Poor quality and improper use: A review of common reasons of possible adversity in Ayurvedic practice

Abstract

Can Ayurvedic drugs do harm? When this was asked from Ayurvedic physicians in Maharashtra, India, the revelations were groundbreaking. About 83% physicians have accepted the possibility of adverse effects from Ayurveda [28]. Another survey conducted upon institutionally qualified Ayurvedic physicians from Uttar Pradesh and Bihar has shown the similar inference [18]. Poor drug quality and improper drug use were identified as two important qualifiers for the cause of any possible adversity through Ayurvedic drug use in these surveys. Poor drug use is relatively a new synthesis for conventional pharmacovigilance understanding. This primarily pertains to the poor selection of drug, poor dosing, overdosing, poor determination of patient’s clinical conditions and his individual susceptibility to the type of drug. These determinants, though equally important but far less complex in conventional medicine when they are compared to the underlying judgmental system of Ayurveda asking for subtle details of drug, patient and the disease before a prescription is finally made. Adverse drug reaction (ADR) is rarely reported from Ayurvedic drugs and hence this is difficult to find these reports through the electronic retrievable system. The basic reason is unawareness of Ayurvedic physicians about collective use to this information resulting in their poor documentation and reporting. Any reported adversity association of Ayurvedic drugs by and large is the adversity due to poor drug quality including impurities, heavy metal components or presence of components other than herbs [10, 23,22]. A possible ADR due to Vatsanabha (Aconite) resulting through an overdosing of Ayurvedic drugs was however reported recently and has shown the importance of proper drug use in Ayurveda as an important aspect to be dealt with before a drug safety can finally be assured [20]. Present review identifies the possible hiccoughs associated with manufacturing and clinical usage of Ayurvedic drugs specially in India which may lead to drug induced adversities. Ayurveda and the traditional medicines in general have witnessed an exponential increase in their consumption pattern in recent past. This is a globally occurring phenomena and is reported for developed