Part 6 of 6 in the "Chinese herb risks and checkpoints" series. The list of the other five is at the foot of this part.

The first five parts were about things: which class has a record, how to check it, how to store it. This part is about people — the situations where you ask first and drink second.

This is the part of the series to read first. Every item below names its source; the signs themselves and their tiers are unchanged, and all that has been added is a reason.

The short version

• Grouped by situation, not by constitution: on Western medication, surgery coming up, pregnant or trying or breastfeeding, infants and children, older adults and anyone under long-term review.
• If you experience discomfort or an unusual reaction after taking herbs, stop taking them and contact your practitioner.
• A severe allergic reaction (such as difficulty breathing or facial swelling) or loss of consciousness is the one item that means calling 999 now — the reason is on that item below.
• Never stop or adjust your Western medication on your own. Stopping a herb and changing Western medication are two different things.

A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.

I. Situations that need extra care

Grouped by situation, not by constitution.

• On Western medication. How herbs and Western medication are arranged is in "Can You Take Chinese Herbs With Western Medication?" (/chinese-herbs-with-western-medicine/). Let both your TCM practitioner and your doctor know what you take; never stop or adjust your Western medication on your own.
• Surgery coming up. Singapore's HealthHub (Ministry of Health, content by the Health Sciences Authority) says: if you are scheduled for a surgical operation, inform your doctor about any Chinese proprietary medicine you are taking; some products may interfere or interact with anaesthetics and other medicines used during surgery, and you may also be required to stop taking them before the operation. Whether and when to stop is the surgical team's call.
• Pregnant, trying, or breastfeeding. Singapore's HealthHub (Ministry of Health, content by the Health Sciences Authority) notes that Chinese proprietary medicines carry information on documented side effects and contraindications, such as pregnancy and lactation, on their labels. If the label says so, do not use it; if the label says nothing, ask a practitioner first.
• Infants under 12 months, and children. Singapore's HealthHub (Ministry of Health, content by the Health Sciences Authority) notes that in general, Chinese proprietary medicine should not be given to infants under 12 months of age unless advised by a TCM practitioner. For older children, give the practitioner the age, the weight and what is in the packet together.
• Older adults, chronic conditions under regular review, and anyone with an existing kidney or liver condition. Tell both your doctor and your practitioner what herbs you take, and leave prescribed medication as it is. TCM and Western medicine complement each other; it is not a choice between them.
• ⚠️ I feel unwell after taking herbs: If you experience discomfort or an unusual reaction, stop taking the herbs and contact your practitioner. Do not stop or adjust your Western medication on your own. If you experience a severe allergic reaction (such as difficulty breathing or facial swelling) or loss of consciousness, call 999 now, or go to the nearest hospital emergency department. The NHS's anaphylaxis page puts "your lips, mouth, throat or tongue suddenly become swollen", "you're breathing very fast or struggling to breathe" and "you suddenly become very confused, drowsy or dizzy" on its own "Call 999 if" list; that page states that anaphylaxis is a life-threatening allergic reaction that happens very quickly, can be caused by food, medicine or insect stings, and that these can be signs of a serious allergic reaction and may need immediate treatment in hospital.
• ⚠️ I plan to increase or decrease the dosage myself: Never do this. The dosage was determined through assessment. Adjusting it yourself is equivalent to changing the treatment plan on your own.

A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.

II. Where the reason was added, and where it stops

Only one item above gained a reason: the 999 item. What was added is a reason, not a band — the NHS page's own tier for those signs is "Call 999", the same tier these items already carried.

Two places where this part stops, stated here rather than filled in.

• The older-adults, long-term-review and existing kidney or liver condition item has no reason to add. None of the material quoted in this series gives a cause or a mechanism for that item; it is a be-thorough reminder rather than a sign. Where the material stops, this part stops.
• The self-adjusting-the-dose item has none either, because it is not a sign from the body; it is a decision.

And one thing to be plain about: a reason tells you what a sign can point to, not what you have. That second question takes Western medical investigation and diagnosis, which a TCM consultation does not substitute for.

A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.

