Media release

From: Western Sydney University

A comprehensive webpage-based database, named as IMgateway, currently offers rigorous, evidence-based information on the integration of complementary and conventional medicine but has lacked data on Chinese herbal medicines – until now.

A research team, led by Dr Phoebe Zhou at the National Institute of Complementary Medicines, has added new data to fill this gap, detailing 540 general Chinese herb–drug interactions and 607 individual reports.

According to Dr Zhou about two in three Australians use some form of complementary medicines, but only 36 per cent consult a practitioner and she said this could come with unknown risks.

Examples on risks of concurrent use include St John’s Wort reducing the effectiveness of antidepressants, oral contraceptives, and certain heart medications; ginkgo biloba increasing bleeding risk when combined with warfarin; and garlic supplements interacting with anticoagulants, also raising the risk of bleeding.

“For chronic conditions, this practice is estimated to be five times more common among those over 65,” Dr Zhou said.

“However, there remains lack of informed decision making for practitioners and consumers.”

IMgateway currently houses over 1650 herb-drug, supplement-drug and food-drug interactions.

The platform provides a reliable decision-making tool to inform clinicians and consumers, leading to enhanced safety and clinical outcomes when using complementary medicines.

There are about 4508 registered Traditional Chinese Medicine practitioners in Australia and Chinese medicines account for 3.2 per cent of total complementary use in the country.

The statistics are much more substantial in Asian countries, such as China.

“Currently, there is no simple, widely accessible way for most people to check these interactions. Instead, patients often rely on word-of-mouth advice, online forums or Dr Google, which can be inaccurate or incomplete,” Dr Zhou said.

The IMgateway platform incorporates a traffic light guidance system that shows when combinations should be avoided, used with caution, and when an interaction in unlikely or may be potentially beneficial. This saves clinicians and TCM practitioners precious time by avoiding the need to check safety and efficacy concerns.

“Not all interactions are negative, and some combinations can enhance therapeutic effects, reduce side effects, or improve outcomes. For example, the beneficial effects of combining ginger with anti-nausea medications for gastrointestinal comfort,” Dr Zhou said.

“These examples highlight why evidence-based guidance is essential. Rather than avoiding all herb–drug combinations completely, the focus should be on informed, evidence-based use.

“The majority of preclinical and clinical studies indicate potentially beneficial interactions that may improve clinical outcomes.

“There are also combinations unlikely to cause interactions, supported by good evidence, and a few with insufficient or contradictory information in the literature.”

Dr Zhou said awareness and proactive checking of interactions was crucial.

“Before combining herbs with medications, patients and practitioners should consult reliable databases such as IMgateway or other evidence-based resources, or seek professional advice,” Dr Zhou said.

“This helps prevent serious risks, ensures safe prescribing, and also recognises combinations that may offer unique therapeutic benefits.”

Professor Alan Bensoussan, Professor Chun Guang Li and Professor Dennis Chang of NICM had also been involved in the research, and Adjunct Professor Kylie O’Brien.