Planta Med 2016; 82(06): 505-515
DOI: 10.1055/s-0042-103495
Reviews
Georg Thieme Verlag KG Stuttgart · New York

Chemical Adulterants in Herbal Medicinal Products: A Review

Jacob Calahan
1   Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, USA
,
Dylan Howard
1   Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, USA
,
Ahmad J. Almalki
1   Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, USA
2   Department of Pharmaceutical Chemistry, Faculty of Pharmacy, King Abdulaziz University, Jeddah, Kingdom Saudi Arabia
,
Mahabir P. Gupta
3   Centro de Investigaciones Farmacognósticas de la Flora Panameña, Facultad de Farmacia, Universidad de Panamá, Panamá, República de Panamá
,
Angela I. Calderón
1   Department of Drug Discovery and Development, Harrison School of Pharmacy, Auburn University, Auburn, AL, USA
› Author Affiliations
Further Information

Publication History

received 31 July 2015
revised 31 January 2016

accepted 10 February 2016

Publication Date:
07 April 2016 (online)

Abstract

Many herbal medicinal products have been found to contain synthetic prescription drugs as chemical adulterants. This has become evident by the number of toxicity cases and adverse reactions reported in which casualties were reported via analytical techniques that detected the presence of chemical adulterants in them, which could be responsible for their toxicity. The adulteration of herbal medicinal products with synthetic drugs continues to be a serious problem for regulatory agencies. This review provides up to date information on cases of toxicity, major chemical adulterants in herbal medicinal products, and current analytical techniques used for their detection.

 
  • References

  • 1 Chan TY, Critchley JA. Usage and adverse effects of Chinese herbal medicines. Hum Exp Toxicol 1996; 15: 5-12
  • 2 Liang Q, Luo G, Wang Y. Rapid and reliable determination of illegal adulterants in herbal medicines and dietary supplements by LC/MS/MS. J Pharm Biomed Anal 2006; 40: 305-311
  • 3 Yee SK, Chu SS, Xu YM, Choo PL. Regulatory control of Chinese Proprietary Medicines in Singapore. Health Policy 2005; 71: 139-144
  • 4 Sahoo N, Manchikanti P, Dey S. Herbal drugs: standards and regulation. Fitoterapia 2010; 81: 462-471
  • 5 Colson K, Luchsinger S, Hicks JM. Adulterated natural product extract detection – Viagra derivatives. Available at. http://www.theresonance.com/adulterated-natural-products/ Accessed June 4, 2015
  • 6 Teschke R, Wolff A, Frenzel C, Eickhoff A, Schulze J. Herbal traditional Chinese medicine and its evidence base in gastrointestinal disorders. World J Gastroenterol 2015; 21: 4466-4490
  • 7 Ernst E. Toxic heavy metals and undeclared drugs in Asian herbal medicines. Trends Pharmacol Sci 2002; 23: 136-139
  • 8 Ernst E. Adulteration of Chinese herbal medicines with synthetic drugs: a systematic review. J Intern Med 2002; 252: 107-113
  • 9 Pradesh A. Adulteration of toddy continues unabated (The Hindu, August 29, 2009). Available at. http://www.thehindu.com/todays-paper/tp-national/tp-andhrapradesh/adulteration-of-toddy-continues-unabated/article215606.ece Accessed November 17, 2015
  • 10 American Botanical Council. About the ABC-AHP-NCNPR Botanical Adulterants Program. Available at. http://cms.herbalgram.org/BAP/BotanicalAdulterantsIndex.html%23AbouttheProgram Accessed June 5, 2015
  • 11 European Commission – Public Health. Medicinal products for human use. Available at. http://ec.europa.eu/health/human-use/herbalmedicines/index_en.htm Accessed November 17, 2015
