Feverfew products
CMAJ 1997;157:510
Re: "Herbal products begin to attract the attention of brand-name drug companies" (CMAJ 1996;155:216-9 [full text / en bref]), by Kate Cottrell
In response to: D.V.C. Awang
Clearly, despite considerable efforts to clarify the conditions under which a herbal product requires a DIN, I have not managed to fully grasp the intricacies of the process. Dr. Awang says a product may be classified as a drug requiring a DIN when "the Drug Directorate decides it has pharmacologic activity"; yet he goes on to say that "many products with widely recognized pharmacologic activity are sold in Canada . . . without a DIN." Perhaps I am not alone in failing to understand under what circumstances a product's pharmacologic activity warrants drug classification and thus requires a DIN.
McNeil stressed that Tanacet contains a consistent percentage of parthenolide, the active ingredient, and that the company had chosen to use a type of feverfew known to produce it in high enough levels for its product. I erred in inferring that the company had been active in identifying the species of plant; it was active only insofar as it made use of existing research that identified that plant, some of which must be credited to Awang.
Regarding my statement about the testing of Life Brand products to ensure standardization and shelf life of the active ingredients: I was clearly mistaken to take what I was told at face value. I should have asked for a more specific definition as to whether their standardization and shelf life referred to quality control and batch-to-batch consistency or to reliability of effect, as was implied.
Herbal medicine is indeed fraught with contention, and there are many grey areas surrounding the manufacture, regulation and control of these products that need to be addressed. I apologize for any confusion I may have inadvertently caused, and I hope that Awang's criticisms will help shed light on a complex subject.
Kate Cottrell, BA
Consecon, Ont.
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