Safety Of Herbal Medicines Research Articles

Herbal medicine for the treatment of non-erosive reflux disease: A systematic review and meta-analysis.

Non-erosive reflux disease (NERD) is the most prevalent gastroesophageal reflux disease. Currently, proton pump inhibitors are the most commonly used treatment for NERD. Recently, the demand for herbal medicines with relatively few side effects is increasing and trials confirming the effectiveness and safety of herbal medicines for the treatment of NERD have been conducted. This study aimed to investigate the effectiveness and safety of herbal medicine in the treatment of NERD through published randomized-controlled trials. Ten electronic databases were searched from inception until May 2023. Disease, intervention-related terms, and publication type keywords were combined as search terms. Studies designed as randomized controlled trials, including participants diagnosed with NERD with any type of herbal medicine as a treatment intervention were included. Data extraction and analysis were conducted by 2 independent reviewers. The total clinical efficacy rate was assessed as a primary outcome, while the secondary outcomes were recurrence rate, reflux diagnostic questionnaire score, short-form 36 health survey score, and serum motilin level. The risk of bias in each study and quality of evidence were assessed. Thirty-four randomized controlled trials involving 3759 patients were analyzed. Herbal medicine was significantly more effective in improving total clinical efficacy, recurrence rate, reflux diagnostic questionnaire score, some domains of short-form 36 health survey, and serum motilin levels in patients with NERD than conventional medical therapy. No severe intervention-related adverse effects were observed. Regarding the quality of evidence, most outcomes were revealed to have moderate to low levels of evidence. This systematic review and meta-analysis suggests that herbal medicine can be an effective and safe therapy for NERD; however, there are several limitations regarding the methodological quality of the included studies. Further research with high methodological quality is necessary to improve the quality of evidence.

A systematic approach of efficacy and safety of herbal medicine in the treatment of Vitiligo

Vitiligo is a chronic dermatological disorder caused by the loss of melanin. Conventional therapies for vitiligo require prolonged treatments, have low efficacy, and are complicated by side effects. This study aimed to review the role of herbal medicine in the treatment of vitiligo. A comprehensive search was conducted in PubMed, Embase, and Google Scholar for studies conducted till December 2023 using related keywords linked with Boolean operators such as AND, OR, and NOT. Subsequently, a more comprehensive search was performed using the name of each specific herb. A variety of herbs were used to treat vitiligo. The most widely used herbal therapies among vitiligo populations were Khellin, Ginkgo biloba L., Picrorhiza kurroa, Polypodium leucotomos, Cucumis melo, Psoralea corylifolia L., Turmeric, Curcumin, and Nigella sativa L. were used either alone or in combination with other therapies. The majority of herbs were found to be efficacious with negligible side effects. No severe toxicities were reported. Most herbal medicines showed a positive impact on vitiligo. Therefore, healthcare providers may consider herbal medicine as an option for patient’s refractory to conventional therapies

Safety of herbal medicines used in early gestations among the Chinese population: A population-based cohort study

BackgroundHerbal medicines have a long history of use for pregnant women around the world. However, their use in the early pregnancy is often questioned in terms of safety on offspring. PurposeTo investigate whether herbal medicines used at early pregnancy are associated with an increased risk of birth defects. Study designThe population-based retrospective cohort study included pregnancies registered in a population-based and long-term follow-up database (i.e., REPRESENT) with live births between January 2013 and December 2018, by linking a population-based drug prescription database covering all the hospitals in Xiamen, China. MethodsThe exposure of interest was defined as the consecutive administration of one or more prescriptions of herbal medicines to prevent miscarriage during the first trimester. We examined the overall birth defects (excluding chromosomal malformations) and 23 individual types by national surveillance. To facilitate comparison, we included blank (non-use) and active controls. Poisson regression based on propensity score matching (PSM) was applied to control for the confounders. Multiple sensitivity analyses and negative control analyses were conducted to examine the robustness. ResultsThe final cohort included 195,824 pregnancies, and 29,063 (14.8 %) were prescribed with herbal medicines at early pregnancy, of which 3,024 (1.5 %) received herbal medicine monotherapy. These herbal medicines were often used in combination with other medicines (especially pharmaceutical medicines) and peaked between the fifth and eighth gestational weeks. A total of 2,795 birth defects were identified. Compared to progesterone monotherapy (i.e., active control), herbal medicine monotherapy was not associated with a higher risk of overall birth defects (relative risk [RR] 1.28, 95 %CI 0.57–2.90). Compared to no use of drug (i.e., blank control), pregnancies with herbal medicine monotherapy showed a similar risk (RR 1.25, 95 %CI 0.69–2.29). Consistent results were shown in sensitivity analyses. ConclusionThe current evidence dose not suggest an increased risk of birth defects when using herbal medicines in early pregnancy, although larger studies with wider pregnancy populations are needed for further confirmation.

