Herb Drug Interactions

Herbal botanicals have been used in many cultures throughout the world for hundreds of years. These products are usually seen as natural; they should not be synonymous with safe.

Possible interactions can involve hepatic cytochrome P-450 and changes in intestinal absorption, distribution, and renal excretion. Herbal interactions with certain drugs are listed in Table 3.

Table 3 Herbal-drug interactions

Herbal

Drugs

Effect/mechanism

Echinacea

Methotrexate, aminodarone, ketoconazole, steroids (anabolic)

Increased hepatotoxicity

Feverfew

NSAIDs

Decreased herbal effect

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