Dangerous Herb-Medication Interactions, Part 1

Is it safe to use herbal supplements?

The use of herbs for disease prevention and healing has a long history - dating back thousands of years and medicines extracted from botanicals include reserpine, morphine, penicillin, as well as anti-cancer drugs.

Herbal supplements can be purchased over-the-counter (OTC) and may be labeled "all-natural" and are sold in many different forms - dried leaves for teas, powdered, as capsules or tablets, or in solution.

But does "all-natural" mean they are always safe?

Absolutely not! Although herbal supplements may be from plant or herb sources, the active ingredients are potent chemicals. Because of this, herbal supplements can have drug interactions, interactions with other herbs, or with food and alcohol.

Herbal interactions with prescription medications or other chemicals can:

• interfere with how the drug may be broken down in the body
• enhance side effects of prescription medications
• block the intended therapeutic effect of a drug

BLACK COHOSH (Actaea racemosa, formerly Cimicifuga racemosa)

Black cohosh is a shrub-like plant found in North America. Black cohosh is often used for menopausal disorders ("hot flashes"), painful menstruation, uterine spasms, and vaginitis. However, prescription drugs broken down by certain liver enzymes may accumulate in the body and lead to toxicity if used with black cohosh. There is concern that black cohosh might also be toxic to the liver and may enhance liver toxicity with certain medications, such as:

• Atorvastatin (Lipitor)
• Acetaminophen (Tylenol)

May reduce the effectiveness of:

• Amiodarone
• Fexofenadine (Allegra)
• Glyburide, and many statin medications

COENZYME Q10

CoenzymeQ10 is found naturally in the heart, kidney, liver and pancreas, but aging and smoking can deplete these natural stores. CoQ10 is promoted to help heart damage caused by certain cancer medicines and for breast cancer, gum disease, or muscular dystrophy, although robust studies confirming these uses are lacking.

• May decrease the blood-thinning effects of the anticoagulant and increase the risk for a clot.

CRANBERRY

Cranberries are a fruit chock full of vitamin C, and some people drink cranberry juice to help prevent urinary tract infections (UTI). Although data is conflicting, some studies have shown cranberry can reduce recurrent UTIs in pregnant women, the elderly, and hospitalized patients; but it is not helpful to cure a UTI.

• May exert an increased effect on blood thinners (anticoagulants) like warfarin and lead to bruising or bleeding.

CURCUMIN

Curcuma longa

Research suggests that curcumin can help in the management of oxidative and inflammatory conditions, metabolic syndrome, arthritis, anxiety, and hyperlipidemia. It may also help in the management of exercise-induced inflammation and muscle soreness, thus enhancing recovery and subsequent performance of active people.

• May cause decreased levels of many antidepressant and antipsychotic medications
• May increase sulfasalazine (Azulfidine) levels

ECHINACEA

Also known as the American Cone Flower, Black Susan, or Purple Coneflower.

Echinacea has been used to stimulate the immune system and is most commonly used in the treatment of the common cold.

• May affect blood levels of drugs like tizanidine (Zanaflex)
• a muscle relaxant or rasagiline (Azilect) used in Parkinson's disease.
• May slow the metabolism of caffeine in your body, and could lead to side effects like jitteriness, headache, or insomnia.
• Echinacea may also change how the body metabolizes many drugs that go through the liver. These are somewhat complicated interactions that can lead to side effects or reduced effectiveness of your medicine.

EVENING PRIMROSE

Used to treat atopic dermatitis (a type of eczema), rheumatoid arthritis, premenstrual syndrome (PMS), breast pain, menopause symptoms, and other conditions. contains gamma linoleic acid that may slow blood clotting and increase the likelihood of bruising or bleeding.

• May increase blood thinner effects of warfarin (Coumadin)
• May increase the risk for seizures if you take anti-seizure medications or phenothiazine drugs.

To be continued next week...

Written by Erika M Szabo

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