NEJM Letters to Editor Discuss Herbals and PDRs

NEJM Letters to Editor Discuss Herbals and PDRs

BOSTON--In a letter to the editor published in the April 19 New EnglandJournal of Medicine (NEJM) (344, 16:1255, 2001) (www.nejm.org),concerns were expressed over herbal products cited in the Physicians' DeskReference (PDR). Carl Lawyer, M.D., from the Milwaukee Medical Clinic, stated inhis letter that the PDR includes herbal medications (such as Samra Health &Beauty's Calm Colon) that contain "toxic" ingredients that lead toadverse events and that the guide's editors should review its policies inincluding these type of products. A Calm Colon capsule contains 500 mg of a 5 to1 ratio of an aqueous extract of 20 herbs meant to aid irritable bowel syndrome.Samra had not commented on this letter by press time.

In the same NEJM, Mukesh Mehta, a spokesperson for the PDR, respondedto Lawyer's concerns. He concurred with Lawyer that "Calm Colon" wasan inappropriate inclusion to the PDR and that the company was taking measuresto prevent similar oversights in the future. He also said that "[w]e haveattempted to address the recent proliferation of unapproved dietarysupplements" by developing the PDR for Herbal Medicines and the PDR forNutritional Supplements. "These references supply physicians with detailedinformation on the actions and pharmacology of specific herbs and supplements,including their potential for toxicity and the circumstances in which they arecontraindicated," Mehta wrote.