Risk of Concurrent Use of Prescription Drugs with Herbal and Dietary Supplements in Ambulatory Care

Excerpt

Introduction: Little is known about the prevalence of herbal and dietary supplement (HDS) use among ambulatory patients who use prescription medications or about the risk of adverse drug events (ADEs) related to drug-HDS interactions. Methods: We conducted a secondary analysis of a study of patients who received prescription medications at four primary care practices. We used chart reviews and patient interviews to identify potential drug-HDS interactions, and we used MICROMEDEX to classify interactions. Results: A total of 101 of 657 patients (15.4 percent) reported using HDS, including echinacea (21.8 percent), ginkgo biloba (13.9 percent), glucosamine (13.9 percent), omega-3 fatty acids (12.9 percent), garlic (7.9 percent), St. John’s wort (6.9 percent), and ginseng (6.9 percent). Although we found no increased rate of ADEs among HDS users compared to nonusers, 14 percent of users had potentially dangerous interactions with their prescription drugs. Conclusion: HDS use is common in adult ambulatory care. The risk of interactions between these agents and prescription medications is worrisome.