Content area
Full Text
Context * Patients often combine prescription medications with herbal and dietary substances (herein referred to as herbal medicines). A variety of potential adverse herb-drug interactions exist based on the pharmacological properties of herbal and prescription medications.
Objective * To determine the incidence of potential and observed adverse herb-drug interactions in patients using herbal medicines with prescription medications.
Design * Consecutive patients were questioned about their use of herbal medicines in 6 outpatient clinics. Patients reporting use of these products provided a list of their prescription medications, which were reviewed for any potential adverse herb-drug interactions using a comprehensive natural medicine database. Any potential adverse herb-drug interactions prompted a review of the patient's chart for evidence of an observed adverse herb-drug interaction.
Main Outcome Measure * The rate of potential and observed adverse herb-drug interactions.
Results * Eight hundred four patients were surveyed, and 122 (15%) used herbal medicines. Eighty-five potential adverse herb-drug interactions were found in 49 patients (40% of herbal medicine users). Twelve possible adverse herb-drug interactions in 8 patients (7% of herbal medicine users) were observed. In all 12 cases, the severity scores were rated as mild, including 8 cases of hypoglycemia in diabetics taking nopal (prickly pear cactus).
Conclusions * A substantial number of potential adverse herb-drug interactions were detected and a small number of adverse herb-drug interactions observed, particularly in diabetics taking nopal. Screening for herbal medicine usage in 804 patients did not uncover any serious adverse interactions with prescription medications. (Altern Ther Health Med. 2007;13(2):30-35.)
The use of herbal and dietary substances (herein referred to as herbal medicines) in the United States has increased substantially during the last decade. National telephone surveys documented an increase in the percentage of respondents using herbal remedies from 2.5% in 1990 to 18.8% in 2002.1,2 The common use of herbal medicines has been confirmed in smaller clinical studies, with use by 22% of patients in an internal medical clinic and 18% of patients in an arthritis clinic.3,4 Approximately 16% of patients combine herbal medicines with prescription medications.5 Herbal medicines have been associated with a variety of adverse herb-drug interactions;6,7 however, the actual incidence of adverse herb-drug interactions in patients using multiple herbal and prescription medications has not been measured.
A variety of herb-drug...