Mohammadi Soroush, Asghari Gholamreza, Emami-Naini Afsoon, Mansourian Marjan, Badri Shirinsadat
Pharmacy Students' Research Committee, Isfahan University of Medical Sciences, Isfahan, Iran.
Department of Pharmacognosy, Isfahan University of Medical Sciences, Isfahan, Iran.
J Res Pharm Pract. 2020 Jun 26;9(2):61-67. doi: 10.4103/jrpp.JRPP_20_30. eCollection 2020 Apr-Jun.
The prevalence of herb-drug interactions and herb's adverse effects may be serious in susceptible population such as patients with chronic kidney disease (CKD). In this study, we planned to determine the usage prevalence of herbal products and herb-drug interactions in CKD patients.
A cross-sectional prospective study was conducted on CKD and posttransplant patients with a history of using herbal supplements in Isfahan, Iran. The patients were subjected to a validated checklist, containing demographic and clinical information. The knowledge of herbal use, side effects, and herb-drug interactions was assessed based on patients' responses. Data were reported as prevalence (percent) of the occurrence.
The prevalence of herbal supplement usage among CKD patients was 18.6% in this study. The study included 400 patients (261 males and 139 females). The majority of the study population were in the age range of 50-70 years (61.5%). Hypertension (34.36%) was the most common cause of kidney failure, while diabetes mellitus (21.80%) took the second place. The most frequently used unformulated medicinal herb was () (15.27%), and the most commonly used formulated herbal products were anticough and mucolytic based on (24.27%). Eighteen patients (4.5%) used herbal mix with unknown entity and sources. In this study, ginseng has the most possible interactions with prescription drugs (18 interactions), while this interaction (with clopidogrel, warfarin, and heparin) was severe in six cases.
The present study provided the information on possible herb-drug interactions in CKD patients on herbal usage. Since the issue of using herbal products may be arbitrarily in the majority of the patients, and considering the importance of adverse reactions or major interactions, health-care providers should play an active role to identify these cases and inform the patients regarding herbal product safety, adverse effects, and possible interactions.
草药 - 药物相互作用的发生率以及草药的不良反应在慢性肾病（CKD）患者等易感人群中可能较为严重。在本研究中，我们计划确定CKD患者中草药产品的使用发生率以及草药 - 药物相互作用情况。
在伊朗伊斯法罕对有使用草药补充剂史的CKD患者及肾移植后患者进行了一项横断面前瞻性研究。患者接受一份经过验证的包含人口统计学和临床信息的清单。根据患者的回答评估其对草药使用、副作用及草药 - 药物相互作用的了解情况。数据以发生率（百分比）报告。
本研究中CKD患者使用草药补充剂的发生率为18.6%。该研究纳入了400名患者（261名男性和139名女性）。研究人群的大多数年龄在50 - 70岁之间（61.5%）。高血压（34.36%）是肾衰竭最常见的原因，而糖尿病（21.80%）位居第二。最常使用的未配方草药是（此处原文缺失草药名称）（15.27%），最常用的配方草药产品是以（此处原文缺失相关草药）为基础的止咳和祛痰药（24.27%）。18名患者（4.5%）使用了成分和来源不明的草药混合物。在本研究中，人参与处方药的相互作用可能性最大（18种相互作用），而其中与氯吡格雷、华法林和肝素的相互作用在6例中较为严重。
本研究提供了CKD患者使用草药时可能存在的草药 - 药物相互作用的信息。由于大多数患者使用草药产品的问题可能比较随意，且考虑到不良反应或重大相互作用问题的重要性，医疗保健提供者应积极发挥作用来识别这些情况，并告知患者有关草药产品的安全性、不良反应及可能的相互作用。
