Herbs and Foods May Lead to Complications If You Take Them with Drugs - Good reference info!

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Herbs and Foods May Lead to Complications If You Take

Them with Drugs

by Dr. Farr on 29 January 2003

Herb/Food Interactions

Many people have the mistaken notion that, being

natural, all herbs and foods are safe. This is not so.

Very often, herbs and foods may nteract with

medications you normally take that result in serious

side reactions. It is always a good practice to tell

your doctor or health practitioners what you are

taking so that they can advise you of possible

complications, if there is any. You should also keep

an eye for unusual symptoms. Very often, this may

foretell the symptoms of a drug interaction.

Experts suggest that natural does not mean it is

completely safe. Everything you put in your mouth has

the potential to interact with something else. The

medication that is taken by mouth travels through the

digestive system in much the same way as food and

herbs taken orally do. So, when a drug is mixed with

food or another herb, each can alter the way the body

metabolizes the other. Some drugs interfere with the

body's ability to absorb nutrients. Similarly, some

herbs and foods can lessen or increase the impact of a

drug.

Alcohol is a drug that interacts with almost every

medication, especially antidepressants and other drugs

that affect the brain and nervous system. Some dietary

components increase the risk of side effects.

Theophylline, a medication administered to treat

asthma, contains xanthines, which are also found in

tea, coffee, chocolate, and other sources of caffeine.

Consuming large amounts of these substances while

taking theophylline increases the risk of drug

toxicity.

Certain vitamins and minerals impact on medications

too. Large amounts of broccoli, spinach, and other

green leafy vegetables high in vitamin K,

whichpromotes the formation of blood clots, can

counteract the effects of heparin, warfarin, and other

drugs given to prevent clotting. Dietary fiber also

affects drug absorption. Pectin and other soluble

fibers slow down the absorption of acetaminophen, a

popular painkiller. Bran and other insoluble fibers

have a similar effect on digoxin, a major heart

medication.

As more and more people discover new herbs, there is

more and more potential for the abuse of these herbs

and the patients may end up in serious problems.

I was attending an herb meeting a few weeks ago and a

person came to the speaker and told her that she had

very good luck with St. 's Wort to control her

depression. St. 's Wort has been shown to have

great potential to control minor depression. The

National Institutes of Health is conducting a clinical

study to determine the effect of St. 's Wort

scientifically. This person, however, continued saying

that she is now trying St. 's Wort for her OCD

(Obsessive Compulsive Disorder). Now, this is getting

into unproven uncharted territory. If you are taking

prescription medication for this disorder, you can get

into trouble due to drug interaction. As shown under

the discussion on St. 's Wort, the herb can be

quite dangerous, as it acts similar to MAO inhibitors.

They have severe side reactions, and if not careful,

can even lead to death.

High-risk patients, such as the elderly, patients

taking three or more medications for chronic

conditions, patients suffering from diabetes,

hypertension, depression, high cholesterol or

congestive heart failure, should be especially on the

lookout for such side reactions.

The following are the examples of known interaction

between popular herbs, foods, and prescription and

over-the-counter drugs.

Hawthorn, touted as effective in reducing angina

attacks by lowering blood pressure and cholesterol

levels, should never be taken with Lanoxin (digoxin),

the medication prescribed for most for heart ailments.

The mix can lower your heart rate too much, causing

blood to pool, bringing on possible heart failure.

Ginseng, according to research, can increase blood

pressure, making it dangerous for those trying to keep

their blood pressure under control. Ginseng, garlic or

supplements containing ginger, when taken with the

blood-thinning drug, Coumadin, can cause bleeding

episodes. Coumadin is a very powerful drug that leaves

little room for error, and patients taking it should

never take any medication or otherwise before

consulting a qualified health professional. In rare

cases, ginseng may overstimulate resulting in

insomnia. Consuming caffeine with ginseng increases

the risk of overstimulation and gastrointestinal

upset. Long tern use of ginseng may cause menstrual

abnormalities and breast tenderness in some women.

Ginseng is not recommended for pregnant or lactating

women.

Garlic capsules combined with diabetes medication can

cause a dangerous decrease in blood sugars. Some

people who are sensitive to garlic may experience

heartburn and flatulence. Garlic has anti-clotting

properties. You should check with your doctor if you

are taking anticoagulant drugs.

