Herbal Product–Drug Interactions from a Pharmacological Perspective



Herbal products and their constituents can not only have medicinal benefits, but they have the potential to interfere with the therapeutic activity of anticancer agents and exacerbate side effects. This potential is difficult to determine given the uncertainty of the chemical complexity of herbal formulations, many of which contain multiple compounds with largely unknown safety and biological functions. Preclinical studies on some herbal extracts and their bioactive constituents pinpoint different levels of interaction with biochemical pathways, including the modulation of drug transporters, metabolizing enzymes, and signaling molecules, some of which are the major targets for anticancer drugs. Yet, a compilation of the literature reveals that information on molecular interactions between herbs and anticancer drugs is vastly underreported, and the few published studies are limited to a small number of herbal products.

Similarly, limited, controlled clinical studies have been undertaken, often limited to small pilot studies or scarce clinical case reports and with discrepant results. This is further exasperated by an absence of adequate global standardization of herbal product formulations, labeling, and surveillance mechanisms for monitoring and reporting herb–drug interactions and adverse effects. The wide usage of herbal products by patients remains a double-edged approach that can possibly hamper or be exploited to develop alternative synergistic modalities for successful management of cancer. In this chapter, we provide a comprehensive updated review of established and potential interactions between the most commonly used herbal products and anticancer drugs. Where possible, the clinical impact, practical recommendations, and major source of information for health care providers are highlighted. Finally, future perspectives into exploiting pharmacological interactions for discovery of herbal constituents that may synergize with anticancer drugs are discussed.


Benign Prostatic Hyperplasia Chronic Fatigue Syndrome Grapefruit Juice Herbal Product Aristolochic Acid 


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© Springer Science+Business Media, LLC 2010

Authors and Affiliations

  1. 1.Departments of Experimental Medicine, Oncology, and Pharmacology, Therapeutics Faculty of Medicine, Segal Cancer Center, Lady Davis Institute for Medical ResearchSir Mortimer B. Davis Jewish General Hospital, McGill UniversityMontrealCanada

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