When someone talks about alternative or complementary medicines what do you think of?

• vitamin and mineral supplements?
• herbal and natural medicines?
• traditional Chinese medicines?
• traditional remedies used by your family or community?
• the oils used in aromatherapy?

All these products are complementary or alternative medicines, even though we don't always think of them as being 'real' medicines. They are medicines because they prevent or treat illness by changing the way the body works.

Although complementary medicines are generally safer and less potent than prescription medicines, they still need to be used with care. Like other medicines, they can cause side effects in some people, and they may interact with other medicines.

Complementary medicines can interact
with prescription medicines

Quality, safety and effectiveness

Manufacturers of complementary medicines sold in Australia must comply with certain quality and safety standards. However, when it comes to providing evidence of their effectiveness, they are not vetted as thoroughly as prescription and pharmacy medicines.

The less thorough vetting process does not mean that complementary medicines don't work. Rather, it means that manufacturers don't have to provide as much scientific evidence as they do for prescription and pharmacy medicines. This usually means that less is known about the effectiveness, side effects and interactions of complementary medicines than is the case for prescription and pharmacy medicines.

Choose carefully

It is best to seek advice from someone with the relevant training and experience when choosing a complementary medicine, be it a doctor, pharmacist, naturopath or Chinese medicine practitioner. Seek advice about suitable brands, how much to take, how often to take it, and what side effects and interactions to look out for.

If using a traditional or herbal medicine made up by a practitioner, make sure that the person treating you is suitably qualified and is a member of a recognised professional organisation. Reputable organisations include the National Herbalist Association of Australia, the Australian Natural Therapists Association, and the Australian Acupuncture and Chinese Medicine Association.

If you are choosing a medicine, obtain as much information about the medicine and its use as you can, buy a reputable brand, and read the label. Be aware that just because a medicine is 'natural', it does not necessarily mean it is safe for everyone: it is still a medicine, so it may have adverse effects in some people.

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Side effects and interactions

Like all medicines, complementary medicines affect the way the body works, so they can cause side effects in some people. For example, echinacea, a remedy for the common cold, has over 20 known side effects, including asthma attacks, aching muscles and stomach upsets.

Complementary medicines can also interact with some prescription medicines. For example, St John's wort can interfere with the working of the oral contraceptive pill, causing bleeding between periods and pregnancy.

Most side effects and inter-actions involving complementary medicines are minor. However, some are serious.

Tell your health professionals

The possibility of side effects and interactions between medicines means that it is important to tell all your health professionals about all the medicines you are taking—prescription, pharmacy and complementary—especially when starting a new medicine. You also need to tell them about any changes to your medicines. Keeping a list of your medicines and carrying it in your handbag or wallet will make this task easier.

In most cases, you don't need to be worried about telling your doctor about your use of complementary medicines, because doctors' attitudes to such medicines have changed in recent years. They may not be convinced that all complementary medicines are effective, but will appreciate being told about your use of them.

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Sources of information

Obtaining comprehensive and reliable information about complementary medicines can be difficult. However, if you want information try

• talking to your doctor, pharmacist, herbalist, naturopath, etc
• ringing Medicines Line on 1300 888 763
• searching the Internet.

Thousands of websites provide information about complementary medicines. However, be careful which sites you use, because many are just selling a product and don't provide reliable information. Good sites include

• www.healthinsite.gov.au/topics/Complementary_and_Alternative_Therapies
• www.mydr.com.au and go to 'Complementary Medicine Centre'
• www.nccam.nih.gov
• www.uq.edu.au/accmer
• www.choice.com.au, and go to 'Health', then 'Alternative medicine'.