Bitkisel Kaynaklı Besin Destek Ürünleri ve İlaçlarla Etkileşimleri/Herbal Dietary Supplements and Their Interaction With Drugs

Recently, the use of herbal dietary supplements has extensively increased in the World and in our country as well. Before marketing, they are are not obligatorily controlled in terms of safety and efficacy. Thus, their content of active ingredients may not be standard. These products are generally labeled as “ all natural “ without safety warnings and purchased as “over the counter” . For this reason, the consumers generally consider them as safe and effective. In fact, eventhough are originated from herbs, they probably contain many chemicals concomitantly interacting with drugs. These interactions may decrease or increase the effect of drugs sometimes causing severe, even lethal results. Mechanism of these interactions are highly complex and existing data are based mostly on individual case reports. Unfortunately, documents concerning with clinical trials are not satisfactory. The physicians should routinely ask patients about their use of dietary supplements and inform them in terms of safety, effectiveness and risks of these products. As for the patients, they should not use these products without consulting their physician or pharmacist. This review summarizes, chemical composition, pharmacological effects, intended use and drug interactions of commonly used herbal dietary supplements, namely St. John's wort, golden seal, kava, garlic, ginkgo, echinacea, ginseng, milk thistle, licorice, valerian, black cohosh, cranberry, saw palmetto, aloe vera, hawthorn, cat's claw, dong quai, bai zhi, Chinese salvia.