Hungarian Medical Journal
Volume/Issue:
Volume 2: Issue 3
Pharmacovigilance in Herbal Medicine: A Paradigm to Drug Toxicity Monitoring in Conventional Health Care
Authors:
Yousif Asiri College of Pharmacy, King Saud University Departments of Clinical Pharmacy Riyadh 11451 Saudi Arabia

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Abdlatif Al-Dhawailie College of Pharmacy, King Saud University Departments of Clinical Pharmacy Riyadh 11451 Saudi Arabia

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Saleh Alqasoumi

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Mohammed Al-Yahya College of Pharmacy, King Saud University Pharmacognosy Riyadh 11451 Saudi Arabia

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Syed Rafatullah College of Pharmacy, King Saud University Medicinal, Aromatic and Poisonous Plants Research Center Riyadh 11451 Saudi Arabia

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Pages:
351–363
Online Publication Date:
28 Sep 2008
Publication Date:
01 Sep 2008
Article Category:
Research Article
DOI:
https://doi.org/10.1556/hmj.2.2008.3.3
Keywords:
herbal medicine; adverse drug reaction; pharmacovigilance
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From prehistoric times, herbal medicine has been used by various communities and civilizations throughout the world. This trend continues to the present day. For the past several decades, herbal medicines have been increasingly consumed by people without prescription. They are traditionally considered as harmless since they belong to natural sources. Herbal formulations which have reached widespread acceptability as therapeutic agents are such as antidiabetics, anti-arthritics, aphrodisiacs, hepatoprotectives, cough remedies, memory enhancers and adoptogens. However, with a more efficient case reporting of adverse drug reactions, the hazards of herbal medicines as self prescriptions have been well recorded. In this regard the World Health Organization (WHO) has set specific guidelines for the assessment of the safety, efficacy and quality of herbal medicines. The purpose of pharmacovigilance is to detect, assess and understand, and to prevent the adverse effects or any other possible drug-related problems, which is not only confined to chemical drugs, but extended to herbal, traditional and complementary medicines, biologicals, vaccines, blood products and medical devices. Herbal pharmacovigilance should be implemented and authorities should record apart from existing information on various aspects of the single herb and/or compound herbal formulations on concomitant use with chemical drugs, adverse drug reaction, delayed or acute toxic effects, allergies etc. Most over-the-counter herbal products like ginseng have drawn great public attention but there are several case reports mentioned in the literature of adverse drug reactions of herbal drugs which are generally considered safe. In this paper, we have succinctly reviewed the various aspects associated with the pharmacovigilance of herbal medicines ranging from the pathophysiology to the various clinical elements of adverse drug reactions associated with herbal medicine.

  • Firenzouli, F. et al.: Symposium on pharmacovigilance of herbal medicine, London, March 28, 2006.

  • Barnes, J.: Pharmacovigilance of herbal medicines: a UK perspective. Drug Safety, 2003, 26 , 829–51.

    Barnes J. , 'Pharmacovigilance of herbal medicines: a UK perspective ' (2003 ) 26 Drug Safety : 829 -51 .

    • Search Google Scholar

  • Wiholm, B. et al.: Spontaneous reporting systems outside the US. Pharmacoepidemiology. 3rd edition, Wiley, UK, pp. 175–192, 2000.

    Wiholm B. , '', in Spontaneous reporting systems outside the US. Pharmacoepidemiology , (2000 ) -.

  • Gossell, M., Simon, O. R., West, M. E.: The past and the present use of plants for medicines. West Indian Med. J., 2006, 55 , 217.

    West M. E. , 'The past and the present use of plants for medicines ' (2006 ) 55 West Indian Med. J. : 217 -.

    • Search Google Scholar

  • Ackernecht, E. H.: Therapeutics from the Primitives to the Twentieth Century. Hafner Press, New York, 1973.

    Ackernecht E. H. , '', in Therapeutics from the Primitives to the Twentieth Century , (1973 ) -.

  • Steiner, R.: Folk Medicine: the Art and the Science. American Chemical Society Press, 1986.

  • Ernst, E., Pittler, M. H.: Herbal medicine. Med. Clin. N. Am., 2002, 86 , 149–161.

    Pittler M. H. , 'Herbal medicine ' (2002 ) 86 Med. Clin. N. Am. : 149 -161 .

