[Herbal medicine - Adverse effects and drug-interaction.].
OBJECTIVE
The aim of the study was to estimate the frequency of adverse effects and drug-interactions attributable to the use of herbal medicine and dietary supplements in Iceland. A further objective was to assess the perception and attitudes of Icelandic physicians towards these products.


METHODS
A questionnaire was sent to all physicians registered in Iceland, a total of 1083. Physicians were questioned as to whether they had become aware of adverse effects or drug interactions that could be related to the use of herbal medicines or dietary supplements. Several questions concerned education and attitudes towards these products. A search was made using the computer system of the University Hospital in order to find cases of hospitalization resulting from consumption of herbal medicine. Details on admissions to the Emergency Department of the hospital were studied daily for one month. Enquiries made to the Icelandic Poison Center from 1997-2000 and formal reports submitted to the Icelandic Medicines Control Agency and the Surgeon General were examined.


RESULTS
Of the 410 physicians that responded, 134 had become aware of adverse effects and 25 had become aware of herbal/drug interactions. Details on 253 adverse effects and 13 interactions were presented. Hospitalization was estimated to have been the consequence of 38 cases, 14 of which had been considered life-threatening. Of those who responded, 17% reported asking their patients always/frequently if they used herbal medicines or dietary supplements, whilst 62% reported asking occasionally/ seldom and 19% never asking. Approximately 55% of the respondents regard it as being very important/important that patients consult a physician before using herbal products or dietary supplements.


CONCLUSIONS
Adverse effects and interactions between herbal medicines/dietary supplements and prescribed drugs appear to be under-reported in Iceland. It is important to increase awareness and education in this field amongst physicians and other health-care professionals in Iceland.
Thornórhallsdóttir
Olœf
O
Department of Pharmacy, University of Iceland, 101 Reykjavík, Iceland. olof@omega.is.
Ingólfsdóttir
Kristín
K
Jóhannsson
Magnús
M