Goldenseal is used for coughs, stomach upsets,

menstrual problems and even arthritis. However, the

plant's active ingredient will raise blood pressure,

complicating treatment for those taking

antihypertensive medications, especially

beta-blockers. For patients taking medication to

control diabetes or kidney disease, this herb can

cause dangerous electrolyte imbalance. High amount of

consumption can lead to gastrointestinal distress and

possible nervous system effects. Not recommended for

pregnant or lactating women.

Feverfew, believed to be the natural remedy for

migraine headaches, should never be taken with Imitrex

or other migraine medications. It can result in the

patient's heart rate and blood pressure to rise

dangerous levels.

Guarana, an alternative remedy being used as a

stimulant and diet aid, contains 3 percent to 5

percent more caffeine than a cup of coffee. So, if you

are taking any medication that advises you against

taking any drink with caffeine, you should avoid

taking this stimulant. It may cause insomnia,

trembling, anxiety, palpitations, urinary frequency,

and hyperactivity.

Avoid during pregnancy and lactation period. Long term

use of Guarana may lead to decreased fertility,

cardiovascular disease, and several forms of cancer.

Kava, a herb that has antianxiety, pain relieving,

muscle relaxing and anticonvulsant effects, should not

be taken together with substances that also act on the

central nervous system, such as alcohol, barbiturates,

anti depressants, and antipsychotic drugs.

St. 's Wort is a popular herb used for the

treatment of mild depression.

The active ingredient of St. 's Wort is hypericin.

Hypericin is believed to exert a similar influence on

the brain as the monoamine oxidase (MAO) inhibitors

such as the one in major antidepressants. Mixing MAO

inhibitorswith foods high in tyramine, an amino acid,

produces one of the most dramatic and dangerous

food-drug interactions. Symptoms, which can occur

within minutes of ingesting such foods while taking an

MAO inhibitor, include rapid rise in blood pressure, a

severe headache, and perhaps collapse and even death.

Foods high in tyramine include aged cheese, chicken

liver, Chianti (and certain other red wines), yeast

extracts, bologna (and other processed meats), dried

or pickled fish, legumes, soy sauce, ale, and beer.

Some patients report that Saint s Wort caused

excessive stimulation and sometimes dizziness,

agitation and confusion when taken with other

antidepressants or over-the-counter medications like

Maximum Strength Dexatrim and Acutrim. It also caused

their blood pressure to shoot up.

White Willow, an herb traditionally used for fever,

headache, pain, and rheumatic complaints may lead to

gastrointestinal irritation, if used for a long time.

It exhibits similar reactions as aspirin (aspirin is

derived from white willow). Long term use may lead to

stomach ulcers.

Drug Interactions and Food

Drug interaction risk isn't limited to herbal

supplements. Certain foods can interact with

medications.

People taking digoxin should avoid Black licorice

(which contains the ingredient glycyrhizin). Together,

they can produce irregular heart rhythms and cardiac

arrest; licorice and diuretics will produce

dangerously low potassium levels, putting a patient at

risk for numbing weakness, muscle pain and even

paralysis. Licorice can also interact with blood

pressure medication or any calcium channel blockers.

Aged cheese (brie, parmesan, cheddar and Roquefort),

fava beans, sauerkraut, Italian green beans, some

beers, red wine, pepperoni and overly ripe avocados

should be avoided by people taking MAO

antidepressants. The interaction can cause a

potentially fatal rise in blood pressure.

And because Saint s Wort contains the same

properties as these MAO antidepressants, it stands to

reason that people ingesting the herb should avoid

these same foods.

Grapefruit juice interacts with calcium channel

blockers (including Calan, Procardia, Nifedipine, and

Verapamil), cholesterol control medications, some

psychiatric medications, estrogen, oral contraceptives

and many allergy medications (Seldane, Hismanal). The

juice modifies the body's way of metabolizing the

medication, affecting the liver's ability to work the

drug through a person's system.

Orange juice shouldn't be consumed with antacids

containing aluminum. 'The juice increases the

absorption of the aluminum. Orange Juice and milk

should be avoided when taking antibiotics. The juice's

acidity decreases the effectiveness of antibiotics, as

does milk.

