Adverse drug reactions in some African herbal medicine: literature review and stakeholders’ interview

Background In view of the large consumption of herbal medicine in Africa countries, it is likely that many adverse drugs reactions go unrecorded with either patients failing to present to health services, or no pharmacovigilance analysis being made, or the analysis not being reported centrally. This problem is of interest especially for those who are working in the general area of adverse drug reactions or stakeholders in the domain of herbal medicine for considering safety issues. Methods We are particularly interested in the way that the use of very well-known and highly valued plants is linked to the observation of adverse drug reactions in African countries. We investigated, through a literature review and using the Internet (with a semantic search strategy), some well-known or popular medicinal plants used in African herbal medicine (AHM). Other information on the properties related to use, and characteristics of medicinal plants was complemented by some interviews with stakeholders. Results Although substantial progress has been made in elucidating the mechanisms of action of many drugs, the pharmacological actions of many medicinal plants are generally not well understood. The results of a literature review suggest that the reported adverse drug reactions of herbal remedies are often due to a lack of understanding of their preparation and appropriate use. The results of stakeholders’ interviews suggest that there is a growing need to provide patients with correct information about the herbal medicines they consume. Conclusion An important aspect of herbal medicine is the correct, timely, and integrated communication of emerging data on risk as an essential part of pharmacovigilance, which could actually improve the health and safety of patients. This calls for improved collaboration between traditional practitioners and modern healthcare professionals, researchers, and drug regulatory authorities. In addition, there is a need for an adverse drug reaction reporting system to facilitate the collection, monitoring, and evaluation of adverse drug events.

[1]  R. Marles,et al.  Assessment of herbal medicinal products: challenges, and opportunities to increase the knowledge base for safety assessment. , 2010, Toxicology and applied pharmacology.

[2]  O. Awodele,et al.  Doctors’ attitudes towards the use of herbal medicine in Lagos, Nigeria , 2012 .

[3]  A. Viljoen,et al.  'Buchu' -Agathosma betulina and Agathosma crenulata (Rutaceae): a review. , 2008, Journal of ethnopharmacology.

[4]  L. Seeff,et al.  Chapter 27 – Hepatotoxicity of Herbal Preparations , 2006 .

[5]  K. Woodward,et al.  The potential impact of the use of homeopathic and herbal remedies on monitoring the safety of prescription products , 2005, Human & experimental toxicology.

[6]  S. Asia,et al.  WORLD HEALTH ORGANIZATION REGIONAL OFFICE FOR , 2003 .

[7]  R. Teschke,et al.  Herbalife hepatotoxicity: Evaluation of cases with positive reexposure tests. , 2013, World journal of hepatology.

[8]  V. Kuete,et al.  Medicinal Plants Market and Industry in Africa , 2013 .

[9]  R. Teschke,et al.  Herbal hepatotoxicity: a tabular compilation of reported cases , 2012, Liver international : official journal of the International Association for the Study of the Liver.

[10]  C. Bunchorntavakul,et al.  Review article: herbal and dietary supplement hepatotoxicity , 2013, Alimentary pharmacology & therapeutics.

[11]  B. Ncube,et al.  Toxicology of some important medicinal plants in southern Africa. , 2013, Food and chemical toxicology : an international journal published for the British Industrial Biological Research Association.

[12]  Hongcai Shang,et al.  Quality of herbal medicines: challenges and solutions. , 2012, Complementary Therapies in Medicine.

[13]  R. Teschke,et al.  Herbal hepatotoxicity: a critical review. , 2013, British journal of clinical pharmacology.

[14]  R. Teschke,et al.  Drug and herb induced liver injury: Council for International Organizations of Medical Sciences scale for causality assessment. , 2014, World journal of hepatology.

[15]  C. Stephens,et al.  Causality assessment methods in drug induced liver injury: strengths and weaknesses. , 2011, Journal of hepatology.

[16]  S. Qiu,et al.  Kava and Kava Hepatotoxicity: Requirements for Novel Experimental, Ethnobotanical and Clinical Studies Based on a Review of the Evidence , 2011, Phytotherapy research : PTR.

