Over the counter medicine, supplements and herbals – benefits and risks

By Julia Lee

Over the counter medicine, supplements and herbals are commonly used for a variety of purposes and their effects can be very beneficial to our health. However, it is important to be aware of what can occur as a result of taking them with other drugs at the same time, since adverse effects as a result of combining them are not uncommon.


According to the Food and Drug Administration (FDA), dietary supplements are defined as vitamins, minerals, herbs or other botanicals, and amino acids used to supplement the diet by increasing dietary intake or concentrates, metabolites, and extracts. However, the fact that dietary supplements were derived from natural sources does not guarantee their safety.


The Dietary Supplement Health and Education Act of 1994 requires that manufacturers are responsible for ensuring their products are safe and that claims about their products are not false or misleading. However, ingredients sold in the United States prior to October 15th, 1994 are not required to be reviewed as safe by the FDA before they are marketed. Unfortunately, many new products are often not submitted to the FDA prior to their sale, and dietary supplements are only regulated but not approved by the FDA.


It is important to be aware that dietary supplements may describe the role of a nutrient or dietary ingredient intended to affect the normal structure or function of the human body, such as claiming that “calcium builds strong bones”. However, this does not necessarily mean that the claim is always proven and true.


Natural plants and herbs have been used for medicinal purposes for thousands of years. They are pharmacologically active, which means they can positively impact your health by improving your symptoms, but also negatively impact your health by producing adverse effects and drug-herb interactions. Increasing data show the potential for herbal medicines to interact with prescription and nonprescription pharmaceuticals which isn’t always a positive thing, so it is important to always talk to your doctor and pharmacist about supplements you are taking.


By being open to having these conversations and asking your healthcare provider about potential drug-supplement interactions, you can make better and more informed choices that are right for you and avoid adverse effects that could have detrimental effects on your health. For example, black cohosh is commonly used to relieve menopausal symptoms or painful menstruation, but if taken with certain drugs, the drugs broken down by certain liver enzymes may accumulate in the body and lead to toxicity. Other common herbal medicines that can lead to negative interactions include ginseng, garlic, melatonin, cranberries, and green tea.


The United States Pharmacopoeia (USP) Dietary Supplement Verification Program certifies that tested contain the listed ingredients in the indicated amounts, are free of contaminants, and have been manufactured under appropriate conditions. A USP Seal of Approval can be found on certain products, and a list of approved products can be found at www.usp.org.


Even the medicine and supplements with the best of effects can have unpredictable repercussions when used in certain ways, so it is important to be transparent and open when communicating with your healthcare provider about whatever it is that you may be taking. Don’t hesitate to talk to any pharmacist in the University Pharmacy with any questions you may have regarding herbals, supplements or any over-the-counter medications.