Adverse reactions and interactions:
- Hepatotoxicity was reported in 13 cases of individuals using Pelargonium sidoides but the patients taking this herb also had been taking other hepatotoxic medications or had other conditions including acute pancreatitis, cholangitis, acute cholecystitis, hepatic contusion, viral hepatitis, and autoimmune hepatitis. (8)
- If the cases of hepatotoxicity were in fact related to Pelargonium sidoides, this may have been due to the coumarin content of the herb. Until there is enough safety data determined on the use of the herb and the concentration of coumarin is known, it may be best to avoid the use of Pelargonium sidoides.
- Pelargonium sidoides was studied for increased risk of bleeding. There was no change seen in thromboplastin time (TPT), partial TPT (PTPT) or thrombin time (TT) in rats given extremely large doses of EPs 7630. Also, the supplement added to warfarin treatment did not affect the lab values either. Hemorrhage caused by this agent was felt to be unlikely. (7)
- Research which defines the amount of coumarin present in Pelargonium sidoides is not available. Once coumarin content of Pelargonium sidoides is known some of the fears on the herb’s safety can be alleviated. There is no clear definition of how much coumarin is dangerous for any particular individual, but Abraham K, et al determined the tolerable daily intake of coumarin to be 0.1 mg per kg of body weight. For a person weighing 80 kg, or about 176 lbs, a tolerable daily intake would be approximately 8 mg of coumarin. (6) Nonetheless, the various studies mentioned have defined few adverse effects even in children.
- Patients should not take Pelargonium sidoides if they have an allergy to this herbal preparation or allergy to a similar plant family.