Herb-drug interactions (HDIs) are a growing concern in modern healthcare, with almost 70% of individuals using herbal remedies alongside conventional pharmaceuticals. These interactions can have either beneficial or adverse consequences, and the concentration of a medicine in a certain tissue may change due to these interactions. Herb-mediated blockage and activation of protein transporters and drug-metabolizing enzymes, such as the CYP450 framework, is a common method that pharmaceuticals and herbs collaborate on. Herbovigilance, is the surveillance and assurance of the responsible use of conventional drugs, is crucial for the safety of herbal treatments. However, the frequency of adverse pharmacological reactions associated with herbal treatments has been refuted by numerous scientific studies. Herbal molecules can interact with medicines via pharmacodynamic pathways, leading to antagonistic, combined, and synergistic effects. The quality of herbal remedies is another significant risk factor, as it is difficult to precisely evaluate the safety and efficacy of herbal remedies due to problems like adulteration, misidentification, and contamination. Unpredictable therapeutic effects and an elevated risk of interaction can also result from variations in the content of herbal products, often caused by variations in production and preparation techniques. Despite the increasing awareness of the importance of monitoring HDIs, there is still a lack of standardized guidelines for assessing HDIs, leading to unreported adverse reactions and underestimated risks of using traditional and herbal remedies simultaneously.