Overview on pharmacovigilance of nephrotoxic herbal medicines used worldwide

Abstract

There is a growing use of herbal medicines worldwide. Especially in patients with chronic diseases such as kidney disease, when numerous studies have shown a generalized high prevalence [ 1 , 2 , 3 , 4 ]. However, there are concerns about herbal medicines and their ability to produce harmful effects. Examples from the literature have clearly shown the association between the use of herbs and kidney disease [ 5 , 6 ]. The increasing use of herbal medicines has increased the need to monitor their safety. Thus, the approach recommended by the World Health Organization (WHO) was to include herbal medicines in existing national pharmacovigilance systems [ 5 ]. The pharmacovigilance of medicinal plants or phytovigilance involved the evaluation of the risks and benefits of phytotherapy. The ultimate goal is to protect patients from herbal harm [ 6 ] . It is essential to develop reliable information on the safety of herbal medicines [ 7 ]. Becoming necessary due to risks of toxicity (acute or chronic) or risks of drug interactions (of pharmacokinetic or pharmacodynamic nature), as regards interactions between several associated plants, phytovigilance also represents a legal obligation [ 8 ]. Several issues related to how herbal medicines are named, perceived, obtained and used [ 9 ]. At international level, the WHO published guidelines on pharmacovigilance of herbal medicines [ 10 ]. However it is still a new activity in the majority of countries of Africa. Except in Morocco where a pharmacovigilance program in phytotherapy was created in 2000 [ 6 ]. Also the creation of Botanicus and Phytotox [ 11 ]. This situation requires knowledge, recognition and monitoring of adverse reactions through pharmacovigilance of herbal medicines activities [ 12 , 13 ]. In order to show renal sides effects of herbal medicines use and current need to monitor phythovigilance worldwide, systematic research was carried out on PubMed, Science direct and Scopus. Moreover, some accessible databases on pharmacovigilance of herbal medicine or phytovigilance were consulted (Table 1 ). The aim of this article was to provide an overview of nephrotoxicity associated with the use of herbal medicines.

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