Adverse effects of herbal medicines: an overview of systematic reviews

Posadzki, Paul; Watson, Leala K.; Ernst, Edzard

doi:10.7861/clinmedicine.13-1-7

Cited by 211 publications

(141 citation statements)

References 88 publications

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“…As a result of insufficient herbal product regulations, some ADR may 21 be attributable to a lack of standardization, contamination, adulteration, plant misidentification/substitution, improper use of herbal medicines including their inappropriate labeling rather than pharmacological/toxicology effects of herbals [5][6][7]31]. Also, implementation of innovative preparation methods of traditionally used herbal remedies may alter pharmacological/toxicological properties of herbs and lead to their toxicity rather than therapeutic use.…”

Section: Suspect Herbalsmentioning

confidence: 99%

“…In most countries, herbal medicines are defined as dietary supplements and as such do not have to meet pre-and postmarketing drug policy regulations [5]. However, use of herbal medicines can be associated with development of severe adverse reactions as a result of complex chemistry of herbals as well as their inappropriate use and a lack of quality control [6,7]. In addition, patients may not disclose self-medication with herbal medicines to their health care professionals, and even if they do there may be limited knowledge of their potential adverse reactions and interactions with concomitantly used prescription drugs [8,9].…”

Section: Introductionmentioning

confidence: 99%

“…Although there are many case reports of ADR associated with herbals in the literature, the majority of reports are documented in large pharmacovigilance databases, and those valuable resources should be systematically analyzed for ADR associated with herbals [7,11,12]. ADR to herbals cover a wide range of manifestations that are mostly mild and followed by full recovery.…”

Section: Introductionmentioning

confidence: 99%

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Allergy-Like Immediate Reactions with Herbal Medicines: A Retrospective Study Using Data from VigiBase®

et al. 2016

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INTRODUCTION Herbal medicines are used worldwide and with an increasing popularity in Western countries. Although often perceived as 'naturally safe', herbals may cause severe adverse drug reactions (ADRs), with immediate allergic reactions being particularly life threatening. OBJECTIVES The aim of this study was to analyse immediate allergy-like ADRs to herbals documented in VigiBase(®), the WHO international pharmacovigilance database. METHODS The documentation of all suspected ADRs in association with herbal exposure reported to VigiBase(®) from 1969 to August 2014 was retrieved. Among all reports in which WHO-ART reaction terms were indicative of acute allergic reactions, those classified as 'suspect' with a documented causality assessment and latency time of 1 day were selected. For the most frequent specific herbal-ADR combinations, the information component (IC) as a measure of disproportionality based on Bayesian statistics was calculated. RESULTS We identified 757 reports out of 1039 ADRs. Products with mixed herbals (36.0 %) as well as those administered orally (63.2 %) were predominant. The most frequent reactions were urticaria and rash (49.2 %). Anaphylactic reactions accounted for 9.5 %. Disproportionally frequent reporting of mouth edema (IC = 1.81) and anaphylactic reactions (IC = 1.24) to Phleum pretense were noted. CONCLUSION Our findings indicate that herbal medicines for oral use carry a risk of causing immediate allergy-like ADRs. Studies using the Vigibase(®) database can identify specific combinations of particular herbs and adverse reactions. Healthcare professionals and patients should be aware of these risks and report any serious adverse experiences. Results:We identified 757 reports with 1,039 ADR. Products with mixed herbals (36.0%) and oral administration (63.2%) were predominant. The most frequent reactions were urticaria and rash (49.2%).Anaphylactic reactions accounted for 9.5%. We found disproportionally frequent reporting of mouth oedema (IC=1.81) and anaphylactic reactions (IC=1.24) with Phleum pratense. Conclusion:Our findings indicate that herbal medicines for oral use carry a risk for allergy-like immediate ADR.Studies using the Vigibase ® database can identify specific combinations of particular herbs and adverse reactions. Health care professionals and patients should be aware of these risks and report any serious adverse experiences.

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Section: Suspect Herbalsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Allergy-Like Immediate Reactions with Herbal Medicines: A Retrospective Study Using Data from VigiBase®

et al. 2016

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“…), валериана (Valeriana officinalis), шал-фей (Salvia officinalis), мелисса (Melissa officinalis), розма-рин (Rosmarinus officinalis), куркума (Curcuma), корица (Cinnamomum spp. ), гинкго двулопастный (Ginkgo biloba) и зверобой (Hypericum) [14]. Среднетяжелые нежелатель-ные явления отмечены при использовании пеларгонии сидовидной (Pelargonium sidoides), алоэ (Aloe vera), мяты перечной (Mentha piperita), люцерны посевной (Medicago sativa), клопогона кистевидного (Actaea (Cimicifuga) racemosa), стеблелиста (Caulophyllum thalictroides), оду-ванчика обыкновенного (Taraxacum officinale), камелии китайской, или листьев чайного куста (Camellia sinensis), омелы белой (Viscum album), клевера лугового (Trifolium pratense), стевии (Stevia rebaudiana), серенои ползучей (Serenoa repens), коммифоры (Commifora mukul), худии гордони (Hoodia gordonii).…”

Section: Introductionunclassified

“…Среднетяжелые нежелатель-ные явления отмечены при использовании пеларгонии сидовидной (Pelargonium sidoides), алоэ (Aloe vera), мяты перечной (Mentha piperita), люцерны посевной (Medicago sativa), клопогона кистевидного (Actaea (Cimicifuga) racemosa), стеблелиста (Caulophyllum thalictroides), оду-ванчика обыкновенного (Taraxacum officinale), камелии китайской, или листьев чайного куста (Camellia sinensis), омелы белой (Viscum album), клевера лугового (Trifolium pratense), стевии (Stevia rebaudiana), серенои ползучей (Serenoa repens), коммифоры (Commifora mukul), худии гордони (Hoodia gordonii). Наиболее тяжелые побочные эффекты могут оказать белладонна, или красавка обык-новенная (Atropa belladonna), ларрея трехзубчатая, или креозотовый куст (Larrea tridentata), перец опьяняю-щий, или кава-кава (Piper methysticum) и сенна (Cassia acutifolia) [14].…”

Section: Introductionunclassified

Phytotherapy: Present State of the Issue

Селимзянова¹,

Вишнёва²,

Федосеенко³

et al. 2016

Pediatr. farmakol.

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Pelargonium sidoides extract for treating acute respiratory tract infections

Timmer

Günther²,

Motschall

et al. 2013

Cochrane Database of Systematic Reviews

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P. sidoides may be effective in alleviating symptoms of acute rhinosinusitis and the common cold in adults, but doubt exists. It may be effective in relieving symptoms in acute bronchitis in adults and children, and sinusitis in adults. The overall quality of the evidence was considered low for main outcomes in acute bronchitis in children and adults, and very low for acute sinusitis and the common cold. Reliable data on treatment for other ARIs were not identified.

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Adverse effects of herbal medicines: an overview of systematic reviews

Abstract: -This overview of systematic reviews (SRs) aims to evaluate critically the evidence regarding the adverse effects of herbal medicines (HMs).

Cited by 211 publications

References 88 publications

Allergy-Like Immediate Reactions with Herbal Medicines: A Retrospective Study Using Data from VigiBase®

Allergy-Like Immediate Reactions with Herbal Medicines: A Retrospective Study Using Data from VigiBase®

Phytotherapy: Present State of the Issue

Pelargonium sidoides extract for treating acute respiratory tract infections

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