III. Three scenes from life in Malaysia

• A colleague organising a group buy of a particular herb: a recommendation is not an assessment. If you want to try it, photograph the contents and let a practitioner look first.
• A kopi with your herbs during crunch season: see the first question below.
• Direct-sales supplements, "secret family recipes" brought from overseas or bought online: why a supplement whose label says 红曲 or "red yeast rice" is something to tell both your doctor and your practitioner is in the red yeast rice passage of "Can You Take Chinese Herbs With Western Medication?" (/chinese-herbs-with-western-medicine/).

The words in this part

All four are written into the material quoted in this part, and all four are words you may meet at a clinic, on a dispensing label, or on a pre-surgery form.

• Anaphylaxis (严重过敏反应) — the NHS's description: a life-threatening allergic reaction that happens very quickly, which can be caused by food, medicine or insect stings. It is the one situation in this part that goes to 999.
• Anaesthetics (麻醉药) — the medicines used during an operation. Singapore's HealthHub (Ministry of Health, content by the Health Sciences Authority) notes that some Chinese proprietary medicines may interfere or interact with anaesthetics and other medicines used during surgery.
• Side effects (副作用) — Singapore's HealthHub (Ministry of Health, content by the Health Sciences Authority) notes that Chinese proprietary medicines carry information on their documented side effects on their labels, and its examples are nausea and vomiting.
• Taking with warm water (送服) — the Chinese Medicine Regulatory Office's pamphlet "General Knowledge of Taking Chinese Medicines" states that Chinese medicine is generally taken with warm water. That is what "take with warm water" on a dispensing label refers to.

A note: this section is general information only. For conditions like these, follow your doctor's diagnosis and treatment, and seek medical attention when you need it.

Frequently asked

Can I drink coffee while taking Chinese herbs? The Chinese Medicine Regulatory Office's pamphlet "General Knowledge of Taking Chinese Medicines" states that Chinese medicine is generally taken with warm water and that, unless the TCM practitioner instructs otherwise, strong tea is generally not to be drunk at the same time; the pamphlet's pictograms list coffee among the things not to take together with tonifying herbs and with cooling herbs. The pamphlet gives no number of hours for coffee. Which class your prescription belongs to, and how far apart to keep the coffee, is a question for the practitioner who wrote it.

I already see a TCM practitioner — do I still need to tell my doctor? Yes. That is the first item above: let both sides know what you take. Running both together is fine — bring your reports to the consultation, and take what you hear at the consultation back to your doctor. Do not stop, reduce or adjust any Western medication because you have started taking herbs — never stop or adjust your Western medication on your own.

Do not: stop, reduce or adjust any Western medication because you have started taking herbs.

The other five parts

• Part 1: Do Chinese herbs carry risks? Which class has the record, and how Malaysia regulates it
• Part 2: The class with the record: what the record says, and why registration screening catches it
• Part 3: Can I take what I bought? Reading and checking the MAL number and Meditag
• Part 4: One table: what you are holding, and how to check it
• Part 5: Storing Chinese herbs — herbs and 凉茶 ingredients in a hot, humid climate, and when "too long" starts

👉 If you are unsure whether "this packet of herbs, or this bottle of proprietary medicine in my hand, is actually right for me to use", you are welcome to book an online consultation with HansMed, where a practitioner registered under the T&CM Act 2016 assesses it with you; if any of the situations listed in this part applies to you, ask your doctor and your practitioner first.

Sit with a licensed TCM practitioner from wherever you are.

HansMed Modern TCM

Sources

• Singapore MOH HealthHub, "Chinese Proprietary Medicine", contributed by the Health Sciences Authority, page last reviewed 24 July 2025 — https://www.healthhub.sg/well-being-and-lifestyle/personal-care/chinese_proprietary_medicine
• NHS, Anaphylaxis, page last reviewed 21 June 2023 — https://www.nhs.uk/conditions/anaphylaxis/
• Chinese Medicine Regulatory Office, Department of Health, Hong Kong, pamphlet "General Knowledge of Taking Chinese Medicines" — https://www.cmro.gov.hk/files/b5/useful_information/public_health/pamphlet/General_Knowledge_of_Taking_Chinese_Medicines_tc_pp.pdf

