Herbal drugs: knowledge, attitude and practice of its concurrent use with allopathic drugs, scientific testing and effectiveness in common diseases among educated class

Md. Faiz Akram, Mohd Tariq Salman, Divya G. Krishnan, Nihal Ahmad, Afzal Khan


Background: Craving for a holistic approach for healthcare and concern about side effect of the chemically produced drug is increasing interest in herbal medicine. There is a favourable perception about its effectiveness in complete cure of certain diseases. Its regulation, concurrent use with allopathic medicine and scientific testing has always been of concern.

Methods: Cross sectional descriptive study was done using predesigned questionnaire among the educated class. Socio-demographic data, attitude and practice about simultaneous use, effectiveness in common disease, scientific testing and regulation of herbal medicine were asked. Also a rating of different system of medicine i.e allopathy, unani, ayurveda, homeopathy was asked.

Results: Total completed participants were 120. Across level of education use of herbal medicine was 55% in the last 1 year, 56.7% have used or intend to use herbal along with allopathic and only 18.9 % tell it to treating physician. 50% consider concurrent use as safe, 43% believe it cures completely, 31.7% consider equally effective than allopathic and 95% have not encountered any side effect or allergic reaction with it. A majority did not know about any scientific testing and clinical study of herbal drugs.

Conclusions: Herbal medicines have very positive perception. The regulatory authorities are also patronising it in many countries. They are also being used along with allopathic medicine and many times even without knowledge of treating doctor. The perception about herbal medicine is historical based on personal or clinical experiences, mostly lacking with good grade of strength of evidence. There is need to have Level Ia or Ib evidence for their effectiveness and safety.


Herbal drugs, Complementary and alternative medicine, Drug herb interaction, Doctor patient communication

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What is complementary and alternative medicine (CAM)? Bethesda, Maryland, National Center for Complementary and Alternative Medicine, 2005 (Publication No. D156). Available at /cam. Accessed on 15 May 2016.

WHO traditional medicine strategy WH. 2002-2005. (document WHO/EDM/TRM/2002.1). Geneva. Available at: http:// medicines/organization/trm/orgtrmmain.shtml. Accessed on 15 May 2016.

National policy on traditional medicine and regulation of herbal medicines report of a WHO global survey World Health Organization. Geneva. May 2005:133-134.

Eisenberg DM, Davis RB, Ettner SL, Appel S, Wilkey S, Van RM, et al. Trends in alternative medicine use in the United States, 1990-1997: results of a follow-up national survey. J Am Med Asso. 1998;280(18):1569-75.

Fisher P, Ward A. Complementary medicine in Europe. B Med J. 1994;309(6947):107-11.

Erns E. The role of complementary and alternative medicine. B Med J. 2000;321(7269):1133-5.

Ministry of AYUSH, Government of India. Available at Accessed on 24 May 2016.

Ayush research portal, evidence based research data of AYUSH systems at global level ministry of AYUSH, Government of India Available at http:// Default.aspx. Accessed 24 May 2016.

Central Council of Indian Medicine. A statutory body under IMCC Act 1970 Ministry of Ayush, Govt of India. Available at http:// Accessed on 24 May 2016.

Demand and supply of medicinal plants in india. National medicinal plant board. Available at http:// FRLHT/ Contents.pdf. Acessed on 24 May 2016.

Sharma A, Shanker C, Tyagi, Singh M, Rao CV. Herbal medicine for market potential in india: an overview. Academic J Plant Sci. 2008;1(2):26-36.

Akram MF, Salman MT, Khan A, Krishnan DG, Ahmad N. Herbal drugs: study of knowledge attitude and practices about their side effects, source of advice and conditions for preference among educated class. Eur J Biomedical Pharm Sci. 2015:2(2),180-8.

Alkharfy KM. Community pharmacists' knowledge, attitudes and practices towards herbal remedies in Riyadh, Saudi Arabia. East Mediterr Health J. 2010;16(9):988-93.

Al Shaar, Ismail IAMS, Yousuf MFS, Salama RE. Knowledge, attitudes and practice of general practitioners towards complementary and alternative medicine in Doha, Qatar. East Mediterr Health J. 2010;16 (5):522-7.

Adibe MO. Prevalence of concurrent use of herbal and synthetic medicines among outpatients in a mission hospital in Nigeria. Int J Drug Dev Res. 2009;1(1):60-6.

Liwa AC, Smart LR, Frumkin A, Epstein HA, Fitzgerald DW, Peck RN. A traditional herbal medicine use among hypertensive patients in sub-Saharan Africa: a systematic review. Curr Hypertens Rep. 2014;16(6):437.

Renuka G, Thiruvengadarajan VS ,Amruthkumar N, Mahesh KC. Madhusudhan C, A review on herb-drug interactions. Int J Pharm Res Development. 2011;3(03):17.

Tsai HH, Lin HW, Simon Pickard A, Tsai HY, Mahady GB. Evaluation of documented drug interactions and contraindications associated with herbs and dietary supplements: a systematic literature review. Int J Clin Pract. 2012;66(11):1056-78.

Ara T, Viqar M, Arshad J. Use of herbal products and potential interactions in patients with cardiovascular diseases. J Am Coll Cardiol. 2010;55(6):515-25.

Jennifer FH. Anat DS, Longnecker N. Doctor-patient communication: a review. Ochsner J. 2010;10(1):38-43.

Henrdon J, Pollick K. Continuing concerns, new challenges, and next steps in physician-patient communication. J Bone Joint Surg Am. 2002;84(2):309-15.

Muriel P, Rivera EY. Beneficial drugs for liver diseases. J Appl Toxicol. 2008;28(2):93-103.

Liu H. Bicyclol: a novel drug for treating chronic viral hepatitis B and C. Med Chem. 2009;5(1):29-43.

Ferenci P. Treatment of chronic viral hepatitis. Best Pract Res Clin Gastroenterol. 2004;18:113-20.

Dhiman RK, Chawla YK. Herbal medicines for liver diseases. Dig Dis Sci. 2005;50(10):1807-12.

Koch KL, Stern RM. Functional disorders of the stomach. Semin Gastrointest Dis. 1990;1(1):23-36.

Jones MP, Maganti K. Symptoms, gastric function, and psychosocial factors in functional dyspepsia. J Clin Gastroenterol. 2004;38(10):866-72.

Drugs and Cosmetics Act of 1940 (DCA). Government of India. Ministry of Health and Family Welfare. Available at http:// Accessed on 24 May 2016.

Mc Namara. FDA regulation of ingredients in dietary supplements after passage of the dietary supplement health and education act of 1994: an update. Food Drug Law J. 1996;51(2):313-8.

Morris CA, Avorn J. Internet marketing of herbal products. J Am Med Asso. 2003;290(11):1505-9.

Essential medicines and health products information portal a World Health Organization resource. Available at http:// medicinedocs/e n/d/Jwhozip42e/13.1.html#Jwhozip42e.13.1 Accessed on 24 May 2016.