Herbal Supplements: Precautions and Safe Use

Nurs Clin North Am. 2021 Mar;56(1):1-21. doi: 10.1016/j.cnur.2020.10.001. Epub 2020 Dec 29.


The Food and Drug Administration (FDA) classifies herbal preparations as food supplements. New herbal supplements and products are not governed by the strict FDA drug approval process and there is no premarket approval required. The FDA prohibits manufacturers and distributors from marketing adulterated or misbranded products but does not rigorously define safe practices. Scientific evidence related to herbal supplements is limited. Herbal supplements have been associated with adverse reactions and herbal-drug interactions. Information and precautions for 20 common herbal supplements, including St. John's wort, ginseng, echinacea, and ginkgo, are reviewed. Resources for consumers and health care professionals are highlighted.

Keywords: Botanicals; Herbal medicine; Herbal supplements; Herbal-drug interactions; Precautions; Safe use.

Publication types

  • Review

MeSH terms

  • Dietary Supplements / adverse effects*
  • Dietary Supplements / statistics & numerical data*
  • Ginkgo biloba / adverse effects
  • Humans
  • Hypericum / adverse effects
  • Kava / adverse effects
  • Panax / adverse effects
  • Phytotherapy / adverse effects*
  • Phytotherapy / statistics & numerical data*
  • Plant Preparations / adverse effects*
  • Plant Preparations / therapeutic use*
  • Tinnitus / therapy
  • United States
  • United States Food and Drug Administration


  • Plant Preparations