[17]  V. Luyckx Nephrotoxicity of alternative medicine practice. , 2012, Advances in chronic kidney disease.

[18]  J. Groenewald,et al.  Plant-made therapeutics: an emerging platform in South Africa. , 2012, Biotechnology advances.

[19]  B. De,et al.  Challenges and opportunities in the advancement of herbal medicine: India’s position and role in a global context , 2011 .

[20]  R. Teschke,et al.  Kava hepatotoxicity in traditional and modern use: the presumed Pacific kava paradox hypothesis revisited. , 2012, British journal of clinical pharmacology.

[21]  D. Talbot,et al.  Critical evaluation of vinflunine in the treatment of refractory metastatic urothelial carcinoma , 2010 .

[22]  R. Teschke,et al.  Severe hepatotoxicity by Indian Ayurvedic herbal products: a structured causality assessment. , 2009, Annals of hepatology.

[23]  M. Manns,et al.  Zakim and Boyer's hepatology , 2012 .

[24]  M. D. de Broe,et al.  Kidney injury from alternative medicines. , 2005, Advances in chronic kidney disease.

[25]  I. Edwards,et al.  Adverse drug reactions: definitions, diagnosis, and management , 2000, The Lancet.

[26]  R. Teschke,et al.  Kava hepatotoxicity: a clinical survey and critical analysis of 26 suspected cases , 2008, European journal of gastroenterology & hepatology.

[27]  A. Al‐Motarreb,et al.  Khat chewing, cardiovascular diseases and other internal medical problems: the current situation and directions for future research. , 2010, Journal of ethnopharmacology.

[28]  Bernard Kamsu-Foguem,et al.  Conceptual graph-based knowledge representation for supporting reasoning in African traditional medicine , 2013, Eng. Appl. Artif. Intell..

[29]  Li Zhang,et al.  Pharmacovigilance practice and risk control of Traditional Chinese Medicine drugs in China: current status and future perspective. , 2012, Journal of ethnopharmacology.

[30]  G. Deray,et al.  Herbs and the kidney. , 2004, American journal of kidney diseases : the official journal of the National Kidney Foundation.

[31]  G. Danan,et al.  Causality assessment of adverse reactions to drugs--I. A novel method based on the conclusions of international consensus meetings: application to drug-induced liver injuries. , 1993, Journal of clinical epidemiology.

[32]  Jianpin Liu,et al.  Evidence-based toxicity evaluation and scheduling of Chinese herbal medicines. , 2013, Journal of ethnopharmacology.

[33]  V. Colizzi,et al.  Traditional medicine: past, present and future research and development prospects and integration in the National Health System of Cameroon. , 2011, African journal of traditional, complementary, and alternative medicines : AJTCAM.

[34]  S. Shetti,et al.  Pharmacovigilance of herbal medicines: Current state and future directions , 2011, Pharmacognosy magazine.

[35]  S. Thomson,et al.  The toxicity of Callilepis laureola, a South African traditional herbal medicine. , 2001, Clinical biochemistry.

[36]  T. Brendler,et al.  A historical, scientific and commercial perspective on the medicinal use of Pelargonium sidoides (Geraniaceae). , 2008, Journal of ethnopharmacology.

[37]  O. Awodele,et al.  Towards integrating traditional medicine (TM) into National Health Care Scheme (NHCS): Assessment of TM practitioners’ disposition in Lagos, Nigeria , 2011 .

[38]  S. Singh,et al.  Metabolic effect of short term administration of Hoodia gordonii, an herbal appetite suppressant , 2013 .

[39]  V. Kuete Medicinal plant research in Africa : pharmacology and chemistry , 2013 .

[40]  R. Teschke,et al.  Clinical and causality assessment in herbal hepatotoxicity , 2013, Expert opinion on drug safety.

[41]  Myeong Soo Lee,et al.  Dietary supplements for benign prostatic hyperplasia: an overview of systematic reviews. , 2012, Maturitas.

[42]  V. Navarro,et al.  Herbs and liver injury: a clinical perspective. , 2014, Clinical gastroenterology and hepatology : the official clinical practice journal of the American Gastroenterological Association.

[43]  A. Gillespie Conservation, biodiversity and international law , 2012 .