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Pregnancy, prescription medicines and the potential risk of herb-drug interactions: a cross-sectional survey.

McLay, James S.; Izzati, Naila; Pallivalapila, Abdul R.; Shetty, Ashalatha; Pande, Binita; Rore, Craig; Al Hail, Moza; Stewart, Derek C.

Authors

James S. McLay

Naila Izzati

Abdul R. Pallivalapila

Ashalatha Shetty

Binita Pande

Craig Rore

Moza Al Hail

Derek C. Stewart

Abstract

Background: - Pregnant women are routinely prescribed medicines while self-medicating with herbal natural products to treat predominantly pregnancy related conditions. The aim of this study was to assess the potential for herb-drug interactions (HDIs) in pregnant women and to explore possible herb-drug interactions and their potential clinical significance. Methods: - A cross-sectional survey of women during early pregnancy or immediately postpartum in North-East Scotland. Outcome measures included; Prescription medicines use excluding vitamins and potential HDIs assessed using Natural Medicines Comprehensive Database. Results: - The survey was completed by 889 respondents (73% response rate). 45.3% (403) reported the use of at least one prescription medicine, excluding vitamins. Of those taking prescription medicines, 44.9% (181) also reported concurrent use of at least one HNP (Range 1-12). A total of 91 different prescription medicines were reported by respondents using HNPs. Of those taking prescription medicines, 44.9% (181) also reported concurrent use of at least one HNP (Range 1-12). Thirty-four herb-drug interactions were identified in 23 (12.7%) women with the potential to increase the risk of postpartum haemorrhage, alter maternal haemodynamics, and enhance maternal/fetal CNS depression. Almost all were rated as moderate (93.9%), one as a potentially major (ginger and nifedipine) and only one minor (ondansetron and chamomile). Conclusion: - Almost half of pregnant women in this study were prescribed medicines excluding vitamins and minerals and almost half of these used HNPs. Potential moderate to severe HDIs were identified in an eighth of the study cohort. Healthcare professionals should be aware that the concurrent use of HNPs and prescription medicines during pregnancy is common and carries potential risks.

Journal Article Type Article
Publication Date Dec 19, 2017
Journal BMC complementary and alternative medicine
Electronic ISSN 1472-6882
Publisher Springer (part of Springer Nature)
Peer Reviewed Peer Reviewed
Volume 17
Article Number 543
Institution Citation MCLAY, J.S., IZZATI, N., PALLIVALAPILA, A.R., SHETTY, A., PANDE, B., RORE, C., AL HAIL, M. and STEWART, D. 2017. Pregnancy, prescription medicines and the potential risk of herb-drug interactions: a cross-sectional survey. BMC complementary and alternative medicine [online], 17, article ID 543. Available from: https://doi.org/10.1186/s12906-017-2052-1
DOI https://doi.org/10.1186/s12906-017-2052-1
Keywords Herbal; Botanical; Pregnancy; Herb drug interaction; Antenatal; Postnatal; Female; Surveys and questionnaires

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