Toxicity of Chinese Herbal Medicine and drug-herb Interactions

Abstract

According to some clinical reports, simultaneous administrations of particular herbs and modern medications might lead to severe damages to patients' health. Those publications have attracted the public's attention toward the safety of Chinese herbal medicines and the combinations of herbs and modern drugs. Even though most of the public believe Chinese herbal medicines or western herbal remedies are not associated with side effects, but the fact shows herbs could be toxic or interact with other medications. Hence, it is necessary for doctors, pharmacists, and other medical experts to understand the toxicity of commonly used herbs and drugs, and interactions among them. In general, toxicity of Chinese medicine herbs can be discussed in two parts: toxicity originates from existing toxins in raw herbs, and adverse effects result from the combinations of herbs. From the aspect of handling raw herbs, medical professionals should know the property, lethal dose, usual dose, degree of potency, and preparations of toxic herbs. For example, one need to concern about the dose, methods of preparation, and compatibility of combinations when dispensing strong toxic herbs, such as Aconiti Tuber, Arisaematis Rhizoma, Bufonis Venenum, Pinelliae Tuber, Strychni Semen, Tiglii Semen, etc. Meanwhile, the medical professionals also need to consult patients with their current medications so as to avoid possible drug interactions. Similar concepts should be applied when co-administrate herbs, drugs, food, or nutrient supplements. In order to assist in revealing the knowledge of toxicity of Chinese herbal medicine, and mechanisms of drug-herb interactions, we undertook a reviewed research on the general idea of toxicity of the Chinese herbal medicine, the basic concept regarding the processes how to reduce the toxicity of some commonly used Chinese medicine herbs, discussion on the evidence-based drug-herb and herb-food interactions, and the cautions clinical practitioners might need to concern. Hoping this article might contribute valuable ideas to the readers.