  • Eisenberg, D. M, Kessler, R. C., Foster, C.: Unconventional medicine in the United States. N. Engl. J. Med., 1993, 328 , 246–52.

    Foster C. , 'Unconventional medicine in the United States ' (1993 ) 328 N. Engl. J. Med. : 246 -52 .

    • Search Google Scholar

  • Ozcakir, A., Aydin, S.: Complementary/alternative medicine use in primary care. Res. J. Med. Sci., 2007, 1 , 21–25.

    Aydin S. , 'Complementary/alternative medicine use in primary care ' (2007 ) 1 Res. J. Med. Sci. : 21 -25 .

    • Search Google Scholar

  • Izzo, A. A., Carlo, G. D., Borrelli, F. et al.: Complementary pharmacotherapy and herbal medicines: the risk of drug interaction. Int. J. Cardiol., 2005, 98 , 1–14.

    Borrelli F. , 'Complementary pharmacotherapy and herbal medicines: the risk of drug interaction ' (2005 ) 98 Int. J. Cardiol. : 1 -14 .

    • Search Google Scholar

  • Agrawal, O. P., Raju, P.: Global market of health products: opportunities for India. Traditional system of medicine. Narosa Publishers, New Delhi, India, 2006, pp. 5–10.

    Raju P. , '', in Global market of health products: opportunities for India. Traditional system of medicine , (2006 ) -.

  • Gohil, K. J., Patel, J.: Herb-drug interactions: A review and study based on assessment of clinical case reports in literature. Indian J. Pharmac., 2007, 39 , 129–139.

    Patel J. , 'Herb-drug interactions: A review and study based on assessment of clinical case reports in literature ' (2007 ) 39 Indian J. Pharmac. : 129 -139 .

    • Search Google Scholar

  • Valli, G., Giardina, E. V.: Benefits, adverse effects and drug interactions of herbal therapies with cardiovascular effects. J. Am. Coll. Cardiol., 2002, 39 , 1085–1095.

    Giardina E. V. , 'Benefits, adverse effects and drug interactions of herbal therapies with cardiovascular effects ' (2002 ) 39 J. Am. Coll. Cardiol. : 1085 -1095 .

    • Search Google Scholar

  • Commission of the European Communities. Proposal for amending the direction 2001/83/EC as regards traditional herbal medicinal products. 2002/008 (OOD). Brussels: European Commission, 2002.

  • Barnes, J. O.: An introduction to herbal medicinal products. The Pharmaceutical Journal, 2002, 268 , 804–806.

    Barnes J. O. , 'An introduction to herbal medicinal products ' (2002 ) 268 The Pharmaceutical Journal : 804 -806 .

    • Search Google Scholar

  • Chopra, R. N., Nayor, S. L., Chopra, I. C.: Glossary of Indian Medicinal Plants. Council of Scientific and Industrial Research, New Delhi, India, 1956, pp. 330.

    Chopra I. C. , '', in Glossary of Indian Medicinal Plants , (1956 ) -.

  • Medicine Control Agency. Traditional Ethnic Medicines. Public health and compliance with medicine law. London, Medicines Control Agency, 2001, http://www.maa.gov.uk

  • Schulz, V., Hansel, R., Tyler, V. E.: Rational phytotherapy: A Physician Guide to Herbal Medicine, 4th edition. Berlin, Springer, 2000.

    Tyler V. E. , '', in Rational phytotherapy: A Physician Guide to Herbal Medicine , (2000 ) -.

  • De Los Leyes, G. C., Koda, R. T.: Determining hyperforin and hypericin content in eight brands of St. John’s wort. Am. J. Health Syst. Pharm., 2002, 59 , 545–7.

    Koda R. T. , 'Determining hyperforin and hypericin content in eight brands of St. John’s wort ' (2002 ) 59 Am. J. Health Syst. Pharm. : 545 -7 .

    • Search Google Scholar

  • Kressman, S., Muller, W. E., Blume, H. H.: Pharmaceutical quality of different Ginko biloba brands. J. Pharm. Pharmacol., 2002, 54 , 681–9.

    Blume H. H. , 'Pharmaceutical quality of different Ginko biloba brands ' (2002 ) 54 J. Pharm. Pharmacol. : 681 -9 .

