Botanical-drug interactions: a scientific perspective

Planta Med. 2012 Sep;78(13):1400-15. doi: 10.1055/s-0032-1315145. Epub 2012 Aug 3.

Abstract

There is a continued predisposition of concurrent use of drugs and botanical products. A general lack of knowledge of the interaction potential together with an under-reporting of botanical use poses a challenge for the health care providers and a safety concern for patients. Botanical-drug interactions increase the patient risk, especially with regard to drugs with a narrow therapeutic index (e.g., warfarin, cyclosporine, and digoxin). Examples of case reports and clinical studies evaluating botanical-drug interactions of commonly used botanicals in the US are presented. The potential pharmacokinetic and pharmacodynamic bases of such interactions are discussed, as well as the challenges associated with the interpretation of the available data and prediction of botanical-drug interactions. Recent FDA experiences with botanical products and interactions including labeling implications as a risk management strategy are highlighted.

Publication types

  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.
  • Research Support, U.S. Gov't, P.H.S.
  • Review

MeSH terms

  • Drug Labeling / legislation & jurisprudence
  • Drug Synergism
  • Enzyme Inhibitors / pharmacology*
  • Herb-Drug Interactions*
  • Humans
  • Organic Anion Transporters / drug effects*
  • Pharmacokinetics*
  • Plant Preparations / pharmacology*
  • United States
  • United States Food and Drug Administration / legislation & jurisprudence

Substances

  • Enzyme Inhibitors
  • Organic Anion Transporters
  • Plant Preparations