Abstract:

Herbal products are used in the prevention and treatment of many chronic diseases such as hypertension, diabetes, hyperlipidemia and cancer. This does not mean that vegetable products are safe from natural sources. The use of plant products along with medications can lead to serious plant product-drug interactions. The plants to be affected by medications are St. John's wort (Hypericum perforatum), Ginkgo (Ginkgo biloba), Ginseng (Panax ginseng), Ginger (Zingiber officinale), Garlic (Allium sativum), Echinasea and Valerian. With the plant products commonly used in this study, pharmacokinetic and pharmacodynamic medicinal interactions have been accumulated. The use of plant products can alter the absorption, distribution, metabolism and deduction of drugs by the inhibition or induction of cytochrome P450 enzymes (CYP450) and P-glycoprotein (P-gp). Pharmacokinetic interactions can lead to a decrease and increase in the pharmacological effect of the drug. There may also be side effects and toxic effects associated with the drug. Pharmacodynamic interactions between herbal products and drugs may be additive and synergistic interactions that will increase the drug effect or antagonistic interactions that will reduce the drug effect. The drugs that are defined to interact with herbal products are anticoagulants, antithrombotics, cardiovascular drugs, immunosuppressants, sedatives, antidepressants, statins, anti-cancer drugs and anti-HIV drugs. Interactions between herbal products and medications are more important especially in medications with a narrow therapeutic index. Doctors should question the use of plant products when prescribing medication to their patients. Effectiveness and safety should not be recommended by clinically controlled research.

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