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=== Adverse herb–drug interactions === {{See also|Grapefruit–drug interactions|Cytochrome P450|label 2=Cytochrome P450 (CYP)}} Some phytochemicals found in herbs and fruits can adversely interact with others and over the counter or prescription medications, among other ways by affecting their metabolism by the body. Herbs and fruits that inhibit or induce the body's Cytochrome P450 enzyme complex function can either cause the drug to be dangerously ineffective, or increase its effective absorbed dose to potentially toxic levels, respectively. Best known examples of adverse herb‑drug interactions are [[grapefruit]] or [[Hypericum perforatum|St John's wort]], contraindicated for several medications including [[Paxlovid]] and [[oral contraceptives]], but other herbs also affect the CYP enzyme family, showing herb‑drug interactions.<ref>{{Cite journal |last1=Zuo |first1=Hua-Li |last2=Huang |first2=Hsi-Yuan |last3=Lin |first3=Yang-Chi-Dung |last4=Cai |first4=Xiao-Xuan |last5=Kong |first5=Xiang-Jun |last6=Luo |first6=Dai-Lin |last7=Zhou |first7=Yu-Heng |last8=Huang |first8=Hsien-Da |date=2022-01-14 |title=Enzyme Activity of Natural Products on Cytochrome P450 |journal=Molecules |language=en |volume=27 |issue=2 |pages=515 |doi=10.3390/molecules27020515 |issn=1420-3049 |pmc=8779343 |pmid=35056827 |doi-access=free }}</ref><ref>{{Cite journal |last1=Cho |first1=Hyun-Jong |last2=Yoon |first2=In-Soo |date=2015 |title=Pharmacokinetic Interactions of Herbs with Cytochrome P450 and P-Glycoprotein |journal=Evidence-Based Complementary and Alternative Medicine |language=en |volume=2015 |pages=1–10 |doi=10.1155/2015/736431 |issn=1741-427X |pmc=4302358 |pmid=25632290 |doi-access=free }}</ref><ref>{{Cite journal |last1=Smith |first1=Dallas J. |last2=Bi |first2=Huichang |last3=Hamman |first3=Josias |last4=Ma |first4=Xiaochao |last5=Mitchell |first5=Constance |last6=Nyirenda |first6=Kumbukani |last7=Monera-Penduka |first7=Tsitsi |last8=Oketch-Rabah |first8=Hellen |last9=Paine |first9=Mary F. |last10=Pettit |first10=Syril |last11=Pheiffer |first11=Wihan |last12=Van Breemen |first12=Richard B. |last13=Embry |first13=Michelle |date=2023-07-12 |title=Potential pharmacokinetic interactions with concurrent use of herbal medicines and a ritonavir-boosted COVID-19 protease inhibitor in low and middle-income countries |journal=Frontiers in Pharmacology |volume=14 |doi=10.3389/fphar.2023.1210579 |issn=1663-9812 |pmc=10368978 |pmid=37502215 |doi-access=free }}</ref>
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