NCCIH Clinical Digest
National Institutes of Health • National Center for Complementary and Integrative Health
The NCCIH Clinical Digest is a monthly e-newsletter that summarizes the state of the science on complementary health practices and a health condition (diabetes, cancer, sleep disorders, etc.)—clinical guidelines, literature searches, research highlights, and information for patients.
In each issue, you'll find evidence-based information for several complementary health practices used for the highlighted condition.
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The possibility of drug interactions, direct toxicities, and contamination with active pharmaceutical agents are among the safety concerns about dietary and herbal supplements. Although there is a widespread public perception that herbs and botanical products in dietary supplements are safe, research has demonstrated that these products carry the same dangers as other pharmacologically active compounds. Interactions may occur between prescription drugs, over-the-counter drugs, dietary supplements, and even small molecules in food—making it a daunting challenge to identify all interactions that are of clinical concern.
Concerns about herb-drug interactions are often not based on rigorous research. Most herb-drug interactions identified in current sources are hypothetical, inferred from animal studies, cellular assays, or based on other indirect means; however, attention to this issue is needed for drugs with a narrow therapeutic index, such as cancer chemotherapeutic agents, warfarin, and digoxin.
To date, well-designed clinical studies evaluating herbal supplement-drug interactions are limited and sometimes inconclusive. This issue of the Digest provides information about several herbs and their potential interactions with other agents.