In Reply We agree with Sbinga and Morris that adverse effects are attributable to both pharmaceutical and nonpharmaceutical therapies, and we published a similar study1 in 2018 indicating many children and adolescents in the United States use prescription medications in interacting drug combinations associated with potentially serious adverse effects, particularly arrythmias.1 We also agree that US clinicians and consumers should be cautious regarding dietary supplements because they are not closely regulated by the US Food and Drug Administration. Many consumers are unaware that dietary supplements recommended by a physician are not subject to the same regulatory and safety standards as prescription medication and may therefore underestimate the risks relative to perceived benefits in their decision making.
Qato DM, Alexander GC, Lindau ST. A More Balanced Approach to Dietary Supplement Data—Reply. JAMA Pediatr. Published online November 12, 2018. doi:10.1001/jamapediatrics.2018.4032
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