Professor Li Fenping's Approach to Treating Insomnia Based on Liver Theory

Insomnia, classified under the category of “Bu Mian” in traditional Chinese medicine (TCM), is a chronic condition characterized by the inability to obtain normal sleep. It is closely related to liver function. TCM treatment for insomnia follows the holistic principle of “integrating man with nature” and applies syndrome differentiation to implement individualized treatments. The safety of herbal medicine, combined with the absence of drug dependence, makes it highly favored by patients compared to Western medications. Professor Li Fenping believes that insomnia results from dysfunction in the liver’s regulation of Qi and blood, which prevents the Hun (ethereal soul) from returning, thus disrupting sleep. Based on clinical practice, she has identified four major liver-related patterns in insomnia: liver Qi stagnation with unsettled Hun, deficiency of heart and liver blood (or Yin) leading to poor nourishment of the Shen (spirit), liver fire excess disturbing the Hun, and blood stasis obstructing the meridians and unsettling the Shen. These distinct approaches to liver-focused treatment of insomnia have expanded the clinical applications of TCM in treating the disorder, with remarkable therapeutic outcomes. This paper presents Professor Li Fenping’s clinical experience in treating insomnia from the perspective of liver pathology.

Comprehensive assessment for species authenticity, pesticide residual, and fungal contamination characteristics of Panax herbal tea

Adulteration, pesticide residues, and fungal contamination are the three key factors affecting herbal medicine safety. Herbal tea is a healthy beverage containing bioactive molecules and is one of the derivatives of medicine food homology herbal medicine. However, these three factors are often ignored in the herbal tea industry. In this study, 171 commercially available Panax herbal tea products were tested. The findings revealed that the target Panax ingredient in the herbal tea products was adulterated by Platycodon grandiflorum or the mixed-using of Panax genus species, with an adulteration rate of 25.1%. The pentachloronitrobenzene (PCNB) pesticide residue rate was 78.4% in the 171 Panax herbal tea products. Two samples demonstrated obvious fungal contamination. Among the 171 Panax herbal teas, 98 samples were qualified with the correct species, qualified pesticide residues, and no fungal contamination (eyeballing). The present investigation not only sheds light on the three key factors exerting a significant impact on herbal tea safety but also provides a reference for the comprehensive evaluation of herbal tea, thereby facilitating the development of this industry.

Safety of herbal medicine in the postpartum period of a Korean Medicine hospital and postpartum care centre: protocol of a registry study (SAFEHERE-PC)

IntroductionHerbal medicines (HMs) are commonly used during the postpartum period in South Korea. However, the safety concerns associated with these medicines remain unresolved. This study aims to establish a registry...

Effect of herbal medicine on postoperative nausea and vomiting after laparoscopic surgery: A systematic review and meta-analysis.

Traditionally, herbal medicines have been used to alleviate nausea and vomiting; however, a comprehensive clinical evaluation for postoperative nausea and vomiting (PONV), especially after laparoscopic surgery, remains limited. This review aimed to evaluate the efficacy and safety of herbal medicine as an alternative therapy to prevent and manage nausea and vomiting after laparoscopic surgery compared with untreated, placebo, and Western medicine groups. We searched 11 databases, including EMBASE, PubMed, and the Cochrane Library, to collect randomized controlled trials (RCTs) of herbal medicines on PONV after laparoscopic surgery on July 7, 2022. Two independent reviewers screened and selected eligible studies, extracted clinical data, and evaluated the quality of evidence using the Cochrane risk-of-bias tool. The primary outcome was the incidence of PONV, whereas the secondary outcomes included the frequency and intensity of PONV, symptom improvement time, antiemetic requirement frequency, and incidence of adverse events. Review Manager Version 5.3. was used for the meta-analysis. We identified 19 RCTs with 2726 participants comparing herbal medicine with no treatment, placebo, and Western medicine. The findings showed that compared with no treatment, herbal medicine demonstrated significant effects on vomiting incidence (risk ratio [RR] = 0.43, 95% confidence interval [CI] 0.32-0.57, P < .00001). Compared with placebo, herbal medicine revealed a significant effect on the severity of nausea 12 hours after laparoscopic surgery (standardized mean difference = -2.04, 95% CI -3.67 to -0.41, P = .01). Herbal medicines showed similar effects with Western medicine on the incidence of postoperative nausea (RR = 0.94, 95% CI 0.63-1.42, P = .77) and vomiting (RR = 0.68, 95% CI 0.25-1.84, P = .45). Furthermore, comparing the experimental group containing herbal medicine and control group excluding herbal medicine, adverse events were considerably lower in the group with herbal medicine (RR = 0.45, 95% CI 0.27-0.72, P = .001). Herbal medicine is an effective and safe treatment for nausea and vomiting secondary to laparoscopic surgery. However, the number of studies was small and their quality was not high; thus, more well-designed RCTs are warranted in the future.

