scholarly journals Best Available Evidence in Cochrane Reviews on Herbal Medicine?

2013 ◽  
Vol 2013 ◽  
pp. 1-7 ◽  
Author(s):  
Elyad Davidson ◽  
Julia Vlachojannis ◽  
Melainie Cameron ◽  
Sigrun Chrubasik
Keyword(s):  
Herbal Medicine ◽  
Adverse Events ◽  
Drug Interactions ◽  
Gold Standard ◽  
Herbal Medicines ◽  
Effect Sizes ◽  
Final Word ◽  
Intervention Effects ◽  
Plant Parts ◽  
Cochrane Reviews

Cochrane reviews are considered by many to be the “gold standard” or the final word in medical conversation on a topic. We explored the eleven most relevant Cochrane reviews on herbal medicine and identified that frequently herbal medicines in the included studies had not been sufficiently well characterised. If data on the effects of the plant parts are unavailable, effects of co-active ingredients need to be considered and the plausibility of the study medications for the specific indications discussed. Effect sizes calculated from exploratory studies would be best used to determine the sample sizes required for future confirmatory studies, rather than as definitive reports of intervention effects. Reviews should be comprehensive, including discussion of putative adverse events and possible drug interactions. We suggest that the guidelines for preparing Cochrane reviews be revised and offer assistance in this task.

scholarly journals Herbal Medicine for Pain Management: Efficacy and Drug Interactions

Pharmaceutics ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 251
Author(s):  
Behdad Jahromi ◽  
Iulia Pirvulescu ◽  
Kenneth D. Candido ◽  
Nebojsa Nick Knezevic
Keyword(s):  
Pain Management ◽  
Herbal Medicine ◽  
Drug Interactions ◽  
Synergistic Effects ◽  
Herbal Medicines ◽  
Scientific Data ◽  
Global Market ◽  
Complementary And Alternative Medicines ◽  
Alternative Medicines ◽  
Complementary And Alternative

Complementary and alternative medicines such as herbal medicines are not currently part of the conventional medical system. As the popularity of and global market for herbal medicine grows among all age groups, with supporting scientific data and clinical trials, specific alternative treatments such as herbal medicine can be reclassified as a practice of conventional medicine. One of the most common conditions for which adults use herbal medicine is pain. However, herbal medicines carry safety concerns and may impact the efficacy of conventional therapies. Unfortunately, mechanisms of action are poorly understood, and their use is unregulated and often underreported to medical professionals. This review aims to compile common and available herbal medicines which can be used as an alternative to or in combination with conventional pain management approaches. Efficacy and safety are assessed through clinical studies on pain relief. Ensuing herb–drug interactions such as cytochrome modulation, additive and synergistic effects, and contraindications are discussed. While self-management has been recognized as part of the overall treatment strategy for patients suffering from chronic pain, it is important for practitioners to be able to also optimize and integrate herbal medicine and, if warranted, other complementary and alternative medicines into their care.

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

2005 ◽  
Vol 24 (5) ◽  
pp. 219-233 ◽  
Author(s):  
K N Woodward
Keyword(s):  
Herbal Medicine ◽  
Drug Interactions ◽  
Adverse Reactions ◽  
Conventional Medicine ◽  
Herbal Medicines ◽  
Adverse Event Reporting ◽  
Herbal Remedies ◽  
Extensive Literature ◽  
Conventional Drug ◽  
Potential Impact

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.

scholarly journals Medicinal Plants Traded in Informal Herbal Medicine Markets of the Limpopo Province, South Africa

2019 ◽  
Vol 2019 ◽  
pp. 1-11
Author(s):  
Marula Triumph Rasethe ◽  
Sebua Silas Semenya ◽  
Alfred Maroyi
Keyword(s):  
South Africa ◽  
Herbal Medicine ◽  
Medicinal Plant ◽  
Plant Species ◽  
Herbal Medicines ◽  
Limpopo Province ◽  
Wild Plants ◽  
Vulnerable Groups ◽  
Prunus Africana ◽  
Plant Parts

