CA has no known toxicity in recommended doses. Side effects are rare but may include skin allergy and burning sensations (with external use), headache, stomach upset, nausea, dizziness, and extreme drowsiness which tend to occur with high doses of the herb. The fresh plant may have a low potential for skin irritation. A Contact dermatitis has been reported on a few occasions using topical preparations [76] . Subcutaneous injections can trigger allergic reactions, cause pain at the injection site, or cause discoloration. Side effects occur less often when using intramuscular injections. Orally consuming an excessive amount of CA (i.e., overdose) can cause headaches and transient unconsciousness. Also, it is postulated that chronic treatment may prevent women from becoming pregnant by causing spontaneous abortion [77] . As there is little or no information regarding the safety of this herb during breast feeding, nursing mothers are advised to refrain from taking this herb. During prolonged treatment, especially with higher doses, the metabolism of active constituents slows down and can produce toxicity, so it was suggested that this pharmacokinetic phenomena should be considered during pharmacotherapy for effective and safe treatment [78] . The use of CA for more than 6 weeks is not recommended in the literature. People taking the herb for an extended period of time (up to 6 weeks) should take a 2-week break before taking the herb again. The standardized CA extracts and asiaticoside were well tolerated in experimental animals especially by oral route. Asiaticoside did not show any sign of toxicity up to the dose of 1 mg/kg after oral administration, whereas the toxic dose by intramuscular application reported for mice and rabbits was 40-50 mg/kg [79] .