Drug interactions between plant-based natural products and medicines used by elderly in the city of Diadema, Brazil
DOI:
https://doi.org/10.70151/j20z4t21Keywords:
elderly, medicinal plants, ethnopharmacovigilance, drug interactionsAbstract
Elderly people often combine the use of synthetic drugs with plant-based natural products (PBNP) to treat diseases, especially chronic ones. However, the association of both can cause adverse drug events, which are generally undesirable and harmful to health, and ethnopharmacovigilance studies aimed at this group are important. In view of the above, the objective was to investigate possible drug interactions (DI) between PBNPs and synthetic drugs, according to reports by elderly people, supported by data from the scientific literature. To this end, meetings were held at the Centro de Convivência Municipal da Melhor Idade in Diadema-SP, involving 30 elderly people, using focus groups, semi-structured interviews and field diaries. Seven reports of possible DIs were obtained by the interviewees, involving seven PBNPs, of which four (chamomile, boldo-de-Chile, clove, hibiscus) were supported by the scientific literature, indicating possible DI with antihypertensive, antidiabetic and anticholesterolemic drugs. For three of the DIs, the events were unwanted, while for one of them it was considered positive by the user, in the case of hibiscus as an adjunct in the treatment of arterial hypertension. It is concluded that the data presented should support the investigation of other reports from elderly people, expanding our limited knowledge about DIs between PBNPs and synthetic drugs, in general, considered safe by the population.
Downloads
References
Ajao AA, Moteetee AN (2017) Tithonia diversifolia (Hemsl) A. Gray. (Asteraceae: Heliantheae), an invasive plant of significant ethnopharmacological importance: A review. S Afr J Bot 113:396-403. https://doi.org/10.1016/j.sajb.2017.09.017
Anvisa – Brazilian Health Regulatory Agency (2014) Resolução - RDC Nº 26 de 13 de maio de 2014. Dispõe sobre o registro de medicamentos fitoterápicos e o registro e a notificação de produtos tradicionais fitoterápicos. Diário Oficial União 14 maio 2014.
ANVISA - Agência Nacional de Vigilância Sanitária (2018). VigiMed: notificação fácil de eventos adversos. Medicamentos e vacinas, Brasil. Available at: http://antigo.anvisa.gov.br/noticias/-asset_publisher/FXrpx9qY7FbU/content/vigimed-notificacao-facil-de-eventos-adversos/219201/pop_up?inheritRedirect=false. Accessed on: 20 nov 2021.
Basila D, Yuan CS (2005) Effects of dietary supplements on coagulation and platelet function. Thromb Res117:49-53. https://doi.org/10.1016/j.thromres.2005.04.017
Bernard RH Research Methods in Cultural Anthropology. London: Sage Publications, 1988. 520p.Budzinski JW, Foster BC, Vandenhoek S, Arnason JT (2000) An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures. Phytomedicine 7:273-282. https://doi.org/10.1016/S0944-7113(00)80044-6
Cancelera RJS, Freitas AC, Oliveira BL (2019) Benefícios do tratamento com Hibiscus sabdariffa para a obesidade, doenças associadas e seus efeitos adversos. Rev Bras Plantas Med 21:192-200.
Carneiro ALC, Comarella L (2016) Principais interações entre plantas medicinais e medicamentos. Rev Saúde Desenv 9:4-19.
Carvalho TB, Lemos ICS, Sales VS, Figueiredo FRSDN, Rodrigues CKS, Kerntopf MR (2015) Papel dos Idosos no Contexto do Uso de Plantas Medicinais: Contribuições à Medicina Tradicional. Ensaios Cienc 19:38-41.
Chen SL, Yu H, Luo HM, Wu Q, Li CF, Steinmetz A (2016) Conservation and sustainable use of medicinal plants: problems, progress, and prospects. Chin Med 11:1-10.
