Herbal V8 and VW for Sexual Stimulation

Potency Herbs for Men and Women

Our tonics to help improve your sexual health:

Herbal V8 and Herbal VW

Natural Herbs
Problems of Sexual Stimulation
Herbal Potency for Men and Women
Herbs can help to improve sexual function and control
Herbs can stimulate the blood flow to the sexual organs
Herbs for erectile dysfunction
Herbs can promote sexual longevity
Herbs can promote sexual health
For herbs for premature ejactulation see PE-Less

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Hello Alan, the herbalv8 and testos4torros are fantastic! made me feel/act like in my 20ties... in the "love-department" (i'm 46) Thank You for your great work! Stephan. Switzerland

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I found your Herbal V8 really good. I have a wife and 2 kids and I had erectile dysfunction and tried many things until I took your V8 tonic. I liked it also cos it was natural and safe. Thanks it was really good.
Adrian. Essex.

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Herbal V8 is for men.
Herbal VW is for women.

We are trying to rival Viagra(TM) with traditional and researched herbal medicines for sexual health for women and men. it's a common condition and it's normal to want to improve your feelings and performance for yourself and your partner. What's more herbs are often bought not because of sexual shortfall but for promoting what is there already.
Men: Herbs for potency, hardness, sexual longevity, premature ejaculation (if PE is a chronic problem see our specific tonic for this condition), fertility (be careful).
Women: Herbal VW. Herbs for women's sexuality, sexual desire, sexual enjoyment, sexual confidence, and fertility (be careful).
Specific herbs are beneficial to genital and reproductive health.

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Hi Alan, I'm very happy to report back that your Herbal V8 works superbly; it makes my penis hard as I've not had for a very long time. What's more, the erection lasts a long time.
There's nothing worse (and especially for my partner) that having the desire and urge to make love and have a penis unable to respond. Your Herbal V8 has rejuvenated our relationship. Thank you for this excellent tonic. Mark

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'Dear Mr Hopking, Many, many thanks for recommending Herbal V8, it has enhanced my life as I feel far more energetic when taking it - a superb tonic that really does reach the parts other supplements don't...!
P.S. The wife's impressed as well!'
JP (Wessex, England)

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This tonic has made a man out of me again! Thanks Alan it's restored my love life and I'd recommend it to anyone having problems with potency. Please send me another large bottle.
Andy S.

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Your Herbal V8 is brilliant, plus it gives me a real boost right through the day! It gives me a satisfied smile! Thank you.
TG

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Hi Alan, I'm 65 and I know hormones show signs of decline at my age. Now, I hadn't 'lost it' but I wasn't the man I used to be. I didn't feel I needed to go the way of Viagra. So I decided to try your V8. I kept to a low dose at night. The effects took a little time to build up. I first realised things were improving when night-time erections kept waking me up. My erections became stronger and lasted longer. Quite honestly I feel 18 again!! Very satisfying for my wife and me. My confidence has been given a huge boost. I can't praise this formula enough. Thank you.
Robert, London.

Herbal VW (for women):

Many women enquire about testosterone at menopause as they believe it will help their sex drive and libido but this is best done with progesterone and achieving hormone balance. Progesterone is the natural precursor for testosterone in the body in menopausal women and has been used by men to help with prostate problems. However testosterone supplements should only ever be taken under the direct supervision on a medical doctor to their potential side effects in women.

"Dear Sir, I found myself aged 50 and in the menopause. Of all the symptoms of the menopause, the one I found most difficult to come to terms with was loss of libido. For some reason a diminished libido I found very emotionally distressing.
I therefore began to look for a stimulant that would help alleviate this. I tried something similar to Herbal VW a few years ago, but it was difficult to get hold of and the bottles were very small. Therefore, I was looking to find something more readily available and Herbal VW fits the bill. I have also taken your herbal HRT (FlushLess Tonic) and Herbal VW together.
But now just Herbal VW suits me because it provides the sexual stimulation that I found diminished. It doesn't have any side effects, works within a couple of hours, is made from natural products and is readily available by mail order. It has also given me back a sense of emotional well-being. I have no hesitation in recommending it and have done so to similar aged people."
Jenifer

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Hormonal Herbal Tonics for Men
1. Herbal V8 - for mature men with problems of potency and for ED (erectile dysfunction): Find it in our store - See how you can boost your testosterone with foods here

2. ProTest Tonic - this is a specific formula for men to balance the progesterone action and testosterone to improve the waistline and the male hormones during male changes in middle age. Find it in our store

