Prescription patterns of herbal medicines at a Brazilian Living Pharmacy: The Farmácia da Natureza experience, 2013–2019

Herbal medicines are an important part of healthcare worldwide. In Brazil, the national authorities issued the concept of “living pharmacies”, that produce and offer herbal medicines in the Brazilian unified public health system. Farmácia da Natureza (Nature’s Pharmacy) is a living pharmacy and a single, not-for-profit institution that integrates traditional and scientific knowledge on medicinal plants, along with the preservation of Brazilian biodiversity, with benefits to the health of the population that uses herbal drugs. A six-year experience of medical prescription of herbal medicines at Farmácia da Natureza is reported A retrospective, descriptive analysis of data on medical prescriptions of herbal medicines was conducted (September 2013 to December 2019) retrieved from a computerized database. A total of 47,418 prescription items for 4739 patients were analyzed. The most frequent pharmaceutical forms were tinctures (39.6%); capsules containing powdered plant material (20.7%); creams, ointments, or gels (12.3%); and aqueous extracts (11.7%). The five most frequently prescribed single-constituent herbal medicines were: Curcuma longa L. (Zingiberaceae); Valeriana officinalis L. (Caprifoliaceae); Aloysia polystachya (Griseb.) Moldenke (Verbenaceae); Eclipta prostrata (L.) L. (Asteraceae); and Baccharis trimera (Less.) DC. (Asteraceae). Nearly half of the plants were naturally occurring in Brazil, while more than 80% of the products were not present in Brazilian official documents. At Farmácia da Natureza, herbal medicines are usually prescribed as tinctures and capsules containing powdered plant material, but other pharmaceutical forms are also prescribed. Half of the plants are of Brazilian origin and almost all preparations are galenic formulations.