Herb-drug interactions

  title={Herb-drug interactions},
  author={Adriane Fugh-Berman},
  journal={The Lancet},

Tables from this paper

Herb-Drug Interactions

An extensive review of the literature identified reported herb-drug interactions with clinical significance, although the underlying mechanisms for the altered drug effects and/or concentrations by concomitant herbal medicines are yet to be determined.

Pharmacodynamic and pharmacokinetic interactions between herbs andwestern drugs

It was reported that anticoagulation was enhanced in addition to bleeding when patients took long-term warfarin therapy in combination with Salvia miltiorrhiza, and laxative herbs accelerate intestinal transit and interfere with the absorption.

Pharmacokinetic interactions between herbal remedies and medicinal drugs

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In transplant patients, self-medication with St John's wort has led to a drop in plasma levels of the immunosuppressant drug cyclosporine, causing tissue rejection, and it is essential that the ability of herbal products to interfere with drug-metabolizing enzyme systems is fully established.

Interactions Between Herbal Medicines and Prescribed Drugs

Interactions between herbal medicines and synthetic drugs exist and can have serious clinical consequences, and healthcare professionals should ask their patients about the use of herbal products and consider the possibility of herb-drug interactions.

Herb–Drug Interactions with St John’s Wort (Hypericum perforatum): an Update on Clinical Observations

St John’s wort extracts, prepared from the aerial parts of Hypericum perforatum, contain numerous pharmacologically active ingredients, including naphthodianthrones, which are widely used for the treatment of mild-to-moderate depression.

Herbal remedies: drug-herb interactions.

Patients taking drugs with a narrow therapeutic index (cyclosporine, digoxin, hypoglycemic agents, lithium, phenytoin, procainamide, theophylline, tricyclic antidepressants, and warfarin) should be discouraged from using herbal products.

Herb -Drug Interactions -An Update on Synergistic Interactions

Several synergistic reports on herb-drug interactions in the area of antimicrobials, antineoplastics, antidiabetics, cardiovascular actives, antihepatotoxics, CNS actives etc are discussed.

Pharmacokinetic Interactions of Drugs with St John’s Wort

The available data indicate that St John’s wort is a potent inducer of CYP 3A4 and P-glycoprotein (PgP), although it may inhibit or induce other CYPs, depending on the dose, route and duration of administration.

Interactions between antiepileptic drugs and herbal medicines

The purpose of this review is to highlight the interactions that have been reported between AEDs and herbal medicines and to clarify the propensity of AED's and herbal medicine to interact and therefore compromise the therapeutics of A EDs.

Herb and dietary supplement interactions with cardiovascular drugs.

Herbal medicines may mimic, decrease, or increase the action of prescribed drugs, which is especially important for drugs with narrow therapeutic windows, and in sensitive patient populations, such as the elderly, chronically ill, and those with compromised immune systems.



Potential Metabolic Interaction between St. John's Wort and Theophylline

The increase in theophylline concentrations observed in this patient after discontinuation of St. John’s wort suggests that components of this herbal supplement may have induced hepatic enzymes (namely, CYP1A2) necessary for theophyLLine clearance.

St. John's Wort and Antidepressant Drug Interactions in the Elderly

A series of five cases of clinically diagnosed central serotonergic syndrome among elderly patients who combined prescription antide pressants with St. John's wort requires further evaluation due to potential for drug interactions with central ner vous system agents and for more definitive therapeutic indications.

Potentiation of Warfarin by Dong Quai

A 46‐year‐old African‐American woman with atrial fibrillation stabilized on warfarin experienced a greater than 2‐fold elevation in prothrombin time and international normalized ratio after taking dong quai concurrently for 4 weeks, and coagulation values returned to acceptable levels 1 month after discontinuing the herb.

Dietary supplements and natural products as psychotherapeutic agents.

There is intriguing preliminary evidence for the use of folate, tryptophan, and phenylalanine as adjuncts to enhance the effectiveness of conventional antidepressants and omega-3 polyunsaturated fatty acids, particularly docosahexaenoic acid, may have mood-stabilizing effects.

Pharmacokinetic interaction of digoxin with an herbal extract from St John's wort (Hypericum perforatum)

The interaction between hypericum extract LI160 and digoxin is studied to study the pharmacokinetics of ingredients and drug interactions of St John's wort.

Chinese herbs and warfarin potentiation by ‘Danshen’

A case of danshen‐induced overcoagulation with severe and dangerous abnormalities of clotting in a patient with rheumatic heart disease is reported.

Maternal ginseng use associated with neonatal androgenization.

To the Editor.— The termginsengrefers to any of 22 different plants, usually of the genusPanax, used as a tonic and restorative. It is estimated that 5 million people in North America consume ginseng

Lesson of the week: hypokalaemia and hypertension associated with use of liquorice flavoured chewing gum

Two cases showing that hypokalaemia induced by glycyrrhizinic acid should be considered in patients with hypertension or oedema even if they have not eaten sweets that obviously contain liquorice are described.