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Bad mixes: Some herbal remedies can be dangerous when used with prescription

drugs

Tuesday, December 01, 1998

The Washington Post

Herbal medicines are increasingly popular, but many patients do not inform

their physicians that they are using these alternative remedies, according

to one of the studies released by the American Medical Association last

month. This can be dangerous because some of the herbs affect prescription

drugs.

Chamomile: Contains coumarin, but chamomile's effects on the body's

anticoagulation system have not been studied. If used with anticoagulants

such as warfarin, close monitoring by a doctor is advised.

Echinacea: May be toxic to the liver if used for more than eight weeks.

Should not be used with drugs that can cause liver problems, such as

anabolic steroids, amiodarone, methotrexate and ketoconazole. Should not be

given with immunosuppressants such as corticosteroids and cyclosporine

because it can stimulate the immune system.

Evening primrose oil and borage: Should not be used with anticonvulsants

because they may lower the seizure threshold.

Feverfew: Effect on migraine headaches may be compromised by nonsteroidal

anti-inflammatory drugs, such as aspirin and ibuprofen. Also should not be

used with the drug warfarin or other anticoagulants because feverfew

inhibits clotting.

Garlic: Should not be used with warfarin because it affects clotting.

Ginger: Should not be used with warfarin because it affects clotting.

Gingko: Can inhibit clotting so should not be used with aspirin or other

nonsteroidal anti-inflamatory drugs or with anticoagulants such as warfarin

or heparin. Also should not be used in conjunction with anticonvulsant drugs

used by epileptics, such as carbamazepine, phenytoin and phenobarbital, or

with tricyclic antidepressants.

Ginseng: Should not be used with warfarin, heparin, aspirin and other

nonsteroidal anti-inflamatory drugs because it can inhibit clotting. Also

may cause headache, tremulousness and manic episodes in patients treated

with phenelzine sulfate. Should not be used with estrogens or

corticosteroids because it may add to those drugs' side effects. May also

interfere with the heart drug digoxin or with digoxin monitoring. Should not

be used by diabetics because it can affect blood glucose levels.

Karela: Should not be used by patients with diabetes because it can affect

blood glucose levels.

Kava: Should not be used with the tranquilizer alprazolam because it may

result in coma.

Kelp: May interfere with thyroid replacement therapies.

Licorice: Can offset the effect of the diuretic drug spironolactone. May

also interfere with heart drug digoxin or with digoxin monitoring.

St. 's wort: Can produce skin reactions to light so fair-skinned users

may wish to take care and anyone taking other drugs that cause light

sensitivity, such as piroxicam or tetracycline, may want to avoid this herb.

The active ingredient in St. 's wort is uncertain, so it should not be

used with two common types of psychiatric drugs called monoamine oxidase

inhibitors and selective serotonin reuptake inhibitors. Tannic acid in the

herb may inhibit absorption of iron.

Valerian: Should not be used with barbiturates, such as thiopental and

pentobarbital -can cause excessive sedation.

--------------------------------------------------------------------------------

Source: Lucinda G. , Texas Tech University Health Sciences Center,

Department of Pharmacy Practice; Archives of Internal Medicine, Nov. 9,

1998.

______________________________________________________

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Guest guest

Bad mixes: Some herbal remedies can be dangerous when used with prescription

drugs

Tuesday, December 01, 1998

The Washington Post

Herbal medicines are increasingly popular, but many patients do not inform

their physicians that they are using these alternative remedies, according

to one of the studies released by the American Medical Association last

month. This can be dangerous because some of the herbs affect prescription

drugs.

Chamomile: Contains coumarin, but chamomile's effects on the body's

anticoagulation system have not been studied. If used with anticoagulants

such as warfarin, close monitoring by a doctor is advised.

Echinacea: May be toxic to the liver if used for more than eight weeks.

Should not be used with drugs that can cause liver problems, such as

anabolic steroids, amiodarone, methotrexate and ketoconazole. Should not be

given with immunosuppressants such as corticosteroids and cyclosporine

because it can stimulate the immune system.

Evening primrose oil and borage: Should not be used with anticonvulsants

because they may lower the seizure threshold.

Feverfew: Effect on migraine headaches may be compromised by nonsteroidal

anti-inflammatory drugs, such as aspirin and ibuprofen. Also should not be

used with the drug warfarin or other anticoagulants because feverfew

inhibits clotting.

Garlic: Should not be used with warfarin because it affects clotting.

Ginger: Should not be used with warfarin because it affects clotting.

Gingko: Can inhibit clotting so should not be used with aspirin or other

nonsteroidal anti-inflamatory drugs or with anticoagulants such as warfarin

or heparin. Also should not be used in conjunction with anticonvulsant drugs

used by epileptics, such as carbamazepine, phenytoin and phenobarbital, or

with tricyclic antidepressants.

Ginseng: Should not be used with warfarin, heparin, aspirin and other

nonsteroidal anti-inflamatory drugs because it can inhibit clotting. Also

may cause headache, tremulousness and manic episodes in patients treated

with phenelzine sulfate. Should not be used with estrogens or

corticosteroids because it may add to those drugs' side effects. May also

interfere with the heart drug digoxin or with digoxin monitoring. Should not

be used by diabetics because it can affect blood glucose levels.

Karela: Should not be used by patients with diabetes because it can affect

blood glucose levels.

Kava: Should not be used with the tranquilizer alprazolam because it may

result in coma.

Kelp: May interfere with thyroid replacement therapies.

Licorice: Can offset the effect of the diuretic drug spironolactone. May

also interfere with heart drug digoxin or with digoxin monitoring.

St. 's wort: Can produce skin reactions to light so fair-skinned users

may wish to take care and anyone taking other drugs that cause light

sensitivity, such as piroxicam or tetracycline, may want to avoid this herb.

The active ingredient in St. 's wort is uncertain, so it should not be

used with two common types of psychiatric drugs called monoamine oxidase

inhibitors and selective serotonin reuptake inhibitors. Tannic acid in the

herb may inhibit absorption of iron.

Valerian: Should not be used with barbiturates, such as thiopental and

pentobarbital -can cause excessive sedation.

--------------------------------------------------------------------------------

Source: Lucinda G. , Texas Tech University Health Sciences Center,

Department of Pharmacy Practice; Archives of Internal Medicine, Nov. 9,

1998.

______________________________________________________

Get Your Private, Free Email at http://www.hotmail.com

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