Trading of herbal medicines generates economic opportunities for vulnerable groups living in periurban, rural, and marginalized areas. This study was aimed at identifying medicinal plant species traded in the Limpopo province in South Africa, including traded plant parts, conservation statutes of the species, and harvesting methods used to collect the species. Semistructured questionnaire supplemented by field observation was used to collect data from owners of 35 informal herbal medicine markets in the Limpopo province. A total of 150 medicinal plant products representing at least 79 plant species belonging to 45 botanical families, mainly the Fabaceae (11.4%), Asteraceae (7.6%), and Hyacinthaceae (6.3%), were traded in the study area. Roots (50.0%), bulbs (19.0%), and bark (16.0%) were the most frequently sold plant parts. Some of the traded species which includeAlepidea amatymbica, Bowiea volubilis, Brackenridgea zanguebarica, Clivia caulescens,Dioscorea sylvatica,Elaeodendron transvaalense, Encephalartos woodii,Eucomis pallidiflorasubsp.pole-evansii,Merwilla plumbea,Mondia whitei,Prunus africana, Siphonochilus aethiopicus, Synaptolepis oliveriana,andWarburgia salutarisare of conservation concern and listed on the South African Red Data List.Findings of this study call for effective law enforcement to curb illegal removal of wild plants especially those species that are at the verge of extinction.

scholarly journals Pharmacists’ Knowledge, Perceptions, and Practices Regarding Herbal Medicine

2019 ◽  
Vol 10 (3) ◽  
pp. 15
Author(s):  
Catherine Santanello ◽  
Ashlyn Carr
Keyword(s):  
Side Effects ◽  
Herbal Medicine ◽  
Drug Interactions ◽  
Herbal Medicines ◽  
Community Pharmacists ◽  
Reliable Information ◽  
Medicine Use ◽  
Article Type ◽  
Knowledge Survey ◽  
The Impact

Introduction: With the increase of herbal medicine sales and a lack of reliable information available to consumers, it is important for pharmacists to be knowledgeable about these products and have the ability to effectively counsel on their uses and risks. The purpose of this study was to: 1) assess community pharmacists’ knowledge, perceptions, and practices regarding herbal medicines, 2) understand the impact pharmacists may have on their patients’ herbal medicine use, and 3) gauge what practices could be improved. Methods: An anonymous survey was distributed to community pharmacists through email, social media, and in-person at local pharmacies. The survey consisted of general background questions, questions assessing perceptions and practices regarding herbal medicine, and a ten-question true/false quiz to assess knowledge. Survey data was collected and assessed using Qualtrics and Excel. Results: Of the 127 community pharmacists who completed the survey, only 34% were confident in their ability to effectively counsel patients on herbal medicines. Approximately 50% of pharmacists reported never or rarely asking patients about herbal medicine use and 80% reported never or rarely documenting herbal medicine use. Only 25% of pharmacists reported that they always discuss side effects and 19% reported that they always discuss herb-drug interactions when patients are using herbal medicines. The average quiz score assessing knowledge of herbal medicines was 6.06 out of 10. Conclusions: It is important for community pharmacists to be knowledgeable about herbal medicines and prepared to educate patients to ensure safe medication use. Pharmacists need to acknowledge the use of herbal medicine in their patients and always discuss potential side effects and herb-drug interactions. It is also important that pharmacists know where they can find reliable information on herbal medicines and use evidence-based resources when possible.   Article Type: Student Project

scholarly journals Characteristics of Herbal Medicine Users and Adverse Events Experienced in South Korea: A Survey Study

2017 ◽  
Vol 2017 ◽  
pp. 1-9 ◽  
Author(s):  
Soobin Jang ◽  
Kyeong Han Kim ◽  
Seung-Ho Sun ◽  
Ho-Yeon Go ◽  
Eun-Kyung Lee ◽  
...  
Keyword(s):  
Herbal Medicine ◽  
Adverse Events ◽  
South Korea ◽  
Herbal Medicines ◽  
Survey Study ◽  
Health Improvement ◽  
The Past ◽  
Digestive Disorders

