Concurrent Use of Prescribed OTC · ETC Drugs and Herbal Medicines in South Korea: Exploring Potential Herb-drug Interactions

Abstract

Herbal medicines have gained a reputation for being efficacious and safe over hundreds of years. Nowadays, people are easily exposed to drugs and herbal medications concurrently. Therefore, it is essential for regulatory authorities and physicians to closely monitor potential herb-drug interactions. The aim of this study was to determine (1) the prevalence of the concurrent use of drugs and herbal medications, (2) demographic and clinical characteristics of concurrent users, (3) risk factors associated with concurrent use, (4) prescription patterns, and (5) potential herb-drug interactions by using a nationwide insurance claims database. We included patients with herbal medicine records in 2010- 2015 from the National Health Insurance Service-National Sample Cohort 2.0. The herbal medicine users were divided into two groups: concurrent users who were prescribed both herbal and drug medications simultaneously and non-concurrent users. The proportion of concurrent use increased steadily from 2.5% in 2010 to 5.2% in 2015, and the growth rate in the elderly population aged 60-79 years was the highest, from 0.7% in 2010 to 2.8% in 2015. Concurrent users in 2015 were prone to be female; old; and have chronic diseases including hypertension (adjusted odds ratio [aOR], 4.89; 95% CI, 4.54-5.27), hyperlipidemia (aOR, 2.01; 1.89-2.14), and diabetes (aOR, 1.81; 1.67-1.98). The most common concurrently used combinations were Gunghatang-aspirin, Ojeoksan-aspirin, and Ojeoksan-atorvastatin. In this study, we investigated the herb-drug combinations that are used concurrently and related characteristics and elucidated the factors related to the concurrent use and the most common concurrently used herb-drug combinations.