Herbs

Herbs have become popular for their potential health benefits. But they also have potential interactions. The list below shows potential interactions for the following top-selling herbs.

As always, check with your physician before beginning or changing a health regimen.

Echinacea

• Avoid with Cyclosporine.
• Avoid with immunosupressant drugs.
• Avoid in patients who have autoimmune diseases.

Garlic

• Avoid in patients with hematological (blood) disorders and/or anticoagulant therapy. Inhibits platelet aggregation.
• Decreases blood sugars, so it can affect blood sugar control.

Ginkgo Biloba

• Avoid in patients who have hematological (blood) disorders and/or anticoagulant/anti-platelet therapy.
• Avoid with aspirin.

Saw Palmetto

• Avoid in pregnant and breast feeding patients.
• May interfere with oral contraceptives ("the pill") and hormone therapy.

St John's Wort

• Avoid with serotonergic drugs.
• Avoid with patients who have high blood pressure, bi-polar or other psychiatric disorders.
• Decreases levels of Digoxin, protease inhibitors and NNRTI's (non-nucleoside reverse transcriptase inhibitors).
• May interfere with MAOI's (monoamine oxidase inhibitors).
• May interfere with oral contraceptive agents and other drugs metabolized via the cytochrome P450 pathway.
• May cause sun sensitivity in fair-skinned people.

Ginseng

• Avoid in patients who have high blood pressure, hematological (blood) disorders and/or anticoagulant therapy.
• Should be avoided by infants and pregnant patients.
• Avoid with MAOI's (monoamine oxidase Inhibitors).
• May interact with furosemide.
• May have estrogen-like effects.
• May decrease glucose levels with oral hypoglycemic agents.

Green Tea

• Avoid with theophylline, xanthine derivatives and/or Lithium. Also, caffeine increases stimulatory effects.
• Due to high Vitamin K content, avoid initiating or Increasing use after anticoagulation therapy has been initiated.

Mahuang & Other Ephedras

• Deaths have occurred due to misuse.
• Avoid in patients with high blood pressure, stroke, history of a heart attack, hepatitis or myopathy.
• Avoid with theophylline and xanthine derivatives, anti-high blood pressure agents, phenothiazines.

Goldenseal

• Do not use on a chronic basis or during pregnancy (uterine stimulant).
• Avoid with sedatives, anti-platelet and anti-coagulation therapy.
• Avoid with anti-high blood pressure agents, cardiac glycosides and during pregnancy.

Milk Thistle

• Due to the potential to cause severe gastritis and thrombocytopenia, it is not recommended for patients who have hematological (blood) and digestive disorders.
• Not recommended with decompensated cirrhosis.

References

Herbal Medicine. Prescriber's Letter. Document No. 131033, 1-7.

Lambrecht, J., Hamilton, W., & Rabinovich, A. (2000) A Review of Herb-Drug Interactions: Documented and Theoretical. August, 2000. USPharmacist.com. 1-10.

Richman, A. & Witkowski, J.P. (2000). Herb Sales Hit Record Levels. Whole Foods. October 2000. 53-59.

Saw Palmetto - Consumer Information and Education, Natural Medicines Comprehensive Database.

Smolinske, S. (2000). Dietary Supplement Adverse Reactions & Interactions: 2000 Update. Pharmacy Practice News. February 2000. 13-18.