Background. This survey aimed to investigate the characteristics of users and nonusers of herbal medicine and the adverse events experienced due to herbal medicines in South Korea. Methods. The questionnaire consisted of safety, using experience, using type, usage and nonusage reason, purchase location, and adverse events of herbal medicine. The survey was administered by online. Results. Of the total 1,134 respondents, 726 (64.0%) considered herbal medicine safe, and 693 (61.1%) answered that they have taken herbal medicines within the past year. Most common place to purchase them was “TKM hospital or clinic” (63.6%), and most participants (72.2%) took a decoction from a TKM institution. The biggest reason for taking them was for “health improvement” (57.3%), and the reasons for not using them was “medication not necessary” (63.7%). Among those who took herbal medicines, 46 experienced adverse events, and the most frequently reported symptoms were digestive disorders (52.2%). Of the 46 participants who experienced adverse events, 20 (43.5%) were treated by TKM doctors. Conclusions. This study suggests that regulation of herbal medicines is needed in order to resolve problems related to the safety of herbal medicines.

scholarly journals Unraveling the Molecular Mechanism of Traditional Chinese Medicine: Formulas Against Acute Airway Viral Infections as Examples

Molecules ◽  
2019 ◽  
Vol 24 (19) ◽  
pp. 3505 ◽  
Author(s):  
Yi Shin Eng ◽  
Chien Hsing Lee ◽  
Wei Chang Lee ◽  
Ching Chun Huang ◽  
Jung San Chang
Keyword(s):  
Chinese Medicine ◽  
Herbal Medicine ◽  
Traditional Chinese Medicine ◽  
Adverse Effects ◽  
Drug Interactions ◽  
Clinical Studies ◽  
Molecular Mechanisms ◽  
Viral Infections ◽  
Herbal Medicines ◽  
Clinical Effects

Herbal medicine, including traditional Chinese medicine (TCM), is widely used worldwide. Herbs and TCM formulas contain numerous active molecules. Basically, they are a kind of cocktail therapy. Herb-drug, herb-food, herb-herb, herb-microbiome, and herb-disease interactions are complex. There is potential for both benefit and harm, so only after understanding more of their mechanisms and clinical effects can herbal medicine and TCM be helpful to users. Many pharmacologic studies have been performed to unravel the molecular mechanisms; however, basic and clinical studies of good validity are still not enough to translate experimental results into clinical understanding and to provide tough evidence for better use of herbal medicines. There are still issues regarding the conflicting pharmacologic effects, pharmacokinetics, drug interactions, adverse and clinical effects of herbal medicine and TCM. Understanding study validation, pharmacologic effects, drug interactions, indications and clinical effects, adverse effects and limitations, can all help clinicians in providing adequate suggestions to patients. At present, it would be better to use herbs and TCM formulas according to their traditional indications matching the disease pathophysiology and their molecular mechanisms. To unravel the molecular mechanisms and understand the benefits and harms of herbal medicine and TCM, there is still much work to be done.

An Insight into Herb - Drug Interactions

1970 ◽  
Vol 2 (4) ◽  
pp. 689-706
Author(s):  
Harish Chandra Rodda ◽  
Raj Kumar Molmoori ◽  
Sujatha Samala ◽  
Nagaraj Banala ◽  
Veeresham Ciddi
Keyword(s):  
Adverse Effects ◽  
Adverse Events ◽  
Drug Interactions ◽  
Alternative Medicine ◽  
Ginkgo Biloba ◽  
Herbal Medicines ◽  
Drug Combinations ◽  
St John's Wort ◽  
Prescription Medicines ◽  
Insight Into

