Useful Interractions

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HERB - DRUG INTERACTIONS: " Herbal medicinals are being used by an

increasing number of patients who typically do not advise their

clinicians of concomitant use. Known or potential drug-herb

interactions exist and should be screened for. If used beyond 8 weeks,

Echinacea could cause hepatotoxicity and therefore should not be used

with other known hepatoxic drugs, such as anabolic steroids,

amiodarone, methotrexate, and ketoconazole. However, Echinacea lacks

the 1,2 saturated necrine ring associated with hepatoxicity of

pyrrolizidine alkaloids. Nonsteroidal anti-inflammatory drugs may

negate the usefulness of feverfew in the treatment of migraine

headaches. Feverfew, garlic, Ginkgo, ginger, and ginseng may alter

bleeding time and should not be used concomitantly with warfarin

sodium. Additionally, ginseng may cause headache, tremulousness, and

manic episodes in patients treated with phenelzine sulfate. Ginseng

should also not be used with estrogens or corticosteroids because of

possible additive effects. Since the mechanism of action of St 's

Wort is uncertain, concomitant use with monoamine oxidase inhibitors

and selective serotonin reuptake inhibitors is ill advised. Valerian

should not be used concomitantly with barbiturates because excessive

sedation may occur. Kyushin, licorice, plantain, uzara root, hawthorn,

and ginseng may interfere with either digoxin pharmacodynamically or

with digoxin monitoring. Evening primrose oil and borage should not be

used with anticonvulsants because they may lower the seizure

threshold. Shankapulshpi, an Ayurvedic preparation, may decrease

phenytoin levels as well as diminish drug efficacy. Kava when used

with alprazolam has resulted in coma. Immunostimulants (eg, Echinacea

and zinc) should not be given with immunosuppressants (eg,

corticosteroids and cyclosporine). Tannic acids present in some herbs

(eg, St 's wort and saw palmetto) may inhibit the absorption of

iron. Kelp as a source of iodine may interfere with thyroid

replacement therapies. Licorice can offset the pharmacological effect

of spironolactone. Numerous herbs (eg, karela and ginseng) may affect

blood glucose levels and should not be used in patients with diabetes

mellitus. " LG. 1998,

" Ginseng may produce manic symptoms. A special risk situation seems to

be affective patients under antidepressant medication. " Vazquez I, et

al. 2002,

Some studies on Kava (for menopausal symptoms, depression, anxiety) St

's Wort (mild depression), Ginkgo Biloba (dementia) and some other

herbs. See also Medicine- Herb/Food Interactions.

http://www.hypoglycemia.asn.au/article/research_hypoglycemia.html#ZINC