Herbal Monographs Including Herbal Medicinal Products and Food Supplements

Set and printed by Print Right Ltd, Qormi

Maria Spiteri

Department of Pharmacy
University of Malta

This book was compiled by Maria Spiteri as part of a project carried out for the partial
fulfillment of the requirements of the course leading to the Degree of Bachelor of Pharmacy
(Hons.). The study was carried out under the supervision of Professor Anthony Serracino-
Inglott, at the Department of Pharmacy, University of Malta, to whom I owe my gratitude
for his guidance.

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Book Details
 252 p
 File Size 
 2,907 KB
 File Type
 PDF format
 Department of Pharmacy,
 University of Malta 2011

Students in the department of pharmacy are encouraged to develop skills to
give advice and support patients on the use of medicines. In order to reach
this goal, students have to present a project in an area of pharmacy. Maria
Spiteri worked on a project to device a formulary of herbal medicines
available locally under the supervision of Professor Anthony Serracino-
Inglott. The department is grateful to all those who helped Maria in this
project leading to the publication of this book.

This book has an academic value as it is the result of careful research
by Maria Spiteri and is of practical use since it is intended to be used by
healthcare professionals during their day to day work.

In this day and age when the health professionals are giving significant
attention to pharmacovigilance, such work presents a good opportunity to
advance the process of vigilance over medicine use. One may state that the
case of herbal medicines, and also for food supplements, merits an extra
dose of input as present sources of information are lacking compared to
what is available on conventional medicine.

This book is meant to promote guidelines. The references provide for
further reading. In practice one should not rely solely on facts presented
in this book, however diligently it was prepared.
Professor Lilian M. Azzopardi
Head, Department of Pharmacy

The focus of medicinal use has shifted from herbal medicines to synthetic
drugs in the last century. There is a movement to reconsider the benefits
of herbal medicines. There is a school advocating the use of traditional
medicine in addition to a more western type of therapy. Herbal medicines
are, however, contrary to common belief, not immune to adverse effects.
Consequently doctors, pharmacists and other health professionals as
well as patients themselves need to extend their knowledge on herbal
medicines. Patients are continuously taught how to take care of their own
health. Since a number of herbal medicines are used in self care a greater
awareness of the benefits and the possible unwanted effects that may occur
is needed. A good glance into the Maltese islands shows that potentially
harmful reactions could result from use of such medicines since many
believe herbal therapy presents a possibility of causing harm. On the one
hand lack of knowledge on the subject not only by patients but also by
some health professionals could potentially be a cause for adverse effects
while on the other hand misconceptions about herbal medicines may limit
the number of patients who could benefit from their use. Easy access to
patients makes community pharmacists the ideal health care professionals
for offering the necessary information and advice. Pharmacies have the
advantage of being conveniently located and the community pharmacist
is easily accessible and may be approached without the need of a prior
The aim of this book on herbal medicines is to provide enough information
to arouse the interest of the reader for further reading. Hence the well
referenced nature of this work.
It was a pleasure to supervise this work by Maria Spiteri who has worked
hard to deliver such a useful service listing the herbal medicines available
in Malta including those classified as borderline products.
Professor Anthony Serracino-Inglott
Department of Pharmacy

About this Herbal handbook
Each monograph summarizes in a concise form the most useful scientific
research and review information on a plant drug, together with brief
information on the herbal medicinal products and food supplements
available in Maltese community pharmacies and health food shops. As
a reflection of the volume of scientific literature available, in most of the
monographs, the proportion of reference papers published since the year
2000 is remarkably high. Internet access to free databases and abstracts
of new papers, especially from major journals published in English, has
greatly enhanced awareness of the available literature. The acquisition of
scientific papers not available at the UOM library was time-consuming
and costly, but essential for documentary research of this kind.

This book aims to address the practical needs of all healthcare
professionals, particularly pharmacists, who advice patients who take
complementary medicines. The monographs provide information on the
classification, indications, cautions, contraindications, side-effects, drug
interactions and dose. The indications in the monographs are subdivided
into principal, major, minor and others in order to give an indication on the
actual and potential use of the herbal medicinal product. Such information
is well referenced, with over 500 references. For a great number of herbs
there is an abundance of research to draw on, whereas for some others the
research is scarce and much is still speculative or based on traditional or
historical use. To make the book more practical for use by pharmacists a
comprehensive indications index is presented. The book was developed
considering current evidence-based practice and was validated by a panel
of experts and also by laymen through a one-to-one interview.

Recent EU legislation, brought about to ensure patients’ safety, gave rise
to a change in the classification of what was previously ambiguously
referred to as herbal products. While many herbal products are medicines,
others are not, and so do not require registration as medicinal products.
Herbal medicinal products, fall into two main categories, depending on
whether they fulfill the criteria for the definition of a traditional herbal
medicinal product or a medicinal product. This re-classification of herbal
products, done by the Malta Medicines Authority, is very lengthy and
time-consuming process, and to date the classification is incomplete. Both
food supplements and herbal medicinal products were included in this book.


Table of Contents
Preface v
Introduction vi
About this herbal handbook vii
Acknowledgements viii
Abbreviations ix
Monographs 1
References 169
Indications Index 191
Contraindications Index 217
Herb Name Index 223
Product Index 229
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