Side Effects Of Herbal Medicines Research Articles

O uso de Mikania glomerata Spreng. (Guaco) no tratamento de alergia respiratória - uma revisão integrativa

The use of medicinal plants for therapeutic purposes to treat various diseases is one of the first resources used by humanity, due to the existence of several plants with numerous therapeutic purposes. The present work intends to cover, in an integrative review, the use of Mikania glomerata, aiming to evaluate its potential in the treatment of respiratory allergy, in which the immunological mechanism involved is mediated by antibodies of the IgE class, and the main Factors that aggravate the allergic picture are called allergens, such as house dust, pet dander, mold and pollen. As for the research approach, it will be qualitative type. Data collection was carried out using the main database platforms such as SciELO, LILACS, MEDLINE, Virtual Health Library (BVS) and the academic search engine Google Scholar. The population and the sample will be the works found in these databases, where the data will be analyzed in a qualitative way. The search in the databases chosen for the present work resulted in 188 articles, after applying the filter, 9 articles were selected for the research, thus being able to confirm the benefits of using M. glomerata for the treatment of allergic diseases that affect the respiratory system. Studies on the side effects of herbal medicines based on the plant in question, or on toxicity, are quite scarce. Leaving evident the need for expansion of studies in order to evaluate the toxicity and side effects of the plant.

Assessing knowledge of herbal medicine course for dental students

BackgroundThe aims of this article are to assess dental students’ knowledge about herbal medicine usage and the potential benefits and side effects, and to conduct a short course about herbal medicine.MethodsAll fourth-year pre-doctoral students were invited to participate in a herbal medicine course as a test while the sixth-year students were the control group. A survey was tested for validity and reliability. It comprised of 16 multiple choice questions was given before the course and one month after the course. The sum score of knowledge for each participant was calcuated based on the ability to identify the use of herbs in dentistry with high-quality evidence (correct answer) or total answer for periodontal disease and caries.ResultsThe response rate for completing the study was 112 fourth-year students (73.7%) and 64 sixth-year students (39.0%). More than half of the participants (52.5%) were unsure about the importance of herbal medicine in dentistry. However, the majority also stated that the most common herbs used in dentistry were clove (62.9%), followed by curcuma turmeric (54.7%) and meswak (43.0%). The fourth-year students displayed evidence of a higher overall knowledge score after the course in herbal medicine related to periodontal disease in total and correct answers (mean 4.48 ± 4.13, 3.73 ± 3.31, respectively) compared to before the course (mean 0.84 ± 1.23, 0.74 ± 1.16, respectively) (p-value < 0.001). The post-course periodontal disease total and correct answers were statistically significant between fourth- and sixth-year students.ConclusionHerbal medicine has a potential positive impact on dentistry. However, these effects are not fully investigated and received full attention in academic institute. This short educational program related to medicinal herbs can improve the knowledge of dental students. This will help increase the awareness about the use and potential side effects of herbal medicine in the dental field.

Антиканцерогенная активность флавоноидов растительного происхождения

In view of the safety and absence of side effects of herbal medicines, extensive research in this area has been launched in world medicine in recent years. In this review, we considered it appropriate to briefly review the results of experimental and pharmacotherapeutic studies in the search and study of the anticarcinogenic properties of natural flavonoids. A review of the data available in the literature showed that both extracts and individual flavonoids of various plants have anticarcinogenic activity. Further study of the anticarcinogenic effect of flavonoids of plant origin deserves the closest attention, since it is closely connected with the problem of finding new methods for the prevention and treatment of various types of cancer.

Ginger and Heart Health: From Mechanisms to Therapeutics.

