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How to be safer with your complementary medicines What about my complementary medicines?

Complementary medicines are used by many people, but they still need to be used with care. Read how you can use complementary medicines safely.

Contents

What about my complementary medicines?

FAQs

Story

What about my complementary medicines?

Many people like to use complementary medicines, which include:

  • natural and herbal medicines
  • alternative or holistic remedies
  • traditional remedies
  • homeopathy
  • aromatherapy oils
  • vitamins and minerals (although these can be part of medical treatment too).

Complementary medicines are often less powerful than prescription medicines — but they still need to be used with care. Like all medicines, they can have benefits. However, they can also have side effects, cause allergic reactions, and may interact with prescription medicines.


Video: Complementary medicines or mainstream medicines — how I decide

©2011 NPS
Run time: 1:11m (14.3 MB)

Video transcript

I tend to try alternative medicine for myself first, because when it’s for the kids it’s hard for them to gauge whether it’s working or not. With myself I know instantly, or fairly quickly, if it’s working for me, so that’s what I tend to do.

I haven’t had a lot of experience with a lot of different medicines, other than the ones you can buy over the counter. But, for example, having done a lot of travelling, if I come back with a nasty bug I know there’s no point — I just go straight for the, you know, cold, hard, medication, antibiotics or whatever, that’s going to get rid of that. And I know there are side effects with that, but I weigh that up against what I’m suffering and the importance of getting rid of that. So that’s an easy decision for me to make.

If I go with something like perhaps a digestive issue, and the doctors need to perform a lot of tests and they need to do all sorts of things. And often you sort of feel like you’re going on this long road and not really getting anywhere — and I have gone down that road — then I might find out what the doctor thinks, and then I’ll go and try some sort of alternative therapy.


Be open with your health professional

As with all medicines, tell your health professional about any complementary medicines you are taking — that way you can avoid potentially harmful interactions with your prescription or pharmacy medicines.

Health professionals know many people use complementary therapies. They may not be convinced that all of them are effective, but they will appreciate knowing about any you are taking.

Keeping a Medicines List will help you remember all the medicines you are taking.

Effectiveness of complementary medicines

Most complementary medicines do not have to be proven to work in the same way that prescription and pharmacy medicines do before they can be sold in Australia. Compared with prescription and pharmacy medicines, complementary medicines undergo less testing in general, so less is known about their effectiveness, side effects and interactions.

Manufacturers of complementary medicines sold in Australia still have to comply with quality and safety standards for their products and have some evidence to back up their claims. For more information on the Government rules for complementary medicines sold in Australia, see the Therapeutic Goods Administration’s The regulation of complementary medicines in Australia – an overview webpage.

Some complementary medicines have been tested in good quality scientific trials to show that they are effective, but most have not.

One complementary medicine that has been tested is fish oil: scientific trials have shown that fish oils high in EPA and DHA lower triglycerides and increase high-density lipoprotein (HDL) cholesterol (i.e. the good cholesterol) and may help people with coronary heart disease.
Get more information on fish oil (one source of omega 3 oils) from the Australian National Heart Foundation.


Sometimes complementary and prescription medicines don’t mix well

St John’s Wort is an example of a complementary medicine that can interact with many prescription medicines. Make sure you tell your health professional if you are taking St John’s Wort so you can avoid interactions with your other medicines.

In most of its interactions, St John’s Wort makes the other medicine less effective. This is the case with:
  • birth control pills
  • warfarin and other medicines used to thin the blood
  • epilepsy medicines
  • digoxin, a medicine used for heart conditions
  • HIV medicines
  • chemotherapy medicines
  • medicines used to prevent rejection after an organ transplant.

St John’s Wort may interact with some antidepressants and increase the risk of side effects.

St John’s Wort has shown some benefit in clinical trials for mild depression, but not for more severe depression. Make sure you talk to your health professional if you think you are depressed so you get the best treatment for your situation.

Like all medicines, St John’s Wort can also have side effects. The most common side effects of St John’s Wort include dry mouth, dizziness, diarrhoea, nausea, increased sensitivity to sunlight, and fatigue.

Related topics

Know the dose you are taking

Many complementary medicines are available in a variety of strengths and they may often contain several active ingredients. It can be difficult to work out what is the best option or to compare alternative brands.

