Evidence map›Paper›PMID 41259156›Full record

ArticlePharmaceutical biology2025

An exploratory evaluation of the interaction risk between herbal products and pharmaceutical medicines used concurrently for disease management in Blantyre, Malawi.

Kumbukani K Nyirenda, John Mponda, Ibrahim Chikowe, Esther Kawonga, Nellie Twatasha Gomani Phiri, Mervis Msukwa, Chimota Phiri, Amy L Roe, Mary F Paine, Bill Gurley and 7 more

Abstract read
In one paragraph

Article in Pharmaceutical biology, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Article
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Kumbukani K NyirendaDepartment of Pharmacy, Kamuzu University of Health Sciences, Blantyre, Malawi.
John MpondaDepartment of Pharmacy, Kamuzu University of Health Sciences, Blantyre, Malawi.
Ibrahim ChikoweDepartment of Pharmacy, Kamuzu University of Health Sciences, Blantyre, Malawi.
Esther KawongaAO Alliance, Lilongwe, Malawi.
Nellie Twatasha Gomani PhiriPartners in Health Malawi, Lilongwe, Malawi.
Mervis MsukwaEquip Group, Lilongwe, Malawi.
Chimota PhiriDepartment of Medicine, Queen Elizabeth Central Hospital, Blantyre, Malawi.
Amy L RoeProcter & Gamble Healthcare, Cincinnati, OH, USA.
Mary F PaineDepartment of Pharmaceutical Sciences, College of Pharmacy and Pharmaceutical Sciences, Washington State University, Spokane, WA, USA.
Bill GurleyNational Center for Natural Products Research, School of Pharmacy, University of Mississippi, University, MS, USA.
Hellen Oketch-RabahUnited States Pharmacopeia, Rockville, MD, USA.
Stefan GafnerAmerican Botanical Council, Austin, TX, USA.
Julie KrzykwaHealth and Environmental Sciences Institute, Washington, DC, USA.
Constance A MitchellHealth and Environmental Sciences Institute, Washington, DC, USA.
Michelle R EmbryHealth and Environmental Sciences Institute, Washington, DC, USA.
Syril PettitHealth and Environmental Sciences Institute, Washington, DC, USA.
Dallas J SmithDepartment of Pharmacy, Kamuzu University of Health Sciences, Blantyre, Malawi.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

contextThe use of herbal products in Malawi remains widespread and culturally significant, often occurring alongside pharmaceutical medicine treatments. As the burden of non-communicable diseases such as diabetes and hypertension continues to rise, the potential for herbal-drug interactions (HDIs) represents an underexamined public health concern.

objectiveEvaluate the concurrent use of herbal products and pharmaceutical medicines among patients with diabetes or hypertension in a large health care facility in Malawi and identify potential adverse HDIs. MATERIALS &

methodsAn exploratory mixed-methods, cross-sectional study was conducted with 301 patients attending a diabetes or hypertension clinic at Queen Elizabeth Central Hospital in Blantyre, Malawi. Participants self-reported herbal and pharmaceutical use, and a targeted literature review was undertaken to assess potential pharmacokinetic and pharmacodynamic interactions between commonly reported herbal products and prescribed medications.

resultsParticipants reported concurrent use of a wide variety of herbal products (e.g., garlic, ginger, okra, lemon, mango, moringa) with prescription medicines (e.g., metformin, insulin, glibenclamide, hydrochlorothiazide, enalapril, amlodipine). While clinical outcomes were not independently verified, literature review findings, in some cases, indicated meaningful potential for HDIs. DISCUSSION AND

conclusionThis study provides foundational data on herbal-pharmaceutical co-use in Malawi and highlights the need for expanded research, improved documentation of herbal use in healthcare settings, and improved education for patients and providers. Integrating awareness of herbal product use into clinical care is essential, and the methodology and findings may inform future hypothesis-driven studies across Africa and other regions where traditional and modern medicine use overlaps.

Indexed as

Antihypertensive AgentsDiabetes MellitusHerb-Drug InteractionsHypertensionHypoglycemic AgentsPlant PreparationsAdultAgedCross-Sectional StudiesFemaleHumansMalawiMaleMiddle AgedPhytotherapyAntihypertensive AgentsHypoglycemic AgentsPlant PreparationsbotanicalsCYPsdiabetesethnobotanicalHDIHerbal-drug interactionshypertensionMalawisafety

Identifiers

PMID41259156
PMCPMC12632214

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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.