Quantitative Analysis of Fungal Contamination of Different Herbal Medicines in China.

Herbal medicines are widely used for clinical purposes worldwide. These herbs are susceptible to phytopathogenic fungal invasion during the culturing, harvesting, storage, and processing stages. The threat of fungal and mycotoxin contamination requires the evaluation of the health risks associated with these herbal medicines. In this study, we collected 138 samples of 23 commonly used herbs from 20 regions in China, from which we isolated a total of 200 phytopathogenic fungi. Through morphological observation and ITS sequencing, 173 fungal isolates were identified and classified into 24 genera, of which the predominant genera were Fusarium (27.74%) and Alternaria (20.81%), followed by Epicoccum (11.56%), Nigrospora (7.51%), and Trichocladium (6.84%). Quantitative analysis of the abundance of both Fusarium and Alternaria in herbal medicines via RT-qPCR revealed that the most abundant fungi were found on the herb Taraxacum mongolicum, reaching 300,000 copies/μL for Fusarium and 700 copies/μL for Alternaria. The in vitro mycotoxin productivities of the isolated Fusarium and Alternaria strains were evaluated by using liquid chromatography-tandem mass spectrometry (LC-MS/MS), and it was found that the Fusarium species mainly produced the acetyl forms of deoxynivalenol, while Alternaria species mainly produced altertoxins. These findings revealed widely distributed fungal contamination in herbal medicines and thus raise concerns for the sake of the quality and safety of herbal medicines.

Efficacy and safety of herbal medicine combined with acupuncture in pediatric epilepsy treatment: A meta-analysis of randomized controlled trials.

To evaluate the efficacy and safety of herbal medicine and acupuncture combination for pediatric epilepsy treatment. Databases were searched from their interception until October 2023 to identify randomized controlled trials focusing on the therapeutic efficacy of herbal medicine-acupuncture combination (intervention group) for pediatric epilepsy. The primary outcome was the risk of treatment failure, whereas the secondary outcomes included the risk of post-treatment electroencephalogram (EEG) abnormalities and adverse events. Subgroup analyses were conducted based on the type of herbal compound formulas. Meta-regression analysis was conducted to examine the influence of patient demographics and clinical history on the therapeutic efficacy of herbal medicine-acupuncture combination for pediatric epilepsy. To assess the cumulative evidence, trial sequential analysis (TSA) was performed. The analysis included 10 trials involving a total of 882 pediatric patients. Meta-analysis revealed that the intervention group had a lower risk of treatment failure than the control group (risk ratio [RR] = 0.3, 95% confidence interval [CI]: 0.19-0.47, P<0.00001, I2 = 0%, 10 trials). Subgroup analyses showed that therapeutic efficacy was consistent among the different herbal compound formulas. Meta-regression analysis revealed that the efficacy of the treatments did not significantly vary with patient age, male sex, and duration of seizure history. TSA suggested that herbal medicine-acupuncture combination exerted a robust and conclusive effect on seizure treatment. Although the combined used of herbal medicine and acupuncture was not associated with a lower risk of post-treatment EEG abnormalities (RR = 0.82, 95%CI:0.6-1.11, P = 0.2, 3 trials), the risk of adverse events was reduced (RR = 0.27, 95%CI:0.18-0.41, P<0.00001, 4 trials). The meta-analysis suggested that combined use of herbal medicine and acupuncture is a promising and safe clinical approach for pediatric epilepsy treatment. Further large-scale studies are necessary to conclusively determine the efficacy and safety of herbal medicine and acupuncture in pediatric epilepsy treatment.

Evaluating the Safety of Herbal Medicine on Renal Function: A Comprehensive Analysis from Six Randomized Controlled Trials Conducted with Four Formulations from Traditional Korean Medicine.