Milk also doesn't mix with laxatives containing

bisacodyl (Correctol and Dulcolax). You might find the

laxative works a little " too well " in the morning.

Large amounts of oatmeal and other high-fiber cereals

should not be eaten when taking digoxin. The fiber can

interfere with the absorption of the drug, making the

act of swallowing the pill a waste of time.

However, don't stop eating your cereal right away,

because that could cause digoxin levels in your system

to soar to toxic levels. A professional should make

the dietary changes after carefully examining the

digoxin levels.

Leafy green vegetables, high in vitamin K, should not

be taken in great quantities while taking Coumadin.

These vegetables could totally negate the affects of

the drug and cause blood clotting.

Caffeinated beverages and asthma drugs taken together

can cause excessive excitability. Those taking

Tagament (Simetidine), quinolone antibiotics (Cipro,

Penetrex, Noroxin) and even oral contraceptives should

be aware these drugs may cause their cup of coffee to

give them more of a Java jolt than they expected.

Grilled meat can lead to problems for those on asthma

medications containing theophyllines. The chemical

compounds formed when meat is grilled somehow prevent

this type of medication from working effectively,

increasing the possibility of an unmanageable asthma

attack.

Regularly consuming a diet high in fat while taking

anti-inflammatory and arthritis medications can cause

kidney damage and can leave the patient feeling,

drowsy and sedated.

Alcoholic beverages tend to increase the depressive

effects of medications such as benzodiazepines,

antihistamines, antidepressants, antipsychotics,

muscle relaxants, narcotics, or any drug with sedative

actions.

It's a good idea to not consume any alcoholic

beverages, or at least scale way back, when taking

prescription medications. Antioxidant and

beta-carotene intensify alcohol's effect on the liver.

Other commonly used over-the-counter medications can

cause interaction problems also.

Aspirin can modify the effectiveness of arthritis

medications, strong prescription steroids and

diuretics. Combining aspirin with diabetic medications

can drop blood sugars to dangerous levels. Aspirin can

also cause toxicity when taken with glaucoma and

anticonvulsant (anti-seizure) drugs and cause bleeding

episodes when combined with a blood thinner, like

Coumadin.

Acetaminophen can also cause interaction complications

when overused. Heavy drinkers who take acetaminophen

for hangover relief risk liver damage. Taking high

doses of acetaminophen with Coumadin can cause

bleeding episodes.

Antacids taken with antibiotics, heart and blood

pressure or thyroid medications can decrease drug

absorption by up to 90 percent.

Over-the-counter antihistamines - sold under the names

Actifed, Theraflu, Dimetapp, Benadryl and Comtrex

should be avoided if you are taking antianxiety or

antidepressant medications.

Oral contraceptives are less effective when taken with

barbiturates, antibiotics, anti-fungal or tuberculosis

drugs.

Turnips contain two goitrogenic substances, progoitrin

and gluconasturtin, which can interfere with the

thyroid gland's ability to make its hormones. Although

moderate consumption of goitrogens is not a hazard for

healthy people, they can promote development of a

goiter (an enlarged thyroid) in persons with thyroid

disease.

Tomato contains small quantities of a toxic substance

known as solanine that may trigger headaches in

susceptible people. They are also a relatively common

cause of allergies. An unidentified substance in

tomatoes and tomato-based products can cause acid

reflux, leading to indigestion and heartburn.

Individuals who often have digestive upsets should try

eliminating tomatoes for 2 to 3 weeks to see if there

is any improvement.

Strawberries, Raspberries, Spinach, and Rhubarb: These

contain oxalic acid, which can aggravate kidney and

bladder stones in susceptible people, and reduce

body's ability to absorb iron and calcium.

Raspberries contain a natural salicylate that can

cause an allergic reaction in aspirin sensitive

people.

The seeds from fruits such as apple, apricot, and

Quinces contain amygdalin, a compound that turns into

Hydrogen Cyanide in the stomach. Eating large amount

of seeds can result in cyanide poisoning.

Potatoes: Avoid potatoes with a green tint to the

skin, and remove any sprouts; they will taste bitter

and may contain solanine, a toxic substance that can

cause diarrhea, cramps, and fatigue.

