How to Identify a Problem and What to Do

Dietary supplements may not be risk-free under certain circumstances. If you are pregnant, nursing a baby, or have a chronic medical condition, such as diabetes, hypertension, or heart disease, be sure to consult your doctor or pharmacist before purchasing or taking any supplement. Although vitamin and mineral supplements are widely used and generally considered safe for children, you may wish to check with your doctor or pharmacist before giving these or any other dietary supplements to your child.

If you plan to use a dietary supplement in place of drugs or in combination with any drug, tell your health care provider first. Many supplements contain active ingredients that have strong biological effects and their safety is not always assured in all users. If you have certain health conditions and take these products, you may be placing yourself at risk. Under certain circumstances, taking a combination of supplements or using these products together with medications (whether prescription or over-the-counter [OTC] drugs) could produce adverse effects, some of which could be life-threatening.

Be alert to advisories about these products, whether taken alone or in combination. For example: Coumadin (a prescription medicine), Ginkgo biloba (an herbal supplement), aspirin (an OTC drug) and vitamin E (a vitamin supplement) can each thin the blood, and taking any of these products together can increase the potential for internal bleeding. Combining St. John's wort with certain HIV drugs significantly reduces their effectiveness. St. John's wort also may reduce the effectiveness of prescription drugs for heart disease, depression, seizures, and certain cancers, and oral contraceptives.

It is important to fully inform your doctor about the vitamins, minerals, herbs, or any other supplements you are taking, especially before elective surgery. You may be asked to stop taking these products at least 2-3 weeks ahead of the procedure to avoid potentially dangerous supplement/drug interactions—such as changes in heart rate, blood pressure, and increased bleeding—that could adversely affect the outcome of your surgery.

You, your health care provider, or anyone may report a serious adverse event or illness directly to the FDA if you believe it is related to the use of any dietary supplement product, by phone (800) FDA-1088, fax at (800) FDA-0178, or on-line at:

FDA would like to know whenever you think a product caused serious problem, even if you are not sure that the product was the cause, and even if you did not visit a doctor or clinic.

Source: Food and Drug Administration. Available at: Accessed March 20, 2006.