J. Pharm. Pharmacogn. Res., vol. 14, no. 2, Article ID 2405, Mar-Apr 2026.

DOI: https://doi.org/10.56499/jppres_14.2.2405

Review

Adverse events and potential herb-drug interactions of plants used for psoriasis: A systematic review

[Eventos adversos y posibles interacciones entre plantas utilizadas para la psoriasis: una revisión sistemática]

Marwan Gagaa¹, Roberto Esquivel-García^2,3, María E. Velázquez-Hernández⁴, Isis B. Bermúdez-Camps⁵, Manuel García-Pérez⁶, Alain R. Rodríguez-Orozco⁷, Ivette Reyes-Hernández^5*, Martha E. García-Pérez^2**

¹School of Molecular Biosciences, Washington State University, Pullman, WA, USA.

²Facultad de Químico-Farmacobiología, Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Michoacán, México.

³Facultad de Ciencias Naturales, Universidad Autónoma de Querétaro, Querétaro, México.

⁴Clínica de Enfermedades Crónicas y Procedimientos Especiales, Morelia, Michoacán, México.

⁵Instituto de Ciencias de la Salud. Área Académica de Farmacia. Universidad Autónoma del Estado de Hidalgo. Pachuca, Hidalgo, México.

⁶Department of Biological Systems Engineering, Washington State University, Pullman, WA, USA.

⁷Facultad de Ciencias Médicas y Biológicas. Universidad Michoacana de San Nicolás de Hidalgo, Morelia, Michoacán, México.

E-mail: ^*ivette_reyes@uaeh.edu.mx, ^**estrella.perez@umich.mx

Abstract

Context: Medicinal plants have been widely used for psoriasis management for centuries. However, their safety profiles remain insufficiently documented.

Aims: To systematically evaluate adverse events (AEs) and potential pharmacokinetic interactions of antipsoriatic herbal treatments.

Methods: A PRISMA-compliant review was conducted using PubMed, Cochrane, Google Scholar, Web of Science, and Scopus databases (January 2015-December 2022). Clinical trials, case reports, and ethnomedicinal studies reporting AEs of single plant antipsoriatic preparations were included. CONSORT criteria for herbal medicines were applied to assess study quality.

Results: Eleven studies covering nine herbal treatments were included. While most of reported AEs were mild, severe cases involving Indigo naturalis, Psoralea corylifolia, and Ranunculus arvensis were documented. Several herbal metabolites (indirubin, psoralen, curcumin, triptolide) showed potential pharmacokinetic interactions with conventional drugs.

Conclusions: While generally well tolerated, antipsoriatic herbal therapies can induce mild to severe AEs and may alter drug metabolism. Long-term, high-quality randomized trials are needed to establish their safety profile.

Keywords: adverse events; complementary medicine; herb-drug interactions; medicinal plants; pharmacovigilance; psoriasis.

Resumen

Contexto: Las plantas medicinales se han utilizado ampliamente para tratar la psoriasis durante siglos. Sin embargo, sus perfiles de seguridad siguen insuficientemente documentados.

Objetivos: Evaluar sistematicamente los eventos adversos (EA) y las posibles interacciones farmacocinéticas asociadas a los tratamientos herbales antipsoriásicos.

Métodos: Se realizó una revisión según PRISMA utilizando las bases de datos PubMed, Cochrane, Google Scholar, Web of Science y Scopus (enero de 2015 a diciembre de 2022). Se incluyeron ensayos clínicos, informes de casos y estudios etnomedicinales que informaron EA de preparaciones antipsoriásicas de una sola planta. Se aplicaron los criterios CONSORT a los estudios sobre medicamentos herbales para evaluar la calidad de los estudios.

Resultados: Se incluyeron once estudios que abarcaban nueve tratamientos herbales. Si bien la mayoría de los EA notificados fueron leves, se documentaron casos graves relacionados con Indigo naturalis, Psoralea corylifolia y Ranunculus arvensis. Varios metabolitos herbales (indirrubina, psoraleno, curcumina, triptolida) presentaron posibles interacciones farmacocinéticas con fármacos convencionales.

Conclusiones: Si bien generalmente se toleran bien, las terapias herbales antipsoriásicas pueden inducir EA de leves a graves y alterar el metabolismo de los fármacos. Se necesitan ensayos aleatorizados a largo plazo y de alta calidad para establecer su perfil de seguridad.

Palabras Clave: eventos adversos; farmacovigilancia; interacciones entre hierbas y fármacos; medicina complementaria; plantas medicinales; psoriasis.

https://jppres.com/jppres/pdf/vol14/jppres_14.2.2405.pdf

Citation Format: Gagaa M, Esquivel-García R, Velázquez-Hernández ME, Bermúdez-Camps IB, García-Pérez M, Rodríguez-Orozco AR, Reyes-Hernández I, García-Pérez ME (2026) Adverse events and potential herb-drug interactions of plants used for psoriasis: A systematic review. J Pharm Pharmacogn Res 14(2): 2405. https://doi.org/10.56499/jppres_14.2.2405

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