3. Testos4Torros Tonic - this is a specific strong testosterone stimulating herbal tonic for men of all ages. Find it in our store - See how you can boost your testosterone with foods here

Hormonal Herbal Tonics for Women
1. Herbal VW for Women - This is a sexual stimulant for women containing the following herbs: Pasque flower, Sable Berry, Black Haw, Chaste Tree fruit, Rehmannia fruit, Cinnamon seed, Epimedium, Dong Gui, Turnera, Cnidium, Liriosma. Find it in our store

2. Progestereronal Tonic - for women with problem hormones with low progesterone. We also have wild yam cream to help. Find it in our store

3. FlushLess Tonic - this tonic is for women with menopausal sweats and other issues at this age (e.g. dry skin, etc). Find it in our store

To order these tonics go to our store

Find out about herbal medicine for treatment of this condition

Related tonics:
Testosterone
Cancida Tonic for thrush and candida
Sex-drive for women
PE-Less for premature ejaculation
Fertility Tonics for women and men
WorryLess Tonic for stress, anxiety and worry
ProstateLess Tonic for prostatic symptoms
NerveShield for neurological conditions
TireLess for ME and fibromyalgia
MouthShield - a mouthwash for bad breath and gum disease
WindLess for flatulence and bad wind
SkinClear for eczema and skin disease
SpotLess for acne and teenage spots
BodyBuild Powder to enhance muscles during training
MuscleMore - to strengthen and tone the muscles
Horny Goat Weed
Damiana - for mood enhancement and more

Email - Find out about herbal medicine for treatment of these conditions

To order these tonics go to our store

Below is the latest information about Yohimbe from the American Botanical Council:

Yohimbe bark

Latin Name: Pausinystalia yohimbe
Pharmacopeial Name: Yohimbehe cortex
Other Names: johimbe, yehimbe

Overview
Yohimbe is a tall evergreen forest tree, reaching a height of 90 feet and width of 40 feet, native to southwestern Nigeria, Cameroon, Gabon, and the Congo. The material of commerce is collected in the wild in this same region (Bown, 1995; Keay, 1989; Leung and Foster, 1996; Reichert, 1997).
Yohimbe bark has traditionally been used in western Africa as a sexual aphrodisiac, especially in male erectile disorders, reportedly stimulating both erection and salivation. Medicinal use of yohimbe bark reached Europe in the 1890s. The majority of pharmacological data is on one of its isolated constituents, the indole alkaloid yohimbine, rather than on whole bark preparations (Bown, 1995; Duke, 1997; Grasing et al., 1996; Leung and Foster, 1996). Yohimbine is also found in related trees (Pausinystalia macroceras and P. tillesii) as well as in Indian snakeroot (Rauwolfia serpentina (L.) Benth) and quebracho (Aspidosperma quebracho-blanco). In Africa, P. lane-poolei (pamprana, igbepo) is also used therapeutically. A dressing of the ground bark is applied topically to yaws (an infectious tropical skin disease) and itching skin (Bown, 1995; Budavari, 1996; Duke, 1997).
In Germany, yohimbe bark is the subject of a negative (unapproved) monograph in the Commission E due to lack of data and safety concerns.In the United States, yohimbe bark is widely used in numerous aphrodisiac, athletic performance (as an alternative to anabolic steroids) and male sexual performance dietary supplements. The most commonly prescribed drug for functional impotence is yohimbine hydrochloride (e.g., Afrodex, Aphrodyne, Yocon, Yohimex, Yohydrol), which is often combined with other drugs, including strychnine, thyroid, and methyltestosterone (Leung and Foster, 1996; Tyler, 1993). The Merck Index reports its therapeutic category as an a-adrenergic blocker and mydriatic (causing pupillary dilatation), its use as a pharmacological probe for the study of a2-adrenoceptor, and its uses in veterinary medicine as an aphrodisiac and as an adrenergic blocking agent (Budavari, 1996).
No significant human studies on crude yohimbe bark or its whole extract have been conducted.Numerous studies, however, have investigated the actions of the isolated constituent yohimbine; for example, some pharmacokinetic studies have been performed in humans (Grasing et al., 1996; Owen et al., 1987) and human clinical studies have investigated its use for erectile dysfunction or male impotence (Morales et al., 1987; Reid et al., 1987; Riley, 1994). One study indicated that lower doses of yohimbine, given to patients who are fasting or eating a low-fat diet, may be more effective (Grasing et al., 1996).
There are a few studies showing that yohimbine is effective for some impotence, especially of vascular, diabetic, or psychogenic origins. It can improve the quality and staying power of erections, usually without increasing sexual excitement. The Commission E noted side effects, however, including dizziness, nervousness, and anxiety. To determine its therapeutic efficacy and evaluate the safety of yohimbine in regard to its specific use for erectile dysfunction, a systematic review and meta-analysis of randomized clinical trials was conducted (Ernst and Pittler, 1998). The authors found seven trials that fit the predefined inclusion criteria. Overall methodological quality of those studies was satisfactory. The meta-analysis demonstrated that yohimbine is superior to placebo in treating erectile dysfunction. Serious adverse reactions were infrequent and reversible. The authors concluded that the benefits seem to outweigh the risks. Therefore, yohimbine is considered to be a reasonable therapeutic option for erectile dysfunction (Ernst and Pittler, 1998). This conclusion is based not on the bark but on the isolated constituent yohimbine, which is available as a drug. A review of yohimbine and related yohimbe alkaloids details potential adverse effects and drug interactions (De Smet, 1997).
Though yohimbe bark is freely available in the United States in health and natural food stores, pharmacies, and by mail order, it should be used with caution. It is not recommended for excessive or long-term use and may potentiate pharmaceutical MAO-inhibitors. Its pharmaceutical derivative, yohimbine, can significantly increase blood pressure at oral doses of only 1520 mg (12 mg can induce a hypertensive crisis in patients taking tricyclic antidepressants), produce unpleasant digestive and central nervous system symptoms, and may potentiate hypotensive drugs. A dose as low as 10 mg can induce mania in patients with bipolar depression (Bruneton, 1995; De Smet and Smeets, 1994; Grasing et al., 1996; McGuffin et al., 1997; Osol and Farrar, 1955; Reichert, 1997; Roth et al., 1984). An analysis of commercial yohimbe products sold in the United States revealed that few products were found with any appreciable levels of yohimbine, raising concerns about the quality control of some of these products (Betz et al., 1995).

