Pregnancy, prescription medicines and the potential risk of herb-drug interactions

a cross-sectional survey

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

Research output: Contribution to journalArticle

7 Citations (Scopus)
6 Downloads (Pure)

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.

Original languageEnglish
Article number543
Pages (from-to)1-7
Number of pages7
JournalBMC Complementary and Alternative Medicine
Volume17
DOIs
Publication statusPublished - 19 Dec 2017

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Herb-Drug Interactions
Prescriptions
Cross-Sectional Studies
Pregnancy
Vitamins
Pregnant Women
Chamomile
Mothers
Ginger
Postpartum Hemorrhage
Ondansetron
Scotland
Nifedipine
Biological Products
Postpartum Period
Minerals
Cohort Studies
Hemodynamics
Outcome Assessment (Health Care)
Databases

Keywords

  • Herbal
  • Botanical
  • Pregnancy
  • Herb-drug interaction
  • Antenatal
  • Postnatal
  • Female
  • Surveys and questionnaires

Cite this

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.

In: BMC Complementary and Alternative Medicine, Vol. 17, 543, 19.12.2017, p. 1-7.

Research output: Contribution to journalArticle

McLay, James S ; Izzati, Naila ; Pallivalapila, Abdul R ; Shetty, Ashalatha ; Pande, Binita ; Rore, Craig ; Al Hail, Moza ; Stewart, Derek. / Pregnancy, prescription medicines and the potential risk of herb-drug interactions : a cross-sectional survey. In: BMC Complementary and Alternative Medicine. 2017 ; Vol. 17. pp. 1-7.
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note = "Funding All funding was from institutional resource. JSM, AS are employed by the University of Aberdeen. DS is employed by the Robert Gordon University. BP and CR are employed by NHS Scotland. ARP and MAH are employed by the Hamad Medical Corporation. Qatar. NI is a postgraduate student at the University of Aberdeen.",
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T1 - Pregnancy, prescription medicines and the potential risk of herb-drug interactions

T2 - a cross-sectional survey

AU - McLay, James S

AU - Izzati, Naila

AU - Pallivalapila, Abdul R

AU - Shetty, Ashalatha

AU - Pande, Binita

AU - Rore, Craig

AU - Al Hail, Moza

AU - Stewart, Derek

N1 - Funding All funding was from institutional resource. JSM, AS are employed by the University of Aberdeen. DS is employed by the Robert Gordon University. BP and CR are employed by NHS Scotland. ARP and MAH are employed by the Hamad Medical Corporation. Qatar. NI is a postgraduate student at the University of Aberdeen.

PY - 2017/12/19

Y1 - 2017/12/19

N2 - 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.

AB - 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.

KW - Herbal

KW - Botanical

KW - Pregnancy

KW - Herb-drug interaction

KW - Antenatal

KW - Postnatal

KW - Female

KW - Surveys and questionnaires

U2 - 10.1186/s12906-017-2052-1

DO - 10.1186/s12906-017-2052-1

M3 - Article

VL - 17

SP - 1

EP - 7

JO - BMC Complementary and Alternative Medicine

JF - BMC Complementary and Alternative Medicine

SN - 1472-6882

M1 - 543

ER -