    • Search Google Scholar

  • Stephens, M. D. B.: The Detection of New Adverse Drugs Reactions. M. Stockton Press, New York, 1985.

    Stephens M. D. B. , '', in The Detection of New Adverse Drugs Reactions , (1985 ) -.

  • World Health Organization Scientific Group on Monitoring Adverse Reactions WHO document PA/8.65. Geneva, 22–28 November, 1964.

  • Hartigan, K.: Developing a pharmacovigilance system in the Philippines, a country of diverse culture and strong traditional medicine background. Toxicology, 2002, 181 , 103–107.

    Hartigan K. , 'Developing a pharmacovigilance system in the Philippines, a country of diverse culture and strong traditional medicine background ' (2002 ) 181 Toxicology : 103 -107 .

    • Search Google Scholar

  • Yilmaz, M., Yontar, O. et al.: Herbals in cardiovascular practice: are physicians neglecting anything? Int. J. Cardiol., 2006, 100 , 78–86.

    Yontar O. , 'Herbals in cardiovascular practice: are physicians neglecting anything? ' (2006 ) 100 Int. J. Cardiol. : 78 -86 .

    • Search Google Scholar

  • Smet, P.: Health risks of herbal remedies. Drug Safety, 1995, 13 , 81–93.

    Smet P. , 'Health risks of herbal remedies ' (1995 ) 13 Drug Safety : 81 -93 .

  • Koh, H. L., Wooh, S. O.: Chinese proprietary medicine in Singapore: regulatory control of toxic heavy metals and undeclared drug. Drug Safety, 2000, 23 , 351–362.

    Wooh S. O. , 'Chinese proprietary medicine in Singapore: regulatory control of toxic heavy metals and undeclared drug ' (2000 ) 23 Drug Safety : 351 -362 .

    • Search Google Scholar

  • Lazar, J., O’Connor, B.: Talking with patients about their use of alternative medicine. Primary care: Complementary and alternative therapies in primary care, 1997, 24 , 699–714.

    O’Connor B. , 'Talking with patients about their use of alternative medicine ' (1997 ) 24 Primary care: Complementary and alternative therapies in primary care : 699 -714 .

    • Search Google Scholar

  • Dorman, H., Krebs, S. et al.: Incidence and costs of adverse drug reactions during hospitalization: computerized monitoring versus stimulated spontaneous reporting. Drug Safety, 2000, 22 , 161–168.

    Krebs S. , 'Incidence and costs of adverse drug reactions during hospitalization: computerized monitoring versus stimulated spontaneous reporting ' (2000 ) 22 Drug Safety : 161 -168 .

    • Search Google Scholar

  • Hadjibabaie, M., Rastakari, N., Rezaie, A. et al.: The adverse drug reaction in the gastrointestinal tract: an overview. Int. J. Pharmacol., 2005, 1 , 1–8.

    Rezaie A. , 'The adverse drug reaction in the gastrointestinal tract: an overview ' (2005 ) 1 Int. J. Pharmacol. : 1 -8 .

    • Search Google Scholar

  • Lazarou, J., Pomeranz, B. H., Corey, P. N.: Incidence of adverse drug reactions in hospitalized patients: a meta analysis of prospective studies. JAMA, 1998, 279 , 12005.

    Corey P. N. , 'Incidence of adverse drug reactions in hospitalized patients: a meta analysis of prospective studies ' (1998 ) 279 JAMA : 12005 -.

    • Search Google Scholar

  • Einarson, T. R.: Drug related hospital admissions. Ann. Pharmacother., 1993, 27 , 832–40.

    Einarson T. R. , 'Drug related hospital admissions ' (1993 ) 27 Ann. Pharmacother. : 832 -40 .

    • Search Google Scholar

  • Park, B. K., Pirmohamed, M., Kitteringham, N.: Idiosyncratic drug reactions: a mechanistic evaluation of risk factors. Br. J. Clin. Pharmacol., 1992, 34 , 377–95.

    Kitteringham N. , 'Idiosyncratic drug reactions: a mechanistic evaluation of risk factors ' (1992 ) 34 Br. J. Clin. Pharmacol. : 377 -95 .

    • Search Google Scholar

  • Bateman, D. N., Chaplin, S.: Adverse reactions. Br. Med. J., 1988, 296 , 761–4.

