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Thursday, 18 May 2017

Herbal Medicines: challenges in the modern world. Part 5. status and current directions of complementary and alternative herbal medicine worldwide.

2017 Mar;10(3):327-338. doi: 10.1080/17512433.2017.1268917. Epub 2016 Dec 15.


Enioutina EY1,2, Salis ER3, Job KM1, Gubarev MI4, Krepkova LV5, Sherwin CM1,6.

Author information

1
a Division of Clinical Pharmacology, the Department of Pediatrics , University of Utah School of Medicine , Salt Lake City , UT , USA.
2
b Division of Microbiology and Immunology, the Department of Pathology , University of Utah School of Medicine , Salt Lake City , UT , USA.
3
c New Zealand School of Pharmacy , University of Otago , Dunedin , New Zealand.
4
d Pentskiff Inc ., Salt Lake City , Utah , USA.
5
e Division of Toxicology, Center of Medicine , All-Russian Research Institute of Medicinal and Aromatic Plants (VILAR) , Moscow , Russia.
6
f Department of Pharmacology and Toxicology , University of Utah , Salt Lake City , UT , USA.

Abstract

INTRODUCTION:

Herbal medicine (HM) use is growing worldwide. Single herb preparations, ethnic and modern HM formulations are widely used as adjunct therapies or to improve consumer wellbeing. Areas covered: This final part in the publication series summarizes common tendencies in HM use as adjunct or alternative medicine, education of healthcare professionals and consumers, current and proposed guidelines regulating of production. We discuss potential HM-HM and HM-drug interactions that could lead to severe adverse events in situations where HMs are taken without proper medical professional oversight. Expert commentary: A number of serious problems have arisen with the steady global increase in HM use. HM interaction with conventional drugs (CD) may result in inadequate dosing of CD or adverse reactions; HM-HM interaction within herbal supplements could lead to toxicity of formulations. Inadequate education of clinicians and patients regarding medicinal properties of HMs must be addressed regionally and globally to ensure consumer safety.

KEYWORDS:

Herbal medicines; adjunct medicine; alternative antimicrobial herbal medicine; dietary supplements; herbal-herbal and herbal-drug interaction
PMID:
27923318
DOI:
10.1080/17512433.2017.1268917
[Indexed for MEDLINE] 

2016 Dec;9(12):1597-1609. Epub 2016 Oct 3.

Herbal medicines: challenges in the modern world. Part 4. Canada and United States.

Job KM1, Kiang TK2,3, Constance JE1,4, Sherwin CM1,4, Enioutina EY1,5.

Author information

1
a Division of Clinical Pharmacology, Department of Pediatrics , University of Utah School of Medicine , Salt Lake City , UT , USA.
2
b Faculty of Pharmaceutical Sciences , The University of British Columbia , Vancouver , Canada.
3
c Department of Pharmacy , Vancouver General Hospital , Vancouver , Canada.
4
d Department of Pharmacology and Toxicology , University of Utah , Salt Lake City , UT , USA.
5
e Division of Microbiology and Immunology, the Department of Pathology , University of Utah School of Medicine , Salt Lake City , UT , USA.

Abstract

INTRODUCTION:

Similar to other nations North American people used herbs for thousands of years to treat diseases and purify their spirits. By the middle of the 1900s, evidence-based conventional medicine received wide acceptance in Canada and the United States (US). Nowadays, people are going back to their roots and actively using herbal medicines (HMs) and natural health products (NHPs). Areas covered: This article is focusing on use and regulation of the HMs and NHPs in Canada and the US, raises concerns regarding HM and NHP safety and efficacy, offers suggestions on how to overcome these problems. Materials available from legislative and governmental websites, PubMed and news media were used. Expert commentary: Use of HMs, especially dietary supplements is widespread among adults in Canada and US. HMs and NHPs are regulated in both countries, but minimum criteria for product approval and post-market surveillance have been set. Concerns of quality, contamination, adulteration, and efficacy in are of central importance in the discussion of HMs and NHPs. Detailed product description and research are of vital importance to ensure safety and efficacy of these products. Additionally, 'herbal' education of healthcare providers and patients is needed to guarantee further successful integration of HM and conventional medicines.

KEYWORDS:

Canada; Herbal medicines; United States; dietary supplements; legislation; natural health products; regulations
PMID:
27644147
DOI:
10.1080/17512433.2016.1238762

2016 Sep;9(9):1225-33. doi: 10.1080/17512433.2016.1195263. Epub 2016 Jun 8.

Herbal medicines: challenges in the modern world. Part 3. China and Japan.

Teng L1, Zu Q2,3,4, Li G5, Yu T5, Job KM5, Yang X6, Di L2,3,4, Sherwin CM5,7, Enioutina EY5,8.

