CDA Essentials 2017 • Volume 4 • Issue 6

25 Issue 6 | 2017 | I ssues and P eople How prevalent are herbal drugs in today’s marketplace? Many of the pharmaceutical agents that we use in modern medicine probably have their origins in herbal medications. There were 663 listed entities in the 1870 United States Pharmacopeia with regard to herbal medications. They were part of the advent of modern medicine and listed as drugs to use. Yet only 26 were listed in the 2016 edition. That doesn’t mean that over 600 of them have been found to have no medical use; it simply indicates that most of those medications are now produced pharmaceutically with better defined dosage forms. They eventually transitioned from herbal medications to mainstream pharmaceuticals. Sequential survey data from the United States show that on average 30% to 40% of the general adult population report using herbal medications or similar alternative medications. What constitutes an herbal medication? We are referring to drugs that are typically derived from organic matter—plants, herbs, roots—but regulators use a broader definition. The whole basket, known as complementary alternative medications (CAMs), includes herbal medications as well as nutraceuticals, botanicals and several other products people are using for disease treatment or health enhancement. Medications typically fall into 2 categories: they are either pharmaceuticals or CAMs. The regulations surrounding the two are quite different. Pharmaceuticals go through clinical trials and animal and human testing, and we have strong evidence about the most effective dose and the best patients to treat. Similar regulatory requirements do not exist for CAMs, which creates a buyer- beware situation. Herbal Medications When traditional and modern medicines clash Plants have been used for healing purposes since the dawn of time. The herbal medicine market is still thriving, with a myriad of over-the-counter products perceived by some as natural, safe, and affordable. But are they safe? CDA discussed potential interactions between herbal medications and pharmaceuticals with pharmacist Dr. Mark Donaldson, senior executive director of pharmacy advisory solutions at Vizient Inc. and adjunct professor in the faculty of dentistry at the University of British Columbia. Dr.Mark Donaldson Should you believe there is a risk for an interaction, ask your patient to stop taking an herbal medication at least 24 hours prior to a dental intervention. mark.donaldson@