Herbal remedies may be associated with adverse reactions. The toxicity of any therapeutic agent can be classified into groups based on a number of features.
Parameters using in classification:
(1) acute or delayed effect
(2) predictability
(3) associated dose
Timing
Predictability
Dose
Other
Type
acute
predictable
high dose (dose dependent)
avoid with lower dose
A
acute or delayed
idiosyncratic (unpredictable)
any
can be life threatening
B
delayed (weeks or months)
predictable or expected
chronic use
may be cumulative
C
delayed (months or years)
variable
any
carcinogenic, teratogenic
D
where:
• Pharmacogenetics can have an effect, primarily on Type A.
• An allergic or other immune reaction may be involved in a Type B reaction.
• A drug with predictable toxicity at low dose would probably not be approved.
• Carcinogenicity may be affected by the presence of other risk factors such as smoking.
• An herbal remedy may be associated with more than 1 type of adverse reaction.
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