  • 12 Bronstein AC, Spyker DA, Cantilena jr. LR, Green J, Rumack BH, Heard SE. 2006 Annual Report of the American Association of Poison Control Centersʼ National Poison Data System (NPDS). Clin Toxicol (Phila) 2007; 45: 815-917
  • 13 Gardiner P, Sarma DN, Low Dog T, Barrett ML, Chavez ML, Ko R, Mahady GB, Marles RJ, Pellicore LS, Giancaspro GI. The state of dietary supplement adverse event reporting in the United States. Pharmacoepidemiol Drug Saf 2008; 17: 962-970
  • 14 United States Government Accountability Office. Dietary supplements: FDA may have opportunities to expand its use of reported health problems to oversee products (GAO Publication No. GAO-13–244; 2013). Available at. http://www.gao.gov/products/GAO-13-244 Accessed June 5, 2015
  • 15 Vohra S, Cvijovic K, Boon H, Foster BC, Jaeger W, LeGatt D, Cembrowski G, Murty M, Tsuyuki RT, Barnes J, Charrois TL, Arnason JT, Necyk C, Ware M, Rosychuk RJ. Study of natural health product adverse reactions (SONAR): active surveillance of adverse events following concurrent natural health product and prescription drug use in community pharmacies. PLoS One 2012; 7: e45196
  • 16 Gupta MP. Herbal medicinal products. Pharmaceutical Policy and Law 2015; 17: 231-249
  • 17 Nisoli E, Carruba MO. An assessment of the safety and efficacy of sibutramine, an anti-obesity drug with a novel mechanism of action. Obes Rev 2000; 1: 127-139
  • 18 Nakadai A, Inagaki H, Minami M, Takahashi H, Namme R, Ohsawa M, Ikegami S. Determination of the optical purity of N-nitrosofenfluramine found in the Chinese slimming diet. Yakugaku Zasshi 2003; 123: 805-809
  • 19 Lai V, Smith A, Thorburn D, Raman VS. Severe hepatic injury and adulterated Chinese medicines. BMJ 2006; 332: 304-305
  • 20 Lau G, Lo DS, Yao YJ, Leong HT, Chan CL, Chu SS. A fatal case of hepatic failure possibly induced by nitrosofenfluramine: a case report. Med Sci Law 2004; 44: 252-263
  • 21 Binkley K, Knowles SR. Sibutramine and panic attacks. Am J Psychiatry 2002; 159: 1793-1794
  • 22 Cordeiro Q, Vallada H. Sibutramine-induced mania episode in a bipolar patient. Int J Neuropsychopharmacol 2002; 5: 283-284
  • 23 Taflinski T, Chojnacka J. Sibutramine-associated psychotic episode. Am J Psychiatry 2000; 157: 2057-2058
  • 24 Vidal C, Quandte S. Identification of a sibutramine-metabolite in patient urine after intake of a “pure herbal” Chinese slimming product. Ther Drug Monit 2006; 28: 690-692
  • 25 Ministry of Health, Labour and Welfare (Japan). Unauthorised drugs. Available at. http://www.mhlw.go.jp/english/ Accessed November 17, 2015
  • 26 Yuen YP, Lai CK, Poon WT, Ng SW, Chan AYW, Mak TWL. Adulteration of over-the-counter slimming products with pharmaceutical analogues – an emerging threat. Hong Kong Med J 2007; 216-220
  • 27 Jung J, Hermanns-Clausen M, Weinmann W. Anorectic sibutramine detected in a Chinese herbal drug for weight loss. Forensic Sci Int 2006; 161: 221-222
  • 28 European Medicines Agency. European Medicines Agency recommends suspension of marketing authorisations for sibutramine. [Press release EMA/39408/2010]. London: EMA; 2010
  • 29 Food and Drug Administration. FDA drug safety communication: FDA recommends against the continued use of Meridia (sibutramine). Available at. http://www.fda.gov/Drugs/DrugSafety/ucm228746.htm Accessed October 8, 2015
  • 30 Patel DN, Li L, Kee CL, Ge X, Low MY, Koh HL. Screening of synthetic PDE-5 inhibitors and their analogues as adulterants: analytical techniques and challenges. J Pharm Biomed Anal 2014; 87: 176-190
