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Comment & Response
November 12, 2018

A More Balanced Approach to Dietary Supplement Data—Reply

Author Affiliations
  • 1Department of Pharmacy Systems, Outcomes and Policy, University of Illinois at Chicago, College of Pharmacy
  • 2Division of Epidemiology and Biostatistics, University of Illinois at Chicago School of Public Health
  • 3Department of Epidemiology, Johns Hopkins School of Public Health, Baltimore, Maryland
  • 4Center for Drug Safety and Effectiveness, Johns Hopkins School of Public Health, Baltimore, Maryland
  • 5Department of Obstetrics and Gynecology, University of Chicago, Chicago, Illinois
JAMA Pediatr. Published online November 12, 2018. doi:10.1001/jamapediatrics.2018.4032

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.

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