Critical evaluation of causality assessment of herb–drug interactions in patients

Abstract

The aim of this review was to assess the severity of adverse drug reactions (ADRs) due to herb-drug interactions (HDI) in patients taking herbs and prescribed medications based on published evidence. Electronic databases of PubMed, the Cochrane Library, Medline and Scopus were searched for randomized or nonrandomized clinical studies, case-control and case reports of HDI. The data were extracted and the causal relationship of ADRs as consequences of HDI assessed using Horn's drug interaction probability scale or Roussel Uclaf Causality Assessment Method scoring systems. The mechanism of interaction was ascertained using Stockley's herbal medicine interaction companion. Forty-nine case reports and two observational studies with 15 cases of ADRs were recorded. The majority of the patients were diagnosed with cardiovascular diseases (30.60%), cancer (22.45%) and renal transplants (16.32%) receiving mostly warfarin, alkylating agents and cyclosporine, respectively. HDI occurred in patients resulting in clinical ADRs with different severity. Patients may poorly respond to therapeutic agents or develop toxicity due to severe HDI, which in either scenario may increase the cost of treatment and/or lead to or prolong patient hospitalization. It is warranted to increase patient awareness of the potential interaction between herbs and prescribed medicines and their consequences to curb HDI as a potential health problem.

Polygonum multiflorum-Induced Liver Injury: Clinical Characteristics, Risk Factors, Material Basis, Action Mechanism and Current Challenges

“…Herbal medicines and other botanicals are often used as complementary and alternative medicines which are believed safe, also has no strict safety and effective standards, should be paid great attention (Moreira et al, 2014;Lee et al, 2015;Alamgir, 2017;Cho et al, 2017;Cecilia and Orish, 2018;Jing and Teschke, 2018;Teschke et al, 2018). Herb-induced liver injury (HILI) refers to liver damage caused by TCMs, natural medicines and related preparations, resulting in adverse reactions such as dermatitis, nausea, vomiting, diarrhea, thrombocytopenia, coagulopathy, mental state changes, hepatotoxicity, nephrotoxicity, and electrolyte imbalance (Dag et al, 2014;Divya et al, 2016;Ming et al, 2017;Awortwe et al, 2018). However, the degree of HILI varies among different countries and regions (Zhou et al, 2013;Navarro et al, 2014).…”

Potential Therapeutic Benefits of Herbs and Supplements in Patients with NAFLD

“…The lack of regulation in this field of treatment agents suggests caution with use of herbs in the context of NAFLD. Also, the lack of research indicates the possibility of drug interactions or adverse effects [ 158 , 159 , 160 , 161 ]. Herb–drug interactions have already been noted in warfarin, aspirin, alkylating agents, and cyclosporine, leading to toxicity in patients [ 158 , 161 ].…”

Unripe Coccinia grandis Fruit have Anti-diabetes Properties The Janus Corner

“…The gourd is reputed to maintain a healthy digestive tract by maintaining the microbiome balance, improving metabolism and preventing renal disease. 1 A recent study has confirmed that the gourd also has antidiabetic properties. 2 The authors reported that the gourd extracts had a significant impact on several markers of diabetes.…”

“…1 The patients in the 50 published studies suffered from a variety of diseases including cancer, cardiovascular disease and kidney transplants. These patients were prescribed alkylating agents, warfarin and cyclosporine respectively.…”