Warning of risks in surgery for patients on some herbal remedies

Ireland's chief pharmacist says patients about to undergo surgery should tell their doctors if they take herbal remedies. This follows a US report, published today, which warns that such remedies may cause serious health complications.

The comments of Mr Tom McGuinn, chief pharmacist at the Department of Health, coincided with publication of the report, which found that popular medications - including garlic, St John's Wort and ginseng - could cause excessive bleeding and other complications.

The substances "potentially pose the greatest impact to the care of patients undergoing surgery", according to anaesthesiologist Michael Ang-Lee, of the Pritzker School of Medicine at the University of Chicago, writing in the Journal of the American Medical Association.

St John's Wort became a prescription-only medication in Ireland in January 2000, at which time it was estimated that about 70,000 Irish people were taking it. However, other products examined in the US report are still available over the counter in the State.

The report estimated that as many as one-third of surgical patients in the US used the remedies referred to, but 70 per cent did not tell their doctors. Eight herbal products, accounting for more than half of the single-herb preparations sold in the US, were reviewed in the study.

It was found that they may interact with drugs prescribed for surgery and may prevent clotting or increase the potency of anaesthetics, even if their use has been stopped days before.

The report says that garlic, gingko and ginseng could cause bleeding when combined with commonly prescribed drugs used in surgery. Ephedra could cause irregular heartbeat; ginseng may exacerbate low blood sugar; kava and valerian could exaggerate the impact of anaesthetics; St John's Wort could speed up the metabolism; and echinacea posed a risk of poor wound-healing and infection.

However, Green Party TD Mr Trevor Sargent, who is an advocate of herbal remedies, said that people should not accept the report's findings unquestioningly. He commented: "It's important that people are not browbeaten into turning their backs on herbal medicine. They should inform themselves and make sure their GPs are also properly informed, which very few of them are, unfortunately."

The Irish Medicines Board recently established a committee, made up of medical experts and other interested parties, to investigate herbal remedies.