Herbal medicines, widely used for primary healthcare globally, are complex mixtures of bioactive compounds (e.g., flavonoids, alkaloids, terpenoids) rather than single chemical entities,. While often perceived as inherently safe, these products can induce significant adverse effects and interact with conventional pharmaceuticals through pharmacokinetic and pharmacodynamic mechanisms,.

Mechanisms of Interaction

• Pharmacokinetic: Herbs can alter the absorption, distribution, metabolism, and excretion (ADME) of drugs. A primary mechanism involves the modulation of Cytochrome P450 (CYP) enzymes and transporters like P-glycoprotein. For example, St. John's Wort is a potent inducer of CYP3A4, which accelerates the metabolism of drugs like cyclosporine and oral contraceptives, potentially leading to treatment failure,. Conversely, grapefrui ...