Dataset Information

Co-ingestion of herbal medicines and warfarin.

ABSTRACT:

Background

A large proportion of patients use herbal remedies with a potential to interact with prescribed drugs. Such interactions can be dangerous, particularly if the therapeutic window of the prescribed drug is small, as with warfarin.

Aims

Our aim was to estimate the prevalence of the use of herbal medicines by patients taking warfarin (co-ingestion).

Design of study

Postal questionnaire.

Setting

General practices in the South West of England.

Method

Thirty-five general practices in Devon and Somerset identified 2600 patients taking warfarin and sent postal questionnaires to them.

Results

One thousand, three hundred and sixty usable responses were received (response rate = 54.2%). One or more of the specified herbal remedies thought to interact with warfarin were taken by 8.8% of all patients. Complementary or homeopathic treatments not specified in the survey questionnaire were taken by 14.3% of responders. Overall, 19.2% of responders were taking one or more such medicines. The use of herbal medicines had not been discussed with a conventional healthcare professional by 92.2% of patients. Twenty-eight point three per cent of responders thought that herbal medicines might or definitely could interfere with other drugs prescribed by their doctor, however, patients taking any non-prescribed medication were less likely to believe this (chi2 = 20, degrees of freedom = 1, P<0.001).

Conclusion

A substantial proportion of patients taking warfarin in southwest England self-medicate with both herbal medicines that are thought to interact with warfarin and with others of unknown effect, usually without informing their healthcare team. Patients have a responsibility to mention such non-prescribed medication to their general practitioners, and general practitioners also have a responsibility to ask whether such co-ingestion is occurring.

SUBMITTER: Smith L

PROVIDER: S-EPMC1266203 | biostudies-literature | 2004 Jun

REPOSITORIES: biostudies-literature

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Publications

Co-ingestion of herbal medicines and warfarin.

Smith Lindsay L Ernst Edzard E PaulEwings Myers Patrick P Smith Calli C

The British journal of general practice : the journal of the Royal College of General Practitioners 20040601 503

<h4>Background</h4>A large proportion of patients use herbal remedies with a potential to interact with prescribed drugs. Such interactions can be dangerous, particularly if the therapeutic window of the prescribed drug is small, as with warfarin.<h4>Aims</h4>Our aim was to estimate the prevalence of the use of herbal medicines by patients taking warfarin (co-ingestion).<h4>Design of study</h4>Postal questionnaire.<h4>Setting</h4>General practices in the South West of England.<h4>Method</h4>Thir ...[more]

PMID: 15186565

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Project description:BackgroundHypercholesterolemia is an important key contributory factor for ischemic heart disease and is associated with age, high blood pressure, a family history of hypercholesterolemia, and diabetes. Chinese herbal medicines have been used for a long time as lipid-lowering agents.ObjectivesTo assess the effects of Chinese herbal medicines on hypercholesterolemia.Search strategyWe searched the following databases: The Cochrane Library (issue 8, 2010), MEDLINE (until July 2010), EMBASE (until July 2010 ), Chinese BioMedical Database (until July 2010), Traditional Chinese Medical Literature Analysis and Retrieval System (until July 2010), China National Knowledge Infrastructure (until July 2010), Chinese VIP Information (until July 2010), Chinese Academic Conference Papers Database and Chinese Dissertation Database (until July 2010), and Allied and Complementary Medicine Database (until July 2010).Selection criteriaWe considered randomized controlled clinical trials in hypercholesterolemic participants comparing Chinese herbal medicines with placebo, no treatment, and pharmacological or non-pharmacological interventions.Data collection and analysisTwo review authors independently extracted data and assessed the risk of bias. We resolved any disagreements with this assessment through discussion and a decision was achieved based by consensus. We assessed trials for the risk of bias against key criteria: random sequence generation, allocation concealment, blinding of participants, incomplete outcome data, selective outcome reporting and other sources of bias.Main resultsWe included 22 randomized trials (2130 participants). The mean treatment duration was 2.3 ± 1.3 months (ranging from one to six months). Twenty trials were conducted in China and 18 trials were published in Chinese. Overall, the risk of bias of included trials was high or unclear. Five different herbal medicines were evaluated in the included trials, which compared herbs with conventional medicine in six comparisons (20 trials), or placebo (two trials). There were no outcome data in any of the trials on cardiovascular events and death from any cause. One trial each reported well-being (no significant differences) and economic costs. No serious adverse events were observed. Xuezhikang was the most commonly used herbal formula investigated. A significant effect on total cholesterol (two trial, 254 participants) was shown in favor of Xuezhikang when compared with inositol nicotinate (mean difference (MD) -0.90 mmol/L, 95% confidence interval (CI) -1.13 to -0.68) .Authors' conclusionsSome herbal medicines may have cholesterol-lowering effects. Our findings have to be interpreted with caution due to high or unclear risk of bias of the included trials.

Dataset Information

Co-ingestion of herbal medicines and warfarin.

Background

Aims

Design of study

Setting

Method

Results

Conclusion

Publications

Co-ingestion of herbal medicines and warfarin.

Similar Datasets

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