Coelho Filho JM, Marcopito LF, Castelo A (2004) Perfil de utilização de medicamentos por idosos em área urbana do Nordeste do Brasil. Rev Saúde Pública 38:557-564. https://doi.org/10.1590/S0034-89102004000400012
Contreras-Puentes N, Alvíz-Amador A (2020) Hypoglycaemic property of yacon (Smallanthus sonchifolius (Poepp. and Hendl.) H. Robinson): A review. Pharmacogn Rev 14:27. https://doi.org/10.5530/phrev.2020.14.7
Debbie S, Graeme L, Pierre D, Elizabeth W, Kelvin C (2012) Pharmacovigilance of herbal medicine. J Ethnopharmacol 140:513-518. https://doi.org/10.1016/j.jep.2012.01.051
Desmarchelier C (2010) Neotropics and natural ingredients for pharmaceuticals: why isn't South American biodiversity on the crest of the wave? Phytother Res 24:791-799. https://doi.org/10.1002/ptr.3114
EMA-HMPC. European Medicines Agency - Committee on Herbal Medicinal Products (HPMC) (2015). European Union Herbal Monograph on Matricaria Recutita L., Flos; London, EMA.
Ejelonu OC, Elekofehinti OO, Adanlawo IG, Kundu R (2022) TGR5 potentiates GLP-1 secretion and cause pancreatic islet regeneration in response to Tithonia diversifolia saponin-rich extract in diabetic model mice. Phytomedicine Plus 2(1):100203. https://doi.org/10.1016/j.phyplu.2021.100203
Fauziyah Y, Sunarti S, Hanoum IF, Wahyuningsih MSH (2018) Ethanol extract of Tithonia diversifolia (hemsley) a gray standardized ameliorates hyperglycemia, polyphagia, and weight loss in diabetic rats. Molekul 13(1):72-79. http://dx.doi.org/10.20884/1.jm.2018.13.1.417
Ferreira MRA, Soares LAL (2015) Libidibia ferrea (Mart. ex Tul.) LP Queiroz: A review of the biological activities and phytochemical composition. J Med Plant Res 9:140-150. http://dx.doi.org/10.5897/JMPR.2014.5706
Foster BC, Vandenhoek S, Hana J, Krantis A, Akhtar H, Bryan M, Budzinski JW, Ramputh A, Arnason JT (2003) In vitro inhibition of human cytochrome P450-mediated metabolism of marker substrates by natural products. Phytomedicine 10:334–342. https://doi.org/10.1078/094471103322004839
Gantala R, Devaraju RR, Goud SG, Aitha H, Kubbi JR (2015) Condiments costing high! A case report of Erythema multiforme. J Clin Diagn Res 9:ZD22-ZD24. http://dx.doi.org/10.7860/JCDR/2015/12075.6221
Handa SS, Kaul MK (1996) Supplement to cultivation and utilization of medicinal plants (No. na). Jammu-Tawi: Regional Research Laboratory. vii-viii. 849p.
Haraguchi LMM, Sañudo A, Rodrigues E, Cervigni H, Carlini ELDA (2020) Impacto da Capacitação de Profissionais da Rede Pública de Saúde de São Paulo na Prática da Fitoterapia. Rev Bras Educ Med 44: e016.
Herrera-Arellano A, Miranda-Sanchez J, Avila-Castro P, Herrera-Alvarez S, Jimenez-Ferrer JE, Zamilpa A, Román-Ramos R, Ponce-Monter H, Tortoriello J (2007) Clinical effects produced by a standardized herbal medicinal product of Hibiscus sabdariffa on patients with hypertension. A randomized, double- blind, lisinopril-controlled clinical trial. Planta Med 73:6–12. http://dx.doi.org/10.1055/s-2006-957065
Huberman AM, Miles MB (1994) Data management and analysis methods. In: Denzin NK, Lincoln YS. Handbook of Qualitative Research, Thousand Oaks: Sage Publications. 428-444.
IBGE - Instituto Brasileiro de Geografia e Estatística (2018) Agência IBGE Notícias - Rio de Janeiro: Instituto Brasileiro de Geografia e Estatística. (Estatísticas Sociais). [online]. Available at: https://agenciadenoticias.ibge.gov.br/agencia-noticias/2012-agencia-de-noticias/noticias/20980-numero-de-idosos-cresce-18-em-5-anos-e-ultrapassa-30-milhoes-em-2017. Accessed on: 25 nov. 2018.