Alternative medicine is becoming popular worldwide and this is clearly evident from the rapidly escalating sales figures. The time tested and clinically proven  herbal medicines like St. John’s wort, Ginkgo biloba, Garlic, Ephedra, Echinacea etc., make up most of the world’s market as for as alternative medicine is concerned. In spite of its increasing popularity, global criticism regarding the safety of herbal medicines is gaining importance. The surfacing of the adverse effects/adverse events due to concomitant use of herbs and prescription medicines undermine the safety of herbal medicines. The safety of herbal medicines still remains a daunting task. The herbs like St. John’s wort, Ginkgo biloba, Garlic, Ephedra, Echinacea etc., have been reported to interact pharmacokinetically and pharmacodynamically with several prescription medicines. The available literature also bolsters that concomitant use of herbs and drugs can lead to several adverse effects/adverse events. This article presents most of the significant herb – drug interactions reported till date along with a note on the predicted interactions which may/may not occur. There are certain herb – drug combinations which can produce therapeutic benefit and these beneficial herb – drug combinations are also detailed in this article. This review gives an insight into herb – drug interactions, stressing the need to carryout studies on herb – drug interactions at a faster pace, which can strengthen the concept of herbal medicine

Knowledge of Herbal Medicines and Herb-drug Interaction Among Medical and Pharmacy Students of the University of Lagos, Nigeria

2020 ◽  
Vol 16 (1) ◽  
pp. 61-70
Author(s):  
O.U. Amaeze ◽  
O.A. Olugbake ◽  
M. Lawal
Keyword(s):  
Drug Interaction ◽  
Herbal Medicine ◽  
Drug Interactions ◽  
Health Care Providers ◽  
Statistical Significance ◽  
Herbal Medicines ◽  
Pharmacy Students ◽  
Care Providers ◽  
Medical Undergraduate ◽  
The University

Background: Concurrent use of herbal and orthodox medicines can result in herb-drug interaction, which could remain unidentified due to the limited knowledge of health care providers on herbal medicines effects and safety.Objectives: This study aimed to assess the knowledge of medical and pharmacy students of the University of Lagos on herbal medicines and herb-drug interactions.Method: The study was a cross-sectional survey of final year pharmacy and medical undergraduate students (422) of the University of Lagos. Data was collected using a validated, previously developed, and standardized self-administered questionnaire. Descriptive statistics was used to evaluate the students’ demographics, knowledge of herbal medicines and herb-drug interactions, types and uses of herbal medicines, while inferential statistics was employed to assess the association between the students’ demographics and their knowledge of herb-drug interactions. Statistical significance was set at P<0.05.Results: The response rate was 97%. The students (98.0%) knew that herbs can be used as medicines; common uses of herbal medicines reported by the students include malaria (11.4%), pain (24.6%), and fever (36.2%). There was no association between the students’ demographics and their knowledge about herbal medicine. Age was significantly associated with knowledge of herb-drug interaction (P<0.05). The students (96.8%) knew that herbs can interact with conventional drugs when administered concurrently. The sources of the students’ knowledge about herbal medicine and herb-drug interaction include lectures (52.2%), literature (14%) and personal experience (13.9%).Conclusion: The students had good knowledge of herbal medicines; however, the subject of herbal medicines and their effects should be given more attention in the medical and pharmacy program curriculum, in order to enhance the students’ knowledge base of herbal medicines and interactions, and equip the future physicians and pharmacists adequately for better patient care. Keywords: Herbal medicines, Herb-drug interaction, Pharmacy students, Medical students

scholarly journals Pharmacokinetic Interactions between Herbal Medicines and Drugs: Their Mechanisms and Clinical Relevance

Life ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. 106 ◽  
Author(s):  
Laura Rombolà ◽  
Damiana Scuteri ◽  
Straface Marilisa ◽  
Chizuko Watanabe ◽  
Luigi Antonio Morrone ◽  
...  
Keyword(s):  
Herbal Medicine ◽  
Medicinal Plant ◽  
Drug Interactions ◽  
Herbal Medicines ◽  
Drug Bioavailability ◽  
Transporter Protein ◽  
Concurrent Use ◽  
Medicinal Plant Extracts ◽  
High Concentrations

