A descriptive study of commercial herbal dietary supplements used for dyslipidemia—Sales data and suspected adverse reactions

Abstract

Herbal dietary supplements (HDS) used for dyslipidemia represent a category of concern in Italy for suspected adverse reactions (ARs). However, we cannot estimate their safety, as we do not know their commercial profile. Sales data of HDS, and particularly, those used for dyslipidemia, were monitored for 2 years in two pharmacies of Rome. Meanwhile, spontaneous reports of suspected ARs potentially related to dyslipidemia supplements were collected by the Italian Phytovigilance System. The 50% of the total dietary supplements are herbal‐derived; the 9% of HDS are recommended for dyslipidemia. From our data, 113 different brands have claims for improving lipids profile and 91% of them are multiingredient preparations. Fifteen spontaneous reports of suspected ARs concerned HDS used, for dyslipidemia. The most frequent ARs were joint, abdominal, and muscles pain; vomiting; erythema and hematological disorders; nausea; and rhabdomyolysis. Our findings point out the limited compliance of commercial dyslipidemia‐HDS and scientific research about their intrinsic safety. A wide range of ingredients could not support the risk/benefit profile of the supplement. The variable compositions of HDS do not assure the safety, as they do not support the reproducibility of their pharmacological activities. This study could contribute to optimize consumer guidance about what they purchase and consume.

Rhabdomyolysis Risk: The Dangers of Tribulus Terrestris, an Over-the-Counter Supplement

“…Drug-induced rhabdomyolysis is well described, especially among the statin medication class [1][2][3]. Rhabdomyolysis contributed to by herbal supplementation, including but not limited to licorice, red yeast rice, and jimson weed, is less well described, but there are reports found in the literature [4,5]. An area where there remains a paucity of research involves drug interactions between the statin medication class and herbal supplements.…”

Case Report: Rhabdomyolysis secondary to vildagliptin overdose in a suicidal attempt: A case report and brief literature review

“…Previous studies have shown that the drugs most likely to cause rhabdomyolysis include psychiatric agents, antihistamines, illicit substances, and those affecting the cytochrome P450 system, such as statins ( Sauret et al, 2002 ; Hohenegger, 2012 ). In addition, concomitant use of Chinese herbal medicine and herbal dietary supplements (HDS) has been shown to be associated with rhabdomyolysis based on case reports and spontaneous reports of suspected adverse events ( Li et al, 2020 ; Allkanjari et al, 2022 ). Dipeptidyl peptidase (DPP)-4 inhibitors, one of the safest oral hypoglycemic agents that reduce the degradation of GLP-1, are usually not considered to cause rhabdomyolysis ( Mulvihill and Drucker, 2014 ; Marx et al, 2021 ).…”