Page 7 - phytotherapy_ EBOOK_2025

robust remedies, and a greater emphasis on tonics.

Cases of herbal medicine use:

• Mild illness: For conditions like nausea, it may be acceptable to let a patient use a safe and effective
herbal medicine, such as ginger.

• Moderately severe illness: A clinician might promote herbals as a primary treatment if conventional
treatment is not working or if the patient has experienced limiting side effects.

• Serious or life-threatening illness: Using herbal medicines as a primary treatment would be limited
to situations where no effective conventional therapies exist or where the herbal medicine has
compelling efficacy data.

• As an adjunct: Many individuals use herbal products to enhance the effect of a pharmaceutical drug
or minimize its side effects. A clinician might be comfortable with a lower standard of efficacy proof
in this case compared to primary treatment. However, precautions must always be taken to avoid harm
from herb-drug interactions.

DRUG – HERB INTERACTION

Interactions between herbs and drugs can be either pharmacodynamic or pharmacokinetic. These interactions
may result in additive (synergistic) or opposing (antagonistic) effects.

In a pharmacodynamic interaction, the effects of one product are altered by the other. For example,
combining chamomile and warfarin can raise the INR (a blood-clotting index) due to the combined
anticoagulatory effects of both products.

In a pharmacokinetic interaction, the absorption, distribution, metabolism, or excretion (ADME) of one
product is affected by another. St. John’s wort, for example, is implicated in a pharmacokinetic interaction
with irinotecan, as it decreases the maximum plasma concentration of this chemotherapy agent when taken at
the same time.

Examples of Herbal medicine–drug interactions

Grapefruit and grapefruit juice Grapefruit is studied for its potential to influence weight loss, promote
cholesterol reduction, and provide antibacterial activity in the urinary tract. However, it has been found to
interact with at least 85 different drugs. This interaction is especially dangerous when the drug has a low

6