Medicines containing Garcinia gummi-gutta (Garcinia cambogia) or hydroxycitric acid (HCA)

Rare link with liver injury

We have become aware of an increasing number of cases of liver injury reported in scientific literature, by consumers who had taken products containing Garcinia gummi-gutta/HCA. Older literature reports mostly involved additional ingredients that may have contributed to the liver injury, but recently more cases have been published with Garcinia gummi-gutta (Garcinia cambogia)/HCA as the only suspected ingredient in the liver injury. 

Many of these cases were severe and required hospitalisation. Of particular concern, 5 cases resulted in liver transplantation, one of which was an Australian case.

We are also aware of several cases of liver injury reported to regulators in other countries.

We have also received a small number of reports of possible liver-injury involving Garcinia ingredients. However, most reports contained limited information about the medicines consumed and some cases involved other ingredients that may have contributed to liver injury.

In response to this safety concern, we completed an investigation into the risk of liver injury for the ingredient Garcinia gummi-gutta (Garcinia cambogia) and its naturally occurring component HCA. Available evidence shows that there may be a rare risk of liver injury from taking Garcinia gummi-gutta (Garcinia cambogia) or HCA. Liver injury concerns also apply to the other HCA-containing ingredients.

We will continue to monitor this issue and are currently considering further regulatory action, including consultation on proposed requirements for a label warning. We will publish the outcome of this consultation including the details of any new labelling requirements in late 2024.

About Garcinia species 

Medicines and herbal supplements containing Garcinia gummi-gutta (sometimes also called Garcinia cambogia) and other HCA-ingredients can be bought in supermarkets, health food shops and pharmacies without a prescription and without the advice of a health professional.

The fruit rind of Garcinia gummi-gutta and Garcinia quaesita naturally contains HCA. HCA can be extracted and used in listed medicines as an active ingredient and is present in the other Garcinia-related ingredients.

There are currently over 50 listed medicines included in the Australian Register of Therapeutic Goods (ARTG) that contain one or more of these ingredients.

Information for consumers

If you take medicines or herbal supplements containing Garcinia-related ingredients, you should be aware of the possible risk for liver injury. While liver injury is a rare side effect, it can be severe. However, the risks are reduced if you recognise the early signs and stop taking the medicine or herbal supplement.

You should immediately stop taking it and seek medical advice if you experience any of the following symptoms: 

• yellowing of the skin or eyes
• dark urine
• nausea
• vomiting
• unusual tiredness
• weakness
• stomach or abdominal pain
• loss of appetite.

As a precaution, if you currently have or have had liver problems, you should avoid medicines and herbal supplements containing Garcinia-related ingredients.

If you have any concerns or questions about this issue, you should discuss them with your health professional. You can report any suspected side effects from medicines or herbal supplements to us or your health professional.

Please note that some reports of liver damage involved products purchased online from overseas. You should exercise caution when considering buying medicines online. Medicines bought online from overseas are not regulated by us for quality and safety.

The benefits of purchasing complementary medicines that are regulated by us include that you have assurances that those products contain the ingredients listed on the label and are made under strict manufacturing standards. If you buy unregulated medicines, either from a local retailer or online, you may be wasting your money and risking your health.

You can identify if a medicine has been included on the ARTG by checking to see if it has an AUST R or AUST L number on the medicine label. For further information, see How we regulate medicines.

Information for health professionals

Health professionals should be aware that products containing Garcinia-related ingredients may cause liver injury in some individuals in rare cases. When treating patients who are presenting with symptoms of liver injury, you should consider whether a complementary medicine could be involved.

Use of medicines or herbal supplements containing these ingredients should be avoided in patients with existing or previous liver pathologies.

Information for sponsors

Sponsors of products containing Garcinia-related ingredients should be aware of this issue and take appropriate risk mitigation action if the available evidence alters the risk-benefit profile for their products.

Sponsors are also reminded of their obligation to report all serious adverse events and significant safety issues to us within required timeframes.

Reporting problems

Consumers and health professionals are encouraged to report problems with medicines or vaccines. Your report will contribute to our monitoring of these products.

We cannot give advice about an individual's medical condition. You are strongly encouraged to talk with a health professional if you are concerned about a possible adverse event associated with a medicine or vaccine.