An evidence-based systematic review of herb and supplement interactions by the Natural Standard Research Collaboration

Abstract

Reported utilisation of prescription drug use concurrently with herbal or vitamin products have increased, placing an estimated 15 million patients at risk of potential drug-supplement interactions. This systematic review aims to consolidate relevant herb and supplement interactions data available for some of the more common classes of interactions experienced by clinicians. These classes include: hypoglycaemic/hyperglycaemics; hypotensive/hypertensives, diuretics, sedatives, cardiac glycosides, monoamine oxidase inhibitors, selective serotonin reuptake inhibitors, laxatives, immunomodulators, agents that may increase the risk of bleeding or clotting, agents that may be hepatotoxic, agents that may have hormonal properties, and agents with cytochrome P450 enzyme activity. The format is designed to promote use as a decision support tool for healthcare providers.

The Use of Complementary and Alternative Medicine in Pediatrics

“…[70][71][72][73][74][75][76][77][78][79] Because of regulations differing from those governing the use of pharmaceuticals, there are concerns about the purity and potency of herbal products and other dietary supplements sold in the United States. Product quality is influenced by many factors, including which portion of the plant is used (ie, root, stem, leaves, flowers), the time of harvest (ie, young versus old plants), the handling of the product, and proper identification of the plant.…”

A Review of Dietary Supplement–Induced Renal Dysfunction

“…Licorice produces rhabdomyolysis-induced renal dysfunction as a result of potassium diuresis. Several other dietary supplements have been used for their diuretic-like effects, and these agents should be used with caution, especially in patients with underlying renal dysfunction or those who take prescription diuretics (67). A list of these agents can be found in Table 3.…”

“…Dietary supplements with documented hepatorenal syndrome are discussed next. However, many CAM are hepatotoxic but have yet to produce published reports of hepatorenal syndrome (67). Table 4 contains those CAM with reported hepatotoxic adverse events.…”

“…In 19 of the 21 patients without carcinoma, urothe- Table 4. Hepatotoxic dietary supplements (common names) (39,67) lial lesions, resulting from mild to moderate dysplasia, were discovered. The authors concluded that cumulative exposure to Ͼ200 g of aristolochic acid significantly increased the risk for urothelial malignancies.…”

Ethics and Culture in Mental Health Care

“…This could be accomplished by searching the growing scientific literature on complementary and alternative medicines and/or by consulting with a knowledgeable colleague (Adams et al, 2002;Ulbricht, Basch, Weissner & Hackman, 2006). Once the psychiatrist had a better understanding of the data regarding the herbs' safety, efficacy, and potential for drug interactions, she would have been able to inform her patient about the risks and benefits of the herbal medicines and make a recommendation based on scientific evidence.…”