scholarly journals Safety of Herbal Medicines in Children

2021 ◽  
Author(s):  
Sevinç Polat ◽  
Ayşe Gürol

Herbal medicine is used by individuals of all ages, including children. Herbal medicine includes herbs, herbal materials and preparations, and finished herbal products. Herbal medicine or herbal products’ use for all ages have increased in recent years. Based on the data of the World Health Organization, almost 80% of the population in developing countries trust herbal medicines to meet their health needs. Herbal medicines use unconsciously as though these products are harmless. The use of herbal products in children is a concern because little information is available concerning the benefits and risks of these products in the pediatric population. This creates a serious problem in the treatment of children, and reveals a serious and under-recognized hazard in clinical care. The safety of most herbal medicinal products is absent since lack of suitable quality controls and not available of appropriate patient information. Owing to the possibility of serious health complications arising from the use of herbal products, it is mandatory to understand their use in the general population in order for appropriate measures to be put into place.

2010 ◽  
Vol 1 (1) ◽  
pp. 53-66
Author(s):  
Domenico Careddu

The recent appreciation of phytotherapy is related to the evidence of efficacy of herbal medicines, as well as to the continuous improvement of scientific and clinical knowledge of their effects. Unfortunately among herbal medicine it is frequent to find products that are neither registered nor controlled by regulatory bodies, with a lack of proofs regarding their constituents and quality.Phytotherapy can find its role among medical therapies only if each medication is standardised and controlled according to the requirements of an official Pharmacopoeia, and produced on the basis of Good Manufacturing Practices similar to those used in pharmaceutical companies. This is even more important in paediatric age, also because often parents administer herbal medications to their children, without asking the physician or the pharmacist for advice, being convinced that “natural products” are always safe and do not have adverse events or interactions. The evaluation of these products, ensuring their safety and efficacy through registration and regulation,is an important challenge. To improve an evidence-based and safe use, herbal medicines should be titrated, standardised and labelled. Clinical applications, pharmacology, dosage, possible contraindications and precautions (i.e. during pregnancy, breastfeeding and paediatric age), and potential adverse reactions should be clearly described and codified, for example in the officialPharmacopeia and in the various Monographs (ESCOP, The European Scientific Cooperative On Phytotherapy, and WHO, World Health Organization).The purpose of this article is to provide a review on the safety and efficacy of some medicinal plants widely used in the paediatric age: echinacea, cranberry, and chamomile. The final aim is to help to use herbal medicine on the basis of the criteria of the Evidence Based Medicine.


