Related Experiment Video
Updated: Jul 19, 2026

Preparation of Herbal Medicine: Er-Xian Decoction and Er-Xian-containing Serum for In Vivo and In Vitro Experiments
Published on: May 31, 2017
[The risks of combining medicine and herbal remedies]
L H Goldstein1, M Elias, M Berkovitch
1Clinical Pharmacology and Toxicology Unit, Assaf Harofeh Medical Center affiliated to the Sackler Faculty of Medicine, Tel Aviv, Zerifin, Israel. leeg@asaf.health.gov.il
Abstract:
The risks of using herbal remedies, considered 'natural', should not be disregarded, as some have serious side effects and some interact with and influence conventional medical therapeutics. The effect may be pharmacokinetic by altering absorption or metabolism, and may be pharmacodynamic, by changing the final effect of the drug. St. John's wort, for example, an antidepressant herbal remedy, may pharmacodynamically interact with specific serotonin reuptake inhibitors (SSRI's), causing a serotonin syndrome. St. Johns wort also causes serious pharmacokinetic interactions by activating the cytochrome CYP3A4, dangerously decreasing blood levels of cyclosporin, warfarin, and theophylline, and reducing the efficacy of contraceptive pills and AIDS therapy. The article presents a review of a number of herbal remedies, commonly used in Israel, that have documented drug interactions, providing details of common indications, adverse reactions and drug interactions of each herbal remedy. Physicians should recognize the fact that patients use herbal remedies, purchased directly at pharmacies or health stores, and be aware of the potential interactions of these remedies with conventional drugs.
Related Concept Videos
Drug toxicity: Drug–Drug Interaction
Combined Effects of Drugs: Synergism
Such synergistic combinations...
Drug Toxicity: Risk factors
Pharmacokinetics: Drug–Drug Interactions
Pharmacokinetics: Drug–Food and Drug–Viral Interactions
Pharmaceutical Poisoning: Potential Scenarios