A Review On Herbal Drug And Drug Interactions

Abstract

Herbal medicines are increasingly popular worldwide, with an estimated one third of adults in developed nations and over 80% of people in developing countries using them for health promotion and to manage conditions like colds, inflammation, heart disease, diabetes, and central nervous system disorders. Despite their popularity, the mechanisms of action of many herbal medicines remain largely unknown, and their efficacy and toxicity are often inadequately supported by evidence. There are more than 11,000 medicinal plant species, with around 500 commonly used in Asia and other regions. Drug interactions with herbal medicines pose significant safety risks, especially with drugs that have narrow therapeutic windows, such as warfarin and digoxin. Combining herbal remedies with pharmaceuticals can alter their pharmacokinetics and pharmacodynamics, leading to potentially severe adverse reactions. A review of the top-selling herbal medicines, including St. John’s wort, ginkgo, ginseng, garlic, echinacea, saw palmetto, and kava, identified interactions with several prescribed drugs. For example, St. John’s wort lowers blood concentrations of warfarin, while ginkgo increases bleeding risks with warfarin. Ginseng affects alcohol and warfarin levels, and garlic alters the pharmacokinetics of paracetamol and warfarin. It is essential for healthcare providers to be aware of these interactions to avoid serious clinical consequences.