Phytotherapeutic agent rationales

see also rational phytotherapy.

Rational phytotherapeutics (phytopharmacon: from the Greek phyton for plant and pharmakon for medicinal product) are medicinal products which, in contrast to chemically defined pharmaceuticals and isolated, chemically identified, pure plant substances, predominantly contain standardized and/or normalized extracts. They are predominantly mixtures of multiple substances that are effective on various molecular target structures in the organism.
Rationalphytotherapeutics are used by doctors in accordance with the generally applicable principles of drug therapy. Their effect and efficacy have been proven on the basis of animal and human pharmacological evidence and in accordance with the guidelines of the German Medicines Act (AMG §4 para. 23), also taking into account medical experience. Because phytopharmaceuticals are variable natural products, today increasingly only well standardized extracts are used, which provide a basis for a consistent effect. This requires a controlled extract quality. This can only be guaranteed if the standardized plant material is processed in a reproducible, consistent, standardized manufacturing process.

Standardization: If an extract is defined by an efficacy-determining ingredient, this is adjusted to a defined and consistent quantity by a standardization process of the plant extract (only extracts from a predetermined, always identical parent plant are used).
If efficacy-determining and co-determiningingredients are not or only partially known, a consistent extract quality is achieved through the quality of the starting drug, through the process quality and through the quantification of so-called lead substances.

Active ingredient and dosage form: Phytotherapeutics are offered in the usual dosage forms (tea, drops, powder, tablets, coated tablets, capsules and 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 monopreparation.

The extract is the active substance in its entirety. In rare cases, a herbal combination product may also contain extracts of several different plants (see explanations under parent plants). This combination preparation is also declared as a monopreparation.
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.

Phytopharmaceuticalsare not homeopathics: phytopharmaceuticals contain active pharmaceutical ingredients. Phytopharmaceuticals are not homeopathic remedies. Due to the strong dilution, homeopathic remedies contain only traces of the active ingredients 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 opposed to that of modern and standardized drug therapy.

Risks and side effects: In principle, phytopharmaceuticals have the same risks as all medicines - there is a potential for adverse effects (ADRs), contraindications and drug interactions.
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.

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