Herb-Drug Interactions Flashcards
What herb interacts with PPIs and why?
Achillea millefolium, Arctium lappa, Artemisia absinthium/vulgaris, Berberis aquifolium/vulgaris, Coleus, Cynara
D/t bitter properties and stimulation of HCl in the gut
What herbs can decrease drug absorption d/t increasing GI motility?
Achillea millefolium, Aloe vera latex, Arctium lappa, Artemisia absinthium/vulgaris, Berberis aquifolium/vulgaris, Cassia, Cynara
What herbs are contraindicated when combined with HRT can lead to estrogen excess?
Actaea racemosa (black cohosh), ***
What herb can decrease hot flashes caused by Tamoxifen?
Actaea racemosa
What herb(s) can cause hypoglycemic effects when combined with oral hypoglycemic meds (i.e. Metformin, Glyburide, Rosiglitazone, Insulin)?
Allium cepa/sativum, Aloe vera gel (internally), Arctium lappa, Artemisia vulgaris, Coleus, Commiphora myrrha
What herb(s) can potentiate (INC) anticoagulation therapy (I.e. Warfarin)?
What herb(s) can antagonize or block anticoagulation therapy (i.e. Warfarin)?
Allium cepa/sativum, Angelica sinensis, Capsella, Capsicum, Chamaelirium, Curcuma
Blocks - Ceanothus, Equisetum
What herbs can decrease drug absorption d/t polysaccharide action?
Aloe vera gel
Althea officinalis
Astragalus membranaceus
What herbs must avoid hypokalemic drugs?
And what are hypokalemic drugs?
Aloe vera latex, Cassia
Cathartics, Convallaria, Digitalis, Equisetum
Diuretics (Furosemide, HCTZ)
Corticosteroids (Hydrocortisone, Prednisone, Dexamethasone)
Cardiac glycosides (Digoxin, Convallaria, Digitalis, Leonarus)
Anti-Arrhythmias (atenolol, propranolol, amiodarone)
Pseudoephedrine
Glycyrrhiza
What herbs should be avoided if undergoing anti-PLT therapy d/t anti-PLT action?
Angelica sinensis
What herb is less effective when urine is acidified by Vit. C or cranberry?
Arctostaphylos uva ursi
What herb is more effective when combined with iron?
Artemisia annua
What herbs interact with cardiac glycosides (digoxin, convallaria, digitalis, leonarus)?
Asclepias tuberosa, Coleus, ***
What herbs can increase the action of Acyclovir and Interferon 1 and 2?
Astragalus membranaceus
What herbs can decrease the action of corticosteroids (hydrocortisone, prednisone, dexamethasone?
Astragalus membranaceus
What herbs can increase the action of anticholinergic drugs (i.e. atropine, bupropion, dextromethorphan, dicyclomine, diphenhydramine, tiotropium bromide, tolterodine, TCAs, amantadine)?
Atropa belladonna
Datura
What herb(s) induce CYP450?
Bacopa, Capsicum, Commiphora mukul,
What herb(s) INC thyroid hormone and potentiates (INC) Levothyroxine?
Bacopa
What herb(s) potentiate CCBs (i.e. Amlodipine)?
Bacopa
What herb(s) potentiate Sedative drugs?
What herb(s) antagonize sedative drugs?
What are some sedative drugs?
Bacopa (INC)
Camellia (DEC)
Antihistamines: Diphenhydramine, Hydroxyzine
Barbiturates: Phenobarbital
Benzos: Alprazolam/Diazepam
Opiates: Codeine, Hydrocodone, Morphine, Oxycodone, Methadone
Trazadone
Zolpidem
What herb(s) potentiate (INC) Barbiturates (Phenobarbitol)?
Bacopa
Berberis vulgaris
What herb(s) enhance NSAIDs (aspirin, ibuprofen, naproxen, celecoxib)?
Boswellia
Camellia
Coleus
What herb dec iron absorption?
Camellia
What herb(s) enhance the action of acetaminophen, clopidogrel, doxorubicin and warfarin?
Camellia
What herb(s) INC CNS stimulants?
What are CNS stimulants?
Camellia
i.e caffeine, dextroamphetamine MDMA, methylphenidate, modafinil, pseudoephedrine
Camellia when combined with what drug can lead to HTN?
MAOIs (Phenelzine)
What 3 drugs can effect caffeine with Camellia and in what way?
Ciprofloxacin (inhibits caffeine elimination)
Phenytoin (INC elimination of caffeine)
OCPs INC caffeine effects
What 2 drugs inhibit metabolism and INC/enhances action of Camellia?
Inhibit: Clozapine
Enhance: Amitriptyline
What herb(s) INC action of opiates and barbiturates?
Cannibis
Capsicum has a specific interaction with an Anti-HTN medicine, whats the med and interaction?
Enhances cough SE with ACEi (Lisinopril)
What herbs(s) can interfere with angina tx and why?
Caulophyllum d/t vasoconstrictive action to heart vessels
Cineraria has a synergistic effect with what kind of drugs?
Hepatotoxic
What herbs when taken with other Tannins can DEC absorption?
Cinnamomum, Crataegus
What does the essential oil form of cinnamomum deplete in the liver with long term use?
Glutathione
What other 2 medications (1 category and 1 individual med) interact with Coleus?
(NOT cardiac glycosides, hypoglycemics, NSAIDs, PPIs)
Levothyroxine
Antihistamines
What 2 drugs have decreased bioavailability when combined with Commiphora mukul?
Propranolol
Diltiazem
What class of drugs interacts with Convallaria and Digitalis and can potentiate or INC their action?
Beta-blockers
What drug does Cordyceps INC?
Epinephrine
What drug class interacts with Cordalis as the have similar MOA?
CCBs
What drug class can cause HTN with given with Crataegus?
B-blockers
What class of drugs does Cynara interact with and INC effects? (not PPIs)
Atorvastatin (Statins)
What herbs can antagonize or work against immune suppressive therapy (Adalimumab, Cyclosporine, Corticosteroids - Hydrocortisone, Prednisone, Dexamethasone)?
Echinacea
Eleutherococcus
What herb(s) work against or antagonize the effects of alpha and beta-blockers?
Ephedra
What herb(s) potentiate or INC sympathomimetics (Albuterol, Epinephrine, Phenylephrine, Pseudoephedrine, Salbutamol), caffeine, dextroamphetamine, methylphenidate, and MOAIs (Phenelzine)?
Ephedra
What 2 drug classes does Eschscholzia INC or potentiate?
MAOIs (Phenelzine)
SSRIs (Fluoxetine)
What drug does Ephedra INC clearance of?
Dextamethasone
