Phytotherapy and Biochemical Interactions in Traditional Medicine Practice: A Professional Assessment in Enugu State

The concurrent use of herbal preparations and conventional pharmaceuticals by patients in Enugu State represents a significant clinical concern, as biochemical interactions between phytochemical compounds and drug metabolizing enzyme systems can produce clinically important pharmacokinetic and pharmacodynamic alterations. This study professionally assesses the nature, prevalence, and biochemical risk profile of herb-drug interactions in traditional medicine practice in Enugu State. A mixed-methods professional assessment combined a patient survey of three hundred individuals attending two general hospitals and two traditional medicine practitioners in Enugu, structured interviews with fifteen traditional healers and twelve hospital pharmacists, and laboratory-based assessment of CYP450 enzyme inhibitory potential of ten commonly used Igbo herbal preparations using the in vitro microsomal incubation method with specific CYP1A2, CYP2D6, and CYP3A4 substrates. Patient survey results reveal that 62 percent of hospital patients concurrently use herbal preparations, with only 19 percent disclosing this to their physicians. Traditional healers report routine prescription of herbal preparations alongside conventional drugs in 44 percent of their consultations. Laboratory enzyme inhibition studies show that five of the ten tested preparations inhibit CYP3A4 activity by more than 50 percent at achievable extract concentrations, indicating significant potential for interactions with drugs metabolized by this pathway including antiretrovirals, antihypertensives, and anticoagulants. The study recommends mandatory herb-drug interaction screening questions in Enugu State hospital admission protocols and biochemistry-informed regulation of herbal formulations. Keywords: herb-drug interactions, phytotherapy, CYP450, traditional medicine, Enugu State.