As a major cause of morbidity and mortality, cardiovascular diseases (CVDs) are globally increasing. In spite of recent development in the management of cardiovascular complications, CVDs have remained a medical challenge. Numerous conventional drugs are used to play cardioprotective roles; however, they are associated with several side effects. Considering the rich phytochemistry and fewer side effects of herbal medicines, they have gained particular attention to develop novel herbal drugs with cardioprotective potentials. Amongst natural entities, ginger is an extensively used and well-known functional food and condiment, possessing plentiful bioactivities, like anti-inflammatory, antioxidant, and antimicrobial properties in several disorders management. The current review deliberated phytochemical properties as well as the ginger/ginger constituents' biological activities and health benefits in several diseases, with particular attention to cardiovascular complications. A comprehensive search was conducted using multiple databases, including Scopus, PubMed, Medline, Web of Science, national database (Irandoc and SID), and related articles in terms of the health benefits and cardioprotective effects of ginger/ginger constituents. These data were collected from inception until August 2019. In recent years, several herbal medicines were used to develop new drugs with more potency and also minor side effects. Amongst natural entities, ginger is used as a traditional medicine in several diseases. The crude extract, along with related pungent active constituents, is mostly attributed to heart health. The cardioprotective effects of ginger are contributed to its cardiotonic, anti- hypertensive, anti-hyperlipidemia, and anti-platelet effects. The signaling pathways and molecular mechanisms of ginger regarding its cardioprotective effects are also clarified. This study revealed the biological activities, health benefits, and cardioprotective properties of ginger/ginger constituents along with related mechanisms of action, which gave new insights to show new avenues in the treatment of CVDs.

Herb-Induced Liver Injury Related to Reynoutria multiflora (Thunb.) Moldenke: Risk Factors, Molecular and Mechanistic Specifics.

Herbal medicine is widely used in Asia as well as the west. Hepatotoxicity is one of the most severe side effects of herbal medicine which is an increasing concern around the world. Reynoutria multiflora (Thunb.) Moldenke (Polygonum multiflorum Thunb., PM) is the most common herb that can cause herb-induced liver injury (HILI). The recent scientific and technological advancements in clinical and basic research are paving the way for a better understanding of the molecular aspects of PM-related HILI (PM-HILI). This review provides an updated overview of the clinical characteristics, predisposing factors, hepatotoxic components, and molecular mechanisms of PM-HILI. It can also aid in a better understanding of HILI and help in further research on the same.

The effect of the herbal medicine on severity of cyclic mastalgia: a systematic review and meta-analysis.

Cyclic mastalgia is one of the most prevalent problems in women of reproductive age and sometimes it is so severe that it influences their activities and requires treatment. The available drug treatments for mastalgia are not satisfactory and most patients have inclined towards complementary and alternative medicine including herbal medicines. Therefore, in order to evaluate the effectiveness and side effects of herbal medicines conducting systematic review studies and meta-analysis seems essential, thus this systematic review was conducted with the aim of determining the effect of herbal medicines on cyclic mastalgia and its probable side effects. The databases of Pubmed, Medline, Embase, ProQuest, Scopus, Web of science, Complementary Medicine Database, SID (Scientific information database), Magiran and Iranmedex were searched from 1997 to 2020 and limited only for English and Persian languages. The studies were appraised according to the Cochrane Collaboration's tool. Meta-analysis was conducted using RevMan software. Standardized mean difference (SMD) was calculated to assess an overall estimate of effectiveness for thecontinuous data. Odds ratio (OR) was calculated for dichotomous data. Thirty papers were included in the study. Meta-analysis of data demonstrated that herbal medicine was an effective method in reducing the severity of mastalgia compared to the placebo (SMD:-3.26, 95% CI:-5.05 to-1.46, p=0.00004). Subanalysis of data showed no difference between the effectiveness of herbal medicine on the severity of mastalgia compared to the pharmacologic treatment.This research demonstrated efficacy of herbal medicines in alleviating cyclic mastalgia. Therefore, these herbal medicines can be regarded as an alternative treatment for women suffering from cyclic mastalgia. However, due to the limited number of studies in relation to each specific herbal treatment, conducting further studies in this area is recommended.

The relevancy of patch testing in the exploration of the cutaneous side effects of herbal medicine

