ABSTRACT
Introduction .................................................................................................................................. 233 Immediate Hypersensitivity Reactions ........................................................................................ 234 Contact Allergic Dermatitis ......................................................................................................... 236 Other Adverse Reactions ............................................................................................................. 236
Delayed Asthmatic Reactions............................................................................................... 236 Rashes ................................................................................................................................... 236 Hepatitis ................................................................................................................................ 236 Toxicity ................................................................................................................................. 237 Other Reported Adverse Reactions ..................................................................................... 237
Use in Pregnancy, Breast Feeding, and Children........................................................................ 237 Drug Interactions, Contraindications, and Precautions ............................................................... 238
Known Hypersensitivity to Asteraceae................................................................................. 238 Liver Disease......................................................................................................................... 238 Interference with Hepatic CYP3A4 Enzyme Activity ......................................................... 238 Anticoagulant Use................................................................................................................. 239 Autoimmune Disease and Chronic Infection ....................................................................... 239 Tissue Transplantation and Surgery ..................................................................................... 239 Interaction with Alcohol, Diuretics, and Hypoglycemic Agents ......................................... 240
Conclusions ................................................................................................................................. 240 Acknowledgments ........................................................................................................................ 240 References .................................................................................................................................... 240
Fifty percent of Australians report using some form of complementary alternative medicines (CAM) apart from vitamins in any 12-month period, with similar patterns of use in British and North American subjects (Eisenberg et al., 1993; Maclennan et al., 1996, 2002; Schafer et al., 2002). Despite the common perception that “natural therapy” is safe, toxic and hypersensitivity reactions to CAM have been described (Drew and Myers, 1997; Mullins and Heddle, 2002; Shaw et al., 1997; Vickers and Zollman, 1999). Given that these products are rarely packaged in childproof containers, accidental exposure also occurs (Anderson, 1996; Portansky, 1998). Allergic reactions are most common in atopic subjects. This is not surprising when one considers that up to 20% of atopic subjects use CAM. Furthermore, these patients are more likely than others to become sensitized to cross-reactive allergens and some use (or are advised to use) products such as
Echinacea
for treatment of allergic disease (Healy et al., 2002; Mullins, 1998).
