Abstract
Many people worldwide use plant preparations for medicinal purposes. Even in industrialized regions, such as Europe, where conventional therapies are accessible for the majority of patients, there is a growing interest in and usage of phytomedicine. Plant preparations are not only used as alternative treatment, but also combined with conventional drugs. These combinations deserve careful contemplation, as the complex mixtures of bioactive substances in plants show a potential for interactions. Induction of CYP enzymes and pGP by St John’s wort may be the most famous example, but there is much more to consider. In this review, we shed light on what is known about the interactions between botanicals and drugs, in order to make practitioners aware of potential drug-related problems. The main focus of the article is the treatment of inflammatory diseases, accompanied by plant preparations used in Europe. Several of the drugs we discuss here, as basal medication in chronic inflammatory diseases (e.g., methotrexate, janus kinase inhibitors), are also used as oral tumor therapeutics.
Highlights
Despite the dominance of medicinal products, with one, or few, chemically-defined active substance(s), in industrialized countries, herbal medicinal products remain popular, and their relevance even grows [1]
When patients use herbal medicinal products (HMP) or herbal supplements conjointly with conventional drugs, this bears the risk of unrecognized potential interactions
This review aims to give an actual compilation of plants that are commonly popular among patients or could be used to treat inflammatory diseases and their interaction potential with important conventional drugs in this field
Summary
Despite the dominance of medicinal products, with one, or few, chemically-defined active substance(s), in industrialized countries, herbal medicinal products remain popular, and their relevance even grows [1]. Adult, and elderly patients in several countries reveal that between 15 and 45% of patients use herbal products for healthcare purposes, besides prescribed medicine [2–6]. The use of complementary herbal medicines and food supplements is frequent among women and older people [7–9]. Surveys indicate that patients with chronic diseases use more supplements [8]. That may result in not considering them as medicine or medicinal products and missing to report them to health professionals, if not explicitly asked [5,6,10,11]. When patients use herbal medicinal products (HMP) or herbal supplements conjointly with conventional drugs, this bears the risk of unrecognized potential interactions
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