Background: Data on the cutaneous side effects of herbal medicine is scarce, especially with regard to allergy skin testing. Our objective was to determine the relevancy of patch testing in the exploration of the cutaneous side effects of herbal medicine. Material and Methods: A prospective study was conducted in the Department of Dermatology of the Hospital Institute of Social Hygiene of Dakar over a one-year period. Patch tests were given to patients with cutaneous side effects related to the exclusive use of herbal medicine. The plants recovered were turned into macerates and powders and mixed with Vaseline at concentrations of 5%, 20%, and 30%. Results: Patch tests were given to 31 of the 53 patients included. They were positive in 11 patients (35.48%). Positive patients displayed systemic eczema (n = 7/15 of cases), Stevens–Johnson syndrome (n = 2/3), contact eczema (n = 1/1), and fixed pigmented erythema (n = 1/2). Positive tests were obtained for 11 medicinal plants identified: Jatropha chevalieri (n = 2), Terminalia avicennoïde (n = 2), Detarium microcarpum, Acacia seyal, Acacia albida, Acacia italic, Sesamum indicum, Mangifera indica, Momordica charantia, Nauclea latifolia, and Anogeisius leiocarpus (in one case each). There was no statistically significant relationship between the type of cutaneous side effect and the test result (p = 0.388) and between the nature of the plant used and the test result (p = 0.402). Conclusion: In view of their high rates of positivity, patch tests could prove promising in the exploration of the cutaneous side effects of herbal medicine.

The Effect of Hydro-Alcoholic Extract of Ocimum basilicum on CaCl2-Induced Cardiac Arrhythmias in Rats

: Ocimum basilicum (OB) contains more than 30 plant species that are found in different regions, especially in Africa. OB contains various substances, especially Chavikol, Methyl Ether or Strangol, Linalool, and Agenol, which have antioxidant, antihypertensive, antidiabetic, and anti-lipid properties. On the other hand, along with lifestyle changes, the prevalence of cardiovascular diseases, such as arrhythmias, which cause high mortality, is increasing. Moreover, the modern drugs used for arrhythmia can also induce another type of abnormal heart rhythm. Regarding the effectiveness and fewer side effects of herbal medicine, we decided to study the preventive effects of hydro-alcoholic extract of OB on CaCl2-induced arrhythmias in rats. Male rats (Sprague-Dawley) were divided into the control group (2 weeks, normal saline, gavage) and three groups receiving different concentrations of hydro-alcoholic extract of OB (100, 200, and 400 mg/kg, gavage for 2 weeks). The arrhythmia model was established using CaCl2 (IV, 140 mg/kg). The number of ventricular fibrillation (VF), ventricular premature (PVC), and ventricular tachycardia (VT) were studied. Also, the oxidative stress parameters, such as malondialdehyde (MDA) and superoxide dismutase (SOD), were measured in heart tissue samples. Statistical analysis was done using Fisher's exact test and ANOVA, and also, P &lt; 0.05 was considered as a significant level. The obtained results showed that administration of OB caused a decrease in MDA and an increase in SOD levels, which were associated with improved electrocardiogram parameters and reduced cardiac arrhythmias, which suggests the therapeutic potential of the plant in cardiovascular disorders.

The importance of herbal medicine use in the German health-care system: prevalence, usage pattern, and influencing factors

BackgroundPrevalence rates for herbal medicine (HM) have been increasing worldwide. However, little is known about prevalence, user characteristics, usage pattern and factors influencing HM usage for the general German population.MethodsA nationwide online survey on HM usage was conducted in Germany. The 2906 participants were categorised into three groups: the ones who used HM in the last 12 months, the ones who did not use HM in the last 12 months but in their lifetime, and the ones who did not use HM until now. Data were analysed by descriptive statistics, Chi Square tests and binary hierarchical logistic regression analyses.ResultsPrevalence rates of HM were found to be very high for the general German population. Self-medication appeared as a common praxis, when at the same time HM users responded that they do not inform their physician about it, rate their knowledge about HM as somewhat poor, and use the internet as the most frequent source of information. The HM user in the last 12 months was found to include people that were more likely female, highly educated, privately insured, employed, and engaged in a more health-oriented lifestyle. While certain sociodemographic- and health-related variables influence HM usage vs. non-usage, they explain variance only to a limited extent. For distinguishing the user in the last 12 months vs. the less recent user who did not use HM in the last 12 months, ratings on different reasons for HM usage were found to perform better as predictors than sociodemographic- and health-related variables.ConclusionsThis study demonstrated that HM usage plays an essential role in the German health-care system. Furthermore, the HM usage pattern may be potentially harmful for patients, as it included self-medication, little knowledge on interaction- and side-effects of HM, and a lack of communication with physicians about the usage. Moreover, prediction of HM usage in the previous year is impacted by variables beyond conventional sociodemographic- and health-related ones. In view of the high prevalence rates of HM in Germany, medical as well as health service providers should be aware of these issues.

