Alternative medicine: regulatory review needed

Ms Winnie Chau from the Flinders Medical Centre, Adelaide, said that online shopping has made herbal medicines more available, and regulation more difficult.

Ms Chau and co-authors studied a 75-year-old man who developed renal failure from chronic exposure to nephrotoxins. The patient’s Chinese herbal products were suspected of causing the renal failure and were sent to the TGA for analysis. The products were found to contain aristolochic acid (AA) – a known nephrotoxin and carcinogen.

In Australia, the sale of complementary and alternative medicine (CAM) is regulated by the TGA, Ms Chau said.

“In July 2001, alerts to health practitioners were distributed by the TGA and in January 2002, bans on herbal products suspected to contain AA were instituted, but this patient was still able to purchase the product by mail order,” Ms Chau said.

“Chinese herbal medicines containing AA remain available for purchase over the Internet and through Chinese herbal retailers.

“The occurrence of this case in Australia highlights the need to review the CAM regulations and for clinicians to be vigilant in their assessment regarding the use of CAM, especially when the aetiology of renal dysfunction cannot be identified.

“Until more stringent regulations are put into place to ensure quality, safety and efficacy of CAM, public awareness of their dangers should be raised.”

The Medical Journal of Australia is a publication of the Australian Medical Association.

The statements or opinions that are expressed in the MJA  reflect the views of the authors and do not represent the official policy of the AMA unless that is so stated.

CONTACT:     Ms Winnie Chau                       (08) 8332 0679 / 0411 378 363