Herbal Supplements-Drug Interactions

2006 ◽  
Keyword(s):  
Drug Interactions ◽  
Herbal Supplements

Comparison of eight screening tools to detect interactions between herbal supplements and oncology agents

2020 ◽  
Vol 26 (8) ◽  
pp. 1843-1849
Author(s):  
Faisal Shakeel ◽  
Fang Fang ◽  
Kelley M Kidwell ◽  
Lauren A Marcath ◽  
Daniel L Hertz
Keyword(s):  
Drug Interaction ◽  
Positive Predictive Value ◽  
Drug Interactions ◽  
Predictive Value ◽  
Screening Tools ◽  
Herbal Supplements ◽  
Interaction Detection ◽  
Natural Medicine ◽  
Interaction Screening ◽  
Drug Drug Interaction

Introduction Patients with cancer are increasingly using herbal supplements, unaware that supplements can interact with oncology treatment. Herb–drug interaction management is critical to ensure optimal treatment outcomes. Several screening tools exist to detect drug–drug interactions, but their performance to detect herb–drug interactions is not known. This study compared the performance of eight drug–drug interaction screening tools to detect herb–drug interaction with anti-cancer agents. Methods The herb–drug interaction detection performance of four subscription (Micromedex, Lexicomp, PEPID, Facts & Comparisons) and free (Drugs.com, Medscape, WebMD, RxList) drug–drug interaction tools was assessed. Clinical relevance of each herb–drug interaction was determined using Natural Medicine and each drug–drug interaction tool. Descriptive statistics were used to calculate sensitivity, specificity, positive predictive value, and negative predictive value. Linear regression was used to compare performance between subscription and free tools. Results All tools had poor sensitivity (<0.20) for detecting herb–drug interaction. Lexicomp had the highest positive predictive value (0.98) and best overall performance score (0.54), while Medscape was the best performing free tool (0.52). The worst subscription tools were as good as or better than the best free tools, and as a group subscription tools outperformed free tools on all metrics. Using an average subscription tool would detect one additional herb–drug interaction for every 10 herb–drug interactions screened by a free tool. Conclusion Lexicomp is the best available tool for screening herb–drug interaction, and Medscape is the best free alternative; however, the sensitivity and performance for detecting herb–drug interaction was far lower than for drug–drug interactions, and overall quite poor. Further research is needed to improve herb–drug interaction screening performance.

scholarly journals Potential Drug-Drug and Herb-Drug Interactions in Patients With Cancer: A Prospective Study of Medication Surveillance

2017 ◽  
Vol 13 (7) ◽  
pp. e613-e622 ◽  
Author(s):  
Allan Ramos-Esquivel ◽  
Álvaro Víquez-Jaikel ◽  
Cristina Fernández
Keyword(s):  
High Risk ◽  
Prospective Study ◽  
Drug Interactions ◽  
Anticancer Therapy ◽  
Herbal Supplement ◽  
Herbal Supplements ◽  
Patients With Cancer ◽  
Clinical Consequences ◽  
Clinically Significant ◽  
A Prospective Study

Purpose: Patients with cancer frequently use herbal supplements and concomitant medications along with antineoplastic agents. These patients are at high risk of herb-drug interactions (HDIs) and drug-drug interactions (DDIs). We aimed to determine clinically relevant DDIs and HDIs leading to pharmaceutical intervention. Methods: Patients starting a new anticancer therapy were asked to complete a questionnaire to identify concomitant use of any over-the-counter drug or herbal supplement. Potential DDIs and HDIs were identified using two different databases. If a potentially clinically relevant DDI was recognized by the clinical pharmacist, a notification was sent to the prescribing oncologist, who decided whether to carry out a suggested intervention. Regression analyses were performed to identify variables associated with clinically relevant DDIs. Results: A total of 149 patients were included in this study, with 36 potentially clinically relevant DDIs identified in 26 patients (17.4%; 95% CI, 11.3% to 23.5%), all of them leading to therapy modifications. In total, four patients (2.7%; 95% CI, 0.1% to 5.3%) had experienced clinical consequences from DDIs at the time of pharmacist notification. Additionally, 84 patients (56.4%; 95% CI, 48.4% to 64.4%) reported using concurrent herbal supplements, and 122 possible HDIs were detected. Concomitant use of two or more drugs was independently associated with high risk of a clinically significant DDI (odds ratio, 2.53; 95% CI, 1.08 to 5.91; P = .03). Conclusion: Potentially clinically relevant DDIs and possible HDIs were frequently detected in this prospective study. A multidisciplinary approach is required to identify and avoid potentially harmful combinations with anticancer therapy.

scholarly journals Pharmacokinetic Drug–Drug Interactions and Herb–Drug Interactions

Pharmaceutics ◽  
2021 ◽  
Vol 13 (5) ◽  
pp. 610
Author(s):  
Min-Koo Choi ◽  
Im-Sook Song
Keyword(s):  
Drug Interactions ◽  
Herbal Supplements ◽  
Pharmacokinetic Drug ◽  
Herbal Supplementation

Due to the growing use of herbal supplementation—ease of taking herbal supplements with therapeutics drugs (i [...]

Implications of Cannabidiol in Pharmacogenomic-Based Drug Interactions with CYP2C19 Substrates

2021 ◽  
Vol 36 (12) ◽  
pp. 674-680
Author(s):  
Anastasia Engeleit ◽  
Sheena Crosby ◽  
Michael J. Schuh
Keyword(s):  
Drug Interactions ◽  
Dietary Supplements ◽  
Gene Interactions ◽  
Test Results ◽  
Herbal Supplements ◽  
Patient Case

This is a patient case exploring the importance of evaluating herbal and dietary supplements and how they may impact drug-drug and drug-gene implications based on pharmacogenomics test results. Even though herbal supplements are considered natural by many patients, which is often the reason for starting them, herbal supplements may still be metabolized by the same pathways as other medications, potentially contributing to drug-drug, drug-herb, and drug-gene interactions, and therefore, potentially impacting a patient’s response to medications.

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