title: Post-marketing safety monitoring of shenqifuzheng injection: a solution made of dangshen (Radix Codonopsis) and huangqi (Radix Astragali Mongolici).
abstract: OBJECTIVE
  To identify the potential risk factors associated with Shenqifuzheng injection (SFI), a solution made of Dangshen (Radix Codonopsis) and Huangqi (Radix Astragali Mongolici), for the timely provision of information to regulatory authorities.
  
  
  METHODS
  A comprehensive analysis of the production process, quality standards, pharmacology, post-marketing clinical studies, and safety evaluation using the primary literature of adverse reactions (ADR), case analyses, and systematic reviews, intensive hospital safety monitoring of post-marketing drugs, and data provided by the hospital information system (HIS).
  
  
  RESULTS
  Sub-acute toxicity tests suggesting that a dose of 15 mL/kg (concentrated solution) had specific biological effects, whereas a smaller dose engendered no observable effects. Long-term toxicity testing in domestic rabbits showed that after SFI was administered for 90 days, the animals in each dosing group showed no chronic toxic reactions. Among 20 100 cases observed, the incidence of an ADR was 1.85 per thousand. From March to November 2013, of the leading institutions and 22 sub-centers involved in the post-marketing clinical safety intensive hospital monitoring, 21 units completed 8484 cases of monitoring, and reported 23 cases of adverse reactions. No damage to renal function was found using SFI at a dosage and a treatment course larger and longer than that recommended for the adjuvant treatment of tumors. This could reduce the mortality rate of admitted patients based on the analysis of the data provided by the HIS. A total of 16 clinical case reports of adverse reactions related to SFI in 1999-2012 were obtained through literature retrieval. These reports contained information concerning 17 cases, with adverse reaction symptoms including thrombocytopenia, rash, chills, feeling cold, palpitation, dyspnea, edema of a lower extremity, palpebral edema, and superficial vein inflammation, among others.
  
  
  CONCLUSIONS
  This study introduces "get full access" to the flow of information on medicines regarding their ADR incidence rate and characteristics and factors. It supports the safety of SFI for clinical, research,and production uses based on objective, reliable, and scientific information to provide safe medication.
authors.forename: Qinghua
authors.initials: Q
authors.lastname: Ai
authors.forename: Wen
authors.initials: W
authors.lastname: Zhang
authors.forename: Yanming
authors.initials: Y
authors.lastname: Xie
authors.forename: Wenhua
authors.initials: W
authors.lastname: Huang
authors.forename: Hong
authors.initials: H
authors.lastname: Liang
authors.forename: Hui
authors.initials: H
authors.lastname: Cao
mesh_terms: D000818:Animals; D027883:Astragalus Plant / Q000737:chemistry*; D002681:China / Q000453:epidemiology; D029745:Codonopsis / Q000737:chemistry*; D064420:Drug-Related Side Effects and Adverse Reactions / Q000453:epidemiology*; D004365:Drugs, Chinese Herbal / Q000009:adverse effects* / Q000191:economics / Q000633:toxicity; D006801:Humans; D023421:Models, Animal; D011358:Product Surveillance, Postmarketing
chemical_list: D004365:Drugs, Chinese Herbal