    Chaplin S. , 'Adverse reactions ' (1988 ) 296 Br. Med. J. : 761 -4 .

  • Kubo, K. et al.: Hypersensitive hepatic injury induced by shosaikoto, a liver supporting herbal medicine. Jpn. J. Nat. Med. Serv., 1986, 40 , 205–206.

    Kubo K. , 'Hypersensitive hepatic injury induced by shosaikoto, a liver supporting herbal medicine ' (1986 ) 40 Jpn. J. Nat. Med. Serv. : 205 -206 .

    • Search Google Scholar

  • Tsukiyama, K. et al.: A rare case of pneumonitis due to Sho-saiko-to. Jpn. J. Thor. Dis., 1989, 27 , 1556–1561.

    Tsukiyama K. , 'A rare case of pneumonitis due to Sho-saiko-to ' (1989 ) 27 Jpn. J. Thor. Dis. : 1556 -1561 .

    • Search Google Scholar

  • Daibo, A, Yoshida, Y., Kitazawa, S. et al.: A case of pneumonitis and hepatic injury caused by a herbal drug (sho-saiko-to). Jpn. J. Thor. Dis., 1992, 30 , 1583–1588.

    Kitazawa S. , 'A case of pneumonitis and hepatic injury caused by a herbal drug (sho-saiko-to) ' (1992 ) 30 Jpn. J. Thor. Dis. : 1583 -1588 .

    • Search Google Scholar

  • Kawasaki, M., Mizushima, Y., Kunitani, H. et al.: A useful diagnostic method for drug induced pneumonitis: a case report. Am. J. Chin. Med., 1994, 23 , 329–36.

    Kunitani H. , 'A useful diagnostic method for drug induced pneumonitis: a case report ' (1994 ) 23 Am. J. Chin. Med. : 329 -36 .

    • Search Google Scholar

  • Anonymous: Dtsch. Apoth. Ztg., 1993, 133 , 2791–4.

    Anonymous , '' (1993 ) 133 Dtsch. Apoth. Ztg. : 2791 -4 .

  • Cosyns, J. P. et al.: Urothelial malignancy in nephropathy due to Chinese herbs. Lancet, 1994, 344 , 188–89.

    Cosyns J. P. , 'Urothelial malignancy in nephropathy due to Chinese herbs ' (1994 ) 344 Lancet : 188 -89 .

    • Search Google Scholar

  • Zhou, S. et al.: Herbal bioactivation: the good, the bad and the ugly. Life Sci., 2004, 74 , 935–968.

    Zhou S. , 'Herbal bioactivation: the good, the bad and the ugly ' (2004 ) 74 Life Sci. : 935 -968 .

    • Search Google Scholar

  • Nebert, D. W., Russel, D. W.: Clinical importance of the cytochromes P450. Lancet, 2002, 360 , 1155–1162.

    Russel D. W. , 'Clinical importance of the cytochromes P450 ' (2002 ) 360 Lancet : 1155 -1162 .

    • Search Google Scholar

  • Rendic, S.: Summary of information on human CYP enzymes: human P450 metabolism data. Drug Metab. Rev., 2002, 29 , 83–448.

    Rendic S. , 'Summary of information on human CYP enzymes: human P450 metabolism data ' (2002 ) 29 Drug Metab. Rev. : 83 -448 .

    • Search Google Scholar

  • Zhou, S. F., Gao, Y. H., Wen, Q. J. et al.: Interactions of herbs with cytochrome P450. Drug Metab. Rev., 2003, 35 , 35–98.

    Wen Q. J. , 'Interactions of herbs with cytochrome P450 ' (2003 ) 35 Drug Metab. Rev. : 35 -98 .

    • Search Google Scholar

  • Guengerich, F. P., Lieber, D. C.: Enzymatic activation of chemicals to toxic metabolites. Crit. Rev. Toxicol., 1985, 14 , 259–307.

    Lieber D. C. , 'Enzymatic activation of chemicals to toxic metabolites ' (1985 ) 14 Crit. Rev. Toxicol. : 259 -307 .

    • Search Google Scholar

  • Guengerich, P. P.: Forging the links between metabolism and carcinogenesis. Mutat. Res., 2001, 488 , 195–209.