Jacquin-Porretaz C, Nardin C, Blanc D, Aubin F (2017) Cutaneous toxicity induced by hibiscus tea in a patient treated with erlotinib. J Thorac Oncol 12:e47-e48. https://doi.org/10.1016/j.jtho.2017.01.010
Kitzinger J (2000) Focus groups with users and providers of health care. In: Pope, C.; Mays, N. (Org.). Qualitative research in health care. 2.ed. London: BMJ Books. 20-29.
Leal LR, Tellis CJM (2015) Farmacovigilância de plantas medicinais e fitoterápicos no Brasil: uma breve revisão. Rev Fitos 9:253-303. https://doi.org/10.5935/24464775.201500 20
Leny ABT (2009) Grupos focais: conceitos, procedimentos e reflexões baseadas em experiências com o uso da técnica em pesquisas de saúde. Physis 19:777-796. https://doi.org/10.1590/S0103-73312009000300013
Lorenzi H, Matos FJA (2008) Plantas medicinais do Brasil: nativas e exóticas cultivadas. São Paulo: Instituto Plantarum. 576p.
Machado HL, Moura VL, Gouveia NM, Costa GA, Espindola FS, Botelho FV (2014) Pesquisa e atividades de extensão em fitoterapia desenvolvidas pela Rede FitoCerrado: uso racional de plantas medicinais e fitoterápicos por idosos em Uberlândia-MG. Rev Bras Plantas Med 16:527-533. https://doi.org/10.1590/1983-084X/13_072
Malinowski B (1990) O objeto, método e alcance dessa pesquisa. In: Guimarães AZ (org). Desvendando máscaras sociais. 3.ed. Rio de Janeiro: Francisco Alves, 39-61.
Mayring, P. Qualitative content analysis: theoretical foundation, basic procedures and software solution. Klagenfurt, 2014.
Morgan DL (1997) Focus group as qualitative research. 2.ed. London: Sage. https://dx.doi.org/10.4135/9781412984287
Muniz ECS, Goulart FC, Lazarini CA, Marin MJS (2017) Análise do uso de medicamentos por idosos usuários de plano de saúde suplementar. Rev Bras Geriatr Gerontol 20:375-387. https://doi.org/10.1590/1981-22562017020.160111
Ndu OO, Nworu CS, Ehiemere CO, Ndukwe NC, Ochiogu IS (2011) Herb–drug interaction between the extract of Hibiscus sabdariffa L. and hydrochlorothiazide in experimental animals. J Med Food 14:640–644. https://doi.org/10.1089/jmf.2010.0117.
Nowack R, Nowak B (2005) Herbal teas interfere with cyclosporin levels in renal transplant patients. Nephrol Dial Transplant 20:2554–2556. https://doi.org/10.1093/ndt/gfi003
Oliveira DR, Oliveira ACD, Marques LC (2016) O estado regulatório dos fitoterápicos no Brasil: um paralelo entre a legislação e o Mercado farmacêutico (1995-2015). Vigil Sanit em Debate 4:139-148. https://doi.org/10.22239/2317-269X.00806
Oliveira FGS, Lehn CR (2015) Riscos e perspectivas na utilização de fitoterápicos no Brasil. Opará: Etnic Mov Soc Educa 3:35-44.
OMS - Organización Mundial de la Salud (2002) Vigilancia de la seguridad de los medicamentos: guía para la instalación y puesta en funcionamiento de un centro de farmacovigilancia. Uppsala: Uppsala Monitoring Centre/Organización Mundial de la Salud. 32p.
Ondieki G, Nyagblordzro M, Kikete S, Liang R, Wang L, He X (2017) Cytochrome P450 and P-Glycoprotein-Mediated Interactions Involving African Herbs Indicated for Common Noncommunicable Diseases. Evid Based Complement Alternat Med 2017:1-18. https://doi.org/10.1155/2017/2582463
Pagno AR, Gross CB, Gewehr DM, Colet CDF, Berlezi EM (2018) Drug therapy, potential interactions and iatrogenesis as factors related to frailty in the elderly. Rev Bras Geriatr Gerontol 21:588-596. https://doi.org/10.1590/1981-22562018021.180085
Passos MMB, Albino RC, Feitoza-Silva M, Oliveira DR (2018) A disseminação cultural das garrafadas no Brasil: um paralelo entre medicina popular e legislação sanitária. Saúde em Debate 42: 248-262. https://doi.org/10.1590/0103-1104201811620
Péres DS, Magna JM, Viana LA (2003) Portador de hipertensão arterial: atitudes, crenças, percepções, pensamentos e práticas. Rev Saúde Pública 37:635-642. https://doi.org/10.1590/S0034-89102003000500014
Rocha IP, Sales AS, da Silva JM, Bastos NLV, Oliveira JS (2021) Farmacodinâmica e farmacocinética nas interações medicamentosas geriátricas: reflexão sobre medicamentos potencialmente inadequados. Humanidades & Inovação 8:91-102.