  • 31 Venhuis BJ, de Kaste D. Towards a decade of detecting new analogues of sildenafil, tadalafil and vardenafil in food supplements: a history, analytical aspects and health risks. J Pharm Biomed Anal 2012; 69: 196-208
  • 32 Gilard V, Balayssac S, Tinaugus A, Martins N, Martino R, Malet-Martino M. Detection, identification and quantification by 1H NMR of adulterants in 150 herbal dietary supplements marketed for improving sexual performance. J Pharm Biomed Anal 2015; 102: 476-493
  • 33 Lam YH, Poon WT, Lai CK, Chan AY, Mak TW. Identification of a novel vardenafil analogue in herbal product. J Pharm Biomed Anal 2008; 46: 804-807
  • 34 Cohen PA, Zeijlon R, Nardin R, Keizers PH, Venhuis B. Hemorrhagic stroke probably caused by exercise combined with a sports supplement containing β-methylphenylethylamine (BMPEA): a case report. Ann Intern Med 2015; 162: 879-880
  • 35 Raterman K. BMPEA/Acacia rigidula Controversy Fuels Further Criticism of Botanicals. HerbalGram 2015; 12: 60
  • 36 Palmer ME, Haller C, McKinney PE, Klein-Schwartz W, Tschirgi A, Smolinske SC, Woolf A, Sprague BM, Ko R, Everson G, Nelson LS, Dodd-Butera T, Bartlett WD, Landzberg BR. Adverse events associated with dietary supplements: an observational study. Lancet 2003; 361: 101-106
  • 37 China Food and Drug Administration. Announcement of the China Food and Drug Administration about the illegal production and sale of Ginkgo leaf products by the Guilin Xingda Pharmaceutical Company Ltd. and other companies. Beijing, China; 19 May 2015. Available at. http://www.sda.gov.cn/WS01/CL0087/119540.html Accessed October 13, 2015
  • 38 Mathon C, Ankli A, Reich E, Bieri S, Christen P. Screening and determination of sibutramine in adulterated herbal slimming supplements by HPTLC-UV densitometry. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2014; 31: 15-20
  • 39 European Medicines Agency. Committee for medicinal products for human use. Referral Sibutramine. CHMP/4514/02. London: EMA; 2002
  • 40 Poon WT, Ng SW, Lai CK, Chan YW, Mak WL. Factitious thyrotoxicosis and herbal dietary supplement for weight reduction. Clin Toxicol (Phila) 2008; 46: 290-292
  • 41 Firstenberg J. FDA panel votes against new obesity drug Qnexa. Available at. http://www.digitaljournal.com/article/294716 Accessed July 15, 2015
  • 42 Piggee C. Investigating a not-so-natural high. Anal Chem 2009; 81: 3205-3207
  • 43 Auwärter V, Dresen S, Weinmann W, Müller M, Pütz M, Ferreirós N. ‘Spice’ and other herbal blends: harmless incense or cannabinoid designer drugs?. J Mass Spectrom 2009; 44: 832-837
  • 44 Uchiyama N, Kikura-Hanajiri R, Kawahara N, Haishima Y, Goda Y. Identification of a cannabinoid analog as a new type of designer drug in a herbal product. Chem Pharm Bull 2009; 57: 439-441
  • 45 Auwärter V. Synthetic cannabinoids in herbal products. Available at. https://www.unodc.org/documents/scientific/Synthetic_Cannabinoids.pdf Accessed November 17, 2015
  • 46 U.S. Food and Drug Administration. Tainted products marketed as dietary supplements_CDER. Available at. http://www.accessdata.fda.gov/scripts/sda/sdNavigation.cfm?sd=tainted_supplements_cder&displayAll=false&page=5 Accessed November 17, 2015
  • 47 American Botanical Council. Many “grapefruit seed extracts” adulterated, says nonprofit research consortium. Available at. http://cms.herbalgram.org/press/2012/Many_GFSE_Adulterated_Says_Nonprofit_Research_Consortium.html?t=1338823765&ts=1447688132&signature=8dff4ede0721f8f1c7bf82f7f11cf3d6 Accessed May 28, 2015
  • 48 Geller A, Shehab N, Weidle N, Lovegrove M, Wolpert B, Timbo B, Mozersky R, Budnitz D. Emergency department visits for adverse events related to dietary supplements. N Engl J Med 2015; 373: 1531-1540