    Guengerich P. P. , 'Forging the links between metabolism and carcinogenesis ' (2001 ) 488 Mutat. Res. : 195 -209 .

    • Search Google Scholar

  • Yang, C. S. et al.: Dietary effects on cytochrome P450, xenobiotic metabolism, and toxicity. FASEB J., 1992, 6 , 737–744.

    Yang C. S. , 'Dietary effects on cytochrome P450, xenobiotic metabolism, and toxicity ' (1992 ) 6 FASEB J. : 737 -744 .

    • Search Google Scholar

  • Ioset, J. R., Raoelison, G. E. et al.: Detection of aristolochic acid in Chinese phytomedicines and dietary supplements used as slimming regimens. Food Chem. Toxicol., 2003, 41 , 29–36.

    Raoelison G. E. , 'Detection of aristolochic acid in Chinese phytomedicines and dietary supplements used as slimming regimens ' (2003 ) 41 Food Chem. Toxicol. : 29 -36 .

    • Search Google Scholar

  • Arlt, V. M., Stiborova, M., Schmeiser, H. H.: Aristolochic acid as a probable human cancer hazard in herbal medicines: a review. Mutagenesis, 2002, 17 , 265–277.

    Schmeiser H. H. , 'Aristolochic acid as a probable human cancer hazard in herbal medicines: a review ' (2002 ) 17 Mutagenesis : 265 -277 .

    • Search Google Scholar

  • Cosyns, J. P.: Aristolochic acid and ‘Chinese Herbs Nephropathy’: A review of the evidence to date. Drug Safety, 2003, 26 , 33–48.

    Cosyns J. P. , 'Aristolochic acid and ‘Chinese Herbs Nephropathy’: A review of the evidence to date ' (2003 ) 26 Drug Safety : 33 -48 .

    • Search Google Scholar

  • Lord, G. M., Cook, T. et al.: Urothelial malignant disease and Chinese herbal nephropathy. Lancet, 2001, 358 , 1515–1516.

    Cook T. , 'Urothelial malignant disease and Chinese herbal nephropathy ' (2001 ) 358 Lancet : 1515 -1516 .

    • Search Google Scholar

  • Nortier, J. L., Vanherweghem, J. L.: Renal interstitial fibrosis and urothelial carcinoma associated with the use of a Chinese herb (Aristolochia fangchi). Toxicology, 2002, 181 , 577–580.

    Vanherweghem J. L. , 'Renal interstitial fibrosis and urothelial carcinoma associated with the use of a Chinese herb (Aristolochia fangchi) ' (2002 ) 181 Toxicology : 577 -580 .

    • Search Google Scholar

  • Budavari, S.: The Merck Index 12th Edition. Merck Research Laboratories Merck NS Co., Inc., Whitehouse Station, NJ. 1996.

    Budavari S. , '', in The Merck Index , (1996 ) -.

  • Hall, R. L., Osler, B. L.: Recent progress in the consideration of flavoring ingredients under the food additives amendment GRAS substances. Food Technol., 1965, 19 , 253–271.

    Osler B. L. , 'Recent progress in the consideration of flavoring ingredients under the food additives amendment GRAS substances ' (1965 ) 19 Food Technol. : 253 -271 .

    • Search Google Scholar

  • Anderson, T. F.: Pennyroyal toxicity: measurement of toxic metabolite levels in two cases and review of literature. Ann. Int. Med., 1996, 124 , 726–734.

    Anderson T. F. , 'Pennyroyal toxicity: measurement of toxic metabolite levels in two cases and review of literature ' (1996 ) 124 Ann. Int. Med. : 726 -734 .

    • Search Google Scholar

  • Gordon, W. P. et al.: The metabolism of the abortifacient terpene, (R)-()-pulegone, to a proximate toxin, menthofuran. Drug Metab. Dispos., 1987, 15 , 589–594.

    Gordon W. P. , 'The metabolism of the abortifacient terpene, (R)-()-pulegone, to a proximate toxin, menthofuran ' (1987 ) 15 Drug Metab. Dispos. : 589 -594 .

    • Search Google Scholar

  • Thompson, D. C. et al.: Cresol isomers: comparison of toxic potency in rat liver slices. Toxicol. Appl. Pharmacol., 1994, 125 , 51–58.

