In a systematic review of observational studies the intensity of exposure to ergotamine, but not to triptans, was associated with increased incidence of serious cardiovascular outcomes in patients with migraine. A national pharmacoepidemiological study showed that use of triptans in the second trimester of pregnancy was associated with increased risk of post-partum haemorrhage. In the same study, use of triptans before pregnancy was associated with increased risk of congenital malformations, low birth weight and pre-term birth. A case of acute haemolytic anaemia possibly related to Ginkgo biloba leaf extract was reported. Two cases of possible muscle damage with raised creatinine kinase and lactate dehydrogenase concentrations were associated with the use of diosmin. In vitro studies described potential mechanisms responsible for Ginkgo biloba-associated tumorigenicity and genotoxicity, benzbromarone-associated liver toxicity, and tadalafil-associated alterations in hepatic glucose homeostasis.