The potential impact of the use of homeopathic and herbal remedies on monitoring the safety of prescription products

Abstract

<jats:p> The purpose of this paper is to explore the possibility that adverse reactions and drug interactions arising from the use of homeopathic and herbal medicines could lead to confusion when adverse reactions to conventional medicines are reported. An extensive literature review was conducted on the occurrence of adverse reactions and drug interactions following the use of homeopathic or herbal remedies, and the potential for these to confound adverse event reporting to conventional medicines considered. The survey demonstrates the potential for herbal remedies and homeopathic products, to produce adverse drug reactions or drug interactions, and shows the scope for potential for confusion with those arising from conventional medicines. There is a need for greater awareness that adverse reactions apparently due to a conventional medicine, might in reality be due to a herbal medicine or a drug interaction between a herbal medicine and a conventional drug, particularly when a health professional is unaware of the extent of a patient's selfmedication with alternative therapies. </jats:p>

Drug Interactions With Herbal Medicines

“…This is important because adverse reactions observed following use of conventional medicines might in reality be due to HM or herb-drug interactions, when physicians and other healthcare providers are unaware of the extent of a patient's self medication with alternative therapies. 97 Herb-drug interactions must be monitored. Scientific recommendations on the use of HM and their coadministration with conventional therapy should be based on robust scientific data rather than on the inadequate data of case reports only.…”

Drug Safety Reports on Complementary and Alternative Medicines (Ayurvedic and Homeopathic Medicines) by a Spontaneous Reporting Program in a Tertiary Care Hospital

“…23 A review by Woodward et al on the safety concerns of herbal remedies has revealed many potential adverse effects, including life-threatening effects. 6 Similarly to conventional medicines, various safety-related aspects are of concern for CAMs. ADRs to herbal medicine may arise not only from the pharmacological and toxicological effects of the active constituent or constituents, but also depend on problems in commercial manufacture and extemporaneous compounding.…”

“…4,5 Patients often turn to CAMs, for chronic and inflammatory conditions, and those refractory to the effects of conventional products. 6 exercise, and lifestyle modification where necessary. 10 Homeopathy is also an established and well-accepted treatment approach, with its origin tracing back to the 1800s.…”

Predicting Future Human and Environmental Health Challenges: The Health and Environmental Sciences Institute's Scientific Mapping Exercise

“…kinetics, metabolism, mechanisms of toxicity) (National Research Council, 1996). There are several well-documented toxicities associated with the use of alternative therapies (Colson and De Broe, 2005;Duleba et al, 2006;Fraunfelder, 2005;Niggemann and Gruber, 2003;Woodward, 2005), such as severe renal urothelial toxicity and carcinogenicity resulting from the intake of natural weight-loss supplements containing aristolochic acid (Cosyns et al, 1999), and the recently demonstrated association between cardiovascular toxicity and the intake of supplements containing ephedra (Fontanarosa et al, 2003). Furthermore, alternative therapies can influence the pharmacokinetics of pharmaceuticals that are also taken by the patient, possibly decreasing the desired pharmacologic and therapeutic effect or increasing the risk of an adverse effect.…”