ADULTERATION BY SYNTHETIC THERAPEUTIC SUBSTANCES OF TRADITIONAL CHINESE MEDICINES IN TAIWAN

The adulteration by synthetic therapeutic substances of traditional Ch inese medicines has been reported on various occasions and has been a public health concern in Taiwan over the past several years. A large-s cale effort was initiated in 1992 to screen traditional Chinese medici nes that were suspected of adulteration with synthetic therapeutic sub stances. The term ''adulteration'' refers to traditional Chinese medic ines that are tested and found to contain chemical substances not pres cribed or labeled as part of the intended use. A total of 2,609 sample s were collected by eight major general hospitals in Taiwan. Samples w ere collected through physicians' referrals during patient visits. The samples were analyzed by hospital pharmacists following the establish ed standard procedures in comparison to references by thin-layer chrom atography. An average of 23.7% (n = 618) of the samples collected from the eight hospitals were adulterated. Four samples with either a rheu matoid or an antiinflammatory indication contained six different kinds of adulterants. More than half (52.8%) of the adulterated traditional Chinese medicines contained two or more adulterants. The sources of a dulterated samples and their claimed indications, as well as the most frequently detected synthetic therapeutic substances, are presented in this report. The controversies regarding the combination of synthetic therapeutic substances and traditional Chinese medicines without adeq uate labeling should be resolved through regulatory actions for better safety of drug use.