Herbal Medicine Safety: Comparative Evaluation of Adverse Drug Reactions in Two Subdistrict, Gorontalo City

Abstract

Amid the growing trend of herbal medicine consumption in Indonesia, it is essential to understand the potential Adverse Drug Reactions (ADRs) that may arise across various communities. Gorontalo, a region rich in biodiversity, continues to widely utilize herbal medicines in daily practices. This study aimed to evaluate the profile of Adverse Drug Reactions (ADRs) among herbal medicine users in the Sipatana and Kota Utara sub-districts of Gorontalo City. A descriptive observational approach was employed, with data collected through direct interviews with 194 respondents, comprising 97 participants from each sub-district. Collected data included demographic characteristics, types of herbal medicines used, and clinical manifestations of ADRs. Quantitative analyses were conducted to determine the frequency, ADR categories based on causality, and causal relationships according to the Naranjo ADR Probability Scale. The results indicated that most respondents were of productive age (31–50 years), predominantly female and housewives. Among the nine reported ADR cases, 22.3% were classified as possible, 44.4% as probable, and 33.3% as definite. The herbs most frequently associated with ADRs included garlic, moringa leaves, Peperomia pellucida, Kayu Bajakah, Clinacanthus nutans, and soursop leaves. The most common manifestations involved the gastrointestinal system, such as epigastric pain, colic, diarrhea, as well as certain metabolic and hypoglycemic effects. The study emphasizes the importance of individual factors, dosage, duration of use, and herbal combinations in determining ADR risk. These findings underscore the need for patient education on safe herbal use, appropriate clinical monitoring, and consultation with healthcare professionals before combining multiple herbs. Further research is recommended to examine interactions between herbs and conventional drugs and to develop community-based herbal pharmacovigilance systems. Consequently, this study provides a scientific basis to enhance the safety of herbal medicine use and support evidence-based pharmacy practice in the community.