What’s on the Label? Limited Information

A scan of labels on several supplements carried by a Los Angeles medical center pharmacy found a wide variation in the level of warnings about potential interactions, showing the limited information available to consumers.

Several brands included generic warnings:

* “If pregnant or nursing or taking a prescription drug, consult a health care practitioner,� stated the label for kava kava from NaturaLife of Provo, Utah.

* “As with any supplement, if you are taking a prescription medication, or if you are pregnant or nursing a baby, contact your physician before using this product,� cautioned labels for products such as St. John’s wort, ginseng, echinacea, ginkgo and saw palmetto in the Centrum Herbals line from Whitehall-Robins Health Care of Madison, N.J.

Some product labels cautioned about combining a supplement with a class of drugs:

* “Do not mix with pharmaceutical sedatives or MAO inhibitors,� warned Kavatrol, a kava kava product from Natrol Inc. of Chatsworth.

Others advised against combining with certain drugs unless a doctor is consulted:

* “If you are taking prescription antidepressant medication, consult your physician before using this product,� warned SAM-e from Nature Made of Mission Hills. SAM-e is believed to affect mood and mental functions.

* “If you are currently on any antidepressant medication, Alterra should not be taken unless directed by a physician,� said the label for Alterra, a St. John’s wort product from Upsher-Smith of Minneapolis.

Still other products contained no interaction information, only a caution about sun sensitivity. HyperiMed, a St. John’s wort product from PhytoPharmacia of Green Bay, Wis., included such a warning.

Susan Loscutoff, a toxicologist in the food and drug branch of the California Department of Health Services in Sacramento, has been studying label warnings.

“When you try to be specific about a particular supplement, you end up with a lot of potential warnings that can be really confusing,� she said.

Her office has informally proposed to interested groups like the Council for Responsible Nutrition, a national trade association, and the Marin County pharmacists association that labels include the generic warning: “If you have a medical condition, are pregnant or are nursing a baby, talk to a health professional before using this product.� By including consumers with a medical condition instead of simply those taking prescription drugs, the warning would include people with something like an autoimmune disease, whose health might worsen if they take an immune system stimulant such as echinacea or zinc.