Table 1: Mechanism of action, interactions and adverse reactions of the interventions included in this systematic review.

Intervention

Common names

Mechanism of action

Interactions (Lexicomp)

Adverse reactions (Lexicomp)

Satureja khuzistanica [9]

Mint

This plant has antispasmodic, antidiarrheal, antioxidant, anti-inflammatory, and chemotherapeutic properties.

None well documented.

The oil is strongly irritating in animal skin models, but is not phototoxic.

Proaftol (25% propolis, benzocaine, sage, peppermint, aniseed, menthol) [10]

Propolis (bee glue)

This mixture is an antibiotic with anti-inflammatory and anti-oxidant properties. 

None well documented.

Allergic reactions with skin and mucous membrane irritations have been reported. Sensitization to propolis, long recognized by apiary workers, has also been reported.

Myrtle [11]

 

Periwinkle

Myrtle has anti-hyperglycemic, antibacterial and analgesic properties.

An in vitro study evaluated the effect of periwinkle alkaloids on the cytochrome (CYP) P450 enzyme system, and some isolated alkaloids showed potent inhibition of CYP2D6, but weak activity against CYP3A4.

Clinical information is lacking. Adverse reactions are documented for vinca alkaloids related to doses used in chemotherapy.

Aloe vera [12,17]

 

Aloe Vera is wound healing, anti-inflammatory, and anti-infection agent.

Hypoglycemic-associated agents: Herbs (hypoglycemic properties) may enhance the hypoglycemic effect of hypoglycemic associated agents. Monitor therapy.

Except for dried latex, aloe is not approved as an internal medication. The external use of aloe has not been associated with severe adverse reactions; the majorities are relatively mild and reversible upon cessation.

Reports of burning sensations following topical application of aloe gel to dermabraded skin have been described.

Contact dermatitis from the related Aloe arborescens has been reported.

Erythema, edema, urticaria, and eczematous rash have also been reported following A. vera application.

Honey [13]

 

Honey has anti-infection and rapid wound healing properties.

None well documented for honey or bee pollen. Case reports of hematuria due to potentiation of warfarin have been documented with royal jelly.

Allergic reactions may occur to pollen in honey when ingested. Attempts to hyposensitize patients by administering bee pollen may produce severe anaphylaxis and other acute or chronic responses. Although rare, bee pollen can cause serious, sometimes fatal, adverse reactions. Some case reports of acute hepatitis and photosensitivity following ingestion of bee pollen have been reported. In many allergic patients, skin tests are positive for royal jelly. Case reports exist of allergy, acute exacerbation of asthma, anaphylaxis, and death.

Rosa damascene [14]

 

Antioxidant, anti-inflammatory, and anti-bacterial properties have been reported for this plant.

Nausea, indigestion, peptic ulcer, and diarrhea are some of the side-effects of these treatments.

None well documented

0.65% Yunnan Baiyao [16]

 

This powder has anti-hemorrhagic hemostatic and wound healing properties.

None well documented

None well documented

Myrrh [17]

 

Myrrh has anti-inflammatory and wound healing properties.

Myrrh may interact with warfarin and other coumarin derivatives, resulting in a reduction in the international normalized ratio (INR).

Several cases of dermatitis have been reported.

Berberine [15]

 

Berberine has been shown to have antimicrobial, anti-inflammatory, antitumor, and anti-pyretic properties.

Case reports are lacking; however, barberry exhibits anti-cytochrome P450 3A4 (CYP3A4) activity similar to that of grapefruit. Caution is warranted with co-administration of potentially toxic medicines such as cyclosporine.

1. GI symptoms (eg, nausea, vomiting, diarrhea), dizziness, and fainting have been reported.
2. Effects on the cardiovascular system (eg, hypotension, decreased heart rate) and decreased respiration may occur with high dosages. The German Commission E reports that lower doses of berberine are well tolerated.
3. Hypersensitivity has been documented.

Camel thorn [18]

 

Camel thorn has been shown to protect gastric mucosa of rats through its inhibitory effects on acid secretion. 

None well documented

None well documented

Pudilan keyanning [19]

 

Anti-inflammatory, anti-bacterial and anti-viral properties.

None well documented

None well documented.