The growing popularity of herbal medicine raises concerns about potential nephrotoxicity risks, while limited evidence hinders a comprehensive impact assessment. This study aims to investigate the overall risk features of herbal medicine on kidney injury. We conducted a retrospective analysis on renal function changes, including blood urea nitrogen (BUN), serum creatinine, and estimated glomerular filtration rate (eGFR), through data from six randomized controlled trials (RCTs) in South Korea. A total of 407 participants (142 males, 265 females) received either one of four different herbal medicines (240 participants) or a placebo (167 participants). When comparing changes in eGFR regarding the mean, 90th-percentile value, and 20% reduction after treatment, there was no significant difference between the herbal-treated and placebo groups. This study provided a helpful reference for examining the safety issues of herbal remedies, especially regarding kidney function.

Effectiveness analysis of herbal medicine for gastroesophageal reflux disease: A retrospective study.

This study aimed to identify the clinical features of gastroesophageal reflux disease (GERD) in primary clinics and the effectiveness and safety of herbal medicine (HM). Thirty-five patients with gastroesophageal-reflux symptom who visited the 16 Korean medicine (KM) primary clinics from June 2022 to October 2022 were included in the study. We retrospectively analyzed the charts of 35 patients and collected clinical characteristics, HM, and outcome variables such as the numerical rating scale, gastroesophageal reflux disease questionnaire, frequency scale for symptoms of gastroesophageal reflux disease, Euro-Quality Of Life-5 Dimension, and adverse events. Of the 35 patients, 12 (34.3%) were men, and the average age of all patients was 47.0 ± 14.3 years. HM was prescribed for all 35 patients; Pinelliae Tuber (n = 31, 88.57%), Zingiberis Rhizoma Recens (n = 30, 85.71%), and Poria Sclerotium (n = 28, 80%) were the most prescribed herbs. All scores including numerical rating scale, frequency scale for symptoms of gastroesophageal reflux disease, gastroesophageal reflux disease questionnaire, and Euro-Quality Of Life-5 Dimension after 30 and 60 days from baselines showed significant improvement, and there were only a few adverse events. This study supports the effectiveness and safety of HM in reducing GERD symptoms in primary Korean medicine clinics. The most frequently used herbs may play significant roles in GERD symptom management.

Acute toxicity profiling of medicinal herb Ardisia elliptica leaf extract by conventional evaluations and proton nuclear magnetic resonance (NMR) metabolomics

Background and aimInterest in the safety of herbal medicine is growing rapidly regarding knowledge and challenges in natural products. Hence, this study aimed to reveal the toxicological profile of Ardisia elliptica, a traditional medicinal plant used in the treatment of various illnesses. Experimental procedureAcute toxicity study was performed on female and male Sprague Dawley rats with a single oral administration of 2000 mg/kg BW of 70% ethanolic A. elliptica leaf extract, using a combination of conventional investigations and 1H-NMR-based metabolomics approaches. ResultsPhysical, hematological, biochemical, and histopathological assessments demonstrated the usual rat profile, with no mortality and delayed toxicity 14 days after administration. 1H NMR serum metabolomics depicted similar metabolites between normal and treated groups. Nevertheless, 1H NMR of urinary metabolomics revealed perturbation in carbohydrate, amino acid, and energy metabolism within 24h after extract administration, while no accumulation of toxic biomarkers in the collected biological fluids on Day 14. A minor gender-based difference revealed the influence of sex hormones and different energy expenditure on response to extract treatment. ConclusionThis study suggested that 2000 mg/kg BW of 70% ethanolic A. elliptica leaf extract is considered as safe for consumption and offered a comprehensive overview of the response of physiological and metabolic aspects applicable to food and herbal product development.

Characteristics and Challenges of Providing Acupuncture and Chinese Herbal Medicine in Oncology Treatment: Report of Survey Data and Experience of Five Unique Clinical Settings.

Acupuncture is an integrative therapy with strong evidence to support its use in the oncology setting, yet barriers exist for implementation into conventional medical clinics. Though acupuncture is recommended in clinical practice guidelines for oncology, there is little data in the literature showing how acupuncture and other related therapies, including herbal medicine are successfully implemented in some oncology clinics, while others experience barriers to care. To characterize the current use of acupuncture (ACU) and herbal medicine (HM) in oncology clinics, we collected general demographic and usage data from 5 example clinics. In addition, to better understand the barriers faced by ACU and HM clinics in implementing acupuncture as a treatment modality, a survey was deployed to 2320 members of the Society for Integrative Oncology. This article examines the characteristics of oncology settings around the world, and shares data from the survey on the use of these therapies in the field of oncology. The primary barrier to acupuncture care, as reported by providers, was cost. With just under 70% of the oncologists reporting it as the most important obstacle. Additional barriers to implementation included concerns about competency and training, accessibility and safety of herbal medicine during treatment. Though acupuncture is being incorporated into more conventional oncology settings, organized strategies for implementation involving payers and policymakers is needed.