    Thompson D. C. , 'Cresol isomers: comparison of toxic potency in rat liver slices ' (1994 ) 125 Toxicol. Appl. Pharmacol. : 51 -58 .

    • Search Google Scholar

  • Ben Yahia, M. et al.: Chronic active hepatitis and cirrhosis induced by wild germander. 3 cases. Gastroenterol. Clin. Biol., 1993, 17 , 959–962.

    Yahia M. , 'Chronic active hepatitis and cirrhosis induced by wild germander. 3 cases ' (1993 ) 17 Gastroenterol. Clin. Biol. : 959 -962 .

    • Search Google Scholar

  • Castot, A., Larrey, D.: Hepatitis observed during a treatment with a drug or tea containing wild Germander. Evaluation of 26 cases reported to the Regional Centers of Pharmacovigilance. Gastroenterol. Clin. Biol., 1992, 16 , 916–922.

    Larrey D. , 'Hepatitis observed during a treatment with a drug or tea containing wild Germander. Evaluation of 26 cases reported to the Regional Centers of Pharmacovigilance ' (1992 ) 16 Gastroenterol. Clin. Biol. : 916 -922 .

    • Search Google Scholar

  • Dao, T. et al.: Chronic cirrhogenic hepatitis induced by germander. Gastroenterol. Clin. Biol., 1993, 17 , 609–610.

    Dao T. , 'Chronic cirrhogenic hepatitis induced by germander ' (1993 ) 17 Gastroenterol. Clin. Biol. : 609 -610 .

    • Search Google Scholar

  • Loeper, J. et al.: Hepatotoxicity of germander in mice. Gastroenterology, 1994, 106 , 464–472.

    Loeper J. , 'Hepatotoxicity of germander in mice ' (1994 ) 106 Gastroenterology : 464 -472 .

    • Search Google Scholar

  • World Health Organization (Geneva): The Importance of Pharmacovigilance. 2002.

  • Biswas, P., Biswas, A. K.: Setting standards for proactive pharmacovigilance in India: the way forward. Indian J. Pharmacol., 2007, 39 , 124–128.

    Biswas A. K. , 'Setting standards for proactive pharmacovigilance in India: the way forward ' (2007 ) 39 Indian J. Pharmacol. : 124 -128 .

    • Search Google Scholar

  • WHO Expert Committee on Specification for Pharmaceutical Preparations. Fortieth Report. World Health Organization Technical Report Series, 2006, 937, 1–461.

  • Barnes, J., Mills, S. Y., Abott, N. C. et al.: Different standards for reporting ADRs to herbal remedies and conventional OTC medicines: face-to-face interviews with 515 users of herbal remedies. Br. J. Clin. Pharmacol., 1998, 45 , 496–500.

    Abott N. C. , 'Different standards for reporting ADRs to herbal remedies and conventional OTC medicines: face-to-face interviews with 515 users of herbal remedies ' (1998 ) 45 Br. J. Clin. Pharmacol. : 496 -500 .

    • Search Google Scholar

  • Anonymous: Credibility of herbal supplements. Kuwait Pharm. Bull., 2007, 11 , 11–12.

    Anonymous , 'Credibility of herbal supplements ' (2007 ) 11 Kuwait Pharm. Bull. : 11 -12 .

    • Search Google Scholar

  • Fugh-Berman, A.: Herb-drug interactions. Lancet, 2000, 355 , 134–138.

    Fugh-Berman A. , 'Herb-drug interactions ' (2000 ) 355 Lancet : 134 -138 .

  • Ernst, E.: Herbal Medicines – A Concise Overview for Professionals. Butterworth-Heinemann, Oxford, England, 2000.

    Ernst E. , '', in Herbal Medicines – A Concise Overview for Professionals , (2000 ) -.

  • Izzo, A. A., Borrelli, F., Capassp, R.: Herbal medicine: the risk of drug interaction. Trends Pharmacol. Sci., 2002, 23 , 358–9.

    Capassp R. , 'Herbal medicine: the risk of drug interaction ' (2002 ) 23 Trends Pharmacol. Sci. : 358 -9 .

    • Search Google Scholar

  • Ernst, E.: St. John’s wort, an antidepressant? A systematic, criteria based review. Phytomedicine, 1995, 2 , 67–71.