本文是「中药的风险与把关」系列的第 6 篇，共 6 篇。另外五篇的清单在文末。

前五篇讲的是东西：哪一类有记录、怎么查、怎么存。这一篇讲的是人——在哪些情况下，先问一句再喝。

这一篇是整个系列里最该先读的一篇。下面每一项都写明出处；信号本身与它的分级照原样保留，加上的只有理由。

一分钟看完

• 按情况分，不按体质分：正在吃西药、即将手术、怀孕备孕哺乳、婴儿与儿童、乐龄人士与长期复诊的人。
• 服用中药后若出现不适或异常反应，请立即停止服用该中药并联络您的医师。
• 若出现严重的过敏反应（如呼吸急促、脸部肿胀）或意识不清，这一项是立刻拨打 999——理由见下面那一条。
• 切勿自行停药或自行调整西药剂量。 停中药和动西药是两件事。

小提醒：本段仅为一般知识说明。相关情况请以西医的诊断与治疗为主，并在需要时及时就医。

一、这些情况要特别小心

以下按情况分，不按体质分。

• 正在吃西药。 中药与西药怎么安排，见〈中药和西药可以一起吃吗〉（/chinese-herbs-with-western-medicine/）。让中医师和西医生都知道您在吃什么；切勿自行停药或自行调整西药剂量。
• 即将手术。 新加坡卫生部 HealthHub 的说明是（内容由卫生科学局提供），若已安排手术，请告知医生您正在服用的中成药；部分产品可能干扰或与麻醉药及术中用药相互作用，您也可能被要求在手术前停用。停不停、何时停，由外科团队决定。
• 怀孕、备孕、哺乳中。 新加坡卫生部 HealthHub 的说明是（内容由卫生科学局提供），中成药的标签会附上已知副作用与禁忌的资讯，例如孕期与哺乳期。标签写了，就不用；标签没写，先问医师。
• 12 个月以下的婴儿与儿童。 新加坡卫生部 HealthHub 的说明是（内容由卫生科学局提供），一般而言，除非中医师建议，12 个月以下的婴儿不应服用中成药。年纪更大的孩子，把年龄、体重和药包成分一起问医师。
• 乐龄人士、慢性病长期复诊、已有肾脏或肝脏问题。 把您在吃的中药告诉两边的医生与医师，处方药一样不动。中医与西医是互相补位的关系，不是二选一。
• ⚠️ 服用中药后出现不适：若出现不适或异常反应，请立即停止服用该中药，并联络您的医师。切勿自行停药或自行调整西药剂量。若出现严重的过敏反应（如呼吸急促、脸部肿胀）或意识不清，请立刻拨打 999，或前往最近的医院急诊部。NHS 的严重过敏反应（anaphylaxis）页把「嘴唇、口腔、喉咙或舌头突然肿胀」「呼吸很快或呼吸困难」「突然变得很困惑、昏沉或头晕」都列在它自己的「Call 999 if」那一项里；该页写明严重过敏反应是一种发生得很快、可能致命的过敏反应，可由食物、药物或昆虫叮咬引起，并写明这些可能是严重过敏反应的征象，可能需要在医院立即处理。
• ⚠️ 我打算自己加量或减量：这是绝对不要做的事。药量是经过评估的，自行调整等于自行改变治疗方案。

小提醒：本段仅为一般知识说明。相关情况请以西医的诊断与治疗为主，并在需要时及时就医。

二、理由加在哪里，以及它停在哪里

上面只有一项加了理由：999 那一项。 加的是理由，不是档位——NHS 那一页自己的分级就是「Call 999」那一档，和这几项原本的档位相同。

两处本篇停住了，说明在这里。

• 乐龄人士、长期复诊、已有肾脏或肝脏问题那一条，没有理由可加。 本篇引用的几份资料都没有为这一条给出成因或机制；它是一条「把话说全」的提醒，不是一个信号。资料停在哪里，这一篇就停在哪里。
• 自行加减剂量那一条也没有理由可加，因为它不是身体的信号，是一个决定。