2020 ◽  
Vol 54 (1) ◽  
Author(s):  
Cecilia C. Maramba-Lazarte

There are several problems that continue to plague the Philippine health care system. The cost of branded drugs in the Philippines is 22 times more than international reference prices while generic drugs are 4 times more.1 Despite price reductions due to legislations such as the Cheaper Medicines Act of 2008, as well as the Generics Act of 1988, those in the lower-income brackets still cannot afford maintenance medicines for hypertension and diabetes as well as antibiotics.2 Access to medicines and care from physicians and other healthcare professionals is especially challenging for geographically isolated and disadvantaged areas wherein the people are physically or economically inaccessible. Filipino traditional medicine, of which herbal medicine plays a large role has been around for centuries and is wellaccepted in the rural areas. Validating the use of these traditional medicinal plants through research is essential in order to have an evidence-based practice of herbal medicine. The main areas of research can be defined as (1) herbal medicine quality and standardization, (2) preclinical pharmacological assessments and action mechanisms, and (3) clinical efficacy and safety assessments.3 These types of researches aimed at developing safe and efficacious, as well as low-cost Philippine herbal medicines, may well be a long-term solution to the obstacles to a healthy population cited above. Our Philippine medicinal plants are a valuable but often underappreciated resource with innumerable applications for non-communicable and communicable disease indications. Limited research in this field had long been ongoing in the Philippines. Support for this movement came with the passage of the Traditional and Alternative Medicine Act of 1997 which affirmed the commitment of the government towards the support and development of traditional medicine including herbal medicine.4 Another boost was the endorsement of the Department of Health of the Sampung Halamang Gamot in the 1990s.5 The World Health Organization has advocated the integration of Traditional Medicine within national health care systems and has urged governments to develop and implement national traditional medicine policies and programs especially with Universal Health Coverage.6 It was the National Integrated Research Program of the Philippines (NIRPROMP) who was at the forefront of this field and conducted the initial studies of these Ten Medicinal Plants.7 Many of them have been developed into modern formulations. These include Lagundi (Vitex negundo) tablet and syrup for cough and asthma, Sambong (Blumea balsamifera) tablet as a diuretic and treatment of urolithiasis, Tsaang gubat (Ehretia microphylla) tablet for gastrointestinal and biliary colic, Akapulco (Senna alata) lotion for cutaneous fungal infections, Yerba Buena (Mentha villosa) tablet as an analgesic, Ulasimang bato (Peperomia pellucida) tablet for the treatment of gout and hyperuricemia. Ampalaya (Momordica charantia) tablet was also developed as a glucose-lowering agent, but it is presently undergoing researches on the reformulated tablet.8 Several of the articles in this issue present evidence for the use of some of the mentioned medicinal plants. The NIRPROMP was the forerunner and is still an integral part of the Institute of Herbal Medicine. Lagundi and Sambong have been integrated into the clinical practice of physicians in the Philippines, even by specialists. They have both been scientific and commercial successes.9 Their production has contributed to the revenue and growth of the Philippine Pharmaceutical Industry, as well as improved the economic status of farmers cultivating these crops. Developing more herbal medicines needed for primary health care would decrease our dependence on the importation of medicines, and increase the accessibility of drugs even in geographically isolated areas. Bringing back the herbal medicine gardens to the barangays in the rural communities will also assist in empowering the population. The integration of herbal medicines into mainstream clinical practice will only be possible if the researches performed, both non-clinical and clinical, are as robust as those for synthetic medicine.     Cecilia C. Maramba-Lazarte, MD Director Institute of Herbal Medicine National Institutes of Health University of the Philippines Manila     REFERENCES 1. Paris J. Pharma Companies Offer to Cut Drug Prices [Internet] Rappler. 2019 25 October [cited 2020 Jan 15]. Available from https://www. rappler.com/nation/243372-pharmaceutical-companies-offer-cut-drug-prices. 2. Clarete RL, Llanto GM. 2017. Access to medicines in the Philippines: Overcoming the barriers [Internet]. Philippine Institute for Development Studies. 2017 [cited 2020 Jan 14]. Available from http://hdl.handle.net/11540/7967. 3. Zhang AL, Xue CC, Fong HH. Integration of Herbal Medicine into Evidence-Based Clinical Practice Current Status and Issues. In: Benzie IFF, Wachtel-Galor S, eds. Herbal Medicine: Biomolecular and Clinical Aspects, 2nd ed. Boca Raton (FL): CRC Press/Taylor & Francis; 2011. 4. Traditional and Alternative Medicine Act (TAMA) of 1997, Republic Act No. 8423, Approved: December 9, 1997. 5. World Health Organization. Report of the Working Group on Herbal Medicines Meeting, March 1997. 6. World Health Organization. WHO Traditional Medicine Strategy: 2014-2023. 7. Eusebio JE, Umali BE. Inventory, documentation and status of medicinal plants research in Philippines. In: Batugal PA, Kanniah J, Young LS, Oliver JT, editors. Medicinal plants research in Asia, Volume 1: The framework and project workplans. Selangor DE, Malaysia: International Plant Genetic Resource Institute-Regional office for Asia, the Pacific and Oceania (IPGRI-APO), Serdang; 2004. 8. Purificacion J, Maramba N. Research Proposal Phase 1 Clinical Trial: Safety and Efficacy of Lyophilized Momordica charantia (Ampalaya) leaf tablet among Normal Volunteer Subjects (2018 version). 9. From Herbal Folklore to Modern Medicine [Internet]. World Intellectual Property Organization. 2013 [cited 2020 Jan 14]. Available from https://www.wipo.int/ipadvantage/en/details.jsp?id=3661.


Author(s):  
Claudia Sarmento Gadelha ◽  
Vicente Maia Pinto Junior ◽  
Kevia Katiucia Santos Bezerra ◽  
Patricio Borges Maracajá ◽  
Débora S. S. Martins