  • 49 Vaclavik L, Krynitsky AJ, Rader JI. Mass spectrometric analysis of pharmaceutical adulterants in products labeled as botanical dietary supplements or herbal remedies: a review. Anal Bioanal Chem 2014; 406: 6767-6790
  • 50 Metz TO, Zhang Q, Page JS, Shen Y, Callister SJ, Jacobs JM, Smith RD. The future of liquid chromatography-mass spectrometry (LC-MS) in metabolic profiling and metabolomic studies for biomarker discovery. Biomark Med 2007; 1: 159-185
  • 51 Thet K. Gas chromatography. Available at. http://chemwiki.ucdavis.edu/Core/Analytical_Chemistry/Instrumental_Analysis/Chromatography/Gas_Chromatography Accessed November 17, 2015
  • 52 Chatham JC, Blackband SJ. Nuclear magnetic resonance spectroscopy and imaging in animal research. ILAR J 2001; 42: 189-208 Available at http://ilarjournal.oxfordjournals.org/content/42/3/189.full.pdf.html Accessed November 17, 2015
  • 53 Advantages and disadvantages of capillary electrophoresis. Available at. http://www.chromatographytoday.com/news/electrophoretic-separations/35/breaking_news/advantages_and_disadvantages_of_capillary_electrophoresis/32342/ Accessed November 17, 2015
  • 54 Wu X, Zhu B, Lu L, Huang W, Pang D. Optimization of a solid phase extraction and hydrophilic interaction liquid chromatography-tandem mass spectrometry method for the determination of metformin in dietary supplements and herbal medicines. Food Chem 2012; 133: 482-488
  • 55 Lacina O, Zachariasova M, Urbanova J, Vaclvikova M, Cajka T, Hajslova J. Critical assessment of extraction methods for the simultaneous determination of pesticide residues and mycotoxins in fruits, cereals, spices and oil seeds employing ultra-high performance liquid chromatography-tandem mass spectrometry. J Chromatogr A 2012; 1262: 8-18
  • 56 Becue I, Van Poucke C, Van Peteghem C. An LC-MS screening method with library identification for the detection of steroids in dietary supplements. J Mass Spectrom 2011; 46: 327-335
  • 57 Li N, Cui M, Lu X, Qin F, Jiang K, Li F. A rapid and reliable UPLC-MS/MS method for the identification and quantification of fourteen synthetic anti-diabetic drugs in adulterated Chinese proprietary medicines and dietary supplements. Biomed Chromatogr 2010; 24: 1255-1261
  • 58 Kesting JR, Huang J, Sorensen D. Identification of adulterants in Chinese herbal medicine by LC-HRMS and LC-MS-SPE/NMR and comparative in vivo study with standards in a hypertensive rat model. J Pharm Biomed Anal 2010; 51: 705-711
  • 59 Woo H, Kim JW, Han KM, Lee JH, Hwang IS, Lee JH, Kim J, Kweon SJ, Cho S, Chae KR, Han SY, Kim J. Simultaneous analysis of 17 diuretics in dietary supplements by HPLC and LC-MS/MS. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2013; 30: 209-217
  • 60 Bogusz MJ, Hassan H, Al-Enazi E, Ibrahim Z, Al-Tufail M. Application of LC-ESI-MS-MS for detection of synthetic adulterants in herbal remedies. J Pharm Biomed Anal 2006; 41: 554-564
  • 61 Van Poucke C, Detavernier C, Van Cauwenberghe R, Van Peteghem C. Determination of anabolic steroids in dietary supplements by liquid chromatography-tandem mass spectrometry. Anal Chim Acta 2007; 586: 35-42
  • 62 Aqai P, Belsa NG, Major H, Pedotti M, Varani L, Verrerro VEV, Haasnoot W, Nielin MWF. Receptor-based high-throughput screening and identification of estrogens in dietary supplements using bioaffinity liquid-chromatography ion mobility mass spectrometry. Anal Bioanal Chem 2013; 405: 9427-9436
