title: Adverse Effects of Common Drugs: Dietary Supplements.
abstract: Dietary supplement-induced adverse effects often resolve quickly after discontinuation of the offending product, especially in younger patients. The potential for unwanted outcomes can be amplified in elderly patients or those taking multiple prescription drugs, especially where interactions exist with drugs metabolized by cytochrome P450 enzymes. Attributing injury or illness to a specific supplement can be challenging, especially in light of multi-ingredient products, product variability, and variability in reporting, as well as the vast underreporting of adverse drug reactions. Clinicians prescribing a new drug or evaluating a patient with a new symptom complex should inquire about use of herbal and dietary supplements as part of a comprehensive evaluation. Clinicians should report suspected supplement-related adverse effects to the local or state health department, as well as the Food and Drug Administration's MedWatch program (available at https://www.safetyreporting.hhs.gov). Clinicians should consider discussing suspected adverse effects involving drugs, herbal products, or dietary supplements with their community- and hospital-based pharmacists, and explore patient management options with medical or clinical toxicology subspecialists.
authors.affiliation: Department of Family and Community Medicine at Penn State Milton S Hershey Medical Center, 500 University Drive H154, Hershey, PA 17033.
authors.forename: Todd Matthew
authors.initials: TM
authors.lastname: Felix
authors.affiliation: Department of Pharmacology at Penn State Milton S Hershey Medical Center, 500 University Drive R130, Hershey, PA 17033.
authors.forename: Kelly Dowhower
authors.initials: KD
authors.lastname: Karpa
authors.affiliation: Department of Family and Community Medicine at Penn State Milton S Hershey Medical Center, 500 University Drive H154, Hershey, PA 17033.
authors.forename: Peter R
authors.initials: PR
authors.lastname: Lewis
mesh_terms: D016907:Adverse Drug Reaction Reporting Systems; D000367:Age Factors; D019587:Dietary Supplements / Q000009:adverse effects*; D004347:Drug Interactions; D064420:Drug-Related Side Effects and Adverse Reactions; D006801:Humans; D012307:Risk Factors; D014481:United States