A Critical Approach to Evaluating Clinical Efficacy, Adverse Events and Drug Interactions of Herbal Remedies
Systematic reviews and meta‐analyses represent the uppermost ladders in the hierarchy of evidence. Systematic reviews/meta‐analyses suggest preliminary or satisfactory clinical evidence for agnus castus (Vitex agnus castus) for premenstrual complaints, flaxseed (Linum usitatissimum) for hypertension...
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| Published in | Phytotherapy research Vol. 30; no. 5; pp. 691 - 700 |
|---|---|
| Main Authors | , , , |
| Format | Journal Article |
| Language | English |
| Published |
England
Blackwell Publishing Ltd
01.05.2016
Wiley Subscription Services, Inc |
| Subjects | |
| Online Access | Get full text |
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| Abstract | Systematic reviews and meta‐analyses represent the uppermost ladders in the hierarchy of evidence. Systematic reviews/meta‐analyses suggest preliminary or satisfactory clinical evidence for agnus castus (Vitex agnus castus) for premenstrual complaints, flaxseed (Linum usitatissimum) for hypertension, feverfew (Tanacetum partenium) for migraine prevention, ginger (Zingiber officinalis) for pregnancy‐induced nausea, ginseng (Panax ginseng) for improving fasting glucose levels as well as phytoestrogens and St John's wort (Hypericum perforatum) for the relief of some symptoms in menopause. However, firm conclusions of efficacy cannot be generally drawn. On the other hand, inconclusive evidence of efficacy or contradictory results have been reported for Aloe vera in the treatment of psoriasis, cranberry (Vaccinium macrocarpon) in cystitis prevention, ginkgo (Ginkgo biloba) for tinnitus and intermittent claudication, echinacea (Echinacea spp.) for the prevention of common cold and pomegranate (Punica granatum) for the prevention/treatment of cardiovascular diseases. A critical evaluation of the clinical data regarding the adverse effects has shown that herbal remedies are generally better tolerated than synthetic medications. Nevertheless, potentially serious adverse events, including herb–drug interactions, have been described. This suggests the need to be vigilant when using herbal remedies, particularly in specific conditions, such as during pregnancy and in the paediatric population. Copyright © 2016 John Wiley & Sons, Ltd. |
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| AbstractList | Systematic reviews and meta‐analyses represent the uppermost ladders in the hierarchy of evidence. Systematic reviews/meta‐analyses suggest preliminary or satisfactory clinical evidence for agnus castus (Vitex agnus castus) for premenstrual complaints, flaxseed (Linum usitatissimum) for hypertension, feverfew (Tanacetum partenium) for migraine prevention, ginger (Zingiber officinalis) for pregnancy‐induced nausea, ginseng (Panax ginseng) for improving fasting glucose levels as well as phytoestrogens and St John's wort (Hypericum perforatum) for the relief of some symptoms in menopause. However, firm conclusions of efficacy cannot be generally drawn. On the other hand, inconclusive evidence of efficacy or contradictory results have been reported for Aloe vera in the treatment of psoriasis, cranberry (Vaccinium macrocarpon) in cystitis prevention, ginkgo (Ginkgo biloba) for tinnitus and intermittent claudication, echinacea (Echinacea spp.) for the prevention of common cold and pomegranate (Punica granatum) for the prevention/treatment of cardiovascular diseases. A critical evaluation of the clinical data regarding the adverse effects has shown that herbal remedies are generally better tolerated than synthetic medications. Nevertheless, potentially serious adverse events, including herb–drug interactions, have been described. This suggests the need to be vigilant when using herbal remedies, particularly in specific conditions, such as during pregnancy and in the paediatric population. Copyright © 2016 John Wiley & Sons, Ltd. Systematic reviews and meta-analyses represent the uppermost ladders in the hierarchy of evidence. Systematic reviews/meta-analyses suggest preliminary or satisfactory clinical evidence for agnus castus (Vitex agnus castus) for premenstrual complaints, flaxseed (Linum usitatissimum) for hypertension, feverfew (Tanacetum partenium) for migraine prevention, ginger (Zingiber officinalis) for pregnancy-induced nausea, ginseng (Panax ginseng) for improving fasting glucose levels as well as phytoestrogens and St John's wort (Hypericum perforatum) for the relief of some symptoms