Traditional medicine alongside prescribed medicine
Most South Africans who use both do not tell their doctor. The risks are real and the solution is disclosure, not abstinence.
The problem is silence, not the practice
A large proportion of South Africans use traditional medicine, often alongside prescribed treatment. Most do not mention it, usually because they expect to be judged or told to stop.
That silence is the actual danger. A clinician who does not know cannot warn about an interaction, cannot interpret an unexpected liver or kidney result, and cannot tell whether a new symptom is the illness, the prescription or something else entirely. Telling them does not mean being told to stop.
The specific risks
- Liver and kidney toxicity. Some preparations are directly harmful to these organs, and traditional medicine is a recognised cause of acute kidney injury and liver failure in South African hospitals.
- Interactions with prescribed medicine, particularly HIV and TB treatment, where reduced drug levels risk treatment failure and resistance.
- Enemas, which are associated with serious complications including bowel injury and severe electrolyte disturbance, especially in children.
- Unknown composition and dose. Preparations vary between practitioners and batches.
- Contamination, and adulteration with undeclared pharmaceutical ingredients.
- Delay — the most common harm of all is a treatable condition presenting late.
Using both more safely
- Tell your clinician what you are taking. You are not obliged to justify it, and a good clinician will focus on interactions rather than on the choice.
- Tell your traditional health practitioner what has been prescribed, for the same reason in the other direction.
- Never stop HIV, TB, epilepsy, heart or psychiatric medication to take something else. Interrupting these is where the most serious harm occurs.
- Be especially careful in pregnancy, in children, and in anyone with existing liver or kidney disease.
- Avoid enemas entirely in children.
- Keep the container or a sample, so anyone treating you later knows what was involved.
- Report a suspected reaction to SAHPRA — this is how patterns get identified.
For clinicians and family members
Asking 'are you taking anything else, including traditional or herbal medicine' as a routine, neutral question gets a far more honest answer than asking only about tablets. Reacting with disapproval to the answer guarantees it will not be given next time.
Common questions
- Will my doctor be angry if I tell them?
- Most will not, and increasingly clinicians ask about it routinely. Even if the conversation is uncomfortable, it is much safer than them not knowing — and you can decline advice you disagree with while still having given them the information.
- Is traditional medicine tested for safety?
- Not in the way registered medicines are. There is no standard dose, no consistent composition, and no systematic safety monitoring, which is why disclosure and caution matter — particularly with liver or kidney problems, in pregnancy and in children.
- Can I take something traditional for HIV instead of ARVs?
- No. Nothing has been shown to control HIV other than antiretroviral treatment, and stopping ARVs allows the virus to rebound and resistance to develop. If you want to use traditional medicine alongside, tell the clinic so interactions can be checked.
Sources
- Primary Healthcare Standard Treatment Guidelines and Essential Medicines ListNational Department of Health, South Africa
- Medicines regulation, safety communications and adverse event reportingSAHPRA
- Medication safety and clinical guidanceWorld Health Organization
Last reviewed 4 August 2026.