Abstract
Background: The use of herbal medicines is on the rise throughout the world due to their perceived
safety profile. However, incidences of herb-drug, herb-herb and herb-food interactions considering safety aspects
have opened new arenas for discussion.
Objective: The current study aims to provide comprehensive insights into the various types of herb interactions,
the mechanisms involved, their assessment, and historical developments, keeping herbal safety at the
central point of discussion.
Methods: The authors undertook a focused/targeted literature review and collected data from various databases,
including Science Direct, Wiley Online Library, Springer, PubMed, and Google Scholar. Conventional literature
on herbal remedies, such as those by the WHO and other international or national organizations.
Results: The article considered reviewing the regulations, interaction mechanisms, and detection of herb-herb,
herb-drug and herb-food interactions in commonly used yet vital plants, including Glycyrrhiza glabra, Mentha
piperita, Aloe barbadensis, Zingiber officinale, Gingko biloba, Withania somnifera, etc. The study found that
healthcare professionals worry about patients not informing them about their herbal prescriptions (primarily
used with conventional treatment), which can cause herb-drug/herb-food/herb-herb interactions. These interactions
were caused by altered pharmacodynamic and pharmacokinetic processes, which might be explained using
in-vivo, in-vitro, in-silico, pharmacogenomics, and pharmacogenetics. Nutrivigilance may be the greatest
method to monitor herb-food interactions, but its adoption is limited worldwide.
Conclusion: This article can serve as a lead for clinicians, guiding them regarding herb-drug, herb-food, and
herb-herb interactions induced by commonly consumed plant species. Patients may also be counseled to avoid
conventional drugs, botanicals, and foods with a restricted therapeutic window.
Keywords:
Herb-drug interactions, Herb-herb interactions, Herb-food interactions, Herbal medicine, Safety monitoring, Regulatory scenario.
Graphical Abstract
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