Safety classification of herbal medicine use among hypertensive patients: a systematic review and meta-analysis.

The use of herbal medicines (HMs) for the treatment of hypertension (HTN) is increasing globally, but research on the potential adverse effects and safety of HMs in HTN patients is limited. Therefore, this systematic review and meta-analysis aim to determine the global prevalence of HM usage among HTN patients and assess the safety of identified herbs based on current scientific evidence. The PubMed/MEDLINE, EMBASE (Ovid), and Cumulated Index to Nursing and Allied Health Literature (CINAHL) databases were searched for cross-sectional studies on the use of HM among HTN patients. Our review includes studies published in English up to the year 2023. After extracting and appraising the data from the studies, a meta-analysis was conducted using the Stata version 16.0 to estimate the pooled prevalence of HM use in patients with HTN (PROSPERO: CRD42023405537). The safety classification of the identified HM was done based on the existing scientific literature. This study analyzed 37 cross-sectional studies from 21 countries and found that 37.8% of HTN patients used HM to manage their health. The prevalence of HM use varied significantly based on publication year and geographical region. Among the 71 identified herbs, Allium sativum L., Hibiscus sabdariffa L., and Olea europaea L. were the most commonly used. However, four herbs were identified as contraindicated, 50 herbs required caution, and only 11 herbs were considered safe for use. The study highlights the potential risks of toxicities and adverse effects associated with HM use in the treatment of HTN. Ensuring patient safety involves using safe HMs in appropriate doses and avoiding contraindicated HMs. Future research should focus on identifying commonly used herbs, especially in resource-limited countries with poor HTN management, and additional clinical research is required to assess the toxicity and safety of commonly used HMs.

Mitigating digestive disorders: Action mechanisms of Mediterranean herbal active compounds.

This study explores the effects of the Mediterranean diet, herbal remedies, and their phytochemicals on various gastrointestinal conditions and reviews the global use of medicinal plants for common digestive problems. The review highlights key plants and their mechanisms of action and summarizes the latest findings on how plant-based products influence the digestive system and how they work. We searched various sources of literature and databases, including Google Scholar, PubMed, Science Direct, and MedlinePlus. Our focus was on gathering relevant papers published between 2013 and August 2023. Certain plants exhibit potential in preventing or treating digestive diseases and cancers. Notable examples include Curcuma longa, Zingiber officinale, Aloe vera, Calendula officinalis, Lavandula angustifolia, Thymus vulgaris, Rosmarinus officinalis, Ginkgo biloba, Cynodon dactylon, and Vaccinium myrtillus. The phytochemical analysis of the plants showed that compounds such as quercetin, anthocyanins, curcumin, phenolics, isoflavones glycosides, flavonoids, and saponins constitute the main active substances within these plants. These natural remedies have the potential to enhance the digestive system and alleviate pain and discomfort in patients. However, further research is imperative to comprehensively evaluate the benefits and safety of herbal medicines to use their active ingredients for the development of natural and effective drugs.

Saudi People’s Knowledge and Attitudes about Herbals’ Side Effects and their Interactions with Medications

Introduction: The safety of herbal medicines is of particular importance because the majority of these products is self-prescribed and is used to treat minor and often chronic conditions. If not used with caution, some herbals may cause side effects and interactions with drugs.&#x0D; Objective: To determine awareness, attitudes of Saudi people about side effects of herbs and herbal products, their interaction with medicines and to determine the common source of information about herbals. &#x0D; Methodology: A cross-sectional study in the period from January to November 2023. on a random sample comprised of 530 Saudi persons living in different regions of Saudi Arabia using questionnaire in Arabic language. All data were analysed by descriptive statistics.&#x0D; Results: Among the study participants, there were 147 (28%) have medium interest in herbals and 36 (7%) have large interest, 150 (28%) believes that herbals have no side effects, 121 (23%) believes that herbals can be taken instead of medications, 82 (16%) believes that herbals have the same efficacy as medications, 103 (19%) take herbals with medications, 172 (32%) think that taking herbals with prescription medications may give better effect than taking each one separately, 78 (15%) don't know that taking medication with herbals can cause side effects, 87 (16%) don't know that herbals can interact with medications, only 73 (14%) reported that they told the doctor or pharmacist about taking herbals with medications. Laxative/constipation and carminative effect (19%), relieving pain (14%), cough and cold (13%), menstrual disturbances (8%) were the most conditions to be treated by herbal remedies among study participants. Only 12 (2%) had adverse effects from taking herbals. Anise (39%), Peppermint (37%), Ginger (21%), cinnamon (20%), cumin (19%), are among the commonly used herbs reported by participants. The source of information about herbals reported among participants were family and relatives (62%), media (12%).&#x0D; Conclusion: Although herbals are widely used, knowledge of their potential adverse effects and interactions with drugs is limited. There’s a need to increase public awareness of the community about risks of medical herbs.

