If you are considering using herbal supplements, you need to know that many herbal supplements may interact with prescription and non-prescription medications, and may cause some very serious interactions and side effects. Patients with certain health conditions are at increased risk for developing adverse effects from using herbal supplements. For instance, taking a combination of herbal supplements, or using supplements along with prescription medications, can result in harmful, even life-threatening, outcomes.
Prescription drugs can have undesirable side effects, and those side effects can be what prompts people to consider using herbal medicines. Herbal medicines can be used by patients concurrently to regular medications, resulting in potentially serious adverse events. Healthcare providers should be alert to the potential interactions of herbal medicines with prescription drugs, particularly if drugs of narrow therapeutic index are used.
Therefore, it is critical to educate patients, particularly patients on cardiovascular, immunosuppressant, or antiretroviral therapies, about possible adverse effects caused by interactions between herbal products and conventional medicines. It is thus imperative for healthcare providers to inquire with patients regarding the use of herbal remedies. Clinicians must remain vigilant about the negative effects and medication interactions associated with herbal remedies, and should question all patients about the use of these products.
Herbal and Natural Supplements
Therefore, it is the responsibility of physicians to check patients for the use of herbal products prior to surgical intervention. Patients frequently use supplements without consulting their physicians, and they frequently fail to disclose dietary supplement intake unless specifically asked. Asking about supplement use is critical when patients are taking prescribed medications, as detrimental drug-supplement interactions can occur. In addition, it is essential that physicians are knowledgeable about the quality of supplements in order to deliver adequate care and to recognize adverse events.
Verification and certification programs for dietary supplements and for the ingredients of dietary supplements may be used by manufacturers to help assure the quality of their products. USP Documentation standards for dietary supplements are supported by chemical reference standards, which are highly characterized samples of food ingredients, impurities, and degrading products, as well as by compendium-level reagents and performance calibrators from the United States Pharmacopeia, Inc., which are specified for use in conducting official tests and analyses in accordance with the USP-NF. Supplements and botanical products are subject to FDA regulation through the 1994 Dietary Supplement Health and Education Act (an amendment to the Food, Drug, and Cosmetic Act). Requirements of the 1994 Act state a products should be safe and that advertisements should be truthful.
The Dietary Supplement Health Education Act of October 1994 does not require manufacturers of herbal products to demonstrate that their products are either safe or effective before putting them on the market. The Dietary Supplement Health and Education Act has freed manufacturers of herbal supplements from regulation (see www.fda.gov/ regulatory information/legislation/).
Herbal supplements are regulated by the FDA, but not as rigorously as prescription or over-the-counter (OTC) drugs. Sometimes called botanicals,herbal supplements have been used medicinally for centuries, and herbal supplements continue to be popular with consumers today. Herbal remedies are not new – plants have been used medicinally for thousands of years.
However, herbs and botanical products — including the ones labelled as “natural” — may be powerfully effective on the body. Herbal products may present an unexpected risk, as many supplements contain active ingredients that exert powerful effects on the body. The herbal supplements feverfew, ginger, and ginkgo may interact with certain drugs used to treat breast cancer, as well as a wide range of other medications.
The effects of the herbs can vary from mild to powerful, depending on who takes them and what medications are being used. Although some herbs can be effective at slowing down the growth of tumors, patients should avoid herbs that are sold as treatments for cancer. People who have cancer should get their permission first from an oncologist before taking any type of herbal medication, as some herbs can have negative effects on the results of treatment for the tumor. If you would like to try herbs while on treatment for your cancer, speak to your oncologist about this so that he or she can monitor your reaction and alert you of any potential drug interactions.
Always talk with your health care provider, especially if you are taking medicines, have chronic health problems, or are pregnant or nursing. If you take aspirin, digoxin, diuretics, hypoglycemics, nonsteroidal anti-inflammatory drugs, spironolactone, or warfarin, do not use herbal supplements without checking first with your health care provider.
In this vein, it is necessary to clarify the true potential and safety profiles of herbal medicines in order to provide a scientific basis for future recommendations about the benefits of using and risks of using them. The recommendations made here are intended for medicines that are regulated by a national body in order to assure their quality and safety. Approximately 20% of the US population confesses to taking at least one herbal supplement or preparation on a daily basis, and over 50% of the population confesses to using a natural product for medical purposes within the last 30 days. Therefore, understanding the purposes of the most frequently used substances, as well as the potential interactions with other supplements and prescription medications, is critically important for healthcare providers.
Approximately 20 % of the U.S. population admits to taking at least one supplement or herbal preparation daily, and more than 50 % of the population admits to having used a natural preparation for medicinal purposes in the past 30 days. Therefore, understanding the purpose of the most commonly used substances and potential interactions with other supplements and prescription medications is critically important for health-care practitioners. These increases in the volume of products and consumer usage highlight the importance for physicians of understanding the potential quality issues of products presented as natural supplements, given the FDAs lack of strict regulation for supplements compared with drugs. In fact, according to the American Diabetes Association, diabetics are more likely to use supplements than non-diabetic individuals. One survey found that about 15% of patients receiving usual pharmacotherapy were also taking herbal products, and among them, 40% of patients had observed a possible negative herbal-drug interaction. Alongside these treatments, diabetic patients tried a number of herbs and supplements for improving their diabetes. There is only limited evidence at this time on whether certain supplements do the aforementioned things for humans.