The therapeutic efficacy of a drug or its unexpected unwanted side effects may depend on the concurrent use of a medicinal plant. In particular, constituents in the medicinal plant extracts may influence drug bioavailability, metabolism and half-life, leading to drug toxicity or failure to obtain a therapeutic response. This narrative review focuses on clinical studies improving knowledge on the ability of selected herbal medicines to influence the pharmacokinetics of co-administered drugs. Moreover, in vitro studies are useful to anticipate potential herbal medicine-drug interactions. In particular, they help to elucidate the cellular target (metabolic or transporter protein) and the mechanism (induction or inhibition) by which a single constituent of the herbal medicine acts. The authors highlight the difficulties in predicting herbal–drug interactions from in vitro data where high concentrations of extracts or their constituents are used and pharmacokinetics are missed. Moreover, the difficulty to compare results from human studies where different kinds of herbal extracts are used is discussed. The herbal medicines discussed are among the best sellers and they are reported in the “Herbal Medicines for Human Use” section of the European Medicinal Agency (EMA).

scholarly journals Herbal Medicine for the Treatment of Coronavirus Disease 2019 (COVID-19): A Systematic Review and Meta-Analysis of Randomized Controlled Trials

2020 ◽  
Vol 9 (5) ◽  
pp. 1583 ◽  
Author(s):  
Lin Ang ◽  
Eunhye Song ◽  
Hye Won Lee ◽  
Myeong Soo Lee
Keyword(s):  
Herbal Medicine ◽  
Adverse Events ◽  
Randomized Controlled Trials ◽  
Western Medicine ◽  
Combined Therapy ◽  
Herbal Medicines ◽  
Risk Of Bias ◽  
Controlled Trials ◽  
Disappearance Rate ◽  
Randomized Controlled

Background: The coronavirus disease 2019 (COVID-19) pandemic has caused a worldwide outbreak of respiratory illness. This review aims to evaluate the effectiveness and adverse events of herbal medicines for the treatment of COVID-19. Methods: Twelve databases were searched through 12 May 2020. Randomized controlled trials (RCTs) and quasi-RCTs assessing the effects of herbal medicines for the treatment of COVID-19 were eligible. The study selection and data extraction were performed by two independent reviewers. The Cochrane risk of bias tool was used for the assessment of the risk of bias in all included RCTs. Mean differences (MDs), risk ratios (RRs) and odds ratios (ORs) with 95% confidence intervals (CIs) were calculated, and the effect sizes of the studies were pooled. Results: Seven RCTs with a total of 855 patients were included. All included trials compared the combined therapy of herbal medicine with Western medicine to Western medicine alone. The combined therapy significantly improved the total effective rate (RR 1.23, 95% CI 1.13 to 1.34, p < 0.001), cough symptom disappearance rate (RR 1.45, 95% CI 1.12 to 1.89, p = 0.005), and sputum production symptom disappearance rate (RR 1.73, 95% CI 1.19 to 2.50, p = 0.004). Beneficial effects of the combined therapy were also seen in TCM syndrome score of cough (MD −1.18, 95% CI −1.34 to −1.03, p < 0.001), fever (MD −0.62, 95% CI −0.79 to −0.45, p < 0.001), dry and sore throat (MD −0.83, 95% CI −1.45 to −0.20, p = 0.009), and fatigue (MD −0.60, 95% CI −1.04 to −0.17, p = 0.007). The overall risk of bias of the included studies was unclear. No serious adverse events were reported. Conclusion: Significant effects of the combined therapy of herbal medicine with Western medicine were found, and revealed the potential role of herbal medicine in treating COVID-19. More high-quality RCTs are needed to further validate the effectiveness and adverse events of herbal medicine in the treatment of COVID-19.

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