Abstract

INTRODUCTION:

Medicinal plants, and formulations prepared from them, have been used in China and Japan for thousands of years. Nowadays, ancient formulations of Traditional Chinese and Kampo (Japanese) Medicines coexist with Western herbal medicines (HMs) and complement each other. HMs are used for the treatment of mild and chronic diseases, as an adjunct therapy, to improve wellbeing and delay aging, or as healthy (functional) foods.

AREAS COVERED:

This article, a third part in a series of reviews, is focusing on history, use and regulation of the traditional and modern HMs in Japan and China. Materials available from legislative and governmental websites, PubMed and news media were used. Expert commentary: HMs are heavily regulated in both countries, often in a similar manner as conventional pharmaceutical drugs. The majority of herbal formulations are sold as over-the-counter medications supplied with leaflets describing indications and appropriate dosages for patients of different ages. Medical practitioners prescribe herbal formulations that are tailored to the needs of particular patients. Both countries had problems with adverse drug reactions and toxicity of single herbs and herbal formulations that have been investigated by authorities, and some drugs have been removed from the market.

KEYWORDS:

Kampo medicine; Yin and Yang balance; five elements; five flavors; four natures; herbal medicines; meridians; regulations; safety; traditional Chinese medicine
PMID:
27232545
DOI:
10.1080/17512433.2016.1195263

2016 Aug;9(8):1117-27. doi: 10.1080/17512433.2016.1189326. Epub 2016 May 27.

Herbal medicines: challenges in the modern world. Part 2. European Union and Russia.

Sammons HM1, Gubarev MI2, Krepkova LV3, Bortnikova VV3, Corrick F1, Job KM4, Sherwin CM4,5, Enioutina EY4,6.

Author information

1
a Division of Medical Sciences & Graduate Entry Medicine, School of Medicine , University of Nottingham, Royal Derby Hospital Centre , Derby , UK.
2
b Pentskiff Inc ., Salt Lake City , UT , USA.
3
c Division of Toxicology, Center of Medicine , All-Russian Research Institute of Medicinal and Aromatic Plants (VILAR) , Moscow , Russia.
4
d Division of Clinical Pharmacology, The Department of Pediatrics , University of Utah School of Medicine , Salt Lake City , UT , USA.
5
e Department of Pharmacology and Toxicology , University of Utah , Salt Lake City , UT , USA.
6
f Division of Microbiology and Immunology, the Department of Pathology , University of Utah School of Medicine , Salt Lake City , UT , USA.

Abstract

INTRODUCTION:

Herbal medicines (HMs) have been well known to people of the European Union (EU) and Russia for centuries. Currently, Western HMs can be classified into two categories, plant-derived conventional medicines and dietary supplements. Interest to HMs has grown rapidly in all countries during the past two decades.

AREAS COVERED:

The main goal of this review article is to present the history of HMs in the EU and Russia, forms of modern HMs, including Oriental Medicines that are popular among consumers of both countries. Additional discussion points comprise safety and adulteration issues associated with HMs, including regulatory changes and new legislative measures undertaken by the authorities. Materials available from legislative and governmental websites, PubMed and news media were used. Expert commentary: Due to cultural diversities in the EU and Russia, traditional HMs of other regions, particularly Chinese Traditional and Ayurvedic medicines, are also popular. Recently, dietary supplements containing multiple herbal and other natural products have flooded the EU and Russian markets. Pharmacovigilance in these markets is challenging in terms of establishing quality and safety of ingredients, determining efficacy, and defining risks of herb-herb and herb-drug interactions. Both the EU and Russia have introduced new legislation aimed to overcome these deficiencies.

KEYWORDS:

European Union; Herbal medicines; Russian Federation; legislations; regulations; traditional medicines

2016 Jul;9(7):905-15. doi: 10.1586/17512433.2016.1171712. Epub 2016 Apr 12.

Herbal medicines: challenges in the modern world. Part 1. Australia and New Zealand.

Barnes J1, McLachlan AJ2,3, Sherwin CM4,5, Enioutina EY4,6.

Abstract

As in many developed countries, herbal medicines (HMs) are widely used in Australia and New Zealand (NZ). The popularity of HM continues to rise. Western, Asian and indigenous HMs are used, reflecting the cultural diversity of people in this region. HMs in Australia are regulated on a risk-based system with many HMs identified as being low risk. The legislation was reviewed in 2015 and proposals for change are under consideration. In NZ, it is recognised that current regulations for HMs and other natural health products (NHPs) do not adequately protect public health. NZ is entering a phase of regulatory change for this sector, and proposals for a 'light-touch' regulatory framework for NHPs are planned to be introduced into legislation during 2016.

KEYWORDS:

Australia; Herbal medicines; New Zealand; legislation; natural health products; regulations; traditional medicines
PMID:
27070431
DOI:
10.1586/17512433.2016.1171712
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