Herb-drug interactions

[Guest guest]

My husband is a pharmacist and herbalist. He suggests to monitor b/p, metabolic/energy status, and apical pulse which are what she is on her medications for. She may be able to adjust her dosages of these meds with the Rehmannia formulation but have her work closely with her MD.

Hope this helps we also use www.google.com for some of our research in our practice.

Karla Reinhart RN, CMT, ND

[Guest guest]

Toham,

 

What does her practitioner think about her meds? It seems to me that

she/he would be better qualified to determine any contraindications

since he/she is the one treating your in-law. No?

 

Regards,

 

~Fernando

 

, dgcor@w... wrote:

> My mother-in-law in another state would like to take an herbal

remedy

> her practitioner has recommended (Rehmannia 6). She is concerned

> however about the possibility of drug-herb interactions. She is

taking

> synthroid, lanoxin, florinef acetate, and atenolol. Is there a site

or

> other resource where I can get info on this? Any body have any

> knowledge or opinions about this?

>

> Toham Kum Rah, Dana Corbin

[Guest guest]

Fernando, thanks for your suggestion that my mother-in-law ask her

practitioner about any herb-drug interactions. I believe she asked me

because she wants a second opinion and she wants the opinion of someone

who cares about her.

Dana Corbin

[Guest guest]

Karla, thanks much for your right on suggestions. Dana

[Guest guest]

You may also want to look up the individual herbs in

Chan and Cheung " s book, Interactions Between Chinese Herbal

Medicinal Products and Orthodox Drugs (Harwood Academic Publishers,

2000).

 

Jim Ramholz

 

 

 

 

 

 

, dgcor@w... wrote:

> My mother-in-law in another state would like to take an herbal

remedy

> her practitioner has recommended (Rehmannia 6). She is concerned

> however about the possibility of drug-herb interactions. She is

taking

> synthroid, lanoxin, florinef acetate, and atenolol. Is there a

site or

> other resource where I can get info on this? Any body have any

> knowledge or opinions about this?

>

> Toham Kum Rah, Dana Corbin

[Guest guest]

Dear Jim, thanks for the tip.

 

Toham Kum Rah, Dana Corbin

[Guest guest]

Zev

you were going to let us know how good was a book on herb drug interaction is. Did you read it

alon

[Guest guest]

I just got the book this week, Alon, it took months to get it. It

looks valuable, and it is honest. In other words, it points out clearly

that we are only beginning to investigate the phenomenon of drug-herb

interactions. I agree with Bob Flaws, however, in that I think the

issue is overstated when dealing with proper pattern diagnosis and use

of complex ingredient prescriptions. To the credit of this book, it

also examines favorable drug-herb interactions, and suggests protocols

for research on the subject. I highly recommend this text.

 

 

On Saturday, June 1, 2002, at 08:27 AM, Alon Marcus wrote:

 

> Zev

> you were going to let us know how good was a book on herb drug

> interaction is. Did you read it

> alon

>

> Chinese Herbal Medicine, a voluntary organization of licensed

> healthcare practitioners, matriculated students and postgraduate

> academics specializing in Chinese Herbal Medicine, provides a variety

> of professional services, including board approved online continuing

> education.

>

>

>

>

[Guest guest]

Far from " blindly jumping on the bandwagon, " I merely stated that this

particular database had a number of " suspected " interactions. Many have

to do with duplication of function which, imho, is important to

consider, e.g. blood-moving herbs with coumadin, diuretic herbs with

hypertension meds, etc. Also, any herb that affects the P450 cytochrome

pathway can interfere dramatically with drug dosage using the same

metabolic pathway (biochemists out there, correct me if I misstated

this). Personally, if a patient is dedicated to their pharmaceutical

regimen, I need to guard myself from being blamed for their

complications. I don't think in a malpractice case it would be easy to

prove that my herbs did not interfere with their meds if a serious

problem appeared. And I couldn't be so sure that they weren't right,

anyway, given the paucity of actual data. As far as the PRC and reports

of Herb-drug interactions, I take that with a truckload of salt. This is

the same country that produces wildly positive research results for

their " national medicine, " so it seems possible that interactions could

be quite underreported. I don't know what their official medical culture

is like first hand, but judging from their political system, I would

guess it was not " free and open, " and that physicians would not be

inclined to report adverse effects of treatment. Even here in the Land

of the Free, adverse reactions of all kinds are underreported. People

are wont to cover their ass-ets before telling the truth.