in menopause. However, firm conclusions of efficacy cannot be generally drawn. On the other hand, inconclusive evidence of efficacy or contradictory results have been reported for Aloe vera in the treatment of psoriasis, cranberry (Vaccinium macrocarpon) in cystitis prevention, ginkgo (Ginkgo biloba) for tinnitus and intermittent claudication, echinacea (Echinacea spp.) for the prevention of common cold and pomegranate (Punica granatum) for the prevention/treatment of cardiovascular diseases. A critical evaluation of the clinical data regarding the adverse effects has shown that herbal remedies are generally better tolerated than synthetic medications. Nevertheless, potentially serious adverse events, including herb-drug interactions, have been described. This suggests the need to be vigilant when using herbal remedies, particularly in specific conditions, such as during pregnancy and in the paediatric population. Copyright © 2016 John Wiley & Sons, Ltd.Systematic reviews and meta-analyses represent the uppermost ladders in the hierarchy of evidence. Systematic reviews/meta-analyses suggest preliminary or satisfactory clinical evidence for agnus castus (Vitex agnus castus) for premenstrual complaints, flaxseed (Linum usitatissimum) for hypertension, feverfew (Tanacetum partenium) for migraine prevention, ginger (Zingiber officinalis) for pregnancy-induced nausea, ginseng (Panax ginseng) for improving fasting glucose levels as well as phytoestrogens and St John's wort (Hypericum perforatum) for the relief of some symptoms in menopause. However, firm conclusions of efficacy cannot be generally drawn. On the other hand, inconclusive evidence of efficacy or contradictory results have been reported for Aloe vera in the treatment of psoriasis, cranberry (Vaccinium macrocarpon) in cystitis prevention, ginkgo (Ginkgo biloba) for tinnitus and intermittent claudication, echinacea (Echinacea spp.) for the prevention of common cold and pomegranate (Punica granatum) for the prevention/treatment of cardiovascular diseases. A critical evaluation of the clinical data regarding the adverse effects has shown that herbal remedies are generally better tolerated than synthetic medications. Nevertheless, potentially serious adverse events, including herb-drug interactions, have been described. This suggests the need to be vigilant when using herbal remedies, particularly in specific conditions, such as during pregnancy and in the paediatric population. Copyright © 2016 John Wiley & Sons, Ltd. Systematic reviews and meta‐analyses represent the uppermost ladders in the hierarchy of evidence. Systematic reviews/meta‐analyses suggest preliminary or satisfactory clinical evidence for agnus castus (Vitex agnus castus) for premenstrual complaints, flaxseed (Linum usitatissimum) for hypertension, feverfew (Tanacetum partenium) for migraine prevention, ginger (Zingiber officinalis) for pregnancy‐induced nausea, ginseng (Panax ginseng) for improving fasting glucose levels as well as phytoestrogens and St John's wort (Hypericum perforatum) for the relief of some symptoms in menopause. However, firm conclusions of efficacy cannot be generally drawn. On the other hand, inconclusive evidence of efficacy or contradictory results have been reported for Aloe vera in the treatment of psoriasis, cranberry (Vaccinium macrocarpon) in cystitis prevention, ginkgo (Ginkgo biloba) for tinnitus and intermittent claudication, echinacea (Echinacea spp.) for the prevention of common cold and pomegranate (Punica granatum) for the prevention/treatment of cardiovascular diseases. A critical evaluation of the clinical data regarding the adverse effects has shown that herbal remedies are generally better tolerated than synthetic medications. Nevertheless, potentially serious adverse events, including herb–drug interactions, have been described. This suggests the need to be vigilant when using herbal remedies, particularly in specific conditions, such as during pregnancy and in the paediatric population. Systematic reviews and meta‐analyses represent the uppermost ladders in the hierarchy of evidence. Systematic reviews/meta‐analyses suggest preliminary or satisfactory clinical evidence for agnus castus ( Vitex agnus castus ) for premenstrual complaints, flaxseed ( Linum usitatissimum ) for hypertension, feverfew ( Tanacetum partenium ) for migraine prevention, ginger ( Zingiber officinalis ) for pregnancy‐induced nausea, ginseng ( Panax ginseng ) for improving fasting glucose levels as well as phytoestrogens and St John's wort ( Hypericum perforatum ) for the relief of some symptoms in menopause. However, firm conclusions of efficacy cannot be generally drawn. On the other hand, inconclusive evidence of efficacy or contradictory results have been reported for Aloe vera in the treatment of psoriasis, cranberry ( Vaccinium macrocarpon ) in cystitis prevention, ginkgo ( Ginkgo biloba ) for tinnitus and intermittent claudication, echinacea ( Echinacea spp.) for the prevention of common cold and pomegranate ( Punica granatum ) for the prevention/treatment of cardiovascular diseases. A critical evaluation of the clinical data regarding the adverse effects has shown that herbal remedies are generally better tolerated than synthetic medications. Nevertheless, potentially serious adverse events, including herb–drug interactions, have been described. This suggests the need to be vigilant when using herbal remedies, particularly in specific conditions, such as during pregnancy and in the paediatric population. Copyright © 2016 John Wiley & Sons, Ltd. |
| Author | Radhakrishnan, Rajan Williamson, Elizabeth M. Hoon-Kim, Sung Izzo, Angelo A. |
| Author_xml | – sequence: 1 givenname: Angelo A. surname: Izzo fullname: Izzo, Angelo A. email: Correspondence to:Angelo A. Izzo, Department of Pharmacy, University of Naples Federico II, via D. Montesano 49, 80131 Naples, Italy., aaizzo@unina.it organization: Department of Pharmacy, University of Naples Federico II, via D. Montesano 49, 80131, Naples, Italy – sequence: 2 givenname: Sung surname: Hoon-Kim fullname: Hoon-Kim, Sung organization: College of Korean Medicine, Kyung Hee University, 130-701, Seoul, Korea – sequence: 3 givenname: Rajan surname: Radhakrishnan fullname: Radhakrishnan, Rajan organization: School of Pharmacy, University of Charleston, WV, 25304, Charleston, USA – sequence: 4 givenname: Elizabeth M. surname: Williamson fullname: Williamson, Elizabeth M. organization: School of Pharmacy, University of Reading, Whiteknights, RG6 6AP, Reading, UK |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/26887532$$D View this record in MEDLINE/PubMed |
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| CODEN | PHYREH |
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Lissiman E, Bha 2015; 79 2010; 55 2013; 26 2013; 3 2013; 4 2013; 2 2013; 27 2015; 31 2002; 113 2015; 145 2014b; 28 2011; 96 2011; 11 2011; 12 2012; 16 2014; 28 2015; 107 2015; pii: S0261‐5614 2012; 13 2005; 28 2012; 12 2013; 6 2012; 10 2003; 10 2014a; 17 2012; 172 2009; 11 2013; 16 2014; 2 2015b; 228 2013; 2013 2013; 13 2014; 59 2006; 29 2014; 14 2008; 118 2014; 13 2002; 109 2014; 9 2008; 199 2011; 27 2013; 150 2014; 6 2014; 12 2012; 21 2014; 11 2014a; 28 2012; 140 2015; 4 2012 2015; 125 2015; 53 2007 2008; 98 2014; 2014 2004 2007; 11 2016; 16 2015a; 18 2013; 37 2015; 28 2009; 32 2015; 29 2015; 313 2013; 79 2000; 106 2002; 23 2013; 75 2015; 22 2001; 8 2015; 2015 2005; 5 1994; 12 2014 1996; 313 2012; 7 e_1_2_10_23_1 e_1_2_10_46_1 e_1_2_10_69_1 e_1_2_10_21_1 e_1_2_10_44_1 e_1_2_10_42_1 Van Die MD (e_1_2_10_86_1) 2013; 79 e_1_2_10_40_1 Ursoniu S (e_1_2_10_85_1) 2015; 0261 e_1_2_10_91_1 e_1_2_10_70_1 e_1_2_10_93_1 e_1_2_10_2_1 e_1_2_10_72_1 e_1_2_10_95_1 e_1_2_10_4_1 e_1_2_10_18_1 e_1_2_10_74_1 e_1_2_10_53_1 e_1_2_10_6_1 e_1_2_10_16_1 e_1_2_10_39_1 e_1_2_10_76_1 e_1_2_10_55_1 e_1_2_10_8_1 e_1_2_10_14_1 e_1_2_10_37_1 e_1_2_10_57_1 e_1_2_10_78_1 e_1_2_10_58_1 e_1_2_10_13_1 e_1_2_10_34_1 e_1_2_10_11_1 e_1_2_10_32_1 e_1_2_10_30_1 Smith T (e_1_2_10_77_1) 2015; 107 e_1_2_10_51_1 Garrison MM (e_1_2_10_35_1) 2000; 106 e_1_2_10_80_1 e_1_2_10_82_1 e_1_2_10_61_1 e_1_2_10_29_1 e_1_2_10_63_1 e_1_2_10_27_1 e_1_2_10_65_1 e_1_2_10_88_1 e_1_2_10_25_1 e_1_2_10_48_1 e_1_2_10_67_1 e_1_2_10_24_1 e_1_2_10_45_1 e_1_2_10_22_1 e_1_2_10_43_1 e_1_2_10_20_1 e_1_2_10_41_1 Milić N (e_1_2_10_62_1) 2014; 9 e_1_2_10_90_1 e_1_2_10_71_1 e_1_2_10_92_1 e_1_2_10_73_1 e_1_2_10_94_1 e_1_2_10_52_1 e_1_2_10_3_1 e_1_2_10_19_1 e_1_2_10_75_1 e_1_2_10_54_1 e_1_2_10_5_1 e_1_2_10_17_1 e_1_2_10_38_1 e_1_2_10_56_1 e_1_2_10_79_1 e_1_2_10_7_1 e_1_2_10_15_1 e_1_2_10_36_1 e_1_2_10_12_1 e_1_2_10_9_1 e_1_2_10_59_1 e_1_2_10_10_1 e_1_2_10_33_1 Ulbricht C (e_1_2_10_84_1) 2014 e_1_2_10_31_1 e_1_2_10_50_1 e_1_2_10_60_1 e_1_2_10_81_1 e_1_2_10_83_1 e_1_2_10_64_1 e_1_2_10_28_1 e_1_2_10_49_1 e_1_2_10_66_1 e_1_2_10_87_1 e_1_2_10_26_1 e_1_2_10_47_1 e_1_2_10_68_1 e_1_2_10_89_1 |
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| Title | A Critical Approach to Evaluating Clinical Efficacy, Adverse Events and Drug Interactions of Herbal Remedies |
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