Description
Yohimbe bark consists of the dried bark of the trunk and branches of Pausinystalia yohimbe (K. Schumann) Pierre ex Beille [syn. Corynanthe yohimbi Schumann] [Fam. Rubiaceae] and its preparations. The bark contains alkaloids. The main alkaloid is yohimbine.

Chemistry and Pharmacology
Yohimbe contains up to 6% indole alkaloids, 1015% of which are yohimbine (quebrachine); also a-yohimbine (isoyohimbine), allo-yohimbine (dihydroyohimbine), yohimbinine, a-yohimbane, yohimbenine, corynantheine, and others (Betz et al., 1995; Budavari, 1996; Leung and Foster, 1996).
The Commission E did not report pharmacological actions.

Uses
The Commission E reported its unofficial use for sexual disorders, as an aphrodisiac, and for feebleness and exhaustion. The effectiveness of this herb and its preparations for the claimed applications is not sufficiently documented in the scientific literature, and thus the Commission E categorized it as an unapproved herb.
The Commission E did not find adequate documentation to support this use. The Evaluation section of the original monograph states, 'The therapeutic administration of yohimbe bark and its preparations is not recommended because of insufficient proof of efficacy and the unforeseeable correlation between risk and benefit.'

Contraindications
In existing liver and kidney diseases and in chronic inflammation of the sexual organs or prostate gland (McGuffin et al., 1997; Reynolds, 1989; Roth et al., 1984).

Side Effects
Therapeutic administration of yohimbine can cause nervous excitation, tremor, sleeplessness, anxiety, increased blood pressure, tachycardia, nausea, and vomiting. In case of existing liver and kidney diseases, yohimbe preparations should not be used. Interactions with psychopharmacological herbs have been reported.

Use During Pregnancy and Lactation
No data available.

Interactions with Other Drugs
May potentiate pharmaceutical MAO-inhibitors and, in high doses, potentiate hypotensive drugs (McGuffin et al., 1997).

Dosage and Administration
Evaluation: The therapeutic administration of yohimbe bark and its preparations is not recommended because of insufficient proof of efficacy and the unforeseeable correlation between risk and benefit (Commission E).

Yohimbine Hydrochloride: 5.4 mg, three times daily (Rice et al., 1996); 6 mg., three times daily (Morales et al., 1987; Reid et al., 1987; Reynolds, 1989; Werbach and Murray, 1994); 15-20 mg per day though higher doses up to 42 mg per day may be more effective (Werbach and Murray, 1994). Other sources state that yohimbine may be more effective at lower doses and that there are significant risks associated with doses over 10 mg (Devi, 1998; Reichert, 1997; Riley, 1994).

