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Interacciones entre hierbas y medicamentos
1George Washington University School of Medicine and Health Sciences, Department of Health Care Sciences, Washington, DC 20037, USA. fughberman@aol.com
Lancet (London, England)
|February 16, 2000
Resumen
El uso simultáneo de remedios a base de hierbas y productos farmacéuticos puede conducir a interacciones peligrosas. Los proveedores de atención médica deben aconsejar a los pacientes que eviten mezclar hierbas y medicamentos debido a los posibles efectos adversos.
Área de la Ciencia:
- Farmacología Farmacología.
- La Medicina Integral es una medicina integrada.
- La medicina a base de hierbas es una medicina herbal.
Sus antecedentes:
- El uso simultáneo de productos a base de hierbas y medicamentos farmacéuticos es común.
- Los remedios a base de hierbas pueden interactuar con los medicamentos, alterando su eficacia y seguridad.
- La comprensión de estas interacciones entre hierbas y medicamentos es crucial para la atención al paciente.
Objetivo del estudio:
- Revisar y resumir casos documentados de interacciones entre hierbas y medicamentos.
- Para resaltar los posibles efectos adversos derivados de la combinación de hierbas y productos farmacéuticos.
- Para enfatizar la importancia de la conciencia clínica y el asesoramiento del paciente con respecto al uso de drogas a base de hierbas.
Principales métodos:
- Revisión de la literatura de las interacciones reportadas entre hierbas y medicamentos.
- Identificación de hierbas específicas y sus agentes farmacéuticos que interactúan.
- Categoría de las interacciones basadas en los resultados clínicos (por ejemplo, sangrado, síndrome de serotonina, biodisponibilidad alterada).
Principales resultados:
- El uso simultáneo de warfarina con ginkgo, ajo, dong quai o danshen puede aumentar el riesgo de sangrado.
- La hierba de San Juan puede causar síndrome de serotonina leve con ISRS y disminuir la biodisponibilidad de digoxina, teofilina, ciclosporina y fenprocoumón.
- El Panax ginseng puede inducir manía en pacientes que toman antidepresivos; la nuez betel puede exacerbar los efectos extrapiramidales con los neurolepticos.
- La yohimbina puede aumentar el riesgo de hipertensión con los antidepresivos tricíclicos; el regaliz potencia los corticosteroides.
- Ciertas preparaciones chinas y ayurvédicas pueden disminuir las concentraciones sanguíneas de medicamentos específicos.
Conclusiones:
- Las interacciones entre hierbas y fármacos presentan riesgos significativos, que van desde la eficacia alterada del fármaco hasta los eventos adversos graves.
- Muchas de las interacciones reportadas carecen de un análisis detallado, lo que requiere una interpretación cautelosa.
- Los profesionales de la salud deben aconsejar proactivamente a los pacientes sobre los peligros potenciales de combinar productos a base de hierbas con medicamentos recetados o de venta libre.
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