[Oral anticoagulants: a literature review of herb-drug interactions or food-drug interactions].
OBJECTIVE
To identify herbal medicines and food products which can interact with anticoagulant therapy.


METHODS
Literature review using key words: "anticoagulants", "herb-drug interaction", "food-drug interaction", "drug chinese herbal", "medicine herbal", "plant preparation", "dietary supplements".


METHODS
Medline (january 1966 to june 2006) and Pascal (1987 to 2006). Case reports, systematic reviews, in vitro studies, clinical studies published in french or in english (or with an english extract) have been undertaken.


RESULTS
Eighty articles were selected (two both including a case report and a study): 14 systemic review, 43 case reports, 25 studies (17 studies in humans: nine randomized and controlled, three controlled), six controlled studies in animals and two in vitro studies.


CONCLUSIONS
A wide range of herbal medicines and food products can interact with anticoagulants. Clinical relevance of these effects is difficult to characterise (nature of existing reports, contradiction between studies, difficult extrapolation to human).


CONCLUSIONS
It is difficult to predict the incidence or severity of such interactions. However, awareness of these potential interactions is necessary to achieve optimal anticoagulation therapy: pharmacist can play a crucial role identifying such interactions in case of disturbed INR; clinicians should be informed to monitor closely the therapy, particularly when such products are started or discontinued.
Bourget
S
S
Département Pharmacie, Centre Hospitalier-Universitaire de Grenoble, Grenoble, France.
Baudrant
M
M
Allenet
B
B
Calop
J
J
D000818:Animals; D000925:Anticoagulants / Q000009:adverse effects* / Q000493:pharmacokinetics / Q000627:therapeutic use; D004347:Drug Interactions; D018565:Food-Drug Interactions; D006801:Humans; D028321:Plant Preparations / Q000009:adverse effects*
D000925:Anticoagulants; D028321:Plant Preparations