Herb–Drug Interactions: Worlds Intersect with the Patient at the Center
Abstract: Background
1. Introduction
2. Materials and Methods
3. Results
3.1. Case Report Analysis
3.1.1. Reliability Index Results
3.1.2. Qualitative Analysis of Case Reports
3.2. Case Report and Study Comparison
3.3. Case Report and Interaction Checker Comparison
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Measure | Scoring |
---|---|
Is reporting of relevant demographics (sex, age, relevant conditions) adequate? | Y = +1 N = 0 |
Are concomitant diseases and other medications associated with adverse events included (including dosing)? | |
Are concomitant medications and other herbals/supplements documented (including dosing)? | |
Are interactors adequately described, including scientific name of botanicals? | |
Have alternate explanations been excluded? | |
Is chronology complete? | |
Is chronology sequence reasonable? | |
Is adverse reaction adequately described? | |
Is interaction pharmacologically feasible? | |
Does event cease upon stopping herb? | |
Does event recur upon rechallenge? | Y = +1 N = 0 N/A = 0 and remove from denominator |
Latin Name, Common Name | Drug(s) or Class | N Reports | Severity (N) | Reaction |
---|---|---|---|---|
Curcuma longa, turmeric | Fluindione | 1 | Minor | Increased INR |
Tacrolimus | 1 | Severe | Increased tacrolimus level | |
contaminated with microcystin | Paclitaxel | 1 | Severe | Hepatotoxicity |
Equisetum arvense, horsetail | Antiretrovirals | 2 | Minor | Increased viral load |
Gingko biloba, ginkgo | Antiretrovirals | 1 | Severe | Treatment failure |
Ibuprofen | 1 | Fatal | Intracerebral bleed | |
Trazodone | 1 | Severe | Altered mental status | |
Aescinate | 1 | Severe | Acute kidney injury | |
Ginkgo biloba in multiherbal | Divalproate, phenytoin | 1 | Fatal | Seizures |
Efavirenz | 1 | Mild | Increased viral load | |
G biloba and H perforatum | Buspirone, fluoxetine | 1 | Mild | Serotonin syndrome |
Hypericum perforatum, St. John’s wort | Serotoninergics | 6 | Mild (4) Severe (2) | Serotonin syndrome |
Calcineurin inhibitors | 6 | Mild (3) Severe (3) | Decreased drug levels | |
Clozapine | 1 | Mild | Schizophrenia | |
Sertraline | 1 | Severe | Mania | |
Oral contraceptive | 1 | Severe | Pregnancy | |
H. perforatum in multiherbal | Cyclosporin | 1 | Mild | Decreased drug level |
Lycium barbarum, goji | Warfarin | 3 | Mild (2) Severe | Increased INR Bleeding |
Mitragyna speciosa, kratom | Quetiapine | 1 | Fatal | Increased drug level, neuroleptic malignant syndrome |
Panax ginseng, ginseng | Phenelzine | 1 | Mild | Mania |
Imatinib | 1 | Severe | Hepatotoxicity | |
Raltegravir | 1 | Severe | Increased drug level | |
contaminated with germanium | Furosemide | 1 | Severe | Treatment failure |
P ginseng in multiherbal | Warfarin | 1 | Severe | Intracerebral bleeding |
Vaccinium spp, cranberry | Warfarin | 8 | Mild (6) Fatal (2) | 6 Increased INR, 2 GI and pericardial bleeding |
Clinical Studies | N Studies | N Case Reports | Top Selling Herb Lists Ranks |
---|---|---|---|
Hypericum perforatum St. John’s wort | 17 | 17 | 0, 0 |
Ginkgo biloba, ginkgo | 11 | 7 | 17, 21 |
Panax ginseng, ginseng | 6 | 4 plus 3 NOS | 30, 30 |
Allium sativum, garlic | 3 | 1 (multiherb) | 8, 15 |
Hydrastis canadensis, goldenseal | 3 | 0 | 0, 0 |
Piper methysticum, kava-kava | 3 | 2 (multiherb) | 0, 28 |
Silybum marianum, milk thistle | 3 | 0 | 23, 10 |
Actea racemosa, black cohosh | 2 | 0 | 15, 0 |
Curcuma longa, turmeric | 2 | 3 | 4, 3 |
Crataegus spp, hawthorne | 2 | 0 | 0, 38 |
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Babos, M.B.; Heinan, M.; Redmond, L.; Moiz, F.; Souza-Peres, J.V.; Samuels, V.; Masimukku, T.; Hamilton, D.; Khalid, M.; Herscu, P. Herb–Drug Interactions: Worlds Intersect with the Patient at the Center. Medicines 2021, 8, 44. https://0-doi-org.brum.beds.ac.uk/10.3390/medicines8080044
Babos MB, Heinan M, Redmond L, Moiz F, Souza-Peres JV, Samuels V, Masimukku T, Hamilton D, Khalid M, Herscu P. Herb–Drug Interactions: Worlds Intersect with the Patient at the Center. Medicines. 2021; 8(8):44. https://0-doi-org.brum.beds.ac.uk/10.3390/medicines8080044
Chicago/Turabian StyleBabos, Mary Beth, Michelle Heinan, Linda Redmond, Fareeha Moiz, Joao Victor Souza-Peres, Valerie Samuels, Tarun Masimukku, David Hamilton, Myra Khalid, and Paul Herscu. 2021. "Herb–Drug Interactions: Worlds Intersect with the Patient at the Center" Medicines 8, no. 8: 44. https://0-doi-org.brum.beds.ac.uk/10.3390/medicines8080044