  • 63 Aqai P, Cevik E, Gerssen A, Haasnoot W, Nielen MWF. High-throughput bioaffinity mass spectrometry for screening and identification of designer anabolic steroids in dietary supplements. Anal Chem 2013; 85: 3255-3262
  • 64 Au AM, Ko R, Boo FO, Hsu R, Perez G, Yang Z. Screening method for drugs and heavy metals in Chinese patent medicines. Bull Environ Contam Toxicol 2000; 65: 112-119
  • 65 Song F, El-Demerdash A, Lee SJSH. Screening for multiple phosphodiesterase type 5 inhibitor drugs in dietary supplement materials by flow injection mass spectrometry and their quantification by liquid chromatography tandem mass spectrometry. J Pharm Biomed Anal 2012; 70: 40-46
  • 66 Song F, Monroe D, El-Demerdash A, Palmer C. Screening for multiple weight loss and related drugs in dietary supplement materials by flow injection tandem mass spectrometry and their confirmation by liquid chromatography tandem mass spectrometry. J Pharm Biomed Anal 2014; 88: 136-143
  • 67 Zhou Z, Zhang J, Zhang W, Bai Y, Liu H. Rapid screening for synthetic antidiabetic drug adulteration in herbal dietary supplements using direct analysis in real time mass spectrometry. Analyst 2011; 36: 2613-2618
  • 68 Wang H, Wu Y, Sun W, Ding L, Guo B, Chen B. Rapid screening for illicit additives in weight loss dietary supplements with desorption corona bean ionization (DCBI) mass spectrometry. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2012; 29: 1194-1201
  • 69 Cheng HL, Tseng MC, Tsai PL, Her GR. Analysis of synthetic chemical drugs in adulterated Chinese medicines by capillary electrophoresis/electrospray ionization mass spectrometry. Rapid Commun Mass Spectrom 2001; 15: 1473-1480
  • 70 Auricchio MT, Batistic MA, Markman BEO. Deteaccao de anorexigenos e benzodiazepinicos em formulacoes ʼnaturaisʼ empregadas em regimes de emageccimento. Rev Inst Adolfo Lutz 1991; 51: 105-110
  • 71 Almeida AE, Ribeiro ML, Polese L. Determination of amfepremone hydrochloride, fenproporex, and diazepam in so-called ʼnaturalʼ capsules used in the treatment of obesity. J Liq Chromatogr Relat Technol 2000; 23: 1109-1118
  • 72 de Carvalho LM, Correia D, Garcia SC, de Bairros AV, do Nascimento PC, Bohrer D. A new method for the simultaneous determination of 1,4-benzidiazepines and amfepramone as adulterants in phytotherapeutic formulations by voltammetry. Forensic Sci Int 2010; 202: 75-81
  • 73 Cohen PA. Imported fenproporex-based diet pills from Brazil: a report of two cases. J Gen Intern Med 2009; 24: 430-433
  • 74 Cohen PA. American roulette – contaminated dietary supplements. N Engl J Med 2009; 361: 1523-1525
  • 75 de Carvalho LM, Martini M, Moreira AP, Garcia SC, Nascimento PC, Bohrer D. Determination of synthetic pharmaceuticals in phytotherapeutics by capillary zone electrophoresis with contactless conductivity detection (CE-C4D). Microchem J 2010; 96: 114-119
  • 76 Sombra LL, Gomez MR, Olsina R, Martinez LD, Silva MF. Comparative study between capillary electrophoresis and high performance liquid chromatography in ‘guarana’ based phytopharmaceuticals. J Pharm Biomed Anal 2005; 5: 989-994
  • 77 Schramek N, Wollein U, Eisenreich W. Pyrazolopyrimidines in ‘all-natural’ products for erectile dysfunction treatment: the unreliable quality of dietary supplements. Food Addit Contam Part A Chem Anal Control Expo Risk Assess 2015; 32: 127-140
  • 78 Lin MC, Liu YC, Lin YL, Lin JH. Isolation and identification of a novel sildenafil analogue adulterated in dietary supplements. J Food Drug Anal 2008; 16: 15-20
  • 79 Wollein U, Eisenreich W, Schramek N. Identification of novel sildenafil-analogues in an adulterated herbal food supplement. J Pharm Biomed Anal 2011; 56: 705-712