Herbal Medicine and COVID-19: An Umbrella Review

Background: Most systems of traditional medicine have been using herbal medicines to prevent and treat acute respiratory conditions and various other conditions for centuries. The aim of this project is to identify and examine the systematic and narrative reviews reporting on the therapeutic use of herbal medicines as it relates to the prevention and treatment of COVID-19 and long COVID. Methods: This paper is part of an umbrella review of studies related to natural health products and natural therapies for the prevention or treatment of COVID-19. It is a follow-up to a live review that was conducted by the World Naturopathic Federation between May 2022 and May 2023. PubMed and Google Scholar were searched for systematic and narrative reviews that met defined quality criteria. Results: Over half of the initial systematic reviews were excluded as they did not meet the inclusion and AMSTAR criteria. The final paper included 25 narrative reviews and 41 systematic reviews (SR), with half of the SRs reporting on the safety of herbal interventions. Various therapeutic properties of over 60 herbal medicines were outlined, some individually and most of them as part of herbal formula (combinations). Conclusion/Summary: Herbal interventions demonstrated statistically significant improved recovery in patients with COVID-19. The most common therapeutic properties identified were immunological properties, anti-inflammatory, anti- microbial, and antioxidant while the most frequently investigated herbs were Glycyrrhiza glabra/uralensis, Tinospora cordifolia, and Curcuma longa. More attention is needed on the regulation of herbal medicines, the quality of research, and the safety of herbal medicines.

Review of Advanced Herbal Technology

The use of natural products in drug development and discovery is increasing. Their chemical diversity allows them to affect multiple targets simultaneously in complex systems. The past decade has seen notable technological advancements in the field of herbal medicine. The traditional foundations of ancient medicine can provide insight into the safety of natural medicines. Now is the time to make decisions about the safety of herbal medicines. The legal status and methods used to approve herbal medicines also vary from country to country. The evaluation standard for effectiveness, safety, and quality of herbal medicines are given by WHO. Advances in science and technology are pervasive in natural medicine products. To keep pace with these developments, numerous review articles have been written on the topic to provide a user-friendly platform for those new to this vast field

Herbal medicine safety awareness among Healthcare Professionals in Freetown Sierra Leone

Herbal medicine safety awareness among Healthcare Professionals in Freetown Sierra Leone

Analysis of Cyclamate Content in Unbranded Instant Herbal Medicinal Drink on Market in the City of Pamekasan

Jamu is one of the traditional medicines because most herbal medicine uses natural ingredients or plants. One of the safety of herbal medicine is the absence of abuse such as the addition of artificial sweeteners in the form of cyclamate. Cyclamate is one of the artificial sweeteners that has a sweetness level 30 times higher than natural sweeteners. Excessive use of cyclamate will cause cancer and tumors. The purpose of this study is to determine the presence or absence of cyclamate content and levels in ready-to-drink herbal medicine without a brand sold in the Pamekasan City market. This research was conducted qualitatively with precipitation methods and quantitative with gravimetric methods. From qualitative research, the results of sample A found a white precipitate which indicates a positive sample containing cyclamate. While samples B and C found no deposits indicating that the sample was negative cyclamate. Furthermore, a positive sample is carried out quantitative testing. In determining cyclamate levels, sodium cyclamate levels in sample A were obtained at 4.8047 g/kg. so that the serving rate or per 1 bottle of herbal medicine contains 115.312 g/0.6 kg and this exceeds the threshold determined by BPOM Regulations which is 1.25 g/kg. The conclusion of this study is that 1 out of 3 positive samples contains cyclamate with levels that exceed the threshold determined by BPOM RI No. 32 of 2019.