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"Medicinal" plants: severe hepatitis with Pelargonium

Sometimes commercialised as a simple food supplement, medicinal plants are not always harmless. This is regrettable, especially when they offer no proven benefits.

Extracts from the root of Pelargonium sidoides or Pelargonium reniforme are sometimes suggested for some respiratory or ENT diseases, despite the absence of any proven efficacy. In France, they are sold as health supplements (pelargonium° Arkocaps or other).

At the end of 2011, an independent German pharmacovigilance centre reported a case of liver damage attributed to a Pelargonium-based treatment. A 30-year-old woman took extracts of Pelargonium root for 4 days. One day after finishing the treatment, she developed symptoms of severe liver damage. Pelargonium was implicated, and no other cause of hepatitis could be identified.

In March 2012, the German drug regulatory agency published a review of reports of liver disorders attributed to Pelargonium registered in the German national pharmacovigilance database up until January 2012, totalling around 30.

This report includes 11 cases of hepatitis and 8 of jaundice. One patient received a liver transplant. Sometimes the patients used other liver-toxic drugs, including paracetamol, ibuprofen and aspirin.

In practice, "natural" does not mean harmless, and that includes plant remedies.

©Prescrire 1 October 2012

"Pelargonium: severe liver damage" Prescrire Int 2012; 21 (131): 241. (Pdf, subscribers only).

Download the full review.
Pdf, subscribers only

See also:

Medicinal plants:
frequent use in France
(July 2008)