  • 80 Balayssac S, Gilard V, Zedde C, Martino R, Malet-Martino M. Analysis of herbal dietary supplements for sexual performance enhancement: first characterization of propoxyphenyl-thiohydroxyhomosildenafil and identification of sildenafil, thiosildenafil, phentolamine and tetrahydropalmatine as adulterants. J Pharm Biomed Anal 2012; 63: 135-150
  • 81 Johansson M, Fransson D, Rundlöf T, Huynh NH, Arvidsson T. A general analytical platform and strategy in search for illegal drugs. J Pharm Biomed Anal 2014; 100: 215-229
  • 82 Substandard, spurious, falsely labelled, falsified and counterfeit (SSFFC) medical products. Available at. http://www.who.int/mediacentre/factsheets/fs275/en/ Accessed November 17, 2015
  • 83 Martino R, Malet-Martino M, Gilard V, Balayssac S. Counterfeit drugs: analytical techniques for their identification. Anal Bioanal Chem 2010; 398: 77-92
  • 84 Holzgrabe U, Malet-Martino M. Analytical challenges in drug counterfeiting and falsification – the NMR approach. J Pharm Biomed Anal 2011; 55: 679-687
  • 85 Deconinck E, Sacré PY, Courselle P, De Beer JO. Chemometrics and chromatographic fingerprints to discriminate and classify counterfeit medicines containing PDE-5 inhibitors. Talanta 2012; 100: 123-133
  • 86 Rundlöf T, Mathiasson M, Bekiroglu S, Hakkarainen B, Bowden T, Arvidsson T. Survey and qualification of internal standards for quantification by 1H NMR spectroscopy. J Pharm Biomed Anal 2010; 52: 645-651
  • 87 Rundlöf T, McEwen I, Johansson M, Arvidsson T. Use and qualification of primary and secondary standards employed in quantitative 1H NMR spectroscopy of pharmaceuticals. J Pharm Biomed Anal 2014; 93: 111-117
  • 88 Deconinck E, Cauwenbergh T, Bothy JL, Custers D, Courselle P, De Beer JO. Detection of sibutramine in adulterated dietary supplements using attenuated total reflectance-infrared spectroscopy. J Pharm Biomed Anal 2014; 100: 279-283
  • 89 Fleming W, McClendon KS, Riche DM. New obesity agents: lorcaserin and phentermine/topiramate. Ann Pharmacother 2013; 47: 1007-1016
  • 90 Shram MJ, Schoedel KA, Bartlett C, Shazer RL, Anderson CM, Sellers EM. Evaluation of the abuse potential of lorcaserin, a serotonin 2C (5-HT2C) receptor agonist, in recreational polydrug users. Clin Pharmacol Ther 2011; 89: 683-692
  • 91 Cunha J. Belviq side effects center – RxList. Available at. http://www.rxlist.com/belviq-side-effects-drug-center.htm Accessed November 17, 2015
  • 92 Williams AL. Drug Facts and Comparisons, 60th edition. St. Louis, MO: Wolters Kluwer Health; 2012
  • 93 Zhu Q, Cao Y, Cao Y, Chai Y, Lu F. Rapid on-site TLC-SERS detection of four antidiabetes drugs used as adulterants in botanical dietary supplements. Anal Bioanal Chem 2014; 406: 1877-1884
  • 94 Lindahl I, Masson P. Improved sample and reagent pipetting with the MINILAB. J Clin Chem Clin Biochem 1990; 28: 949-950
  • 95 Risha PG, Msuya Z, Clark M, Johnson K, Ndomondo-Sigonda M, Layloff T. The use of Minilabs to improve the testing capacity of regulatory authorities in resource limited settings: Tanzanian experience. Health Policy 2008; 87: 217-222
  • 96 Cai Y, Cai TG, Shi Y, Cheng XL, Ma LY, Ma SC, Lin RC, Feng W. Simultaneous determination of eight PDE5-is potentially adulterated in herbal dietary supplements with TLC and HPLC-PDA-MS methods. J Liq Chromatogr Relat Technol 2010; 33: 1287-1306
  • 97 Lv D, Cao Y, Lou Z, Li S, Chen X, Chai Y, Lu F. Rapid on-site detection of ephedrine and its analogues used as adulterants in slimming dietary supplements by TLC-SERS. Anal Bioanal Chem 2015; 407: 1313-1325