Herbal medicines put into context-BMJ 2003;327:881

Herbal medicines put into context


BMJ 2003; 327 doi: http://dx.doi.org/10.1136/bmj.327.7420.881 (Published 16 October 2003)

Cite this as: BMJ 2003;327:881

13 December 2003

HERBAL MEDICINES ARE NOT WITHOUT ADVERSE EFFECT

EDITOR - The editorial by Ernst on herbal medicines put into context1 was heartening. Herbal medicines are the most widely used one in India. According to an all India Ethno-botanical survey conducted by Indian Ministry of Environment [1985-1990], the tribal communities alone have a knowledge of the use of over 9000 species of plants of which the single major use catagories is tratitional medicine for which over 7500 species are used. The general public has a more positive view about herbal medicine because they are precieved as being natural and safe. In India some area of Tamil Nadu and Kerala have reported over 2000 plants and other resources are used for health care at the house hold level.

Recently many reports have shown that the plant medicines can also have mild to severe adverse health effects. Aristolochia and kava kava are proved to have nephro and hepatotoxicity2. St.Jhon’s wort is proved to have the potential of interaction with various other medicines and which may led to serious adverse effects such as graft rejection and failure to suppress HIV3. Ginko biloba extract have a variety of adverse effects which include headache, diarrohea, vomiting, and hemorhage due to ginkgolids a component of this extract4. Other commenly used herbal medicines that are thought to affect blood clotting include garlic, ginger, ginseng extracts5.

In India many plant medicines used by the traditional healers are not safe. In one of my study about iatrogenic seizures a 26 years old female had treatment for bronchial asthma from a traditional healer with indigenous plant extract probably containing Xanthine alkaloids developed generalized tonic clonic seizures6.

So it is important to realise that the plant medicines contain biologically active ingradiants which may cause adverse effects or they may interact with other conventional drugs.

M.A.ALEEM. Assitant Professor of Neurology, Dept of Neuromedicine KAPV Govt Medical College and AGM. Hospital, Trichy 620017. TAMIL NADU, INDIA. E-Mail: drmaaleem@hotmail.com

KALAVATHY PONNERIVAN, Professor of Biochemistry & DEAN KAPV. Govt Medical College and AGM Hospital, Trichy 620017. TAMIL NADU, INDIA.

Competing Intersts: None declared.

1. Ernst E.Herbal medicines put into context. BMJ 2003;327:381-2.

2. Barnes J, Quality efficacy and safety of Complementary medicines; fashions, facts and future. Part II: effiecncy and safety Br. J clin pharmacol 2003; 55:331-40

3. Ioannides C pharmacokinetic interactions Between herbal remedies and medicinal drugs, Xenobiotica 2002; 32:451-78

4. koltai M, Hosford D, Guinot P et al. platelet activating factors [PAF]. A review of its effects anatagonists and possible future clinical implications (part 1) Drugs 1991;42:9-29

5. Ang Lee MK.Moss J.Yuan C.S. Herbal medicines and perioperative care JAMA 2001; 286:208-16

6. Aleem.M.A Iatrogenic seizures a clinical study from southern india. J Neurol Sci 2001; 187(suppl):s411;

Competing interests: None declared