{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,22]],"date-time":"2026-09-22T20:45:31Z","timestamp":1790109931587,"version":"4.0.1"},"reference-count":114,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2018,1,29]],"date-time":"2018-01-29T00:00:00Z","timestamp":1517184000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Brit J Clinical Pharma"],"published-print":{"date-parts":[[2018,4]]},"abstract":"<jats:sec>\n                    <jats:label\/>\n                    <jats:p>The aim of this review was to assess the severity of adverse drug reactions (ADRs) due to herb\u2013drug interactions (HDI) in patients taking herbs and prescribed medications based on published evidence. Electronic databases of PubMed, the Cochrane Library, Medline and Scopus were searched for randomized or nonrandomized clinical studies, case\u2013control and case reports of HDI. The data were extracted and the causal relationship of ADRs as consequences of HDI assessed using Horn's drug interaction probability scale or Roussel Uclaf Causality Assessment Method scoring systems. The mechanism of interaction was ascertained using Stockley's herbal medicine interaction companion. Forty\u2010nine case reports and two observational studies with 15 cases of ADRs were recorded. The majority of the patients were diagnosed with cardiovascular diseases (30.60%), cancer (22.45%) and renal transplants (16.32%) receiving mostly warfarin, alkylating agents and cyclosporine, respectively. HDI occurred in patients resulting in clinical ADRs with different severity. Patients may poorly respond to therapeutic agents or develop toxicity due to severe HDI, which in either scenario may increase the cost of treatment and\/or lead to or prolong patient hospitalization. It is warranted to increase patient awareness of the potential interaction between herbs and prescribed medicines and their consequences to curb HDI as a potential health problem.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/bcp.13490","type":"journal-article","created":{"date-parts":[[2018,1,24]],"date-time":"2018-01-24T00:03:11Z","timestamp":1516752191000},"page":"679-693","source":"Crossref","is-referenced-by-count":127,"title":["Critical evaluation of causality assessment of herb\u2013drug interactions in patients"],"prefix":"10.1111","volume":"84","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-8135-7295","authenticated-orcid":false,"given":"Charles","family":"Awortwe","sequence":"first","affiliation":[{"name":"Biomedical Research and Innovation Platform South African Medical Research Council  Tygerberg 7505 South Africa"},{"name":"Division of Clinical Pharmacology, Faculty of Medicine and Health Sciences University of Stellenbosch  Tygerberg 7505 South 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