Plums, Peaches, Apricots, and Cherries: These fruits

may produce allergic reaction in individuals with

confirmed allergies to apricots, almonds, peaches, and

cherries. People who are allergic to aspirin may also

encounter problems after they have eaten plums or

peaches as they contain salicylates. The pits of

plums, peaches and apricots contain a compound called

amygdalin. When consumed in large amounts, amygdalin

breaks down into hydrogen cyanide, a poison.

Horseradish: Very high doses of horseradish can cause

vomiting or excessive sweating. Avoid if you have

hypothyroidism.

Turmeric: Should be avoided by persons with symptoms

from gallstones.

The drug food interaction is summarized in the table

below.

Drugs Effects and Precautions

Antibiotics

Cephalosporins, penicillin Take on an empty stomach to

speed absorption of the drugs.

Erythromycin Don't take with fruit juice or wine,

which decrease the drug's effectiveness.

Sulfa drugs Increase the risk of Vitamin B-12

deficiency

Tetracycline Dairy products reduce the drug's

effectiveness. Lowers Vitamin C absorption

Anticonvulsants

Dilantin, phenobarbital Increase the risk of anemia

and nerve problems due to deficiency of folalte and

other B vitamins.

Antidepressants

Fluoxetine Reduce appetite and can lead to excessive

weight loss

Lithium A low-salt diet increases the risk of lithium

toxicity; excessive salt reduces the drug's efficacy

MAO Inhibitors Foods high in tyramine (aged cheeses,

processed meats, legumes, wine, beer, among others)

can bring on a hypertensive crisis.

Tricyclics Many foods, especially legumes, meat, fish,

and foods high in Vitamin C, reduce absorption of the

drugs.

Antihypertensives, Heart Medications

ACE inhibitors Take on an empty stomach to improve the

absorption of the drugs.

Alpha blockers Take with liquid or food to avoid

excessive drop in blood pressure.

Antiarrhythmic drugs Avoid caffeine, which increases

the risk of irregular heartbeat.

Beta blockers Take on an empty stomach; food,

especially meat, increases the drug's effects and can

cause dizziness and low blood pressure.

Digitalis Avoid taking with milk and high fiber foods,

which reduce

absorption, increases potassium loss.

Diuretics Increase the risk of potassium deficiency.

Potassium sparing diuretics Unless a doctor advises

otherwise, don't take diuretics with potassium

supplements or salt substitutes, which can cause

potassium overload.

Thiazide diuretics Increase the reaction to MSG.

Asthma Drugs

Pseudoephedrine Avoid caffeine, which increase

feelings of anxiety and

nervousness.

Theophylline Charbroiled foods and high protein diet

reduce absorption.

Caffeine increases the risk of drug toxicity.

Cholesterol Lowering Drugs

Cholestyramine Increases the excretion of folate and

vitamins A, D, E, and K.

Gemfibrozil Avoid fatty foods, which decrease the

drug's efficacy in lowering cholesterol.

Heartburn and Ulcer Medications

Antacids Interfere with the absorption of many

minerals; for maximum benefit, take medication 1 hour

after eating.

Cimetidine, Fanotidine, Sucralfate Avoid high protein

foods, caffeine, and other items that increase stomach

acidity.

Hormone Preparations

Oral contraceptives Salty foods increase fluid

retention. Drugs reduce the absorption of folate,

vitamin B-6, and other nutrients; increase intake of

foods high in these nutrients to avoid deficiencies.

Steroids Salty foods increase fluid retention.

Increase intake of foods high in calcium, vitamin K,

potassium, and protein to avoid deficiencies.

Thyroid drugs Iodine-rich foods lower the drug's

efficacy.

Laxatives

Mineral Oils Overuse can cause a deficiency of

vitamins A, D, E, and K.

Painkillers

Aspirin and stronger non-steroidal anti-inflammatory

drugs Always take with food to lower the risk of

gastrointestinal irritation; avoid taking with

alcohol, which increases the risk of bleeding.

Frequent use of these drugs lowers the absorption of

folate and vitamin C.

Codeine Increase fiber and water intake to avoid

constipation.

Sleeping Pills, Tranquilizers

Benzodiazepines Never take with alcohol. Caffeine

increases anxiety and reduce drug's effectiveness.