    Ernst E. , 'St. John’s wort, an antidepressant? A systematic, criteria based review ' (1995 ) 2 Phytomedicine : 67 -71 .

    • Search Google Scholar

  • Miller, L. G.: Herbal Medicines: Selected clinical considerations focusing on known or potential drug-herb interactions. Arch. Int. Med., 1998, 158 , 2200–2211.

    Miller L. G. , 'Herbal Medicines: Selected clinical considerations focusing on known or potential drug-herb interactions ' (1998 ) 158 Arch. Int. Med. : 2200 -2211 .

    • Search Google Scholar

  • Lantz, M. S., Buchlater, E., Giambanco, V.: St. John’s wort and antidepressant drug interactions in the elderly. J. Geriatr. Psych. Neurol., 1999, 12 , 7–10.

    Giambanco V. , 'St. John’s wort and antidepressant drug interactions in the elderly ' (1999 ) 12 J. Geriatr. Psych. Neurol. : 7 -10 .

    • Search Google Scholar

  • Demott, K.: St. John’s wort tied serotonin syndrome. Clin. Psych. News, 1998.

  • EMEA: European Medicine Evaluation Agency. Report from the ad hoc working group on Herbal Medicinal Products. September 25, 1999.

  • Radimer, K. L., Subar, A. F., Thompson, F. E.: Nonvitamin, non mineral dietary supplements: issues and findings from NHANES III. J. Am. Diet Assoc., 2000, 100 , 447–5.

    Thompson F. E. , 'Nonvitamin, non mineral dietary supplements: issues and findings from NHANES III ' (2000 ) 100 J. Am. Diet Assoc. : 447 -5 .

    • Search Google Scholar

  • Vaes, L. P., Chyka, P. A.: Interaction of ginger, garlic, ginko or ginseng: nature of evidence. Ann. Pharmacother., 2000, 34 , 1478–82.

    Chyka P. A. , 'Interaction of ginger, garlic, ginko or ginseng: nature of evidence ' (2000 ) 34 Ann. Pharmacother. : 1478 -82 .

    • Search Google Scholar

  • Rowin, J. et al.: Spontaneous bilateral subdural hematomas associated with chronic gink biloba ingestion. Neurology, 1996, 46 , 1775–6.

    Rowin J. , 'Spontaneous bilateral subdural hematomas associated with chronic gink biloba ingestion ' (1996 ) 46 Neurology : 1775 -6 .

    • Search Google Scholar

  • Vale, S.: Subarachnoid hemorrhage associated with ginko biloba. Lancet, 1998, 352 , 36.

    Vale S. , 'Subarachnoid hemorrhage associated with ginko biloba ' (1998 ) 352 Lancet : 36 -.

    • Search Google Scholar

  • Rosenblatt, M., Mindel, J.: Spontaneous hyphema associated with ingestion of ginko biloba extract. N. Engl. J. Med., 1997, 336 , 1–108.

    Mindel J. , 'Spontaneous hyphema associated with ingestion of ginko biloba extract ' (1997 ) 336 N. Engl. J. Med. : 1 -108 .

    • Search Google Scholar

  • Matthews, M. K.: Association of ginko biloba with intracerebral hemorrhage. Neurology, 1998, 50 , 1933–4.

    Matthews M. K. , 'Association of ginko biloba with intracerebral hemorrhage ' (1998 ) 50 Neurology : 1933 -4 .

    • Search Google Scholar

  • Carlson, M., Thompson, R. D.: Liquid chromatographic determination of methylxanthines and catechins in herbal preparations containing gurana. J. Assoc. Anal. Chem., 1998, 81 , 691–701.

    Thompson R. D. , 'Liquid chromatographic determination of methylxanthines and catechins in herbal preparations containing gurana ' (1998 ) 81 J. Assoc. Anal. Chem. : 691 -701 .

    • Search Google Scholar

  • Zaacks, S. M. et al.: Hypersensitivity myocarditis associated with ephedra use. J. Toxic Clin. Toxicol., 1999, 37 , 485–9.

    Zaacks S. M. , 'Hypersensitivity myocarditis associated with ephedra use ' (1999 ) 37 J. Toxic Clin. Toxicol. : 485 -9 .

