Reading a Chinese Patent Medicine Label

What this page covers

A Chinese patent medicine (also called a proprietary Chinese medicine) is a ready-made product, usually a pill, tablet, capsule, granule or liquid, made from a set formula. This page explains what a label can tell you, what it cannot, and what to check before using one. It is information only. It does not tell you what to take. For the wider picture see Chinese herbal medicine: what it is and what research shows.

Start with the most important limit

A label is a claim by the seller, not a test result. An overview of 26 systematic reviews found herbal products adulterated or contaminated with materials ranging from pesticides and heavy metals to prescription drugs, with serious harm in some cases; contamination was most often noted for Chinese remedies. [1] The US National Center for Complementary and Integrative Health (NCCIH) says some Chinese herbal products have been found contaminated with undeclared plant or animal material, drugs such as warfarin and diclofenac, heavy metals, and pesticides. [2]

In one laboratory study, DNA sequencing of 15 traditional Chinese medicine samples found plants such as Ephedra and Asarum, and animal families that include endangered species, and said animal DNA was rarely declared on the packaging. [3] That is a small sample, but it shows why "not listed" does not always mean "not present".

What a registration number means in different places

Rules differ by country, and a number on a label means something different in each.

Australia: we could not read the Therapeutic Goods Administration's pages in this session, so we make no statement about its listing numbers. Check the TGA directly.

Reading the rest of the label

Hong Kong's Chinese Medicine Regulatory Office lists what a registered product's label must show: the name of the medicine, active ingredients, country of origin, registration number, registration holder, dosage and method of use, expiry date and batch number. [4] Those are a good checklist anywhere. Look for:

• A full ingredient list in a language you can read. Chinese herbs are often named in pinyin (Chinese romanization), Latin pharmaceutical names, or common English names. The same common name can refer to different plants.
• Which part of the plant and what species. Names that sound alike can hide very different plants. FDA says outbreaks of kidney failure tied to aristolochic acid arose when the plant on the label was misidentified, or when "traditional Chinese names were misinterpreted or similar". [10]
• A manufacturer and batch number. These let a company, regulator or poison centre trace a product.
• Minerals and animal parts. Hong Kong's list of toxic Chinese medicines that need a practitioner's prescription includes cinnabar, realgar, mercury and arsenic compounds. [11] A review of Chinese patent medicines noted cinnabar and calomel as mercury-containing ingredients. [12] We do not recommend products with these ingredients or with endangered-species ingredients (see herb sourcing and sustainability).
• Claims that sound like a drug. Promises to cure disease are a warning sign, not reassurance.

When the label is not enough

FDA has recalled a Chinese patent medicine sold as a dietary supplement ("Xanthium & Siler Combo (Bi Yan Pian)") because it contained undeclared Ephedra herba (ma huang), which FDA lists as banned. FDA says such supplements carry a risk of serious adverse events, including heart attack, stroke and death. [13] See adulteration and substitution in Chinese herbal products for more examples, and undeclared drugs in Chinese patent medicines. To buy with more care, read buying Chinese herbs safely.

If you feel unwell

Stop the product and seek medical care. In the US, Poison Help is 1-800-222-1222; other countries are on Poison Help by country. Bring the package. In an emergency in the US, call 911.