Pharmacovigilance of herbal medicines: Concerns and future prospects

Choudhury, Abinash; Singh, Preet Amol; Bajwa, Neha; Dash, Subhransu Sekhar; Bisht, Preeti

doi:10.1016/j.jep.2023.116383

Cited by 39 publications

(13 citation statements)

References 142 publications

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“…Individual variations in metabolism and health status also play a role in these interactions, so it is important to monitor adverse drug reactions (ADRs) because dietary supplements, often derived from plants and other natural sources, may contain active compounds that can interact with prescription medications. These interactions can lead to a range of ADRs, including reduced drug efficacy, increased drug toxicity, or even life-threatening conditions [ 5 ]. Understanding these interactions can help healthcare providers and patients make informed decisions about the use of supplements alongside medications.…”

Section: Introductionmentioning

confidence: 99%

Flavonoids as CYP3A4 Inhibitors In Vitro

Kondža,

Brizić,

Jokić

2024

Biomedicines

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Flavonoids, a diverse group of polyphenolic compounds found abundantly in fruits, vegetables, and beverages like tea and wine, offer a plethora of health benefits. However, they have a potential interaction with drug metabolism, particularly through the inhibition of the cytochrome P450 3A4 enzyme, the most versatile and abundant enzyme in the liver. CYP3A4 is responsible for metabolizing approximately 50% of clinically prescribed drugs across diverse therapeutic classes, so these interactions have raised concerns about potential adverse effects. This review delves into the scientific evidence surrounding flavonoid-mediated CYP3A4 inhibition, exploring the inhibitory potential of investigated flavonoids and future implications. Kusehnol I, chrysin, leachianone A, and sophoraflavone G showed the largest inhibitory potentials and lowest IC50 values. While the clinical significance of flavonoid-mediated CYP3A4 inhibition in dietary contexts is generally considered low due to moderate intake and complex interactions, it poses a potential concern for individuals consuming high doses of flavonoid supplements or concurrently taking medications metabolized by CYP3A4. This can lead to increased drug exposure, potentially triggering adverse reactions or reduced efficacy.

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Section: Introductionmentioning

confidence: 99%

Flavonoids as CYP3A4 Inhibitors In Vitro

Kondža,

Brizić,

Jokić

2024

Biomedicines

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“…As showed in Figure 1 , it is integrated a total of 1,241 reports found using the PubMed Database from the period of 1967–2024 by considering the phrase “Pharmacological interaction of herb-drug”. These publications were original investigations (940) and reviews (301) with cases of antagonism (42) or synergism (84) in the pharmacological interactions, as well as 248 mentions of toxicity that emphasize the lacking and required pharmacovigilance of herbal therapy ( Choudhury et al, 2023 ) alone or combined with other therapies.…”

Section: Introductionmentioning

confidence: 99%

Editorial: Pharmacological interaction between drugs and medicinal plants, Volume II

González-Trujano,

Ventura-Martínez,

Silveira

et al. 2024

Front. Pharmacol.

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“…1 20 23–25 For instance, IHM use could result in heartburn, increased blood flow, miscarriage, premature labour and allergic reactions. 27 They also have herb–drug interactions, 28 are associated with induced liver injury 29 , and complicate the care of pregnant women who have pre-existing conditions such as epilepsy or asthma. 21 Moreover, intrauterine death and intrauterine growth restriction, uterine rupture, stillbirth, birth defects of the eye, ear and heart, and other risks have also been linked to the use of IHMs by pregnant women.…”

Section: Introductionmentioning

confidence: 99%

Indigenous herbal medicine use and its associated factors among pregnant women attending antenatal care at public health facilities in Dire Dawa, Ethiopia: a cross-sectional study

Mohammed,

Amsalu,

Hailu

et al. 2024

BMJ Open

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ObjectiveThe aim of this study was to investigate the prevalence of indigenous herbal medicine use and its associated factors among pregnant women attending antenatal care (ANC) at public health facilities in Dire Dawa, Ethiopia.DesignA facility-based cross-sectional study design.SettingThe study was conducted in seven public health facilities (one referral hospital, three urban and three rural health centres) in Dire Dawa, Ethiopia, from October to November 2022.Participants628 pregnant women of any gestational age who had been on ANC follow-up at selected public health facilities were included.Main outcome measuresPrevalence of indigenous herbal medicine (users vs non-users) and associated factors.ResultsThe study revealed that 47.8% (95% CI 43.8% to 51.6%) of pregnant women used herbal medicines. Lack of formal education (adjusted OR, AOR 5.47, 95% CI 2.40 to 12.46), primary level (AOR 4.74, 95% CI 2.15 to 10.44), housewives (AOR 4.15, 95% CI 1.83 to 9.37), number of ANC visits (AOR 2.58, 95% CI 1.27 to 5.25), insufficient knowledge (AOR 4.58, 95% CI 3.02 to 6.77) and favourable perception (AOR 2.54, 95% CI 1.71 to 3.77) were factors significantly associated with herbal medicine use. The most commonly used herbs were garden cress (Lepidium sativum) (32%), bitter leaf (Vernonia amygdalina) (25.2%), moringa (Moringa oleifera) (24.5%).Commonindications were related to gastrointestinal problems, blood pressure and sugar.ConclusionThe prevalence of herbal medicine use is high (one in two pregnant women) and significantly associated with education level, occupation, ANC visits, knowledge and perceptions. The study’s findings are helpful in advancing comprehension of herbal medicines using status, types and enforcing factors. It is essential that health facilities provide herbal counselling during ANC visits, and health regulatory bodies ought to raise awareness and implement interventions to lower the risks from over-the-counter herbal medicine use by pregnant women.

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Pharmacovigilance of herbal medicines: Concerns and future prospects

Cited by 39 publications

References 142 publications

Flavonoids as CYP3A4 Inhibitors In Vitro

Flavonoids as CYP3A4 Inhibitors In Vitro

Editorial: Pharmacological interaction between drugs and medicinal plants, Volume II

Indigenous herbal medicine use and its associated factors among pregnant women attending antenatal care at public health facilities in Dire Dawa, Ethiopia: a cross-sectional study

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