Phytotherapeutic agent rationales

Authors: Prof. Dr. med. Peter Altmeyer, Prof. Dr. med. Martina Bacharach-Buhles

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Last updated on: 29.10.2020

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Synonym(s)

Herbal remedies; Phytopharmaceutical; Phytopharmaceuticals

Definition
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Rational phytotherapeutics (phytopharmaceutical: from - Greek - phyton for plant and pharmacon for drug) are drugs, which, in contrast to chemically defined drugs, as well as isolated, chemically identified, pure plant substances, contain mainly standardized and / or normalized extracts. They are predominantly mixtures of many substances that are active at different molecular target structures in the organism.
Rational phytotherapeutics are used by doctors in accordance with the generally valid principles of drug therapy. Their effect and their efficacy are proven on the basis of animal and human pharmacological evidence and are also proven in accordance with the guidelines of the German Drug Law (AMG §4 para. 23), also taking into account medical experience. Because phytopharmaceuticals are variable natural products, today only well standardised and standardised extracts are increasingly used, which provide a basis for a constant effect. This requires a controlled extract quality. This can only be guaranteed if the standardized plant material is processed in a traceable, consistent, standardized manufacturing process.

Standardization: If an extract is defined by an efficacy determining ingredient, this is adjusted to a defined and constant quantity by a standardization procedure of the plant extract (only extracts from a previously defined, always the same parent plant are used).
If efficacy determining and efficacy co-determining ingredients are not or only partially known, a constant extract quality is achieved by the quality of the source drug, by the process quality and by the quantification of so-called lead substances.

Active ingredient and dosage form:Phytotherapeutics are offered in the known common dosage forms (tea, drops, powder, tablets, dragees, capsules as well as in topical applications. If a phytopharmaceutical contains an extract of one or more active ingredients from the same plant as the active ingredient, it is (nevertheless) declared as a mono-preparation.

The extract in its entirety is the active ingredient. In rare cases, a herbal combination preparation may also contain extracts from several different plants (see explanations under parent plants). This combination preparation is also declared as a mono-preparation.
Traditional phytopharmaceuticals:Rational phytotherapeutics are clearly distinguished from the so-called "traditional phytopharmaceuticals". The use of traditional (non-monographed) phytopharmaceuticals is primarily based on the clinical experience of individuals. Reliable controlled studies are generally lacking.

Phytopharmaceuticals are not homeopathics: Phytopharmaceuticals contain active pharmaceutical ingredients. Phytopharmaceuticals are not homeopathics. Homeopathic remedies contain only traces of the active ingredients due to the strong dilution and are no longer effective from a pharmacological point of view. Also, unlike phytotherapy, homeopathy has no scientific basis. Its principle of action is fundamentally opposite to that of modern and standardised drug therapy.

Risks and side effects: Basically, phytopharmaceuticals have the same risks as all other drugs - there is a potential for adverse effects (ADR), contraindications and drug interactions exist.
Basic indications: Phytopharmaceuticals are well suited for simple and chronic complaints and can also be used well in older people with multiple prescriptions due to their rather low interaction potential.

Literature
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  1. Falch B et al (2013) Phytotherapy - the well-documented basis of orthodox medicine. Swiss medical journal 94:161-163
  2. Hermann PT et al (2014) Pharmaceutical Dictionary. De Gruyter GmbH Berlin, Boston
  3. Keller K et al (2003) Phytopharmaceuticals. Definitions and backgrounds. Federal Health Gazette 46: 1036-1039
  4. Loew D et al (1999) Phytopharmaceutical report. stone head Darmstadt S 7-12