How can we improve the safe use of herbal medicine and other natural products? A clinical pharmacologist mission
- 10 August 2020
- journal article
- research article
- Published by Taylor & Francis Ltd in Expert Review of Clinical Pharmacology
- Vol. 13 (9), 935-944
- https://doi.org/10.1080/17512433.2020.1803739
Abstract
Three major classes of natural products (NPs) for medicinal purposes or improving wellbeing are generally available in the US: conventional drugs of herbal origin, botanical drugs, and dietary supplements (DSs). Consumer consumption of DSs is growing annually, with >50% of adults in the US taking dietary supplements. The US FDA regulates conventional and botanical drugs for safety and efficacy; however, DSs are minimally regulated. This article will: i) highlight the importance of NP as a significant source of prescription drugs; ii) discuss differences in the regulation of conventional drugs of NP product, botanical drugs, and DSs; iii) discuss the safety and efficacy of DSs and iv) make recommendations for improvement of safety for minimally regulated NPs. The authors conducted a comprehensive literature search in two electronic databases, relevant NP and U.S. government websites for articles and regulatory documents published between January 1994 and April 2020. Toxicities associated with the use of NPs, including vitamins and DSs, are mainly due to excessive use and interactions with conventional drug(s) and may represent challenges for clinicians. Conventional and botanical-based prescription drugs are rarely associated with unknown toxicities. However, DSs are minimally regulated and can produce severe adverse effects. We believe that clinical pharmacologists can have a role in developing criteria for DS safety analysis. There is also the potential for a standardized NP stewardship program(s) and the development of NP policies and practices nationally and globally.Keywords
This publication has 45 references indexed in Scilit:
- Review article: herbal and dietary supplement hepatotoxicityAlimentary Pharmacology & Therapeutics, 2012
- Pharmacokinetic Herb-Drug Interactions (Part 1): Origins, Mechanisms, and the Impact of Botanical Dietary SupplementsPlanta Medica, 2012
- Intestinal absorption of water-soluble vitamins in health and diseaseBiochemical Journal, 2011
- A natural history of botanical therapeuticsMetabolism, 2008
- Dietary Supplements: Inpatient Policies in US Children's HospitalsPEDIATRICS, 2008
- Revisiting the ancient concept of botanical therapeuticsNature Chemical Biology, 2007
- Improving the quality of randomized controlled trials in Chinese herbal medicine, Part Ⅰ: clinical trial design and methodologyJournal of Chinese Integrative Medicine, 2006
- Are national quality standards for traditional Chinese herbal medicine sufficient?: Current governmental regulations for traditional Chinese herbal medicine in certain Western countries and China as the Eastern origin countryComplementary Therapies in Medicine, 2005
- INDUCTION AND INHIBITION OF CYTOCHROMES P450 BY THE ST. JOHN'S WORT CONSTITUENT HYPERFORIN IN HUMAN HEPATOCYTE CULTURESDrug Metabolism and Disposition, 2004
- Durch Pflanzen ausgelöste toxische und allergische Dermatitis (Phytodermatitis)Die Dermatologie, 2002