Pregnancy, prescription medicines and the potential risk of herb-drug interactions: a cross-sectional survey

Abstract

BackgroundPregnant women are routinely prescribed medicines while self-medicating with herbal natural products to treat predominantly pregnancy related conditions. The aim of this study was to assess the potential for herb-drug interactions (HDIs) in pregnant women and to explore possible herb-drug interactions and their potential clinical significance.MethodsA cross-sectional survey of women during early pregnancy or immediately postpartum in North-East Scotland. Outcome measures included; Prescription medicines use excluding vitamins and potential HDIs assessed using Natural Medicines Comprehensive Database.ResultsThe survey was completed by 889 respondents (73% response rate). 45.3% (403) reported the use of at least one prescription medicine, excluding vitamins. Of those taking prescription medicines, 44.9% (181) also reported concurrent use of at least one HNP (Range 1–12). A total of 91 different prescription medicines were reported by respondents using HNPs. Of those taking prescription medicines, 44.9% (181) also reported concurrent use of at least one HNP (Range 1–12). Thirty-four herb-drug interactions were identified in 23 (12.7%) women with the potential to increase the risk of postpartum haemorrhage, alter maternal haemodynamics, and enhance maternal/fetal CNS depression.Almost all were rated as moderate (93.9%), one as a potentially major (ginger and nifedipine) and only one minor (ondansetron and chamomile).ConclusionAlmost half of pregnant women in this study were prescribed medicines excluding vitamins and minerals and almost half of these used HNPs. Potential moderate to severe HDIs were identified in an eighth of the study cohort. Healthcare professionals should be aware that the concurrent use of HNPs and prescription medicines during pregnancy is common and carries potential risks.

Prevalence of drug–herb and drug–supplement interactions in older adults: a cross-sectional survey

“… 13 The study participants were community-dwelling older adults recruited from general practices; previous UK studies have researched patients with cancer, 19 diabetes, 20 , 21 and pregnant women. 22 …”

Utilisation of a NSW teratology information service by pharmacists and patients referred by a pharmacist from 2000 to 2018

“…A recent qualitative study also described significant uncertainty among community pharmacists in providing advice to pregnant women regarding uncategorised medications despite being some of the main suppliers of complementary medicines . An analysis of complementary medicine use by pregnant women indicates that there is often potential for significant drug–herb interactions as many women also use conventional medicines, not to mention concerns about the purity of the compounds and paucity of evidence‐based data about their efficacy . In addition, complementary products may include excipients which may have unknown or unanticipated side effects or interactions with prescribed medications.…”

Self-medication practice among pregnant women in Brazzaville

“…[14][15][16][17][18][19][20] However, its use at doses above four grams may cause maternal or fetal liver damage. 20,21 The use of drugs by pregnant women can be harmful to the mother: this is the case for chloramphenicol, taken as self-medication by nine pregnant women to treat without diagnostic arguments what were probably malaria attacks. It may still cause developmental abnormalities or organ maturation defects in the fetus or newborn.…”