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Herbal remedies:
patients do not always inform their doctors

According to a German study, patients rarely inform their doctors that they are taking herbal remedies. And yet there is a real risk of interactions between herbal remedies and drugs.

St John's Wort, a plant traditionally used to treat depression, is widely used. However, some of its constituents can interfere with a number of drugs, such as oral anticoagulants and hormone-based contraceptives, by speeding up their elimination. The combination exposes the patient to the risk that the drug treatment will be less effective. On the other hand, if the patient stops taking the herbal remedy, symptoms of drug overdose may occur. A German study reveals that most patients who took a treatment based on St John's Wort did not inform their doctors. 150 inpatients in a medical ward were questioned, in particular about the medicines they were taking prior to their admission to hospital. At the same time, some of the constituents of St John's Wort were assayed in each of these patients. 75% of the patients taking St John's Wort had not informed the hospital staff, even though some drugs prescribed during their stay were likely to interact if they took St John's Wort at the same time.

When questioned by their doctors, patients should make sure they mention all the medicines they are taking, including herbal remedies, food supplements, oral contraception, homeopathy, eye drops etc.

©Prescrire January 2006

Source: "Phytothérapie : rarement signalée spontanément" Rev Prescrire 2006 ; 26 (268) : 27.

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