Drug Interactions

Question 1

Garlic

Answer 1

Anti-coagulants & platelet aggregators (ex: Warfarin or Coumadin), saquinavir (HIV drug), may alter P450 detox of drugs like anti-hypertensives.

Question 2

Ginkgo

Answer 2

None known (according to Rational Phytotherapy). Possibly anticoagulants - may increase bleeding risk. May interfere with antiepileptics. May alter P450 detox of drugs like anti-hypertensives. May lower seizure threshhold. May reduce diuretic effectiveness.

Question 3

Red Yeast Rice

Answer 3

statins

Question 4

Evening primrose oil

Answer 4

Maybe anticoagulants. Reports of seizures used with schizophrenia drugs.

Question 5

Bromelain

Answer 5

May potentiate anticoagulants & platelet aggregation inhibitors.
May potentiate antibiotics, sedatives (incl herbs). Limit use to 8-10 days

Question 6

Feverfew

Answer 6

Possibly anticoagulants - may increase bleeding risk

Question 7

Willow Bark

Answer 7

Same active constituent as aspirin

Question 8

Kava

Answer 8

No longer approved (or sold) in Germany. Warning label in US. Don’t use with other anxiolytics or alcohol. Don’t use with benzodiazepines - similar effects.

Question 9

St. John’s Wort

Answer 9

Antibiotic, antidepressant, immunosuppress, anti-epileptic, anti-hypertensive, anti-psychotic, digoxin, chol-lowering, hormone, hypoglycemic. May alter hormone metabolism.

Question 10

Valerian

Answer 10

Possible additive effect w/alcohol, sedatives(benzodapines, CNS depressants, or barbituates), or kava SJW, & melatonin

Question 11

Hawthorn

Answer 11

“none known” according to RP. May enhance action of digoxin.

Question 12

Horse Chestnut

Answer 12

May increase bleeding risk with anticoagulants

Question 13

German Chamomile

Answer 13

None known.

Question 14

Ginger

Answer 14

Possibly anticoagulants - may increase bleeding risk

Question 15

Licorice

Answer 15

Diuretics, meds to reduce potassium

Question 16

Peppermint

Answer 16

May reduce drug clearance/up potency; barium chloride, pilocarpine, physostigmine

Question 17

Black Tea

Answer 17

Green tea may alter anticoagulant function.

Question 18

Flax/ Linseed

Answer 18

Antiperistaltic agents (loperamide, etc). Oil may increase bleeding risk w/ anticoagulants.

Question 19

Milk Thistle

Answer 19

May increase bleeding risk with anticoagulants

Question 20

Brewer’s yeast

Answer 20

MAO inhibitor– may cause hypotension.

Question 21

Saw Palmetto

Answer 21

May increase bleeding risk with anticoagulants

Question 22

Asian Ginseng

Answer 22

Possibly anticoagulants - may increase bleeding risk. May reduce antipsychotic clearance or exacerbate some psychiatric conditions.

Question 23

Cordyceps

Answer 23

Inhibit blood platelet aggregation

Question 24

Echinacea, which uses root extracts

Answer 24

May decrease clearance of antipsychotics

Question 25

Echinacea, which uses juice of aerial parts

Answer 25

May decrease clearance of antipsychotics

Question 26

Goldenseal

Answer 26

May interfere with antacids, H2 antagonists, & proton pump inhibitors. Possibly anticoagulants & anti-hypertensives - may alter function. May decrease clearance (CYP2D6) of antipsychotics

Question 27

Ephedra

Answer 27

Caffeine, stimulants? Banned by FDA in 2004 except from licensed acupuncturists & OMDs