SynthesisPloS one2017
A systematic review of the pharmacokinetic and pharmacodynamic interactions of herbal medicine with warfarin.
Synthesis in PloS one, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 53 citations in OpenAlex.
- The Green Path to Liver Health: Herbal Solutions for Non-alcoholic Steatohepatitis.Cardiovascular & hematological disorders drug targets · 2025Pooled it
- Plant-derived bioactives in depression-related and antidepressant-associated sexual dysfunction: a narrative review.Frontiers in nutrition · 2026Review
- Integrating Traditional Wisdom With Modern Science: Ginsenosides as Antiheart Failure Agents.Cardiovascular therapeutics · 2026Review
- Herbal Medicines and Drugs Interactions: Cytochrome P450 Responsibility.Current medicinal chemistry · 2026Review
- Medical nutrition therapy for the management of type 2 diabetes mellitus.Nature reviews. Endocrinology · 2025Review
- Safety Issues of Herb-Warfarin Interactions.Current drug metabolism · 2024Review
- Integrated traditional herbal medicine in the treatment of gastrointestinal disorder: the pattern of use and the knowledge of safety among the Eastern Region Saudi population.BMC complementary medicine and therapies · 2023Article
- Herbal supplements in Jordan: a cross-sectional survey of pharmacists' perspectives and knowledge.BMJ open · 2022Article
- A comprehensive quality analysis of randomized controlled clinical trials of Asian ginseng and American ginseng based on the CONSORT guideline.Journal of ginseng research · 2022Article
- Economy- and Social-Based Strategies for Anticoagulation of Patients with Atrial Fibrillation.Arquivos brasileiros de cardiologia · 2022Article
- Concurrent use of Chinese herbal medicine and anticoagulants may reduce major bleeding events.PloS one · 2022Article
- Pancreas Cancer-Associated Pain Management.The oncologist · 2021Review
- Cranberry Extract for Symptoms of Acute, Uncomplicated Urinary Tract Infection: A Systematic Review.Antibiotics (Basel, Switzerland) · 2020Review
- Article
- Constructing a bilingual website with validated database for Herb and Western medicine interactions using Ginseng, Ginkgo and Dong Quai as examples.BMC complementary and alternative medicine · 2019Article
- Influence of andrographolide on the pharmacokinetics of warfarin in rats.Pharmaceutical biology · 2018Article
- Potential Therapeutic Benefits of Herbs and Supplements in Patients with NAFLD.Diseases (Basel, Switzerland) · 2018Review
- Review
- Medicinal plants with antithrombotic property in Persian medicine: a mechanistic review.Journal of thrombosis and thrombolysis · 2018Review
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
3 authors at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe aim of this study was to systematically review data regarding pharmacokinetic (PK)-pharmacodynamic (PD) parameters from randomized controlled trials relating to interactions between herbal medicines and warfarin.
methodsThree electronic databases were searched to identify relevant trials. Two reviewers independently performed the study selection and data extraction. The risk of bias and reporting quality were also assessed independently by two reviewers using the Cochrane risk of bias tool and the consolidated standards of reporting trials (CONSORT). Outcomes were measured for all reported PK-PD parameters and adverse events.
resultsNine randomized controlled trials met our inclusion criteria. Most of the included studies were unclear regarding the risk of bias and had a low quality of methodology. Using CONSORT, the reporting percentages for the articles ranged from 36.5% to 61.5% and the mean percentage for all articles was 45.6%. St John's wort and echinacea affected the PK parameters of warfarin. Ginseng, ginger, garlic, and cranberry had no significant effect on the PK parameters. American ginseng altered the PD parameters of warfarin. St John's wort, ginseng, Korea red ginseng, ginkgo, ginger, garlic, aged garlic, and echincea did not significantly alter the PD parameters. Studies of ginkgo and cranberry showed conflicting results on the PK parameters and PD parameters, respectively. The incidence of adverse events in all trials was low and no major adverse events were reported.
conclusionsIt was difficult to determine whether ten herbal medicines had significant effects on the PK-PD parameters of warfarin. Low quality of evidence, different compounds within and different compositions of the herbs, and methodological limitations of the crossover study, which is a clinical study in which subjects receive a sequence of different interventions, made it difficult to form conclusions. Additional studies that remedy these vulnerabilities are necessary to verify these results.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.