Safety profile of traditional Chinese herbal injection: An analysis of a spontaneous reporting system in China

Pharmacoepidemiol Drug Saf. 2019 Jul;28(7):1002-1013. doi: 10.1002/pds.4805. Epub 2019 May 27.

Abstract

Purpose: Although a series of serious adverse events have continually raised concerns about the potential toxicity of traditional Chinese medicine injections (TCM injections), studies on this subject are still sparse. We conducted a descriptive analysis of a spontaneous reporting system in China to describe the safety profile of TCM injections.

Methods: The safety profile of TCM injections is described by descriptive analysis of 559 066 adverse reports collected from Guangdong Provincial Center for adverse drug reaction (ADR) Monitoring in China during 2003 to 2017.

Results: The percentage of new or serious ADRs of TCM injections is much higher than average percentage of China's spontaneous reporting system (SRS) as a whole (48.70% vs <25%). Compared with conventional injections, TCM injections have a slightly lower percentage of serious ADRs (6.02% vs 6.72%) and much higher percentage of unknown (new) ADRs (46.74% vs 24.13%). The gender and age distribution for TCM injections are similar to conventional injections. The reporting rates of ADRs increased with age. Anaphylactic shock and anaphylactoid reaction are high-risk ADRs for TCM injections and, anaphylactic shock is ranked number 1 in causing deaths (50.00%).

Conclusions: There are some differences and similarities on the safety profile between TCM injections and conventional injections. TCM injections have higher risk of adverse effects than any other dosage forms of TCM medications and higher percentage of new or serious adverse effects than conventional injections. A lot of work need to be done to clarify the huge amount of potential unknown adverse effects related to TCM injections.

Keywords: adverse drug reaction; pharmacoepidemiology; spontaneous reporting system; traditional Chinese herbal injection; traditional Chinese medicine.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Anaphylaxis / chemically induced
  • Anaphylaxis / epidemiology
  • China / epidemiology
  • Drug-Related Side Effects and Adverse Reactions / epidemiology*
  • Drug-Related Side Effects and Adverse Reactions / etiology
  • Drugs, Chinese Herbal / adverse effects*
  • Female
  • Humans
  • Injections
  • Male
  • Medicine, Chinese Traditional / adverse effects
  • Middle Aged
  • Pharmacoepidemiology
  • Young Adult

Substances

  • Drugs, Chinese Herbal