and expect a positive outcome is not guaranteed. Much of our Rx and OTC products contain natural ingredients, as well as synthetic…Natural is natural…both can be potent and effective.

This means one needs to be cognizant that mixing drugs or any “medication” or treatment in combination or “cocktails” does not necessarily guarantee positive efficacy or outcome. This means – Choice is essential.   When engaged in treatment or preventative measures it is imperative that information is shared with all health practitioners as well as treatment interventions whether it be OTC, Rx or NHP – natural products.

All are in essence medications or tonics that affect the body physiologically. For a number of reasons, largely by experience Natural Comments supports natural traditional “medicines” in the treatment and prevention of conditions. Seeking the cause and addressing at source with NHP products that are evidenced-based, effective.    

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