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This is a partial list of herbs and herbal treatments with known or suspected adverse effects, either alone or in interaction with other herbs or drugs. Non-inclusion of an herb in this list does not imply that it is free of adverse effects.
Herb-drug interactions are drug interactions that occur between herbal medicines and conventional drugs. [18] These types of interactions may be more common than drug-drug interactions because herbal medicines often contain multiple pharmacologically active ingredients, while conventional drugs typically contain only one. [18]
One 2009 review concluded that regulation of herbalists in Australia was needed to reduce the risk of interaction of herbal medicines with prescription drugs, to implement clinical guidelines and prescription of herbal products, and to assure self-regulation for protection of public health and safety. [57]
Secondary metabolites and pigments may have therapeutic actions in humans, and can be refined to produce drugs; examples are quinine from the cinchona, morphine and codeine from the poppy, and digoxin from the foxglove. [1] In Europe, apothecaries stocked herbal ingredients as traditional medicines.
Drugs that interact usually share three common features: they are taken orally, normally only a small amount enters systemic blood circulation, and they are metabolized by CYP3A4. [1] The effects on the CYP3A4 in the liver could, in principle, cause interactions with non-oral drugs, [citation needed] and non-CYP3A4-mediated effects also exist. [31]
Best known examples of adverse herb‑drug interactions are grapefruit or St John's wort, contraindicated for several medications including Paxlovid and oral contraceptives, but other herbs also affect the CYP enzyme family, showing herb‑drug interactions. [37] [38] [39]
The Physicians' Desk Reference (PDR), renamed Prescriber's Digital Reference after its physical publication was discontinued, is a compilation of manufacturers' prescribing information (package insert) on prescription drugs, updated regularly and published by ConnectiveRx. [citation needed]
When used in combination with an anticoagulant or anti-platelet drug, saw palmetto extract can increase the risk of bleeding by enhancing the anticoagulation or anti-platelet effects. [3] Some examples of anticoagulant and anti-platelet drugs include aspirin , clopidogrel , nonsteroidal anti-inflammatory drugs (NSAIDs) , and warfarin .