Skip to main content

Advertisement

SpringerLink
Log in

A pilot study to compare natural health product–drug interactions in two databases in Canada

  • Research Article
  • Published:
Pharmacy World & Science Aims and scope Submit manuscript

Abstract

Objective The aim of this article is to evaluate and compare two natural health product databases for the purpose of integrating them into a pharmacy information system in Canada. Methods This is a descriptive pilot study that compared the Natural Medicine Comprehensive Database® (NMCD) and Natural Standard® Database (NSD). We randomly chose five hospital patient files. For each drug prescription, we searched for and counted the number of potential natural health product–drug interactions in each database. Main outcome measure We compared all of the potential interactions between dexamethasone and the natural health products in both databases. We also evaluated the quality of a selection of references for 30 potential natural health product–dexamethasone interactions. Results Five pediatric patient files were selected for a total of 21 different common names. The number of potential natural health product–drug interactions identified varied from 12 (salbutamol-albuterol) to 129 (dexamethasone) in the NSD for an average of 63 ± 33. The number of potential natural health product–drug interactions identified varied from 1 (salbutamol-albuterol) to 96 (dexamethasone) in the NMCD for an average of 55 ± 27. There was no significant difference between the average number of potential natural health product–drug interactions between the databases (P = 0.40). The average number of common potential interactions was 9 ± 8. Thirty potential interactions of dexamethasone were compared. The number of abstracts per pair of interactions varied from 0 (Aloe-dexamethasone in the NSD) to 17 (dexamethasone-St. John’s wort in the NMCD). For the 10 pairs that were common to both databases, the number of abstracts given was 4.5 ± 4.7 for the NMCD and 3.1 ± 2.1 for the NSD (P = 0.41) and the average evaluation score was 4.6 ± 1.5 for the NMCD and 5.6 ± 1.2 for the NSD (P = 0.43). Conclusion This pilot study presents a comparison of potential natural health product–drug interactions from two different databases using two different scenarios in a hospital setting. The study reveals a high and variable number of pairs of natural health product–drug interactions per drug between the NSD and the NMCD. Further studies are necessary to evaluate the pertinence and hierarchy of the information offered by suppliers and natural health product databases.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2

Similar content being viewed by others

References

  1. Health Canada. Natural Health Products Regulations. [cited on 3 Apr 2009]. http://www.hc-sc.gc.ca/dhp-mps/prodnatur/index-eng.php (visited on 5 May 2009).

  2. Nestmann ER, Harwood M, Martyres S. An innovative model for regulating supplement products: natural health products in Canada. Toxicology. 2006;221:50–8.

    Article  CAS  PubMed  Google Scholar 

  3. Ohama H. Legal situation of supplements in the United States and European union. Yakugaku Zasshi. 2008;128:839–50.

    Article  CAS  PubMed  Google Scholar 

  4. Murty MP. ostmarket surveillance of natural health products in Canada: clinical and federal regulatory perspectives. Can J Physiol Pharmacol. 2007;85:952–5.

    Article  CAS  PubMed  Google Scholar 

  5. Laeeque H, Boon H, Kachan N, Cohen JC, D’Cruz J. The Canadian Natural Health Products (NHP) regulations: industry perceptions and compliance factors. BMC Health Serv Res. 2006;6:63.

    Article  PubMed  Google Scholar 

  6. Health Canada. Baseline Natural Health Products Survey among consumers—March 2005. [cited on 13 Sept 2005]. http://www.hc-sc.gc.ca/dhp-mps/pubs/natur/eng_cons_survey-eng.php (visited on 5 May 2009).

  7. Kelly JF, Kaufman DW, Kelley K, Rosenberg L, Anderson TE, Mitchell AA. Recent trends in use of herbal and other natural products. Arch Intern Med. 2005;165:281–6.

    Article  PubMed  Google Scholar 

  8. Ansani NT, Ciliberto NC, Freedy T. Hospital policies regarding herbal medicines. Am J Health-Syst Pharm. 2003;60:367–70.

    PubMed  Google Scholar 

  9. Brubaker ML. Setting up the herbal formulary system for an alternative medicine clinic. Am J Health-Syst Pharm. 1998;55:435–6.

    CAS  PubMed  Google Scholar 

  10. Cook TF, Frighetto L, Marra CA, Jewesson PJ. Patterns of use and patients’ attitudes toward complementary medications: a survey of adult general medicine patients at a major Canadian teaching hospital. Can J Clin Pharmacol. 2002;9:183–9.

    PubMed  Google Scholar 

  11. Bazzie KL, Witmer DR, Pinto B, Bush C, Clark J, Deffenbaugh J. National survey of dietary supplement policies in acute care facilities. Am J Health-Syst Pharm. 2006;63:65–70.

