Drug points: Hepatotoxicity associated with herbal tablets: Table 1

On 29 March 1994 a 69 year old woman who was taking levothyroxine (0.1 mg/day) and ibuprofen (400 mg/day) presented to her general practitioner with nausea, pruritus, dark urine, pale stools, and yellow sclerae after six weeks of daily self treatment with 6-15 herbal tablets. These were labelled Venencapsan and industrially prepared for one pharmacy from horse chestnut leaf, milfoil, celandine, sweet clover, milk thistle, and dandelion root with herb. Liver function was abnormal on 14 April but …