The latest scare over a herbal injection that possibly killed three people has triggered wider concern over the safety of Chinese medicines, especially injections.

About 70 percent of the adverse drug reactions in China are related to herbal injections, Central China Television reported, quoting figures from the State Food and Drug Administration (SFDA).

The latest problem was reported over the weekend after the SFDA and the Ministry of Health jointly suspended the sale and use of herbal injection following three deaths this month.

Three patients in Anhui, Yunnan and Jiangsu provinces died between Sept 7 and 15, after receiving shuanghuanglian injections. The herbal drug is produced by the Duoduo Pharmaceutical Company in northeast China's Heilongjiang province, according to SFDA's National Adverse Drug Reaction Monitoring Center.

The three deaths were possibly linked to the use of the herbal injection, SFDA said in a statement.

Plants including honeysuckle, scutellaria and forsythia are the major ingredients of shuanghuanglian. The herb has been widely used to allay fever, as well as treat upper respiratory tract infections, mild pneumonia and acute tonsillitis.

Experts from the Ministry of Health and SFDA have set up a team to investigate the deaths.

Li Jun, spokesman of the Heilongjiang food and drug administration, said the Duoduo Pharmaceutical Company had been ordered to stop producing the medicine, and hospitals are being urged to stop using the injection.

The provincial authorities also started a probe into the production, testing and sales of the herbal injection, he said.

Meanwhile, SFDA officials said they have sped up a national campaign to re-evaluate the safety of all herbal injections in the country.

The campaign, initiated in July, aims to control the safety risks of Chinese herbal injections and eliminate any unstable products, SFDA deputy director Wu Zhen has said.

Official figures show about 120 herbal injections are available in China, accounting for about 3 percent of the total 4,000 medications in the country.

The safety concern over the injection from Duoduo is the latest in a string of such incidents. In February, another factory in Heilongjiang was shut down after its shuanghuanglian injection caused adverse effects on three patients, killing one of them.

Last October, a bacteria-polluted Ciwujia herbal injection made by another Heilongjiang-based company, which was used to treat thrombosis and heart disease, killed three people and seriously injured four in Yunnan province.

In the same month, a yinzhihuang injection produced by a Shanxi company - composed of gardenia and honeysuckle, which was used to treat liver disease and infantile jaundice - caused the death of a newborn baby and had adverse effects on three other infants.

Experts said the reasons why the herbal injections cause problems are complicated.

"The herbal injections' quality, method of use and many other factors can lead to adverse reactions," said Yang Xiangguang, pharmacy deputy director of Guang'anmen Hospital at China Academy of Chinese Medical Sciences, as quoted in the Beijing Legal Evening News.

"A lack of detailed chemical analysis and research of related technologies on traditional Chinese medicine creates potential safety hazards," said Shi Dazhuo, vice-president of Xiyuan Hospital of China Academy of Chinese Medical Sciences, as quoted in China Youth Daily.

Moreover, manufacturers of herbal medicines have difficulty controlling the quality of herbal injections because the ingredients are mainly plants or animals whose quality varies under different habitats, climates and ecological environments, he said.

Many pharmaceutical manufacturers use substandard ingredients, which leads to frequent adverse reactions, the report said.

(China Daily September 22, 2009)