References
Betz, J.M., K.D. White, A. Der Marderosian. 1995. Gas chromatographic determination of yohimbine in commercial yohimbe products. J AOAC Int 78(5):11891194.

Bown, D. 1995. Encyclopedia of Herbs and Their Uses. New York: DK Publishing, Inc. 322.

Bruneton, J. 1995. Pharmacognosy, Phytochemistry, Medicinal Plants. Paris: Lavoisier Publishing.

Budavari, S. (ed.). 1996. The Merck Index: An Encyclopedia of Chemicals, Drugs, and Biologicals, 12th ed. Whitehouse Station, N.J.: Merck & Co, Inc.

De Smet, P.A. 1997. Yohimbe AlkaloidsGeneral Discussion. In: De Smet, P.A., K. Keller, Hnsel R., Chandler, R.F. (eds.) 1997. Adverse Effects of Herbal Drugs, Vol. 3. New York: Springer Verlag. 181205.

De Smet, P.A. and O.S. Smeets. 1994. Potential risks of health food products containing yohimbe extracts [letter]. BMJ 309(6959):958.

Devi, L. 1998. YohimbineClinical Study Shows Effects at Different Dose Levels. HerbClip 060481. Austin, TX: American Botanical Council.

Duke, J.A. 1997. The Green Pharmacy. Emmaus, PA: Rodale Press. 176, 188, 191192, 288.

Ernst, E. and M.H. Pittler. 1998. Yohimbine for erectile dysfunction: a systematic review and meta-analysis of randomized clinical trials. J Urol 159(2):433436.

Grasing, K. et al. 1996. Effects of yohimbine on autonomic measures are determined by individual values for area under the concentration-time curve. J Clin Pharmacol 36(9):814822.

Keay, R.W. 1989. Trees of Nigeria. Oxford: Clarendon Press.

Leung, A.Y. and S. Foster. 1996. Encyclopedia of Common Natural Ingredients Used in Food, Drugs, and Cosmetics, 2nd ed. New York: John Wiley & Sons, Inc.

McGuffin, M., C. Hobbs, R. Upton, A. Goldberg. 1997. American Herbal Product Association's Botanical Safety Handbook. Boca Raton: CRC Press.

Morales, A. et al. 1987. Is yohimbine effective in the treatment of organic impotence? Results of a controlled trial. J Urol 137(6):11681172.

Osol, A. and G.E. Farrar. 1955. The Dispensatory of the United States of America, 25th ed. Philadelphia, PA: J.B. Lippincott Company.

Owen, J.A. et al. 1987. The pharmacokinetics of yohimbine in man. Eur J Clin Pharmacol 32(6):577582.

Reichert, R. 1997. Yohimbine Pharmacokinetics. Quarterly Rev Nat Med Spring:1718.

Reid, K. et al. 1987. Double-blind trial of yohimbine in treatment of psychogenic impotence. Lancet 2(8556):421423.

Reynolds, J.E.F. (ed.). 1989. Martindale: The Extra Pharmacopoeia, 29th ed. London: The Pharmaceutical Press.

Rice, T.F. et al. 1996. Physicians' Desk Reference, 50th ed. Montvale, NJ: Medical Economics Company. 1283, 1322, 1363, 1892, 2552.

Riley, A.J. 1994. Yohimbine in the treatment of erectile disorder. Br J Clin Pract 48(3):133136.

Roth, L. et al. 1984. Giftpflanzen, Pflanzengifte. Munich: Ecomed.

Tyler, V.E. 1993. The Honest Herbal, 3rd ed. Binghamton, N.Y.: Pharmaceutical Products Press. 327329.

Werbach, M.R. and M.T. Murray. 1994. Botanical Influences on IllnessA Sourcebook of Clinical Research. Tarzana, CA: Third Line Press. 199202.
Additional Resources

Clark, J.T. 1991. Suppression of copulatory behavior in the male rats following central administration of clonidine. Neuropharmacology (U.K.) 30(4):373382.

Clark, J.T., E.R. Smith, J.M. Davidson. 1985. Testosterone is not required for the enhancement of sexual motivation by yohimbe. Physiological Behav 35(4):517521.

. 1985. Evidence for the modulation of sexual behavior by alpha-adrenoceptors in male rats. Neuroendocrinology (Switz) 41(1):3643.