If you are choosing a medicine, obtain as much information about the medicine and its use as you can, and read the label so you know the active ingredients it contains and the amount of each.

Also keep in mind that if you change from one brand of a complementary medicine to another, it may contain a higher dose of the active ingredients. This may mean it has a stronger effect on your prescription medicines and may trigger an interaction that you did not have before.

Related topic

Seek advice

It is best to seek advice from a qualified person when choosing a complementary medicine. Seek advice about suitable brands or formulations, how much to take, how often to take the medicine, and what side effects and interactions to look out for. Ask if there will be any effect on your other prescription or pharmacy medicines.

Where to find good information on the internet

There are thousands of websites providing information about complementary medicines. However, many of these are designed to sell products and the information they provide is often not reliable.

Some good websites with information about complementary medicines include:

 • MedlinePlus

 • myDr

 • US National Institutes of Health National Center for Complementary and
    Alternative Medicine (NCCAM)

 • HealthInsite

The topics below will help you find good websites.

Related topics

Story — Could a complementary medicine help? A story about hot flushes

I’ve always had an open attitude to health. I like to know what’s out there and to learn about different treatments, especially natural ones. I’m going through menopause at the moment and the hot flushes are a nuisance. A friend told me about a herbal medicine, black cohosh, and said that it worked well for her.

I decided to look into it. My hot flushes don’t last too long, but sometimes I get them at night and have trouble sleeping. I started browsing on the internet and found a website from the US that said black cohosh had been used by the native North Americans for a couple of hundred years for menopause. It said I could buy black cohosh from their website and get it delivered to Australia.

This set off alarm bells for me, because I like to know that any complementary medicines I buy have been through some sort of check. There can be too many unknowns if you buy something direct from overseas — sometimes they don’t even contain the ingredients they say they do. I was also worried that if the website was written by the people selling it, they might just put all the positive information and not the down sides.

So I checked the NCCAM (National Center for Complementary and Alternative Medicine) website, which is run by the US National Institutes of Health. It said the results of scientific studies on black cohosh were mixed — that is, some said it worked while others said it didn’t. I kept reading and then saw that black cohosh might be linked to liver damage. It was rare, but it made me feel less comfortable.

The more I thought about it, the more it felt like a risk that I didn't want to take. Some people have a really bad reaction to certain medicines, and how would I know if that would be me with black cohosh? I wasn’t sure about it, even if it did work for my friend.

If I’m going to take a medicine, I want it to be safe.

While I was on the NCCAM site, I thought I would see what it said about valerian — another friend uses it to help her sleep. The website said it may be helpful for insomnia, but there wasn’t a huge amount of research to confirm it. There didn’t seem to be anything about safety that worried me. So maybe that’s an option.

I talked to my GP about the hot flushes, and she said I could think about hormone replacement therapy (HRT) if they were really bad, because it was still the most effective proven treatment. She said HRT came with its own risks too, including a small increase in breast cancer risk and other problems that I would need to take into account.

How would you compare HRT to black cohosh? My GP agreed it was difficult. But she said we had to think about the quality of the information available. She pointed out that the risks of HRT were identified in huge studies involving thousands of women. Those kinds of studies haven’t been done for black cohosh, so it’s like comparing apples and oranges.

We know there is a risk with HRT but we also know the size of it. She said if 1000 women took HRT for 5 years, an extra four women (and maybe fewer with shorter treatment) would get breast cancer because of it compared to women who didn’t take it. But for black cohosh and other treatments, we simply don’t know. My GP stressed it was my choice and she suggested I take some time to think about the risks and benefits of both options. She gave me lots of information about exercise and diet and other ways to stay healthy during menopause, and a few tips like avoiding alcohol, hot drinks and spicy food, since they can bring on hot flushes.

I decided that if the hot flushes were unbearable, I might feel differently, but I think I’ll just try to keep cool without taking anything for now — except maybe some valerian tea at night.

This is a fictional account for educational purposes.

MEDICINEWISE CHOICES

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Date published: 2011-01-24 00:00:00

Reasonable care is taken to provide accurate information at the date of creation. This information is not intended as a substitute for medical advice from a qualified health professional. Health professionals should rely on their own expertise and enquiries. Where permitted by law, NPS disclaims all liability (including for negligence) for any loss, damage or injury resulting from reliance on or use of this information. Read our full disclaimer.

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