Prevalence of use and reported side effects of herbal medicine among adults in Saudi Arabia

ObjectiveDespite the availability of well characterized and scientifically proven medicines, many people prefer the use of the less known herbal therapies that have no-scientific or evidence-based values as their first line of treatment. While this represents a growing worldwide issue, it is commonly practiced in developing countries including Saudi Arabia. Hence, the aim of the present study is to assess the prevalence of herbal medicine use, the most reported side effects and influencing factors in Saudi Arabia. DesignA community based cross sectional survey study. SettingsParticipants were recruited by convenience sampling method from local malls and family recreation sites. Main outcome measuresPrevalence of herbal medicine use and the associated risks. ResultsOut of the 1300 surveyed individuals, 1226 respondents (94 %) used herbal medicines for therapeutic purposes with the majority of the respondents using them based on traditional beliefs 699 (57 %) or family recommendations 417 (34 %). Young respondents <35 year olds who live in urban cities, showed a significantly better knowledge about herbal medicines use and the associated risks than their counterparts (p < 0.001). Despite the high percentage of reported side effects (46 %), more than half of the respondents 702 (54 %) use herbal medicines as their first line of therapy. However, the most reported reasons for the use of herbal medicine are the belief that they are safer, more effective and cheaper to buy than the standard medicines. ConclusionThere is a high prevalence use of non-scientifically proven herbal medicine and a low level of knowledge about their risks amongst participants.

Evaluation of the Effect of Aloe Vera Ointment with Chamomile Ointment on Severity of Children’s Diaper Dermatitis : A Randomized, Double-Blind Clinical Trial

Introduction: Diaper dermatitis is an inflammation of the skin under the diapers of children, and is relatively common. The disease is seen in children and adolescents with a degree of urinary incontinence. The aim of this study is to replace uncomplicated herbal medicines in the treatment of this disease instead of chemical drugs. Materials and Methods: This is a randomized, double-blind, clinical trial that was performed on 90 children under 2 years of age who were referred to the Pediatric Department of Tabriz Pediatric Hospital and who used diapers. The children were randomly divided into three groups of 30, and formed a routine group and two other groups, with routine ointment and chamomile and Aloe Vera Ointment. Sampling was performed on the first, third and sixth days of the study using a five point scale. Data were analyzed using SPSS software (version 22) and descriptive and analytical statistics. Results: According to the statistical results, the severity of dermatitis in all three groups improved during the study on the sixth day compared to the first day, but there was no significant difference in the severity of diaper dermatitis between the three groups during the study period. (P> 0.05) Conclusion: Regarding the treatment process in all three groups and having positive results in the treatment of dermatitis, the three groups of drugs were effective in treatment, but they were not superior to each other. But due to the lower side effects of herbal medicine, its use is recommended to treat this condition. Key words: Aloe vera ointment, chamomile ointment, diaper dermatitis

Fenugreek (Trigonella foenum-graecum) induced interstitial nephritis

Herbal medicine has grabbed the public interest and there is a general belief of their safety and life compatibility. There are growing proportion of reported side effects of herbal medicine in past years. We reported a 62-year-old woman who developed acute interstitial nephritis (AIN) accompanied by autoimmune hemolytic anemia (AIHA), three weeks after daily ingestion of heat extract of fenugreek. The patient’s renal, hematologic and liver panels were improved after steroid pulse therapy and fenugreek discontinuation. Fenugreek contains high amount of flavonoid which might be a main culprit for AIN and AIHA.

Herbal medicine use among patients with chronic diseases.

Aim:Complementary and alternative medicine (CAM) is commonly used all over the world, and herbal medicines are the most preferred ways of CAM. The aim of this study was to determine the frequency of herbal medicine use among patients with chronic diseases.Methodology:A cross-sectional descriptive study was conducted from April 2014 to December 2014 among patients who had been diagnosed with diabetes mellitus (DM), hypertension (HT), and hyperlipidemia (HL) in Family Medicine Department of Dışkapı Yıldırım Beyazıt Training and Research Hospital, in Ankara. A questionnaire about herbal drug use was applied by face to face interview to the participants.Results:A total of 217 patients were included in this study. The mean age of the participants was 56.6 ± 9.7 years (55 male and 162 female). The rate of herbal medicine use was 29%. Herbal medicine use among female gender was significantly higher (P = 0.040). Conventional medication use was found to be lower among herbal medicine consumers. There was no relationship between herbal medicine use and type of chronic disease, living area, and occupation or education level. Most frequently used herbs were lemon (39.6%) and garlic (11.1%) for HT, cinnamon (12.7%) for DM, and walnut (6.3%) for HL.Conclusions:In this study, herbal medicine use was found to be higher among patients who had been diagnosed with chronic diseases. Therefore, physicians should be aware of herbal medicine usage of their patients and inform them about the effectivity and side effects of herbal medicines.

