Abstract

Complementary and Integrative Medicine (CIM) is increasingly relevant to clinical practice because many patients use herbal products, dietary supplements, and traditional remedies together with conventional medications. This narrative review summarizes commonly used Ayurvedic, Chinese, and botanical agents with potential drug interactions and safety concerns relevant to future physicians. National survey data show that natural products are widely used in the United States, including among patients with chronic diseases who are more likely to take multiple prescription or over-the-counter medications. This manuscript reviews selected agents, including capsicum, cranberry, echinacea, evening primrose oil, flaxseed, garlic, ginseng, green tea, ginkgo, milk thistle, saw palmetto, soy isoflavones, St. John’s wort, valerian, ginger, turmeric, ashwagandha, guggul, dong quai, danshen, licorice, and ephedra. Major clinical concerns include bleeding risk, additive sedation, altered blood pressure or glucose control, thyroid effects, cytochrome P450 and P-glycoprotein interactions, immune modulation, hepatotoxicity, electrolyte abnormalities, and reduced medication effectiveness. Rather than discouraging all herbal use, this review emphasizes respectful medication reconciliation, patient-centered counseling, and recognition of highrisk patterns, especially in surgical patients, older adults, transplant recipients, oncology patients, and individuals taking anticoagulants, antiplatelet agents, sedatives, antidepressants, immunosuppressants, thyroid medications, or cardiovascular drugs. CIM education can prepare physicians to integrate traditional health practices safely while applying modern pharmacology and evidence-based patientsafety principles.

Keywords:Complementary and integrative medicine; Herbal medicine; Herb-drug interactions; Dietary supplements; Ayurvedic medicine; Traditional chinese medicine; Medication reconciliation; Patient safety