Rodrigues E, Barnes J (2022) Ethnopharmacovigilance and Traditional Medicines. In Barnes, J (Org.). Pharmacovigilance for Herbal and Traditional Medicines. Springer Nature Switzerland AG, pp. 237-48.
Roth GA, Abate D, Abate KH, Abay SM, Abbafati C, Abbasi N, et al. (2018) Global, regional, and national age-sex-specific mortality for 282 causes of death in 195 countries and territories, 1980–2017: A systematic analysis for the Global Burden of Disease Study 2017. Lancet 392:1736–88. https://doi.org/10.1016/S0140-6736(18)32203-7
Santos SLF, Alves HHS, Barros KBNT, Pessoa CV (2017) Uso de plantas medicinais por idosos de uma instituição filantrópica. RPBeCS 4:71-75. https://doi.org/10.6084/m9.figshare.8120819
Segal R, Pilote L (2006) Warfarin interaction with Matricaria chamomilla. Can Med Assoc J 174:1281-1282. https://doi.org/10.1503/cmaj.051191
Showande SJ, Udoh-Kalu CC, Fakeye TO (2017) Pattern of use of water beverage of Hibiscus sabdariffa Linn in a University community in Southwest Nigeria. West Afr Pharm 28:102-111.
Silva R, Schmidt OF, Silva S (2012) Polifarmácia em geriatria. Rev AMRIGS 56:164-74.
Silva AB, Araújo CRF (2015). O uso de plantas medicinais por idosos usuários de uma unidade Básica de Saúde da Família. Rev Enferm 9:7636-43.
Siqueira BVL, Sakuragui CM, Soares BE, Oliveira DR (2018) The rise of medicalization of plants in Brazil: A temporal perspective on vernacular names. J Ethnopharmacol 224:535-540. https://doi.org/10.1016/j.jep.2018.06.024
Soares JAR, Kato ETM, Bugno A, Galduróz JCF, Marques LC, Macrini, T, Rodrigues E (2013) Informal Trade of Psychoactive Plant-based natural herbal products in the City of Diadema, SP, Brazil: Quality and Potential Risks. Evid Based Complement Alternat Med. 2013:1-11. https://doi.org/10.1155/2013/894834
Soldati GT (2016) Local or Traditional Knowledge Transmission and Natural Resource Use. In: Albuquerque UP (Org.). Introduction to Ethnobiology, 2.ed. Springer. 235-238.
Thakkar S, Anklam E, Xu A, Ulberth F, Li J, Li B, Hugas M, Sarma N, Crerar S, Swift S, Hakamatsuka T, Curtui V, Yan W, Geng X, Slikker W, Tong W (2020) Regulatory landscape of dietary supplements and herbal medicines from a global perspective. Regul Toxicol Pharmacol 114:104647. https://doi.org/10.1016/j.yrtph.2020.104647
Ulanowska M, Olas B (2021) Biological Properties and Prospects for the Application of Eugenol - A Review. Int J Mol Sci 22:3671. https://doi.org/10.3390/ijms22073671
Varallo FR, Mastroianni PDC (2013) Farmacovigilância: da teoria à prática. São Paulo: Editora Unesp. 71p.
WHO, IUCN & WWF – World Health Organization, The World Conservation Union & World Wide Fund for Nature. Guidelines on ' the conservation of medicinal plants 1993. Available at: https://apps.who.int/iris/bitstream/handle/10665/41651/2831701368_en.pdf?sequence=1&isAllowed=y. Accessed on: 20 nov 2021.
Zazzara MB, Palmer K, Vetrano DL, Carfì A, Graziano O (2021) Adverse drug reactions in older adults: a narrative review of the literature. Eur Ger Med 12:463-473.
Downloads
Published
Issue
Section
License
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.