 

-ben

 

 

Message: 6

Thu, 05 May 2005 20:54:52 +0000

" mike Bowser " <naturaldoc1

Re: Digest Number 971

 

Ben et all,

I want to caution us from blindly jumping on the bandwagon that most

of our

herbs interact with drugs, cause if they do then so do many foods

and then

cosmetics, air and water pollution etc. The so-called authoritative

studies

do not actually appear to focus on herbs but rather the known

pharmacological constituents. Herbs are not simply a mish-mash of

chemicals

that are free to interact because they are found in the herb. They

could be

bound to other chemicals and not available for interactions. Please

join me

in focusing on more actual studies of how herbs and drugs interact on

people. Before we condemn our herbs we should know if this really does

happen and to what extent. Science is not blind faith so we should

not just

accept these studies without scrutiny.

Thanks

 

 

Mike W. Bowser, L Ac

 

 

>Ueng, Yune-Fang; Tsai, Tung-Hu; Don, Ming-Jaw; Chen, Ruei-Ming;

>Chen, Ta-Liang | Alteration of the pharmacokinetics of theophylline by

>rutaecarpine, an alkaloid of the medicinal herb Evodia rutaecarpa, in

>rats | Journal of Pharmacy and Pharmacology 57 (2) February 2005;

>227-232 | Email: ueng; Natl Res Inst Chinese Med, 155-

>1 Li Nong St,Sec 2, Taipei, 112, Taiwan | Rutaecarpine is a main active

>alkaloid present in the medicinal herb , Evodia rutaecarpa. The

>cytochrome P450 (CYP) 1A2 substrate, theophylline, is an important

>therapeutic agent for the treatment of asthma, but has a narrow

>therapeutic index. To evaluate the pharmacokinetic interaction of

>theophylline with rutaecarpine, the effects of rutaecarpine on CYP1A2

>activity and theophylline pharmacokinetics were investigated. Oral

>treatment of Sprague-Dawley rats with 50 mg kg-1 rutaecarpine for

>three days through a gastrogavage caused a 4- and 3-fold increase in

>liver microsomal 7-ethoxyresorufin O-deethylation (EROD) and 7-

>methoxyresorufin O-demethylation activity, respectively. In the kidney,

>rutaecarpine treatment caused a 3-fold increase in EROD activity. In the

>lungs, EROD activity was elevated from an undetectable to a detectable

>level by rutaecarpine. Pharmacokinetic parameters of theophylline, were

>determined using a microdialysis sampling method. Rutaecarpine pre-

>treatment increased the clearance of theophylline in a dose-dependent

>manner. Pre-treatment of rats with 50 mg kg-1 rutaecarpine caused a 3-

>fold increase in theophylline clearance and a 70%, 68% and 68%

>decrease in the area under the concentration-time curve (AUC), mean

>residence time (MRT) and half-life, respectively. These results

>demonstrated that rutaecarpine treatment elevated CYP1A2 catalytic

>activity and theophylline excretion in rats. In patients taking theophylline,

>adverse effects might be noticed when a rutaecarpine-containing herbal

>preparation is used concomitantly.

>Best regards,

>

>Email: <

>

>

[Guest guest]

Ben,

I appreciate your legal concerns but my comment was directed at what I

perceive to be a growing acceptance in a chemistry-only view from within the

profession.

 

By this I mean that we are hearing more and more do not do this or that and

when questioned why, we are referred to isolated studies of chemical

constituents that have been shown to have interactions. Mind you I am not

against knowledge but following this ideology without question is

politically scary, we might as well quit herbs now.

 

One of the most important issues to understand is that herbs (especially

Chinese herbs) have NOT been tested directly with many pharmaceuticals.

Secondly, chemical constituents are not always available to interact with

other chemicals, ie, natural chelators do not release their toxic loads even

when ingested. This might be just common sense talking from my science

background but we need to learn to discriminate better about the research

outcomes.

 

There was a study, I think it might have been posted on this site, that

concluded that Chinese herbs should all be regulated (no doubt by the

medical community) simply based upon a couple of substances that created

minor reactions. Chinese herbs have functions and they have chemistry and

they will cause reactions. That is what medicine does. We practice a form

of medicine.

 

While it is well and good to talk chemistry we must not forget that much is

missing from this as a world view and that herbs are more than just a sum of

their chemistry. That is my main point in all of this rambling. Sorry I

digressed.

 

If you are worried so strongly about a serious interaction then maybe it

would be better not to prescribe for that patient. First do no harm.

 

Thanks for your response and the web address. Kind of makes you wonder who

to trust, the chemists or foreign researchers.