<p>A utilização de plantas medicinais como medicina alternativa é uma pratica milenar, no entanto, a inserção de fitoterápicos é recente, porém, tem sido incentivado a sua prescrição pelo SUS.  A Organização Mundial de Saúde,  leva em consideração a cultura e a biodiversidade existentes no Brasil, tendo em vista a complexidade que envolve a fitoterapia, a Política Nacional de Planta Medicinal e Fitoterápico. Esta pesquisa teve como principal objetivo avaliar o uso de fitoterápicos e de plantas medicinais na saúde básica do município de Sousa-PB. Para isso foram aplicados formulários com pacientes/usuários e profissionais de saúde (Médicos e Enfermeiros), a respeito do uso, indicações, contra indicações dentre outros. A pesquisa foi realizada entre os meses de julho a outubro de 2014. Em relação ao faixa etária 90% dos entrevistados possuem idade entre 22 e 59 anos, com relação à renda dos usuários 40% dos mesmos possuem uma renda de menos de R$ 1.000,00, já à indicação do uso de plantas medicinais 96,7% dos usuários utilizam por indicação popular. Em relação as plantas mais usadas pelos pacientes foram citadas: Quebra pedra 58 citações, Hortelã 44, Aroeira 38, Babosa 32, Alecrim do nordeste 16 e unha de gato 10 citações, 58,4% dos usuários acham excelente a ideia de plantas medicinais e fitoterápicos do SUS disponível para a comunidade, 90% dos profissionais de saúde consideram inserção da fitoterapia no SUS e principalmente nas UFS como avanço para a terapia comunitária, 88% dos profissionais de saúde relataram que os conhecimentos que possuem não são suficientes para uma orientação e/ou prescrição adequada e plantas medicinais ou de fitoterápicos, em relação a freqüência e recomendações que os profissionais de saúde prescrevem fitoterápicos foram antidepressivo, calmante com uma freqüência de 0,35, seguidos de tosse, gripe e sistema respiratório com 0,31 e mal estar gástrico com 0,21. Entretanto, de acordo com os dados encontrados na pesquisa, sugerem-se mais incentivos por partes do poder público, além, de capacitação aos profissionais de saúde para que os mesmos se sintam preparados para prescrever fitoterápicos.</p><p class="Default" align="center"><strong><em>Use of herbal and medicinal plants in different segments of society</em></strong><em></em></p><p><strong>Abstract</strong>:  The use of medicinal plants as alternative medicine is an ancient practice, however, the inclusion of herbal medicines is recent, however, has been encouraged their prescription by SUS. The World Health Organization, takes into account the culture and the existing biodiversity in Brazil, in view of the complexity involved in herbal medicine, the National Policy on Medicinal Plant and Herbal. This research aimed to evaluate the use of herbal and medicinal plants in the basic health of the municipality of Sousa-PB. To this were applied forms with patients / users and health professionals (doctors and nurses), regarding the use, indications, contraindications among others. The survey was conducted between the months of July to October 2014. In relation to the age group 90% of respondents have aged between 22 and 59, in relation to income users 40% of them have an income of less than R $ 1,000 , 00, as the indication of the use of medicinal plants 96.7% of users use a popular statement. Regarding the plants most used by patients were cited: Breaking stone 58 quotes, Mint 44, Aroeira 38, 32 Aloe, Rosemary Northeast 16 and cat's claw 10 citations. 58.4% of users find the excellent idea of SUS medicinal plants and herbal medicines available to the community, 90% of health professionals consider insertion of herbal medicine in the SUS and especially in the UFS as an advance for the community therapy, 88% of professionals Health reported that the knowledge they have are not enough for an orientation and / or proper prescription and medicinal herbal plants or in relation to frequency and recommendations that herbal prescribing health professionals were antidepressant, soothing with a frequency of 0.35, followed by cough, flu and respiratory system with 0.31 and 0.21 with gastric discomfort. However, according to the data found in the search, it is suggest more incentives for parts of the government, in addition, training for health professionals so that they feel prepared to prescribe herbal medicines.</p>


2018 ◽  
Vol 18 ◽  
pp. 153473541881783 ◽  
Author(s):  
Yihong Liu ◽  
Brian H. May ◽  
Anthony Lin Zhang ◽  
Xinfeng Guo ◽  
Chuanjian Lu ◽  
...  

