Health Canada is advising consumers not to use products containing Aristolochic Acid

Health Canada is advising consumers not to use products containing Aristolochic Acid, a naturally occurring toxin that can cause cancer, mutations in human cells, and end-stage kidney failure.

There have been numerous international reports of death or injury from kidney failure due to ingestion of products found to contain Aristolochic Acid.

Health Canada first issued a warning about Aristolochic Acid in November 1999. Other countries, including the United States, Australia, and member states of the European Union, have also taken regulatory action to address the risk of Aristolochic Acid to consumers.

Health Canada is currently determining whether these products are being sold on the Canadian market, and has issued an alert to the Canadian Border Services Agency to prevent the importation of these products into Canada. There have been no reports of adverse effects related to Aristolochic Acid in Canada.

Herbs being imported and exported may not be adequately labelled because the pinyin (phonetic) spelling of the herbs' Chinese trade names do not always capture critical aspects of pronunciation that properly distinguish these herbs in the Chinese language. The pinyin trade name may also lack the appropriate adjectives that correctly distinguish the different herbs.

Therefore, products labelled to contain the following could contain Aristolochia and its toxic Aristolochic Acid by mistake:

Aristolochia Aristolochic Acid Mu Tong
Stephania Menispermum Cocculus
Diploclisia Sinomenium Akebia
Clematis Saussurea Vladimiria
  Asarum Bragantia

Aristolochia (birthwort, Virginia snakeroot), Asarum (wild ginger - unrelated to common ginger), and Bragantia (also known as Apama or Thottea) are plants known to contain Aristolochic Acid.

If you have products containing Aristolochic Acid, you are asked to contact the Health Products and Food Branch Inspectorate's regional operational centres at 1-800-267-9675.

The Chinese Medicines Board of the Chinese Medicine Council of Hong Kong has recently provided Health Canada with the following list of Chinese medicines that have been found to contain Aristolochic Acid. The Hong Kong Department of Health has instructed manufacturers of these products to recall the products from the market.

Table: Chinese medicines that have been found to contain Aristolochic Acid

Name of Proprietary Chinese Medicine

Name of Manufacturer

"Hoi Ping Pai" Refined Sanshetan Chuanpeimo Guangzhou Qixing Pharmaceutical Co. Ltd.
Hua Tan Cough Capsules Guangzhou Zhongyi Pharmaceutical Company Limited
Herba Asari Purapharm (Nanning) Pharmaceuticals Co. Ltd.
Yishen Juanbi Wan Jackson Industrial (distributor)
Chaisentomg Nasal Chaisentomg Pharmaceutical Factory Ltd.
Fu Zhi Ling Man's Cheung Hong (distributor)
San Bi Tang-Joint Formula Purapharm (Nanning) Pharmaceuticals Co. Ltd.
Chinese Medicine Nasal Rescue Wai Yuen Tong Medicine Co., Ltd.
Rheumatic Pills (translation) Lee Hoong Kee Limited
Pak Fung Pills (translation) Lee Hoong Kee Limited
Shunai Zhike Huatan Wan Beijing Tong Ren Tang Hong Kong Medicine Management Limited
Hay Fever Killer Tung Tak Tong Chinese Medicine MFG. Co., Ltd.
Minor Blue Dragon Combination ACE Pharmaceuticals (HK) Limited (distributor)
Ling Kan Chiang Wei Hsin Jen Tang Extract Granules Sun Ten Pharmaceutical Co., Ltd.
Ma Huang Fu Tzu His Hsin Extract
Granules
Sun Ten Pharmaceutical Co., Ltd.
Pu Fei E Jiao San Extract Granules Sun Ten Pharmaceutical Co., Ltd.
Song Dan Segan Pills Henan Shizhen Medicines Products Co., Ltd.
Gentiana Combination ACE Pharmaceuticals (HK) Limited (distributor)
Du Zhong Jin Gu Bi Tong Wan Ming Wah Company (distributor)
Chui Fong Tou Ku Wan Po Wo Tong Medicine Factory Ltd.
So Hop Pills Ma Pak Leung Co., Ltd.

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