A Study of the Co-Administration of Herbal and Western Medicines to Hospitalized Patients with Osteoarthritis

Abstract

Objectives: The combined use of herbal and Western medicine is increasing. However, herbal medicine is highly likely to interact with Western medicine making it important to understand the effects of co-administration. This study investigates the ratio of patients who take Western medicine with herbal medicine, the types of medicines commonly prescribed together, and the results of hospital examinations. Methods: We investigated patients who were hospitalized at Kyung Hee University Korean Medical Hospital for at least one day from January 1, 2010 to December 31, 2017. There were some inclusion criteria. First, we chose patients aged 19 and over. Second, we chose patients who were diagnosed with osteoarthritis (OA) with diagnosis codes M13, M15, M17 according to KCD-7. Third, patients had liver function tests, renal function tests, and general hematology tests performed at least two times during hospitalization. Results: Among a total of 131 OA patients, 32 (24.4%) patients were treated with herbal-Western medicine combination therapy. The most commonly prescribed herbal medicine was Daegalwhal-tang, and the most commonly prescribed Western medicine was celecoxib. In the laboratory findings, all liver function tests, renal function tests, and general hematology tests showed no difference compared to admission day. There were also no differences between herbal medicine single treatment and herbal-Western medicine combination treatment. Conclusions: From these results, we suggest that herbal medicine single treatment and herbal-Western medicine combination treatment for OA patients does not cause adverse effects.

Pharmacokinetic Analysis and Biomarker‐Assisted Safety Assessment of Acetaminophen in Combination With Ojeok‐san Compared With Acetaminophen Alone

“…In a recent study, liver function tests were performed at admission and discharge in a group of osteoarthritis patients administered herbal medicine versus a group administered a herbalconventional medicine combination. 34 The results from that study showed that, although no differences in liver function were observed between the 2 groups, the patients who showed a slight increase in γ -GT levels in the herbal-conventional drug combination therapy group were all taking acetaminophen. 34 Taken together, our results indicate that further studies with long-term dosing and DILI monitoring, assisted by measurements of serum miR-122 levels, may be helpful in investigating the effects of Ojeok-san on potential acetaminopheninduced liver injury.…”

“…No clinically significant findings were observed in the safety and tolerability assessments, including AE monitoring. In a recent study, liver function tests were performed at admission and discharge in a group of osteoarthritis patients administered herbal medicine versus a group administered a herbal‐conventional medicine combination . The results from that study showed that, although no differences in liver function were observed between the 2 groups, the patients who showed a slight increase in γ‐GT levels in the herbal‐conventional drug combination therapy group were all taking acetaminophen .…”

Utilization Trends and Concentration Ratio of Korean Medicine: Based on the National Health Insurance Data

“…Herbal preparations are relatively safe since they are based on traditionally used prescriptions; however, they can cause synergies or drug interactions when administered in combination with other medications. Studies that show this have included interactions with certain drugs or diseases such as antiplatelet drugs and osteoarthritis, reporting that a combination www.journal-jop.org of herbal preparations and medicines is relatively safe [4,5].…”