Table 2.
Herbs most commonly involved and/or associated with fatal outcomes.
| Latin Name, Common Name | Drug(s) or Class | N Reports | Severity (N) | Reaction |
|---|---|---|---|---|
| Curcuma longa, turmeric | Fluindione | 1 | Minor | Increased INR |
| Tacrolimus | 1 | Severe | Increased tacrolimus level | |
| contaminated with microcystin | Paclitaxel | 1 | Severe | Hepatotoxicity |
| Equisetum arvense, horsetail | Antiretrovirals | 2 | Minor | Increased viral load |
| Gingko biloba, ginkgo | Antiretrovirals | 1 | Severe | Treatment failure |
| Ibuprofen | 1 | Fatal | Intracerebral bleed | |
| Trazodone | 1 | Severe | Altered mental status | |
| Aescinate | 1 | Severe | Acute kidney injury | |
| Ginkgo biloba in multiherbal | Divalproate, phenytoin | 1 | Fatal | Seizures |
| Efavirenz | 1 | Mild | Increased viral load | |
| G biloba and H perforatum | Buspirone, fluoxetine | 1 | Mild | Serotonin syndrome |
| Hypericum perforatum, St. John’s wort | Serotoninergics | 6 | Mild (4) Severe (2) |
Serotonin syndrome |
| Calcineurin inhibitors | 6 | Mild (3) Severe (3) |
Decreased drug levels | |
| Clozapine | 1 | Mild | Schizophrenia | |
| Sertraline | 1 | Severe | Mania | |
| Oral contraceptive | 1 | Severe | Pregnancy | |
| H. perforatum in multiherbal | Cyclosporin | 1 | Mild | Decreased drug level |
| Lycium barbarum, goji | Warfarin | 3 | Mild (2) Severe |
Increased INR Bleeding |
| Mitragyna speciosa, kratom | Quetiapine | 1 | Fatal | Increased drug level, neuroleptic malignant syndrome |
| Panax ginseng, ginseng | Phenelzine | 1 | Mild | Mania |
| Imatinib | 1 | Severe | Hepatotoxicity | |
| Raltegravir | 1 | Severe | Increased drug level | |
| contaminated with germanium | Furosemide | 1 | Severe | Treatment failure |
| P ginseng in multiherbal | Warfarin | 1 | Severe | Intracerebral bleeding |
| Vaccinium spp, cranberry | Warfarin | 8 | Mild (6) Fatal (2) |
6 Increased INR, 2 GI and pericardial bleeding |