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Herb-Drug Interactions: What Clinicians Need to Know

John Neustadt, ND

The current information on herb-drug interactions is compelling. Avoiding potential or negative interactions is essential to patient safety, and understanding which herb-drug combinations work synergistically may improve clinical outcomes. Botanical medicines account for approximately 22% of all complementary and alternative medicine (CAM) therapies.1 A 1997 survey found that up to 70% of all Americans take herbal products, and 18.4% of people on prescription medications combine them with herbs and/or vitamins.2 Clearly, it is necessary for clinicians to have a working knowledge of herb-drug interactions.

Many clinicians are unfamiliar with this subject, however. In 2000, a survey administered at 3 educational meetings on emergency and internal medicine in Orange and Los Angeles counties, Calif., showed that participating doctors and students had “little familiarity with herbal toxicities and herb-drug interactions.”3 Furthermore, they rated their knowledge of this subject as poor. This article reviews potential and known herb-drug interactions and provides information to help clinicians estimate the relative risk of herb-drug interactions.

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