还有一件事要说清楚：一个信号的理由告诉您它可能指向什么，不告诉您您有什么。后者要靠西医的检查与诊断，中医问诊不能取代。

小提醒：本段仅为一般知识说明。相关情况请以西医的诊断与治疗为主，并在需要时及时就医。

三、大马生活里的三种场面

• 同事约团购某个药材：推荐不是评估。想试，把成分拍给医师看一眼再决定。
• 加班季一杯 kopi 配药：见下面第一题。
• 直销保健品、海外带回、网购的「祖传秘方」：成分表上写着「红曲」「red yeast rice」的保健品为什么要告诉医生与医师，见〈中药和西药可以一起吃吗〉（/chinese-herbs-with-western-medicine/）红曲的一段。

这篇出现的几个词

四个都写在本篇引用的资料上，而且您很可能在诊所、药单或术前问卷上真的遇到。

• 严重过敏反应（anaphylaxis）——NHS 的说明：一种发生得很快、可能致命的过敏反应，可由食物、药物或昆虫叮咬引起。它是本篇唯一一项走 999 的情况。
• 麻醉药（anaesthetics）——手术中使用的药物。新加坡卫生部 HealthHub 的说明是（内容由卫生科学局提供），部分中成药可能干扰或与麻醉药及术中用药相互作用。
• 副作用（side effects）——新加坡卫生部 HealthHub 的说明是（内容由卫生科学局提供），中成药的标签会附上已知副作用的资讯，它举的例子是恶心与呕吐。
• 送服（taking with water）——香港卫生署中医药规管办公室的《服用中药常识》单张写明：中药一般以温开水送服。药单上写「温水送服」，说的就是这件事。

小提醒：本段仅为一般知识说明。相关情况请以西医的诊断与治疗为主，并在需要时及时就医。

常见问题

吃中药期间可以喝咖啡吗？ 香港卫生署中医药规管办公室的《服用中药常识》单张写明：中药一般以温开水送服，除非中医特别指示，一般不宜同时喝浓茶；单张的图示把咖啡列在服补益药、寒凉药时不宜同时吃喝的东西之中。单张没有给咖啡要隔开的时数。您那帖药属于哪一类、咖啡要隔多久，问开方的医师。

我已经在看中医，还需要告诉西医生吗？ 需要。上面第一条就是这件事：让两边都知道您在吃什么。两边并行是可以的——把报告带去问诊，也把问诊听到的话带回去给医生。不要因为开始吃中药就自行停掉、减少或调整任何西药——切勿自行停药或自行调整西药剂量。

不要这样做： 不要因为开始吃中药就自行停掉、减少或调整任何西药。

这个系列的另外五篇

• 第 1 篇：中药也有风险？有记录的是哪一类，马来西亚怎么管
• 第 2 篇：有记录的那一类：资料怎么记录它，为什么注册审查能把关
• 第 3 篇：买回来的能不能吃？MAL 编号与 Meditag 怎么看，怎么查
• 第 4 篇：一张表看懂：手上的东西是哪一种，怎么把关
• 第 5 篇：中药怎么存放——湿热气候里的药材与凉茶料，放多久算太久

👉 如果您不确定「我手上这包药材、这瓶中成药，到底能不能用」，欢迎透过汉方中医的线上问诊，由依 2016 年 T&CM 法令注册的医师为您评估；若您有本篇列出的任何一项情况，请先问医生与医师。

无论身在何处，与持证中医师对坐。

汉方现代中医

资料来源

• 新加坡卫生部 HealthHub，〈Chinese Proprietary Medicine〉，内容由卫生科学局提供，页面最后审阅 2025 年 7 月 24 日 — https://www.healthhub.sg/well-being-and-lifestyle/personal-care/chinese_proprietary_medicine
• NHS，Anaphylaxis，页面最后审阅 2023 年 6 月 21 日 — https://www.nhs.uk/conditions/anaphylaxis/
• 香港卫生署中医药规管办公室，《服用中药常识》单张 — https://www.cmro.gov.hk/files/b5/useful_information/public_health/pamphlet/General_Knowledge_of_Taking_Chinese_Medicines_tc_pp.pdf