Objectives: To assess the clinical evidence for integrative herbal medicine therapy in the management of chemotherapy-induced peripheral neuropathy (CIPN) and hand-foot syndrome (HFS) resulting from treatments for colorectal cancer (CRC). Design: Randomized controlled trials (RCTs) were identified from major English and Chinese databases. Participants had been diagnosed with CRC by pathology and had received or were undergoing chemotherapy. Interventions included herbal medicines administered orally or topically. Controls were placebo, supportive care or conventional chemotherapy for CRC. Methods followed the Cochrane handbook. Meta-analyses were grouped by study design, outcome measure, severity, and chemotherapy. Random-effects models with 95% confidence intervals were used. Heterogeneity was assessed as I2. Results: Sixty-three RCTs (4286 participants) were included. Five used a placebo in the control groups. Fifty-eight studies tested oral herbal medicine, and 5 tested topical herbal medicine. Data were available for CIPN (60 studies) and HFS (12 studies). Fifty-seven studies combined orally administered herbal medicine with chemotherapy compared with the same chemotherapy. For CIPN, 33 studies used World Health Organization (WHO) criteria, 7 used Levi’s criteria, and 10 used the National Cancer Institute Common Terminology Criteria for Adverse Events (NCI-CTCAE). These were analyzed separately. For grades III + IV CIPN, there was a significant reduction in the integrative groups for WHO (relative risk [RR] 0.42 [0.23, 0.77], I2 = 0%) and Levi’s (RR 0.28 [0.11, 0.69], I2 = 0%) but not NCI-CTCAE (RR 0.65 [0.37, 1.13], I2 = 26.4%). Hand and foot baths showed no differences for Levi’s grades III + IV CIPN but a significant reduction in all grades (RR 0.69 [0.50, 0.95], I2 = 68.8%). For HFS (all grades) there was a significant reduction in the integrative groups for WHO (RR 0.62 [0.41, 0.96], I2 = 22%) but not for NCI-CTCAE (RR 0.93 [0.55, 1.55], I2 = 75.7%). Sensitivity analyses explored sources of heterogeneity. Conclusions: Integrative herbal therapy appeared to reduce CIPN and HFS in people receiving chemotherapy for CRC. However, the strength of the evidence was limited by lack of blinding in most studies, potential for bias, and relatively short study durations.


2016 ◽  
Vol 8 (2) ◽  
pp. 139 ◽  
Author(s):  
Sandra Celine ◽  
Shawn Tomy ◽  
Ujwala TK ◽  
Sam Johnson Udaya Chander

Diabetes mellitus represents a spectrum of metabolic disorder, which has become one of the major public health concerns worldwide. Diabetes mellitus has emerged as a third leading killer after cancer and cardiovascular/cerebrovascular diseases and India has a distinction of having largest number of diabetics in world second to China. Herbal medicine for treating chronic diseases, especially diabetes has gained an exponential growth in the last few years and both developing and developed countries are adopting herbal drugs for treatment of diabetes mellitus. The World Health Organization (WHO) has listed 21,000 plants, which are used for medicinal purposes around the world. The WHO has defined herbal medicines as finished labelled medicinal products that contain aerial or underground parts of the plants or other plant material or combination thereof as active ingredients, whether in crude state or as plant preparations. This review attempts to present the profiles of plants with hypoglycemic properties, reported in the literature with proper categorization according to the botanical name, family, parts used, chemical constituents, and its other uses. Relevant medical databases and websites were searched. To qualify for inclusion, the herbs should have confirmed hypoglycemic potential. Other criteria for inclusion are: published in English and peer-reviewed journals. We also used related keywords like diabetes mellitus, plant, herb, glycemic control, natural or herbal medicine, Ayurvedic plants, and hypoglycemic plants, as keywords or combination of them. A total of 151 herbs belonging to 72 families were outlined in this review.


2022 ◽  
Vol 20 (2) ◽  
pp. 377-382
Author(s):  
Tehseen Quds ◽  
Maryam Ahmed ◽  
Sadia Shakeel ◽  
Nusrat Jalbani ◽  
Farah Mazhar ◽  
...  

Purpose: To determine the heavy metal content of selected local and international herbal medicines sold for the treatment of various diseases in Pakistan. Methods: The different dosage forms of herbal medicines assessed were crude forms of syrups, gel, capsule, powder and tonic. Wet digestion method was used to prepare the herbal samples using nitric acid, and then analyzed for arsenic (As), cadmium (Cd), lead (Pb) and mercury (Hg), using MHS-15 mercury/hydride system and flame atomic absorption spectrometry (FAAS). Results: The investigated results displayed the Arsenic level (0.00 ppm to 0.580 ppm); Cadmium (0.001 ppm to 0.006 ppm); Lead (0.00 ppm to 1.078 ppm) and Mercury (0.001 ppm to 0.012 ppm). All results were found below the permissible limit of acceptability intake of the World Health Organization (WHO) and American Herbal Products Association (AHPA). The pH of the samples were in the range of 1.52 to 6.99. Conclusion: The findings reveal that the investigated herbal products available in Pakistan are safe with reference to heavy metals, and considered non-toxic for human consumption.


