Herbal medicines for children: an illusion of safety?

Herbal medicaments are in common use. In general, the judicious use of care fully selected and prepared herbal medications seems to cause few adverse e ffects and may be beneficial. However, toxic effects of these products have been reported with increasing frequency. infants and children may be even more susceptible to some of the adverse effects and toxicity of these produ cts because of differences in physiology, immature metabolic enzyme systems , and dose per body weight. Although information promoting the use of herba l medicine is widespread, true evidence-based information about the efficac y and safety of herbal medications is limited. Although the most conservati ve approach is to recommend against use of herbal medicine until such evide nce is available, some patients are not receptive to this approach. A reaso nable approach for health care providers may be to follow such use closely, assist in herbal therapeutic decisions, and monitor for adverse effects an d interactions. This manuscript discusses general concepts about herbal med icines, public health implications, and a framework for mechanisms of adver se effects from the use of botanicals, Adverse effects and toxicity of sele cted herbal products, including Chinese herbal medicines, are presented. Th e authors propose a risk reduction approach in which physicians actively se ek information about the use of complementary or alternative medicine while taking medical histories. (C) 2001 Lippincott Williams & Wilkins. Inc.