A 66 year-old male patient was reported to develop acute on chronic renal failure with cardiopulmonary collapse secondary to hyperkalaemia after the consumption of a traditional medicine, Baike Wan®, obtained from Malaysia. The product was labelled to contain herbal ingredients and indicated for the relief of muscle and joint pain.

Analytical tests revealed the presence of three potent pharmaceutical drugs namely chlorpheniramine, frusemide and piroxicam. Based on the recommended daily intake on the label, the patient would be consuming about 7mg of chlorpheniramine, 11mg of frusemide and 30mg of piroxicam daily (within therapeutic doses). According to the Malaysian Regulatory Authority, a product with the same name has been deregistered in Malaysia since Jan 2005. This illegal product is not a listed Chinese proprietary medicine with HSA and not likely to be sold locally in the retail outlets.

Self-medication with complementary medicines adulterated with potent pharmaceutical drugs can lead to serious health risk. Healthcare professionals are reminded to enquire about complementary medicine use in their patients and are encouraged to report any serious adverse drug reactions to the Pharmacovigilance Unit of HSA.