Herb-Drug Interactions (HDIs) are a growing concern in clinical practice,
especially among vulnerable populations, such as children, the elderly, and pregnant
women. These groups have unique physiological characteristics that significantly
influence the pharmacokinetics and pharmacodynamics of both herbal and
conventional medications, increasing the risk of adverse interactions. In paediatric care,
St. John’s Wort (Hypericum perforatum) is sometimes used to manage childhood
depression. However, it is a strong inducer of the CYP3A4 enzyme, which can reduce
the effectiveness of medications like anticonvulsants and immunosuppressants. In
elderly patients, age-related changes, such as reduced liver and kidney function and the
common issue of polypharmacy, complicate treatment. For example, Ginkgo biloba,
used to enhance cognitive function, may interact with anticoagulants like warfarin,
raising the risk of bleeding. Garlic, if used under supervision, may enhance the blood
pressure-lowering effects of antihypertensive medications, requiring close monitoring.
Pregnancy adds another layer of complexity, as the safety of both the mother and foetus
must be considered. Some commonly used herbs, such as chamomile and ginger, may
interact with prescription drugs. Ginger’s antiplatelet effects, for instance, could
amplify the action of anticoagulants and increase the risk of bleeding during delivery.
Recent pharmacokinetic studies havelinked many of these interactions to changes in the
Absorption, Distribution, Metabolism, and Excretion (ADME) of drugs. Healthcare
professionals must maintain a high index of suspicion for HDIs in special populations
and educate patients on the safe use of herbal supplements alongside conventional
treatments.
Keywords: Bioactive compound, Chronic disease management, Geriatric populations, HDIs, Paediatric populations, Pregnancy.
