A review of potential harmful interactions between anticoagulant/antiplatelet agents and Chinese herbal medicines.

<h4>Background</h4>The risks attributed to drug-herb interactions, even when known, are often ignored or underestimated, especially for those involving anti-clotting drugs and Chinese medicines. The aim of this study was to structurally search and evaluate the existing evidence-based dat...

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Autores principales:	Hsin-Hui Tsai, Hsiang-Wen Lin, Ying-Hung Lu, Yi-Ling Chen, Gail B Mahady
Formato:	article
Lenguaje:	EN
Publicado:	Public Library of Science (PLoS) 2013
Materias:	Medicine R Science Q
Acceso en línea:	https://doaj.org/article/3af44712560141a782c4e4868b745d92
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spelling	oai:doaj.org-article:3af44712560141a782c4e4868b745d922021-11-18T07:46:09ZA review of potential harmful interactions between anticoagulant/antiplatelet agents and Chinese herbal medicines.1932-620310.1371/journal.pone.0064255https://doaj.org/article/3af44712560141a782c4e4868b745d922013-01-01T00:00:00Zhttps://www.ncbi.nlm.nih.gov/pmc/articles/pmid/23671711/?tool=EBIhttps://doaj.org/toc/1932-6203<h4>Background</h4>The risks attributed to drug-herb interactions, even when known, are often ignored or underestimated, especially for those involving anti-clotting drugs and Chinese medicines. The aim of this study was to structurally search and evaluate the existing evidence-based data associated with potential drug interactions between anticoagulant/antiplatelet drugs and Chinese herbal medicines (CHMs) and evaluate the documented mechanisms, consequences, and/or severity of interactions.<h4>Methodology and findings</h4>Information related to anticoagulant/antiplatelet drug-CHM interactions was retrieved from eight interaction-based textbooks, four web resources and available primary biomedical literature. The primary literature searches were conducted in English and/or Chinese from January 2000 through December 2011 using the secondary databases (e.g., PubMed, Airiti Library, China Journal full-text database). The search terms included the corresponding medical subject headings and key words. Herbs or natural products not used as a single entity CHM or in Chinese Medicinal Prescriptions were excluded from further review. The corresponding mechanisms and severity ratings of interactions were retrieved using MicroMedex®, Lexicomp® and Natural Medicines Comprehensive Database®. Finally, we found 90 single entity CHMs contributed to 306 documented drug-CHM interactions. A total of 194 (63.4%) interactions were verified for its evidence describing possible mechanisms and severity. Of them, 155 interactions (79.9%) were attributable to pharmacodynamic interactions, and almost all were rated as moderate to severe interactions. The major consequences of these interactions were increased bleeding risks due to the additive anticoagulant or antiplatelet effects of the CHMs, specifically danshen, dong quai, ginger, ginkgo, licorice, and turmeric.<h4>Conclusions/significance</h4>Conventional anticoagulants and antiplatelet drugs were documented to have harmful interactions with some commonly used single entity CHMs. For those patients who are taking conventional anti-clotting medications with CHMs for cardiovascular or cerebrovascular diseases, the potential risks of increased bleeding due to drug-CHM interactions should not be ignored.Hsin-Hui TsaiHsiang-Wen LinYing-Hung LuYi-Ling ChenGail B MahadyPublic Library of Science (PLoS)articleMedicineRScienceQENPLoS ONE, Vol 8, Iss 5, p e64255 (2013)
institution	DOAJ
collection	DOAJ
language	EN
topic	Medicine R Science Q
spellingShingle	Medicine R Science Q Hsin-Hui Tsai Hsiang-Wen Lin Ying-Hung Lu Yi-Ling Chen Gail B Mahady A review of potential harmful interactions between anticoagulant/antiplatelet agents and Chinese herbal medicines.
description	<h4>Background</h4>The risks attributed to drug-herb interactions, even when known, are often ignored or underestimated, especially for those involving anti-clotting drugs and Chinese medicines. The aim of this study was to structurally search and evaluate the existing evidence-based data associated with potential drug interactions between anticoagulant/antiplatelet drugs and Chinese herbal medicines (CHMs) and evaluate the documented mechanisms, consequences, and/or severity of interactions.<h4>Methodology and findings</h4>Information related to anticoagulant/antiplatelet drug-CHM interactions was retrieved from eight interaction-based textbooks, four web resources and available primary biomedical literature. The primary literature searches were conducted in English and/or Chinese from January 2000 through December 2011 using the secondary databases (e.g., PubMed, Airiti Library, China Journal full-text database). The search terms included the corresponding medical subject headings and key words. Herbs or natural products not used as a single entity CHM or in Chinese Medicinal Prescriptions were excluded from further review. The corresponding mechanisms and severity ratings of interactions were retrieved using MicroMedex®, Lexicomp® and Natural Medicines Comprehensive Database®. Finally, we found 90 single entity CHMs contributed to 306 documented drug-CHM interactions. A total of 194 (63.4%) interactions were verified for its evidence describing possible mechanisms and severity. Of them, 155 interactions (79.9%) were attributable to pharmacodynamic interactions, and almost all were rated as moderate to severe interactions. The major consequences of these interactions were increased bleeding risks due to the additive anticoagulant or antiplatelet effects of the CHMs, specifically danshen, dong quai, ginger, ginkgo, licorice, and turmeric.<h4>Conclusions/significance</h4>Conventional anticoagulants and antiplatelet drugs were documented to have harmful interactions with some commonly used single entity CHMs. For those patients who are taking conventional anti-clotting medications with CHMs for cardiovascular or cerebrovascular diseases, the potential risks of increased bleeding due to drug-CHM interactions should not be ignored.
format	article
author	Hsin-Hui Tsai Hsiang-Wen Lin Ying-Hung Lu Yi-Ling Chen Gail B Mahady
author_facet	Hsin-Hui Tsai Hsiang-Wen Lin Ying-Hung Lu Yi-Ling Chen Gail B Mahady
author_sort	Hsin-Hui Tsai
title	A review of potential harmful interactions between anticoagulant/antiplatelet agents and Chinese herbal medicines.
title_short	A review of potential harmful interactions between anticoagulant/antiplatelet agents and Chinese herbal medicines.
title_full	A review of potential harmful interactions between anticoagulant/antiplatelet agents and Chinese herbal medicines.
title_fullStr	A review of potential harmful interactions between anticoagulant/antiplatelet agents and Chinese herbal medicines.
title_full_unstemmed	A review of potential harmful interactions between anticoagulant/antiplatelet agents and Chinese herbal medicines.
title_sort	review of potential harmful interactions between anticoagulant/antiplatelet agents and chinese herbal medicines.
publisher	Public Library of Science (PLoS)
publishDate	2013
url	https://doaj.org/article/3af44712560141a782c4e4868b745d92
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A review of potential harmful interactions between anticoagulant/antiplatelet agents and Chinese herbal medicines.

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