Davis, G.A. and R. Kohl. 1977. The influence of alpha receptors on lordosis in the female rat. Pharm Biochem Behav 6(1):4753.

Smith, E.R. and J.M. Davidson. 1990. Yohimbine attenuates aging-induced sexual deficiencies in male rats. Physiol Behav 47(4):631634.

Smith, E.R., R.L. Lee, S.L. Schnur, J.M. Davidson. 1987. Alpha 2-adrenoceptor antagonists and male sexual behavior: 1. Mating Behavior. Physiol Behav 41(1):714.

. 1987. Alpha 2-adrenoceptor antagonists and male sexual behavior: 2. Erectile and ejaculatory reflexes. Physiol Behav 41(1):1519.

Taber, C.W. 1962. Taber's Cyclopedic Medical Dictionary, 9th ed. Philadelphia, PA: F.A. Davis Company. M59.

This material was adapted from The Complete German Commission E MonographsTherapeutic Guide to Herbal Medicines. M. Blumenthal, W.R. Busse, A. Goldberg, J. Gruenwald, T. Hall, C.W. Riggins, R.S. Rister (eds.) S. Klein and R.S. Rister (trans.). 1998. Austin: American Botanical Council; Boston: Integrative Medicine Communications.

1) The Overview section is new information.

2) Description, Chemistry and Pharmacology, Uses, Contraindications, Side Effects, Interactions with Other Drugs, and Dosage sections have been drawn from the original work. Additional information has been added in some or all of these sections, as noted with references.

3) The dosage for equivalent preparations (tea infusion, fluidextract, and tincture) have been provided based on the following example:

* Unless otherwise prescribed: 2 g per day of [powdered, crushed, cut or whole] [plant part]
* Infusion: 2 g in 150 ml of water
* Fluidextract 1:1 (g/ml): 2 ml
* Tincture 1:5 (g/ml): 10 ml

4) The References and Additional Resources sections are new sections. Additional Resources are not cited in the monograph but are included for research purposes.

This monograph, published by the Commission E in 1994, was modified based on new scientific research. It contains more extensive pharmacological and therapeutic information taken directly from the Commission E.

Excerpt from Herbal Medicine: Expanded Commission E Monographs
Copyright 2000 American Botanical Council
Published by Integrative Medicine Communications
Available from the American Botanical Council.

ABC Daily Herbal NutriPowder Plus

Email - Find out about herbal medicine for treatment of these conditions

To order these tonics go to our store

 

Related Products

Herbal Potency (Men) HerbalV8 Tonic — men's herbs for sexual strength, ED and potency
Herbal Potency (Women) HerbalVW Tonic — sexual stimulant for women to give confidence

 

 


Prescriptions

Our herbal tonic medicines are carefully prepared on a personal and individual basis for your healing by medical herbalist Alan Hopking MA MNIMH FINEH.

Only whole herbs are used in our herbal medicines. Nothing else is added. If you have symptoms which you consider might be helped with herbal medicine please contact herbal practitioner Alan Hopking for a friendly confidential professional consultation. See terms and fees.

Once you have received your herbal prescription you can contact Alan Hopking at any time for more free advice (preferably by email). When you have completed your bottle of herbal medicine and if you want a repeat prescription you are requested to phone or email so that your progress can be assessed and adjustments made if necessary so that there is no break in your treatment. To order or re-order, click here.

MRCHM - see Alan Hopking's statement about renouncing his association with membership of this organisation

HERBACTIVE Centre of Herbal Medicine, England, UK. Freephone 0800 0834436

General advice to consumers on the use of herbal remedies from the Medicines Healthcare products Regulatory Agency

From the website of the Medicines Healthcare products Regulatory Agency (www.mhra.gov.uk) Department of Health, UK

• Remember that herbal remedies are medicines. As with any other medicine they are likely to have an effect on the body and should be used with care. • Herbal remedies may sometimes interact with other medicines. This makes it particularly important to tell your doctor or pharmacist if you are taking a herbal remedy with other medicines such as prescribed medicines (those provided through your doctor or dentist). • Treat with caution any suggestion that a herbal remedy is '100% safe' or is 'safe because it is natural'. Many plants, trees, fungi and algae can be poisonous to humans. It is worth remembering that many pharmaceuticals have been developed or derived from these sources because of the powerful compounds they contain. Any medicine, including herbal remedies, which have an effect on the body should be used with care. • Treat with caution any herbalist or other person who supplies herbal remedies if they are unwilling or unable to provide written information, in English, listing the ingredients of the herbal remedy they are providing. • If you are due to have a surgical operation you should always remember to tell your doctor about any herbal remedy that you are taking. • Anyone who has previously experienced any liver complaint, or any other serious health complaint is advised not to take any herbal remedy without speaking to their doctor first.

