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Doody's Review ServiceReviewer: Stata Norton, PhD (University of Kansas Medical Center)
Description: The increasing use of herbal remedies has created a need to evaluate interactions between herbal remedies and standard drugs taken concomitantly. The book offers an overview of the pharmacokinetic and pharmacodynamic mechanisms involved in interactions between botanical products and drugs in which the effectiveness and safety of the drug may be altered. The importance of regulatory aspects of reporting of interactions with botanical products and drugs is reviewed.
Purpose: The focus of this book is to provide an improved understanding of the scientific issues involved in interactions of botanicals and drugs and to assist in further development of botanical products. The intent of the book is important, given the growing use of herbal products. The dual purpose of the book is met by inclusion of chapters written by experts in research and development of botanical products and their interactions with drugs and by experts at the appropriate regulatory offices of the Food and Drug Administration.
Audience: The audience, based on the limited focus of the book, is primarily specialists involved in development of botanical products used as remedies or dietary supplements. Several of the chapters contain reviews of mechanisms of specific botanical-drug interactions and reviews of published research on pharmacokinetics and pharmacodynamics of botanicals, such as St. John's Wort, garlic, ginkgo and ginseng, of interest to clinicians dealing with patients taking both herbals and drugs. The nonspecialist interested in herbals would find the book too technical.
Features: The two issues covered by the book, herbal-drug interactions and regulatory issues of herbals as dietary supplements, are authored by different experts on the results of research on selected botanicals. Clinical experience with patients consuming both herbals and drugs is reviewed as well as research documenting the cause of either increased or decreased effects of the drugs. In addition to specific herbals, grapefruit-drug interactions are included. Discussions by experts at the Food and Drug Administration on the regulatory issues posed by development of botanical products are well documented.
Assessment: This book addresses an area of importance to many individuals. However, the language is technical and the audience will of necessity have to be versed in the scientific aspects. The portions on the current status of determining the mechanisms involved in recognized herbal-drug interactions are well done. The chapters on development of botanical products as drugs and the uses of those botanical remedies available since the Dietary Supplement and Education Act of 1994 are informative concerning the regulatory aspects of botanicals.