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Herbal products, botanical products, or phytomedicines are derived from plants or botanicals and are used to maintain health or treat diseases. Herbal supplements are products specifically used for internal use. A large number of prescription drugs and over-the-counter medications originate from plant derivatives. They differ from herbal supplements because they use Food and Drug Administration–regulated purified ingredients. However, the Food and Drug Administration does not regulate the manufacture of herbal supplements. Therefore, preparations may contain a portion of the plant or the whole plant and may vary in consistency. Herbal supplements are often sold in solid forms, such as capsules, pills, tablets, and lozenges, but are also available in liquid or powder forms. This activity focuses on the commonly used herbal supplements in the United States and reviews the treatment of conditions using these medications, highlighting the role of the interprofessional team in treating patients using these medications. This activity about herbal supplements is designed to provide evidence-based insights to enhance patient care and outcomes and emphasize strategies to safely incorporate herbal supplements into treatment plans while minimizing the risk of adverse drug reactions. Healthcare professionals gain knowledge of various herbal supplements' adverse effects and efficacy, enabling them to offer informed, individualized care while navigating the complexities of herbal medicine and ensuring safe and effective patient management. Objectives: Identify the Food and Drug Administration regulations involving herbal supplements. Assess the potential for inconsistency in herbal dosing. Evaluate the risks, benefits, and potential interactions of the common herbal supplements. Implement effective interprofessional team strategies to promote a culture of safety regarding herbal supplements. Access free multiple choice questions on this topic.

Herbal products, botanical products, or phytomedicines are derived from plants or botanicals to maintain health or treat diseases. Herbal supplements are products specifically used for internal use. A large number of prescription drugs and over-the-counter medications originate from plant derivatives. These medications differ from herbal supplements as they use Food and Drug Administration (FDA)-regulated, purified ingredients. However, the FDA does not regulate the manufacture of herbal supplements. Therefore, preparations may contain a portion of the plant or the whole plant and vary in consistency. These supplements are most commonly sold in solid forms, such as capsules, pills, tablets, and lozenges, but are also available in liquid or powder forms. This activity focuses on the following herbal supplements commonly utilized in the United States: Saw palmetto Garlic Ginkgo biloba Echinacea Black cohosh Ginseng Hawthorn St. John's wort Goldenseal Feverfew Capsaicin

Because patients are generally reluctant to disclose their herbal supplementation, it is crucial to develop a trusting relationship that allows patients to discuss dietary supplement use without reservation. All interprofessional healthcare team members need to be on the same page regarding herbal supplements, share information through open communication between team members, and deliver a consistent message to the patient. This approach optimizes therapeutic efficacy and reduces potential adverse effects. To detect possible interactions between supplements and drugs, thorough documentation of herbal supplement usage, including initiation and discontinuation, is essential. Clinicians need to understand whether an herbal supplement affects a prescribed drug's clinical effect without affecting its dosage or whether it is affecting the concentration in the blood and, therefore, its pharmacological action (pharmacokinetics). This understanding leads to a more informed decision on whether to change the dosage of a drug or discontinue the supplement(s) in question altogether. Nurses need to include these agents in the patient's medication record. The pharmacist can consult with the clinician to check for interactions, as these are often not benign substances and can alter drug therapy. Providing continuing medical education and further research into herbal supplement-prescription drug interactions increase understanding and benefit the patient-physician relationship.

All herbal supplements should be documented in the electronic medical records.[54] Potential drug-herb interactions should be checked, and the physician should be notified immediately if significant concerns arise. Patients should be educated about the adverse effects of herbal supplements. Healthcare professionals can report to the FDA for any adverse event associated with herbal supplements through the Safety Reporting Portal.

Liver function tests should be monitored for patients using hepatotoxic herbal supplements.[51] Renal function and electrolyte levels should be monitored for potential nephrotoxicity in patients with CKD.[53]