Adulteration of herbal antidiabetic products with undeclared pharmaceuticals: A case series in Hong Kong

British Journal of Clinical Pharmacology

Volumn 73, Issue 5, 2012, Pages 795-800

  Ching, Chor Kwan ^a   Lam, Ying Hoo ^a   Chan, Albert Y W ^a   Mak, Tony W L ^a  

^a PRINCESS MARGARET HOSPITAL   (Hong Kong)

Author keywords

Antidiabetic agents; Chinese herbal drugs; Drug adulteration

Indexed keywords

AMINOPHENAZONE; ANTIDIABETIC AGENT; CIMETIDINE; DICLOFENAC; DOMPERIDONE; GLIBENCLAMIDE; GLICLAZIDE; GLIMEPIRIDE; HERBACEOUS AGENT; ILLICIT DRUG; METFORMIN; NATEGLINIDE; PHENFORMIN; PIROXICAM; PREDNISOLONE ACETATE; REPAGLINIDE; ROSIGLITAZONE; TADALAFIL;

ADULT; ADULTERATION; AGED; ARTICLE; CLINICAL ARTICLE; DEMOGRAPHY; DRUG QUALITY; DRUG SAFETY; FEMALE; GOVERNMENT REGULATION; HONG KONG; HUMAN; HYPOGLYCEMIA; LACTIC ACIDOSIS; MALE; MEDICAL HISTORY; PRIORITY JOURNAL; RETROSPECTIVE STUDY; TOXICOLOGY;

ACIDOSIS, LACTIC; ADULT; AGED; AGED, 80 AND OVER; DRUG CONTAMINATION; DRUGS, CHINESE HERBAL; FEMALE; HONG KONG; HUMANS; HYPOGLYCEMIA; HYPOGLYCEMIC AGENTS; MALE; MIDDLE AGED; NONPRESCRIPTION DRUGS; PATIENT EDUCATION AS TOPIC; RETROSPECTIVE STUDIES;

EID: 84859399280     PISSN: 03065251     EISSN: 13652125     Source Type: Journal    
DOI: 10.1111/j.1365-2125.2011.04135.x     Document Type: Article

References (17)

1. Nathan DM, Buse JB, Davidson MB, Ferrannini E, Holman RR, Sherwin R, Zinman B. Medical management of hyperglycemia in type 2 diabetes: a consensus algorithm for the initiation and adjustment of therapy: a consensus statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2009; 32: 193-203.
2. Ernst E. Adulteration of Chinese herbal medicines with synthetic drugs: a systemic review. J Intern Med 2002; 252: 107-13.
3. Ching CK, Lai CK, Poon WT, Wong ENP, Yan WW, Chan AYW, Mak TWL. Hazards posed by a banned drug - phenformin is still hanging around. Hong Kong Med J 2008; 14: 50-4.
4. Persson HE, Sjoberg GK, Haines JA, Pronczuk de Garbino J. Poisoning severity score. Grading of acute poisoning. J Toxicol Clin Toxicol 1998; 36: 205-13.
5. Ching CK, Lai CK, Poon WT, Lui MC, Lam YH, Shek CC, Mak TWL, Chan AYW. Drug-induced hypoglycaemia - new insight into an old problem. Hong Kong Med J 2006; 12: 334-8.
6. Huang WF, Wen KC, Hsiao ML. Adulteration by synthetic therapeutic substances of traditional Chinese medicines in Taiwan. J Clin Pharmacol 1997; 37: 344-50.
7. Ko RJ. Adulterants in Asian patent medicines. N Engl J Med 1998; 339: 847.
8. US Food and Drug Administration. Import alert 66-10. Chinese herbal medicines. 2009. Available at (last accessed 29 June 2011).
9. Health Canada. Health Canada warns consumers not to take the Chinese medicine Shortclean due to potential health risk. 2005. Available at (last accessed 29 June 2011).
10. Cosyns JP. Aristolochic acid and 'Chinese Herbs Nephropathy'. A review of the evidence to date. Drug Saf 2003; 26: 33-48.
11. Poon WT, Lai CK, Ching CK, Tse KY, So YC, Chan YC, Hau LM, Mak TWL, Chan AYW. Aconite poisoning in camouflage. Hong Kong Med J 2006; 12: 456-9.
12. Luft D, Schmulling RM, Eggstein M. Lactic acidosis in biguanide-treated diabetics: a review of 330 cases. Diabetologia 1978; 14: 75-87.
13. Bailey CJ. Biguanides and NIDDM. Diabetes Care 1992; 15: 755-72.
14. European Medicines Agency. European Medicines Agency recommends suspension of Avandia, Avandamet and Avaglim. 2010. Available at (last accessed 4 29 June 2011).
15. US Food and Drug Administration. Avandia (rosiglitazone): REMS - risk of cardiovascular events. 2011. Available at (last accessed 29 June 2011).
16. Poon WT, Lam YH, Lee HHC, Ching CK, Chan WT, Chan SS, Lai CK, Tse ML, Chan AYW, Mak TWL. Outbreak of hypoglycaemia: sexual enhancement products containing oral hypoglycaemic agent. Hong Kong Med J 2009; 15: 196-200.
17. Barnes PM, Bloom B, Nahin RL. Complementary and alternative medicine use among adults and children: United States, 2007. Natl Health Stat Report 2008; 12: 1-23.