Stockley's Herbal Medicines Interactions: A Guide to the Interactions of Herbal Medicines. Second edition

Stockley's Herbal Medicines Interactions: A Guide to the Interactions of Herbal Medicines. Second edition

Herbal Medications and Plastic Surgery: A Hidden Danger

Herbal medicine is a multibillion-pound industry, and surveys suggest that ~10% of the UK population uses herbal supplements concurrently with prescription medications. Patients and health care practitioners are often unaware of the adverse side effects of herbal medicines. In addition, because many of these herbal supplements are available over the counter, many patients do not disclose these when listing medications to health care providers. A 39-year-old nurse underwent an abdominoplasty with rectus sheath plication after weight loss surgery. Postoperatively, she experienced persistent drain output, and after discharge, a seroma developed requiring repeated drainage in the clinic. After scar revision 10 months later, the woman bled postoperatively, requiring suturing. Again, a seroma developed, requiring repeated drainage. It was discovered that the patient had been taking a herbal menopause supplement containing ingredients known to have anticoagulant effects. Complementary medicine is rarely taught in UK medical schools and generally not practiced in UK hospitals. Many supplements are known to have anticoagulant, cardiovascular, and sedative effects. Worryingly, questions about herbal medicines are not routinely asked in clinics, and patients do not often volunteer such information. With the number and awareness of complementary medications increasing, their usage among the population is likely to increase. The authors recommend specific questioning about the use of complementary medications and consideration of ceasing such medications before surgery. Level of Evidence V This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Attitude and use of herbal medicines among pregnant women in Nigeria

BackgroundThe use of herbal medicines among pregnant women in Nigeria has not been widely studied.MethodsOpinion of 595 pregnant women in three geopolitical zones in Nigeria on the use of herbal medicines, safety on usage, knowledge of potential effects of herbal remedies on the fetus and potential benefits or harms that may be derived from combining herbal remedies with conventional therapies were obtained using a structured questionnaire between September 2007 and March 2008. Descriptive statistics and Fisher's exact tests were used at 95% confidence level to evaluate the data obtained. Level of significance was set at p < 0.05.ResultsMore than two-third of respondents [67.5%] had used herbal medicines in crude forms or as pharmaceutical prepackaged dosage forms, with 74.3% preferring self-prepared formulations. Almost 30% who were using herbal medicine at the time of the study believed that the use of herbal medicines during pregnancy is safe. Respondents' reasons for taking herbal medications were varied and included reasons such as herbs having better efficacy than conventional medicines [22.4%], herbs being natural, are safer to use during pregnancy than conventional medicines [21.1%], low efficacy of conventional medicines [19.7%], easier access to herbal medicines [11.2%], traditional and cultural belief in herbal medicines to cure many illnesses [12.5%], and comparatively low cost of herbal medicines [5.9%].Over half the respondents, 56.6% did not support combining herbal medicines with conventional drugs to forestall drug-herb interaction. About 33.4% respondents believed herbal medicines possess no adverse effects while 181 [30.4%] were of the opinion that adverse/side effects of some herbal medicines could be dangerous. Marital status, geopolitical zones, and educational qualification of respondents had statistically significant effects on respondents views on side effects of herbal medicines [p < 0.05)] while only geopolitical zones and educational qualifications seemed to have influence on respondents' opinion on the harmful effects of herbal medicines to the fetus [p < 0.05].ConclusionThe study emphasized the wide spread use of herbal medicines by pregnant women in Nigeria highlighting an urgent need for health care practitioners and other health care givers to be aware of this practice and make efforts in obtaining information about herb use during ante-natal care. This will help forestall possible interaction between herbal and conventional medicines.