F1000Research ◽  
2020 ◽  
Vol 9 ◽  
pp. 111 ◽  
Author(s):  
Sunil Shrestha ◽  
Krisha Danekhu ◽  
Binaya Sapkota ◽  
Nisha Jha ◽  
Bhuvan KC

Traditional herbal medicine is widely used globally. Despite its extensive use, there are no proper regulations on standardization and use of herbal medicinal products. Nepal has a rich biodiversity and demography comprising of different socio-ethnic groups. Herbal medicines are utilized prominently in Nepalese communities. These herbal products may cause side effects and adverse effects, such as nephrotoxicity, neurotoxicity with the heavy metal toxicity associated with their powdered dosage forms. The side effects of using herbal products have been documented, such as bleeding with use of Ginkgo biloba and increase in blood pressure with use of Ephedra. Regulation of herbal products is essential to promote their optimal and rational use. Standard tools are available for assessing adverse effects of herbal products from health authorities, like the World Health Organization. In Nepal, self-medication practice using traditional herbal medicines is common and includes the concomitant use of allopathic. There is no focal point to address the regulatory issues on herbal products currently in Nepal. The Department of Drug Administration in Nepal is nominated as a national pharmacovigilance center and there are no reports on adverse events from the use of herbal medicines so far. However, not having any reports does not ensure the absolute safety and effectiveness of herbal products, so vigilance is warranted. Herbal pharmacovigilance is needed for Nepal to ensure safe and effective use of herbal medicines as the current pharmacovigilance ecosystem does not capture those cases. In the Nepalese context, the absence of reporting mechanisms may have underreported adverse cases of herbal products. The present opinion article aims to discuss the use of herbal products in Nepal, the challenges associated with the adverse reaction due to herbal medicines, and recommendations to overcome these challenges


Author(s):  
Mohammed Kadhom ◽  
Ahmed Nadhmi Al-Doori ◽  
Dina S. Ahmed ◽  
Emad Yousif

Background: The current outbreak of the serious respiratory syndrome disease COVID-19 has resulted from a novel coronavirus (SARS-CoV-2).  This infectious disease was classified as a pandemic by the World Health Organization (WHO) because it is threatening public health and life worldwide. Recently, restrictions in many countries are applied to detect the infected individuals and isolate them, in addition to attempts to find appropriate treatments that can help decrease the severe symptoms of the disease. Regardless of the conduced efforts, the number of reported cases of coronavirus infections is still growing up. Yet, no medication or vaccine was approved to prevent and/or treat people from this coronavirus, though many researches from academic groups and medication companies are still ongoing. Objective: This review aims to summarize the possible herbs and plants from the natural herbal medicine along with western medicine, which could assist treat or protect people from COVID-19. Understanding the infection rules, clarifying the pathogenic mechanisms, and detecting the appropriate medication treatment could improve the development of the essential treatment and prevention methods.  Conclusion: Since the finally-approved drug for this virus is still absent and a sharp increase in infection numbers is taking place, it became urgent to present possible alternatives, such as the Chinese herbal medicines, in a trail to cure SARS-CoV-2.


2019 ◽  
Vol 2 (4) ◽  
pp. 129-135
Author(s):  
Ezedike Edward ◽  
Chrisantus Kanayochukwu Ariche

There is increased use and popularity of herbal medicine in Nigeria in recent times. Scholars from different fields have attributed this recent upsurge to economic issues, high cost of modern medical care, loss of confidence in synthetic drugs, resistant of diseases to some modern drugs and easy accessibility of herbal medicines and its practitioners, amongst others. According to the World Health Organization (WHO), a large portion of the world’s population patronizes traditional herbal medicines. However, there is perceived neglect of the core principles of health care ethics by the practitioners and marketers of traditional herbal medicine in Nigeria. This is worrisome. In this connection, this paper argues that Nigerians will benefit immensely from traditional herbal medicine if its practitioners and marketers observe and respect these core principles of health care which includes the principles of beneficence, non-maleficence, autonomy, informed consent, justice, and truthfulness. This study is purely qualitative and adopts a textual critical analytic method.


Herbal medicinal plants are the starting material for herbal preparations such as herbal medicines, herbal oil, herbal teas etc. Recently, herbal alcoholic drinks are being added to the list. The present study was done to check the presence of lead, cadmium, nickel and copper in different herbal medicinal mixtures and herbal alcoholic drinks, sold in the local markets in Lagos, Nigeria. The mixtures were digested and subjected to analysis by Atomic Absorption Spectrophotometer (AAS). Results showed that lead ranged in the Herbal drinks and Mixtures from 0.00 mg/ml to 0.11 mg/ml, copper ranged from 0.00 mg/mi to 0.61mg/ml, chromium ranged from 0.00 mg/ml to 0.02 mg/ml, cadmium ranged from 0.00mg/ml to 0.01mg/ml and nickel ranged from 0.00 mg/ml to 0.02mg/ml. Some of these values are above the permissible levels for heavy metals intake by the World Health Organization. Consumption of these herbal mixtures could pose a serious health risk if consumed over a long period of time.


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