Lesson 2: Safety before prescribing

The following stages are necessary for safe prescribing of herbs and herb combinations:

• individual consultation and assessment
• conventional diagnosis and treatment
• accurate diagnosis
• check safety data for each herb
• check for updates
• check for drug interactions
• check modifications
• use appropriate dose
• check local laws

Individual consultation and assessment
The herbs and herb combinations included in this database should only be supplied to a patient following an individual consultation and assessment of that patient by a licensed health practitioner.

Conventional diagnosis & treatment
The herbs and herb combinations included in this database are not proposed as an alternative to conventional medical diagnosis and treatment, when this is necessary for the patient.

Specialist conventional diagnosis is particularly important when the patient has a potentially severe condition, or to exclude serious illness.

Example of arrhythmia  Herbal prescription should only be used, in appropriate cases of mild to moderate chronic arrhythmia, as an adjunct to conventional treatment, and only after specialist diagnosis. If any symptoms become severe, the patient should stop the herb prescription and get immediate medical attention.

Example of hematuria  Herbal treatment should not commence until the patient has had specialist diagnosis to exclude serious conditions, such as carcinoma of urinary or reproductive system, or sexually transmitted disorders.

Accurate diagnosis
It is the responsibility of the practitioner to make an accurate diagnosis, whether in terms of conventional medicine, Chinese medicine, or both, and to decide whether a particular herb or herb combination is appropriate for a specific patient at a particular time.

Check safety data for each herb
Before you finally prescribe a recipe, we strongly recommend that you check the cautions and contraindications of each herb in your recipe for safety reasons.

Check for updates
Herbal and medical knowledge and practice is constantly changing, and it is the responsibility of the practitioner to keep up-to date with new knowledge in this field. This includes the use of online sources for additional research studies on herbs and their main pharmacologically-active constituents, eg. PubMed https://pubmed.ncbi.nlm.nih.gov/ and Google Scholar https://scholar.google.com/.

Check for herb-drug interactions
What medications is patient taking?  It is the responsibility of the practitioner to determine exactly what medical drugs the patient is taking, including the name of the drug, the dose, the time of day taken, and any side effects produced by the drug.

It is necessary for the patient to tell the practitioner if there are changes in prescribed drugs or drug dose, since this may affect which herbs can safely be prescribed.

Herb-drug data  Data on potential herb-drug adverse reactions are included in the safety data on each of the individual herbs in the database.

Check for updates  The practitioner is advised to check online for new data on interactions, since knowledge of potential herb-drug interactions and resulting recommended practice is constantly changing.

Check modifications  The practitioner may wish to change one of the preset herb prescriptions, or their preset modifications, that are included in this database, to adapt it to the needs of a specific patient.
The practioner should consider the consequences of removing a particular herb from the prescription. For example, was the herb to be removed originally included to reduce the potential side effects of another herb in the prescription.

Create a new combination
The practitioner can create a new combination from the herbs and combinations listed in this database.

Use appropriate dose
Any medical drug, including herbal drugs, should be used within the recommended therapeutic dose range. This is listed for all herbs in database, and will appear on screen, for each of the herbs in the combination, when the practitioner has chosen a prescription for the patient, and clicks on Dose and dispensing.

It is the responsibility of the practitioner to prescribe herbs in appropriate dose for the age, constitution, and condition of the patient, and to to check for updates on dose for a specific herb.

For more detailed information about Dose and Dispensing see the articles in lesson 6 of this online course.

Check local laws
It is the responsibility of practitioners to be aware of any special restrictions on herb prescribing specific to their own country or local area, or to the type of practitioner, eg. whether medical doctor or other health practitioner.