    Article  PubMed  Google Scholar 

  12. De Smet PA, Floor-Schreudering A, Bouvy ML, Wensing M. Clinical risk management of interactions between natural products and drugs. Curr Drug Metab. 2008;9:1055–62.

    Article  PubMed  Google Scholar 

  13. Skalli S, Zaid A, Soulaymani R. Drug interactions with herbal medicines. Ther Drug Monit. 2007;29:679–86.

    Article  CAS  PubMed  Google Scholar 

  14. Hu Z, Yang X, Ho PC, Chan SY, Heng PW, Chan E, et al. Herb–drug interactions: a literature review. Drugs. 2005;65:1239–82.

    Article  CAS  PubMed  Google Scholar 

  15. Joshi R, Medhi B. Natural product and drugs interactions, its clinical implication in drug therapy management. Saudi Med J. 2008;29:333–9.

    PubMed  Google Scholar 

  16. Bent SH. Herbal medicine in the United States: review of efficacy, safety, and regulation: grand rounds at University of California, San Francisco Medical Center. J Gen Intern Med. 2008;23:854–9.

    Article  PubMed  Google Scholar 

  17. Busse JW, Heaton G, Wu P, Wilson KR, Mills EJ. Disclosure of natural product use to primary care physicians: a cross-sectional survey of naturopathic clinic attendees. Mayo Clin Proc. 2005;80:616–23.

    Article  PubMed  Google Scholar 

  18. Bailey DG, Dresser GK. Natural products and adverse drug interactions. CMAJ. 2004;170:1531–2.

    PubMed  Google Scholar 

  19. Traynor K. Report urges scientific standards for alternative medicine. Am J Health-Syst Pharm. 2005;62:562–8.

    PubMed  Google Scholar 

  20. Kroll DJ. ASHP statement on the use of dietary supplements. Am J Health-Syst Pharm. 2004;61:1707–11.

    PubMed  Google Scholar 

  21. Goldman RD, Rogovik AL, Lai D, Vohra S. Potential interactions of drug–natural health products and natural health products–natural health products among children. J Pediatr. 2008;152:521–6. 526.

    Article  CAS  PubMed  Google Scholar 

  22. Singh SR, Levine MA. Potential interactions between pharmaceuticals and natural health products in Canada. J Clin Pharmacol. 2007;47:249–58.

    Article  CAS  PubMed  Google Scholar 

  23. Ulbricht C, Chao W, Costa D, Rusie-Seamon E, Weissner W, Woods J. Clinical evidence of herb–drug interactions: a systematic review by the natural standard research collaboration. Curr Drug Metab. 2008;9:1063–120.

    Article  CAS  PubMed  Google Scholar 

  24. Clauson KA, Polen HH, Peak AM, Marsh WA, DiScala SL. Clinical decision support tools: personal digital assistant versus online dietary supplement databases. Ann Pharmacother. 2008;42:1592–9.

    Article  PubMed  Google Scholar 

  25. Scott GN, Elmer GW. Update on natural product–drug interactions. Am J Health Syst Pharm. 2002;59:339–47.

    PubMed  Google Scholar 

  26. Brulotte J, Vohra S. Epidemiology of NHP-drug interactions: identification and evaluation. Curr Drug Metab. 2008;9:1049–54.

    Article  CAS  PubMed  Google Scholar 

  27. Charrois TL, Hill RL, Vu D, Foster BC, Boon HS, Cramer K, et al. Community identification of natural health product–drug interactions. Ann Pharmacother. 2007;41:1124–9.

    Article  PubMed  Google Scholar 

  28. Lebel D, Faubert G, Bussières JF. Intégration d’une base de données de produits de santé naturels à un progiciel pharmacie en établissement de santé. J Pharm Clin. 2009;28(2):103–7.

    Google Scholar 

Download references

Funding

None.

Conflicts of interest statement

None.

Author information

Authors and Affiliations

  1. Pharmacy Department, Pharmaceutical Practice Research Unit (PPRU), CHU Sainte-Justine, 3175, Chemin de la Côte-Ste-Catherine, Montreal, QC, H3T 1C5, Canada

    Guillaume Faubert, Denis Lebel & Jean-François Bussières

  2. Faculty of Pharmacy, Université de Montréal, Montreal, QC, Canada

    Jean-François Bussières

Authors
  1. Guillaume Faubert
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. Denis Lebel
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. Jean-François Bussières
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to Jean-François Bussières.

Rights and permissions

Reprints and permissions

About this article

Cite this article

Faubert, G., Lebel, D. & Bussières, JF. A pilot study to compare natural health product–drug interactions in two databases in Canada. Pharm World Sci 32, 179–186 (2010). https://doi.org/10.1007/s11096-010-9364-2

Download citation

  • Received:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s11096-010-9364-2

Keywords

Search

Navigation