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Herb Drug Interactions

People are buying herbal remedies for every-thing from migraines to memory preservation to depression. Where once you had to see an herbalist or naturopath to get the daily dose of herbs for what ails you, herbal products now are widely available on drugstore shelves and in health food stores, making the ability to self-medicate greater than ever. But with that opportunity comes a warning: mixing herbal remedies and prescription drugs could be harmful to your health.

Just like drug-drug and drug-food interactions, herb drug interactions are very common. Some herbal medicines may cancel the effect of a prescription drug, others may reduce it, or even exaggerate it.

Part of the problem is many people don't tell their doctors they are taking herbal remedies. "A lot of doctors are not so receptive about this so patients fear telling them and keep it to themselves," says Krawchenko's colleague, pharmacist Zoltan Wighardt. "I think there's a lot of self-medicating going on." Dr. Michael Cameron, a Hamilton family doctor with an interest in complementary medicine, feels doctors often express disapproval or change the subject when patients inquire about herbal remedies. A lot of pharmacists are now tracking medications on computer and can tell you if your drugs and herbs are conflicting with each other."

Cameron also points to pharmacists as a good source of information. "If your doctor doesn't know or isn't sympathetic, then head to a pharmacist and ask them." Bookstores also have entire shelves devoted to herbalism these days, and many outline possible drug interactions.

Since herb drug interactions aren't predictable, and are possible, especially if you're taking a range of prescriptions and herbal remedies. So it's best to play it safe and study the herbal medicine before adding it to your pillbox.

Herb Drug Interactions

Dong Quai: taken for menopausal symptom control. Do not mix Dong Quai with warfarin (anticoagulants), St John's Wort and some antibiotics such as sulfonamides, quinolones.

Echinacea: mostly taken as an immune boost to prevent cold and flu. Do not mix Echinacea with some heart medications, antifungal medications, HIV medications and anti-anxiety medications.

Ephedra: A powerful decongestant. Contains ephedrine, which can open up bronchial passages. It's controversial because it's a powerful stimulant that can raise blood pressure, cause insomnia and high blood pressure. Do not mix with heart medications or if you are being treated for high blood pressure, glaucoma or thyroid problems.

Feverfew: taken to reduce the severity of migraines. Do not take with other migraine medications, as, it may raise heart rate and blood pressure. Feverfew has the potential to react with warfarin anti-coagulants, increasing the thinning of blood.

Ginkgo: increases blood flow and circulation throughout the body, can also help improve memory. May interact with anti-coagulant medications such as Aspirin, Coumadin, heparin and warfarin, causing the blood to thin too much, and provoking a serious bleeding disorder. A recent report in the New England Journal of Medicine describes a case of a man who'd been taking Aspirin to prevent a heart attack and had spontaneous bleeding into the eye from the iris within a week of taking a daily dose of ginkgo.

Garlic: is thought to help lower cholesterol and prevent the formation of blood clots that could lead to heart attacks. Garlic capsules may increase blood thinning if you are already on anti-coagulants. Do not take with diabetes medication because it may cause a decrease in blood sugars.

Ginseng: used to help reduce stress, boost energy and improve stamina, and may also help lower cholesterol. Can cause nervousness and excitation, and overuse can lead to headaches, insomnia and heart palpitations. Can increase blood pressure. Should not be used if you are taking prescriptions for high blood pressure or Coumadin.

Hawthorn: claimed to be effective in helping reduce angina attacks by lowering blood pressure and cholesterol levels. Should not be taken digoxin, a heart medication. The mix may lower heart rate too much.

Kava: is used to treat anxiety. It's also used to relieve insomnia and nervousness. Do not take Kava if you have a history of liver problems. