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Understanding Herb-Drug Interactions

Summary American consumers have clearly expressed their desire to incorporate complementary and alternative therapies, including herbal medicine, into their health care regimes. The use of herbs is rooted in history and has formed the foundation of medicine. Not so established is the use of herbs in combination with modern pharmaceutical medicines. A lack of federal regulation in the herbal industry, variations in herbal product constituents, and failure of patients to report herb use to their physicians have contributed to the dearth of information. Interactions between herbs and drugs may be additive, synergistic, or antagonistic and therefore may be beneficial or adverse. It is not within the scope of this article to touch on all the known herb-drug interactions, but rather to provide an overview of the evidence for popular herbs including St. John’s wort, kava, ginkgo, ginger, and ginseng so that the practitioner can gain a realistic perspective on herb-drug interactions and make the necessary recommendations to ensure the safety of their patients.