01 Introduction

02 Statistics
TOPIC
03 Mechanisms
OUTLINE
04 Examples of Drug-Herb
Interactions

05 Pharmacist’s Role
INTRODUCTION

“being natural is safe”

“the likelihood of herb-drug

interactions is theoretically higher than
drug-drug interactions because
synthetic drugs usually contain single
chemical entity..”
 Timeline

Advancement
Popularization Global
of Herbal High
products prevalence
and rampant
usage
400 B.C. 1950s 1974 2000 onwards

Natural WHO
Products began encouraging
Hippocratic era developing countries
(Greek and to supplement modern
Roman times) pharmacotherapy

Brantley et al. (2014). Herb-Drug Interactions: Challenges and Opportunities for Improved Predictions. The American Society for Pharmacology and Experimental Therapeutics. Vol.42: 301-317
 WHO
As cited in the work of Wills et al., 2009

The world population

70% currently uses medicinal CND
herbs as complementary or EUR
alternative medicine.

USA

AFR
No significant gender
0% or social difference.
AUS

Fasinu et al. (2012). An Overview of the Evidence and Mechanisms of Herb-Drug Interactions. Frontiers Pharmacology. Vol.3(69):1-19.
 Batangas 68.4% Rural
Paranaque Caloocan 51.5% Urban

Philippine
43% LIFECARE
SUPPORT

1Dahilig & Salenga (2012). Prevalence, Perceptions and Predictors of Complementary and Alternative Medicine Use in Selected Communities in the Philippines. JAASP. Vol.1(1):16-24.
2Ladia et al. (2018). Prevalence of and Associations for Complementary and Alternative Medicine Use Among Apparently Healthy Individuals in the Philippine LIFECARE Cohort. Acta Medica Philippina. Vol.52(5):404-410
Mechanisms of Interaction

Pharmacokinetics
Absorption,
Distribution,
Pharmacodynamics
Metabolism and Addition, Synergism,
Excretion Potentiation,
Antagonism
PHARMACOKINETICS
ABSORPTION
Psyllium, Rhubarb, Flaxseed, Marshmallow, And Aloe +
Lithium, Digoxin, Warfarin

DISTRIBUTION
Meadowsweet/Black Willow + Warfarin/Carbamazepine

METABOLISM
Licorice/St. John’s Wort + Corticosteroids/Warfarin

Kuhn, M. (2002). Herbal Remedies: Drug-Herb Interactions. Critical Care Nurse. Vol.22(2):22-35
PHARMACODYNAMICS

Valerian + Benzodiazepines
Ginkgo + Warfarin

Kuhn, M. (2002). Herbal Remedies: Drug-Herb Interactions. Critical Care Nurse. Vol.22(2):22-35
Hussain, S. (2011). Patient Counseling About Herbal-Drug Interactions. African Journal of Traditional Complementary and Alternative Medicine. Vol.8:152-163
Hussain, S. (2011). Patient Counseling About Herbal-Drug Interactions. African Journal of Traditional Complementary and Alternative Medicine. Vol.8:152-163
Pharmacist’s Role

have knowledge of
when patients who use Acknowledge and seek out
CAM experience adverse information about
drug events, and report patients' CAM use.
them appropriately.
must help patients use
need to educate CAM appropriately and
patients about CAM safely.
and its potential
benefits and risks. Increase their knowledge
base about CAM so they
need to work with health have a basic understanding
care professionals of what various products do
and what their risks are.