Anticoagulants, herbal remedies and being on your guard, part 2

This is the second in a small series of posts about remedies and medicines I have found out interact badly with anticoagulants yet contain no warnings, or hidden warnings, to that effect on their packaging. The first post, about arnica, is here.

This post is about that pregnancy staple, Pregnacare.

To be fair to Pregnacare, this is slightly different, because Pregnacare is OK with aspirin and heparin, but it is not OK with warfarin or other oral (taken by mouth) anticoagulants.

And that information is, bizarrely, not included in the information leaflet that comes in the box, but is instead in small print on the side of the box under the title 'Food Supplement'.

So I contend that almost no-one reads it. I nearly didn't, except the box just haappened to be on my bedside table, and just happened to have that side facing me, and I just happen to be spending a lot of time on my bed right now, so I just happened to read it.

Believe me, I've taken Pregnacare on and off for four YEARS now, and it's the first time I've read it.

Here's a bad picture of the warning:

In case you can't read it (and I don't know why my camera won't allow me to take a better picture than that, I held the box right next to a lamp for goodness' sake) the second paragraph says:

As pregnacare contains vitamin K, if you are taking oral anticoagulants (e.g. warfarin)do not take Pregnacare except on the advice of a doctor. Vitamin K is not known to specifically interact with the action of aspirin or heparin.

And this is in white text on a quite dark green background, in letters that can only be about one millimetre high.

If you're visually impaired, forget it, you won't be able to read that. And the leaflet inside, which is where you usually expect to find contraindications? Nothing but a big fluff for Pregnacare and it's various products.

I find this very concerning.

Thankfully for me, heparin is OK with Pregnacare, but what if you were on warfarin? I have never heard a midwife or chemist's shop assistant or a doctor or anyone mention that Pregnacare isn't totally safe to take.

And most of us are not clued up on vitamin K and its effects on prescription drugs.

We're back to that notion of informed choice. We can only make one if we are informed. And I believe that manufacturers of vitamins, herbal remedies and, ahem, food supplements, have a duty of care to make sure we are properly informed.

Which means putting the information in at least 12 point font, in black text on a white background, in the main leaflet that goes inside the box because that is where we consumers expect that kind of information to go.

Hiding it on the side of a box in teeny tiny writing, in white on green, under the title *Food Supplement*, for crying out loud, is just not good enough.

You hear me, Pregnacare? We expect and deserve better. Hop to it.