Abstract and Introduction
Herbal medicines including traditional Chinese medicine are becoming increasingly more popular worldwide. However, there is considerable potential for interaction between herbal components and drugs, as all herbal medicines contain a combination of potentially biologically active compounds possessing various inherent pharmacological activities, and the components of herbal products consumed are eliminated from the body by the same mechanisms that remove drugs. Indeed, many so-called conventional drugs are derived from plant sources. This article provides an update on the mechanisms and evidence of drug–herb interactions (DHIs) and genetic influences on DHIs. The rational prediction of clinically important DHIs is also discussed. Individualized and targeted drug therapy could be achieved by identifying the population most likely to be helped or harmed by drug–herb coadministration.
Herbal medicines have long been used for a variety of ailments in Asian countries and have become more popular worldwide over the last two decades.[1,2] It has been reported by the WHO that approximately 70% of the world's population currently uses medicinal herbs as complementary or alternative medicine.[1,3] There is a general belief by the public that herbal medicines are safe because of their natural origin, and consumers often take these products without consulting or informing their regular healthcare providers. However, all herbal medicines are actually a combination of potentially biologically active compounds possessing various inherent pharmacological activities, and as the metabolism of these compounds usually occurs by the same mechanisms as that of drugs, there is considerable potential for the interaction between herbal components and drugs. Herbal supplements are often used concomitantly with conventional drugs, especially in the elderly or those with chronic disease who are likely to be treated with multiple drugs, raising the increased risk of drug–herb interactions (DHIs) with potentially serious consequences, particularly for those drugs with very narrow therapeutic indices.[2,6–8] This article aims to provide an update on the mechanisms and evidence of DHIs and discusses the rational prediction of clinically important DHIs.
Expert Rev Mol Diagn. 2012;12(8):815-830. © 2012 Expert Reviews Ltd.