    • Search Google Scholar

  • Peterson, A.: The making of herbal superstar. The Wall Street Journal, 1988, 26 , 12–14.

    Peterson A. , 'The making of herbal superstar ' (1988 ) 26 The Wall Street Journal : 12 -14 .

    • Search Google Scholar

  • Almeida, J. C., Grimsley, E. W.: Coma from the health food store: Interaction between alprazolam and kava. Ann. Int. Med., 1996, 125 , 940–1.

    Grimsley E. W. , 'Coma from the health food store: Interaction between alprazolam and kava ' (1996 ) 125 Ann. Int. Med. : 940 -1 .

    • Search Google Scholar

  • De Smet, P. A.: Potential risks of health food products containing yohimbine extracts. Br. Med. J., 1994, 309 , 958–59.

    Smet P. A. , 'Potential risks of health food products containing yohimbine extracts ' (1994 ) 309 Br. Med. J. : 958 -59 .

    • Search Google Scholar

  • Attele, A. S., Wu, J. A., Yuan, C. S.: Ginseng pharmacology: multiple constituents and multiple actions. Biochem. Pharmacol., 1999, 58 , 1685–93.

    Yuan C. S. , 'Ginseng pharmacology: multiple constituents and multiple actions ' (1999 ) 58 Biochem. Pharmacol. : 1685 -93 .

    • Search Google Scholar

  • McRae, S.: Elevated serum digoxin levels in a patient taking digoxin and Siberian ginseng. Can. Med. Assoc. J., 1996, 155 , 293–5.

    McRae S. , 'Elevated serum digoxin levels in a patient taking digoxin and Siberian ginseng ' (1996 ) 155 Can. Med. Assoc. J. : 293 -5 .

    • Search Google Scholar

  • Becker, B. N. et al.: Ginseng induced diuretic resistance. J. Am. Med. Assoc., 1996, 276 , 606–7.

    Becker B. N. , 'Ginseng induced diuretic resistance ' (1996 ) 276 J. Am. Med. Assoc. : 606 -7 .

    • Search Google Scholar

  • Tisserand, R., Balacs, T.: Essential Oil Safety. Churchill Livingstone, Edinburgh, 1995.

    Balacs T. , '', in Essential Oil Safety , (1995 ) -.

  • Roulet, M.: Hepato-veno-occlusive disease in newborn infant of a woman drinking herbal tea. J. Pediatr., 1988, 112 , 433–36.

    Roulet M. , 'Hepato-veno-occlusive disease in newborn infant of a woman drinking herbal tea ' (1988 ) 112 J. Pediatr. : 433 -36 .

    • Search Google Scholar

  • Ernst, E.: Herbal medicines for common ailments in the elderly. Drugs Ageing, 1999, 15 , 423–428.

    Ernst E. , 'Herbal medicines for common ailments in the elderly ' (1999 ) 15 Drugs Ageing : 423 -428 .

    • Search Google Scholar

  • Ang-lee, M. K.: Herbal medicines and perioperative care. J. Am. Med. Assoc., 2001, 286 , 208–216.

    Ang-lee M. K. , 'Herbal medicines and perioperative care ' (2001 ) 286 J. Am. Med. Assoc. : 208 -216 .

    • Search Google Scholar

  • Castot, A. et al.: Pharmacovigilance off the beaten track: herbal surveillance or pharmacovigilance of medicinal plants. Therapie, 1997, 52 , 97–103.

    Castot A. , 'Pharmacovigilance off the beaten track: herbal surveillance or pharmacovigilance of medicinal plants ' (1997 ) 52 Therapie : 97 -103 .

    • Search Google Scholar
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Cover Hungarian Medical Journal
Hungarian Medical Journal
Print ISSN:
1788-6139
Online ISSN:
1789-0403

Hungarian Medical Journal
Language English
Size  
Year of
Foundation		 2007
Publication
Programme		 ceased
Volumes
per Year		  
Issues
per Year		  
Publisher Akadémiai Kiadó
Publisher's
Address		 H-1117 Budapest, Hungary 1516 Budapest, PO Box 245.
Responsible
Publisher		 Chief Executive Officer, Akadémiai Kiadó
ISSN 1788-6139 (Print)
ISSN 1789-0403 (Online)

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