  |
|
 |
|
Advertisement  |
October 28, 2015
Why and How Dietary Supplements Send Users for
Emergency Care Atlanta—Pharmacists might offer this caution to customers loading up on dietary supplements: The products might not always be as safe as you think. A special article published recently in The New England Journal of Medicine suggests that, from 2004 through 2013, dietary supplements were implicated in an average of 23,000 emergency department visits and 2,000 hospitalizations annually. The review, led by researchers from the CDC in Atlanta, notes, “Although the numbers of emergency department (ED) visits and hospitalizations were less than 5% of the numbers that have been reported for pharmaceutical products previously, dietary supplements are regulated and marketed under the presumption of safety.” Interestingly, while most concerns about dietary supplements center around older users and children, 28% of ED visits for supplement-related adverse events in the study involved young adults between the ages of 20 and 34 years, according to the report. More than half of the visits were caused by weight-loss or energy products, usually cardiac symptoms such as palpitations, chest pain, or tachycardia. “Notably, cardiac symptoms were documented more frequently in emergency department visits for adverse events associated with weight loss (43%) and energy products (46%) than for prescription stimulants,” study authors point out, adding that a previous study found that 23% of ED visits were related to prescription stimulants. “Unlike over-the-counter or prescription medications, there are no requirements to identify adverse effects on dietary-supplement packaging,” the researchers explain, suggesting that healthcare professionals should better educate patients about potential cardiac effects from the products. Another issue discussed in the article was unsupervised ingestion by children, causing more than 21% of all estimated ED visits for supplement-related adverse events. Products most commonly involved are multivitamins (33.6%), iron supplements (11.8%), supplements for weight loss (10.4%), and supplements for sleep, sedation, or anxiolysis (8.8%). The report points out that child-resistant packaging is not required for dietary supplements other than those containing iron, although that restriction does not seem to be working as effectively as it could since iron supplements were high on the list of unsupervised ingestion by children. Swallowing problems caused nearly 40% of ED visits for supplement-related adverse events for older adults, with micronutrients implicated in more than 80% of those visits. While the FDA recommends limiting the size of pharmaceutical tablets to 22 mm and requires the reporting of tablet size and shape on abbreviated new-drug applications, no similar size recommendations or similar reporting requirements exist for dietary supplements. “Large amounts or multiple types of micronutrients are often packaged in a single large pill, and many micronutrient products approaching or exceeding 22 mm are commercially available,” according to the report, which adds, “Considerations for reducing the number of emergency department visits for swallowing problems include decreasing the size of supplement pills or using other delivery vehicles (e.g., liquids, gels, or powders), particularly for micronutrients for older adults, along with educating patients on methods for avoiding swallowing problems.”
|
Connect With U.S. Pharmacist     |
|