 

Mike W. Bowser, L Ac

 

 

 

> " Benjamin Hawes, L.Ac. " <bhawes

>Chinese Medicine

>Chinese Medicine

> Herb-drug interactions

>Fri, 06 May 2005 13:18:00 -0600

>

>Far from " blindly jumping on the bandwagon, " I merely stated that this

>particular database had a number of " suspected " interactions. Many have

>to do with duplication of function which, imho, is important to

>consider, e.g. blood-moving herbs with coumadin, diuretic herbs with

>hypertension meds, etc. Also, any herb that affects the P450 cytochrome

>pathway can interfere dramatically with drug dosage using the same

>metabolic pathway (biochemists out there, correct me if I misstated

>this). Personally, if a patient is dedicated to their pharmaceutical

>regimen, I need to guard myself from being blamed for their

>complications. I don't think in a malpractice case it would be easy to

>prove that my herbs did not interfere with their meds if a serious

>problem appeared. And I couldn't be so sure that they weren't right,

>anyway, given the paucity of actual data. As far as the PRC and reports

>of Herb-drug interactions, I take that with a truckload of salt. This is

>the same country that produces wildly positive research results for

>their " national medicine, " so it seems possible that interactions could

>be quite underreported. I don't know what their official medical culture

>is like first hand, but judging from their political system, I would

>guess it was not " free and open, " and that physicians would not be

>inclined to report adverse effects of treatment. Even here in the Land

>of the Free, adverse reactions of all kinds are underreported. People

>are wont to cover their ass-ets before telling the truth.

>

>-ben

>

>

> Message: 6

> Thu, 05 May 2005 20:54:52 +0000

> " mike Bowser " <naturaldoc1

> Re: Digest Number 971

>

> Ben et all,

> I want to caution us from blindly jumping on the bandwagon that most

> of our

> herbs interact with drugs, cause if they do then so do many foods

> and then

> cosmetics, air and water pollution etc. The so-called authoritative

> studies

> do not actually appear to focus on herbs but rather the known

> pharmacological constituents. Herbs are not simply a mish-mash of

> chemicals

> that are free to interact because they are found in the herb. They

> could be

> bound to other chemicals and not available for interactions. Please

> join me

> in focusing on more actual studies of how herbs and drugs interact on

> people. Before we condemn our herbs we should know if this really does

> happen and to what extent. Science is not blind faith so we should

> not just

> accept these studies without scrutiny.

> Thanks

>

>

>Mike W. Bowser, L Ac

>

>

> >Ueng, Yune-Fang; Tsai, Tung-Hu; Don, Ming-Jaw; Chen, Ruei-Ming;

> >Chen, Ta-Liang | Alteration of the pharmacokinetics of theophylline by

> >rutaecarpine, an alkaloid of the medicinal herb Evodia rutaecarpa, in

> >rats | Journal of Pharmacy and Pharmacology 57 (2) February 2005;

> >227-232 | Email: ueng; Natl Res Inst Chinese Med, 155-

> >1 Li Nong St,Sec 2, Taipei, 112, Taiwan | Rutaecarpine is a main active

> >alkaloid present in the medicinal herb , Evodia rutaecarpa. The

> >cytochrome P450 (CYP) 1A2 substrate, theophylline, is an important

> >therapeutic agent for the treatment of asthma, but has a narrow

> >therapeutic index. To evaluate the pharmacokinetic interaction of

> >theophylline with rutaecarpine, the effects of rutaecarpine on CYP1A2

> >activity and theophylline pharmacokinetics were investigated. Oral

> >treatment of Sprague-Dawley rats with 50 mg kg-1 rutaecarpine for

> >three days through a gastrogavage caused a 4- and 3-fold increase in

> >liver microsomal 7-ethoxyresorufin O-deethylation (EROD) and 7-

> >methoxyresorufin O-demethylation activity, respectively. In the kidney,

> >rutaecarpine treatment caused a 3-fold increase in EROD activity. In the

> >lungs, EROD activity was elevated from an undetectable to a detectable

> >level by rutaecarpine. Pharmacokinetic parameters of theophylline, were

> >determined using a microdialysis sampling method. Rutaecarpine pre-

> >treatment increased the clearance of theophylline in a dose-dependent

> >manner. Pre-treatment of rats with 50 mg kg-1 rutaecarpine caused a 3-

> >fold increase in theophylline clearance and a 70%, 68% and 68%

> >decrease in the area under the concentration-time curve (AUC), mean

> >residence time (MRT) and half-life, respectively. These results

> >demonstrated that rutaecarpine treatment elevated CYP1A2 catalytic

> >activity and theophylline excretion in rats. In patients taking

>theophylline,

> >adverse effects might be noticed when a rutaecarpine-containing herbal

> >preparation is used concomitantly.

> >Best regards,

> >

> >Email: <

> >

> >

>

>

>