Drug interaction of chemotherapy drugs and medicinal plants

Abstract

Introduction: The treatment of cancer is considered to be one of the most challenging problems in medicine. Amongst the most used treatments is the usage of herbal medicines, which helps both in prevention and cure of the disease. Although, the use of medicinal plants for treatment of cancer is harmless or even beneficial to patients but presents potential risk when combined with prescribed drugs. Drug interaction during cancer treatments therefore, is an issue that affects the Brazilian population.Methods: To analyze the drug interactions between chemotherapeutic agents and medicinal plants, a systematic literature review was performed with articles published in English and Portuguese between 2012 and 2019 from the databases such as PubMed and ScienceDirect. Search was carried out with the help of the Boolean Operator (AND) using following keywords: medicinal plants, drug interaction, chemotherapy, and herbal medicine. We found 149 articles in PubMed and 625 articles in ScienceDirect. The selection of articles for this study was done first by excluding repeated articles, then selecting articles by title, then by summary, and the last step was to read the full articles. Finally, twelve articles contributed to the research.Results and Discussion: A systematic research revealed that 5 medicinal plants, such as St. John’s wort (Hypericum perforatum), Ginger (Zingiber officinale), Black cohosh (Cimicifuga racemosa), Celandine (Chelidonium majus) and Mango (Mangifera indica) containing metabolites such as polyphenols, alkaloids, flavonoids, saponins and others interacted with chemotherapeutic agents, such as irinotecan, tamoxifen, docetaxel and paclitaxel. In addition, many medicinal plants are used indiscriminately, without proper medical and pharmaceutical guidance in cancer treatment, to minimize side effects, such as nausea, headache and low immunity, that can cause harm to the patient.