Phytotherapy in Community Pharmacy: Legal Aspects, Uses, and Interactions.

Abstract

Phytotherapy, an ancient practice based on the use of plant-based products, has recently seen a strong resurgence, driven by a growing preference for "natural" products. In the context of community pharmacy, it is presented as an alternative or complement to conventional treatments, especially for mild or chronic conditions, or as an adjuvant for serious illnesses. However, its use is not without risks, due to the variability in the composition of marketed products, the pharmacological action of their active ingredients, and the lack of uniform regulatory framework. There are different legal categories for these products, depending on their composition, indication, and scientific backing. Some, such as dietary supplements and medical devices, are available without medical supervision despite containing active ingredients used in prescription medications. In this context, the community pharmacist plays an essential role in patient counseling and promoting the rational and safe use of phytopharmaceuticals. In Spain, 192 authorized plant-based active ingredients are currently identified, underscoring the importance of their proper management in healthcare practice. Although generally well tolerated, these products are not free from adverse effects, especially in vulnerable populations such as pregnant women, children, the elderly, immunosuppressed individuals, and patients on multiple medications. Furthermore, they can generate significant interactions. Therefore, their dispensing and recommendation require specialized and up-to-date knowledge on the part of the pharmacist, thus ensuring a safe and effective therapeutic approach.