interaction info.

[Guest guest]

I had this information in my files, and thought I'd pass it along.

 

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WHEN HERBS AND DRUGS DON'T MIX

by Dr. Andrew Weil March 1999 Issue Self Healing

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Many, many readers of this newsletter have written to me asking whether

particular herbal supplements are safe to take with particular drugs.

While data on herb/drug interactions are only now beginning to be

collected systematically, I can certainly offer some common-sense advice

to help you avoid possible interactions.

In general, you'll want to be careful about mixing herbs and drugs that

have similar actions: For example, ginkgo has blood-thinning properties

and may heighten the effects of anti-coagulant drugs. Conversely, you

should avoid mixing herbs and drugs that have opposite actions: Ephedra,

for example, can exacerbate high blood pressure and may cancel out the

effects of antihypertensive drugs.

Unfortunately, most pharmacists today don't know enough about herbs to

offer much guidance on possible herb/drug interactions. To help remedy

this situation, our Program in Integrative Medicine at the University of

Arizona will soon be offering continuing-medical-education courses

geared specifically for pharmacists, in collaboration with our College

of Pharmacy.

Below are several possible herb/drug interactions to watch out for:

BLOOD THINNERS:

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Many popular herbs-- including garlic, ginger, ginkgo,

feverfew, and bromelain-- reduce the clotting tendency of the blood,

thus helping to protect against heart attack and strokes. However,

taking these herbal supplements in conjunction with prescription

anticoagulants such as warfarin (Coumadin) or even regular aspirin may

increase the risk of excessive bleeding. A case in point: In 1997, the

New England Journal of Medicine reported on a man who experienced

spontaneous bleeding in the eye while taking both ginkgo and aspirin on

a regular basis.

If you are taking an anticoagulant drug (including aspirin), I recommend

using the above herbal supplements only under the supervision of your

doctor, who can monitor your blood and adjust your drug dosage if

necessary. (By the way, it's OK for people who take anticoagulant drugs

to use garlic and ginger as culinary herbs: The problem is with

concentrated extracts.)

ANTI-DEPRESSANTS

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Numerous studies in Europe have shown St. John's Wort to be an effective

treatment for mild to moderate depression, but little is known about how

this herb interacts with prescription antidepressants. There has been

at least one report-- published in American Family Physician last

March-- of " seratonin syndrome " (in this case, lethargy and confusion)

caused by an interaction between St. John's Wort and the antidepressant

drug Paxil. I don't recommend combining St. John's Wort with

antidepressant drugs, unless you are working with a physician to

gradually wean yourself from the drug while slowly increasing your

dosage of the herb.

SEDATIVES:

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I consider kava, a newly popular herb, to be a useful

short-term treatment for anxiety and related insomnia.

However, I caution patients not to mix it with other

depressants such as alcohol, prescription sedatives, and the herbal

relaxant valerian, as kava may intensify their effects. Likewise, I

think it's prudent to avoid combining valerian with other sedatives.

STIMULANTS

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Natural supplements that claim to promote weight loss,

increase energy, or treat asthma and allergies often contain herbal

stimulants such as ephedra, yohimbe, guarana, yerba mate, and Asian

ginseng. I would be wary of combining these supplements with

over-the-counter or prescription drugs that contain stimulants such as

caffeine (including Excedrin), pseudoephedrine (usually sold as a

decongestant), and phenylpropanolamine (found in over-the-counter diet

pills and cold remedies). Taking a double does of stimulants can cause

or exacerbate anxiety, insomnia, high blood pressure, and rapid heart

rate.

In addition, herbal stimulants may interfere with medications that lower

blood pressure or regulate cardiac arrhythmia.

IMMUNE ENHANCERS

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It's possible that immune-enhancing herbs such as

astragalus, echinacea, maitake, and reishi may counteract the effect of

corticosteroids and other drugs that suppress immune response. If you

take an immunosuppressive drug (for an autoimmune condition or to

suppress rejection of an organ transplant), I would avoid long-term use

of immune-enhancing drugs.

LAXATIVES

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In general, I recommend against using herbal irritant

laxatives such as cascara sagrada and senna, because they lead to

dependency and can deplete the body's potassium levels. It's

particularly important to avoid these herbs if you are taking a

prescription diuretic (for high blood pressure or excessive fluid

retention), as diuretics also promote potassium depletion. Severe

potassium loss can result in confusion, weakness, irregular heartbeat,

and even death.

Herbs that act as bulk laxatives -- including psyllium, flaxseed, and

triphala -- don't deplete potassium levels. However, their mucilage

content can slow the absorption of some drugs, so if you're taking

medication, I'd suggest you not take it at the same time of day as you

take these herbs.

 

 

Take good care.

 

Love,

Renee and Jerry