Phytopharmaka

There is a great enthusiasm for herbal medications with increasing and widespread use among the population in various countries. A certain scepticism towards the use of pharmaceutical drugs may promote the use of herbal medicines such as echinacea, ginger, garlic, ginkgo, cranberry, valerian or St. John's wort even in western countries. Although considered safe among users, adverse effects such as increased bleeding tendencies, hypertension and hepatotoxicity can occur. Physicians should caution patients on the adverse side effects of herbal medicines and interactions between herbal medicines and pharmaceutical drugs, leading to various and uncontrollable deterioration of vital functions in the perioperative period. Although evidence-based data are lacking, anaesthesiologists and surgeons should be familiar with the effects of herbal medicines and should enquire about the use of these agents in the preoperative assessment. Currently available data suggest that herbal medications should be discontinued up to 2 weeks before elective surgery, although no guidelines of scientific societies have yet been published.

Pemanfaatan Obat Tradisional Dengan Pertimbangan Manfaat Dan Keamanannya

Herbal medicines in general are safer than modern drug. This matter is caused by the less side effect of herbal medicines than modern drug. Side effects of herbal medicines can be reduced with the used of right materials, accurat dose, accurat usage time, accurat way of usage, accurat analyze information, and without abusing of herbal medicines itself. Accuracy of materials determine the effect of herbal medicines. Dose measuring in set of gram can lessen possibility the happening of effect which do not be expected. Information which is not supported by adequate basic knowledges and enough study can make traditional drug return to endangering.

Acute Hemorrhagic Myocardial Necrosis and Sudden Death of Rats Exposed to a Combination of Ephedrine and Caffeine

Because of possible side effects of herbal medicines containing ephedrine and guarana-derived caffeine, including increased risk of stroke, myocardial infarction, and sudden death, the Food and Drug Administration recently banned the sale of ephedra-containing products, specifically over-the-counter dietary supplements. We report cardiac in 7- and 14-week-old male F344 rats exposed by gavage to ephedrine(25 mg/kg) and caffeine (30 mg/kg) administered in combination for one or two days. The ephedrine-caffeine dosage was approximately 12- and 1.4-fold, respectively, above average human exposure, based on a mg/m2 body surface-area comparison. Several (5/7) of the exposed 14-week-old rats died or were sacrificed in extremis 4-5 h after the first dosing. In these hearts, changes were observed chiefly in the interventricular septum but also left and right ventricular walls. Massive interstitial hemorrhage, with degeneration of myofibers, occurred at the subendocardial myocardium of the left ventricle and interventricular septum. Immunostaining for cleaved caspase-3 and hyperphosphorylated H2A.X, a histone variant that becomes hyperphosphorylated during apoptosis, indicated multifocal generalized positive staining of degenerating myofibers and fragmenting nuclei, respectively. The Barbeito-Lopez trichrome stain revealed generalized patchy yellow myofibers consistent with degeneration and/or coagulative necrosis. In ephedrine-caffeine-treated animals terminated after the second dosing, foci of myocardial degeneration and necrosis were already infiltrated by mixed inflammatory cells. The myocardial necrosis may occur secondarily to intense diffuse vasoconstriction of the coronary arterial system with decreased myocardial perfusion. Our work shows the direct relationship between combined ephedrine and caffeine exposure and cardiac pathology.

Herbal therapy in dermatology.

Herbal therapy is becoming increasingly popular among patients and physicians. Many herbal preparations are marketed to the public for various ailments including those of the skin. Herbal therapies have been used successfully in treating dermatologic disorders for thousands of years in Europe and Asia. In Germany, a regulatory commission oversees herbal preparations and recommended uses. In Asia, herbal treatments that have been used for centuries are now being studied scientifically. Currently, the United States does not regulate herbal products, as they are considered dietary supplements. Therefore, there is no standardization of active ingredients, purity, or concentration. There are also no regulations governing which herbs can be marketed for various ailments. This has made learning about and using these treatments challenging. Information compiled in a practical fashion may enable more patients to benefit from these treatments currently used worldwide. We reviewed the herbal medications that show scientific evidence of clinical efficacy, as well as the more common herbs shown to be useful in the treatment of dermatologic disorders. The safety of each herb has been addressed to better enable the physician to know which herbal therapies they may want to begin to use in practice. Common drug interactions and side effects of herbal medicines that may be seen in the dermatologic setting were also studied.