PRECAUTIONS:

Pregnant/Breast-feeding mothers

Few conventional medicines have been established as safe to take during pregnancy and it is generally recognised that no medicine should be taken unless the benefit to the mother outweighs any possible risk to the foetus. This rule should also be applied to herbal medicinal products. However, herbal products are often promoted to the public as being “natural” and completely “safe” alternatives to conventional medicines. Some herbal ingredients that specifically should be avoided or used with caution during pregnancy. As with conventional medicines, no herbal products should be taken during pregnancy unless the benefit outweighs the potential risk.

Volatile Oils

Many herbs are traditionally reputed to be abortifacient and for some this reputation can be attributed to their volatile oil component.(6) A number of volatile oils are irritant to the genito-urinary tract if ingested and may induce uterine contractions. Herbs that contain irritant volatile oils include ground ivy, juniper, parsley, pennyroyal, sage, tansy and yarrow. Some of these oils contain the terpenoid constituent, thujone, which is known to be abortifacient. Pennyroyal oil also contains the hepatotoxic terpenoid constituent, pulegone. A case of liver failure in a woman who ingested pennyroyal oil as an abortifacient has been documented.

Uteroactivity

A stimulant or spasmolytic action on uterine muscle has been documented for some herbal ingredients including blue cohosh, burdock, fenugreek, golden seal, hawthorn, jamaica dogwood, motherwort, nettle, raspberry, and vervain. Herbal Teas Increased awareness of the harmful effects associated with excessive tea and coffee consumption has prompted many individuals to switch to herbal teas. Whilst some herbal teas may offer pleasant alternatives to tea and coffee, some contain pharmacologically active herbal ingredients, which may have unpredictable effects depending on the quantity of tea consumed and strength of the brew. Some herbal teas contain laxative herbal ingredients such as senna, frangula, and cascara. In general stimulant laxative preparations are not recommended during pregnancy and the use of unstandardised laxative preparations is particularly unsuitable. A case of hepatotoxicity in a newborn baby has been documented in which the mother consumed a herbal tea during pregnancy as an expectorant. Following analysis the herbal tea was reported to contain pyrrolizidine alkaloids which are known to be hepatotoxic.

Breast-feeding mothers

A drug substance taken by a breast-feeding mother presents a hazard if it is transferred to the breast milk in pharmacologically or toxicologically significant amounts. Limited information is available regarding the safety of conventional medicines taken during breast-feeding. Much less information exists for herbal ingredients, and generally the use of herbal remedies is not recommended during lactation.

Paediatric Use

Herbal remedies have traditionally been used to treat both adults and children. Herbal remedies may offer a milder alternative to some conventional medicines, although the suitability of a herbal remedy needs to be considered with respect to quality, safety and efficacy. Herbal remedies should be used with caution in children and medical advice should be sought if in doubt. Chamomile is a popular remedy used to treat teething pains in babies. However, chamomile is known to contain allergenic sesquiterpene lactones and should therefore be used with caution. The administration of herbal teas to children needs to be considered carefully and professional advice may be needed.

Perioperative use

The need for patients to discontinue herbal medicinal products prior to surgery has recently been proposed. The authors considered eight commonly used herbal medicinal products (echinacea, ephedra, garlic, ginkgo, ginseng, kava, St John’s Wort, valerian). On the evidence available they concluded that the potential existed for direct pharmacological effects, pharmacodynamic interactions and pharmacokinetic interactions. The need for physicians to have a clear understanding of the herbal medicinal products being used by patients and to take a detailed history was highlighted. The American Society of Anaesthesiologists (ASA) has advised patients to tell their doctor if they are taking herbal products before surgery and has reported that a number of anaesthesiologists have reported significant changes in heart rate or blood pressure in some patients who have been taking herbal medicinal products including St John’s Wort, ginkgo and ginseng. MCA is currently investigating a serious adverse reaction associated with the use of ginkgo prior to surgery. In this case, the patient who was undergoing hip replacement experienced uncontrolled bleeding thought to be related to the use of ginkgo.

From the website of the Medicines Healthcare products Regulatory Agency (www.mhra.gov.uk) Department of Health, UK

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