HERBAL MEDICINE/DRUG INTERACTION

HFMA Statement: 05.07.04

The HFMA notes the results of a survey, amongst medical practices in Somerset and Devon, investigating the prevalence of use of herbal medicines by patients taking warfarin: this was reported in the June issue of the ‘British Journal of General Practice’ (BJGP). The HFMA also notes a review of trials examining interactions between St John’s Wort and prescribed drugs that has just been published in the ‘British Medical Journal’.

Herbal medicines carry label warnings about known interactions with drugs: for example, St John’s Wort has carried label warnings about interactions with warfarin, a substance notoriously sensitive to interactions, for four years.

Interactions are not confined to herbal medicines but can also result from interactions with, for instance, other OTC medicines as well as some commonly eaten foods. Grapefruit alone is responsible for interactions with numerous drugs: warfarin interacts with broccoli, spinach, liver and various other foods.

The HFMA agrees with the conclusion of the BJGP researchers that ‘Both doctors and their patients have a joint responsibility to raise the issue of …herb-drug reactions in particular when warfarin is prescribed (and) GPs should actively ask patients what form of complementary medicine they are using.’ We also agree with the quoted comments from Edzard Ernst relating to the lack of training that GPs receive in complementary medicine. We have long urged relevant training for health professionals and support the GMC’s encouragement to medical schools to include familiarisation with Complementary and Alternative Medicine in their undergraduate curricula.

DCA

  For further information, please contact the HFMA on 020 8398 4066

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