Some herbals which appear to be relatively benign can interact with prescribed medications. "The classic interaction is with gingko biloba, goldenseal, or garlic with any anti-coagulant," warns Thomas R. Caraccio, PharmD, Clinical Coordinator of Winthrop's Long Island Regional Poison Control Center. "Taken together, they can stimulate bleeding." These kinds of interactions are difficult for physicians to anticipate because patients are often reluctant to discuss their use of herbal remedies with their doctors. "That is why physicians who routinely ask if their patients are taking any medications need to ask specifically about herbals, as well," Dr. Mofenson emphasizes.

Echinacea appears safe, even for children. However, as echinacea boosts the immune system, it should never be taken by those with autoimmune diseases, such as muscular sclerosis or lupus. Purity is also an issue. "Often goldenseal is included in echinacea preparations, and this may not be as safe," adds Dr. Mofenson.

"Part of the problem is the Internet, because people have a high level of confidence in information they find there," says Vito Mannino, Public Educator at the Poison Control Center. "Via the Internet, they can even purchase products that have been banned by Nassau County because they are not safe."

The Long Island Regional Poison Control Center provides information to the community, including healthcare professionals, on all drugs and chemical substances, including herbal supplements; wild plants and mushrooms; and poisons. Calls relating to insect bites, snakebites, marine venomations (such as jellyfish bites), and product recalls all receive immediate responses - around-the-clock - from a staff that includes registered nurses with advanced training in poison information, a doctoral-level pharmacist and toxicologist, and a medical toxicologist/pediatrician.

Winthrop's Poison Control Center can be reached 24-hours-a-day, seven-days-a-week, at 516/663-2650, or 516/542-2323.

HERBAL GUIDELINES FROM WINTHROP POISON CONTROL Herbals should not be administered: to children until proven safe by human studies to pregnant or nursing women to persons on traditional medication for the same complaint without checking on potential interactions with other medications without knowing the appropriate length of time to take the supplement in order to prevent illness in large quantities if they are in packaging that is not properly labeled.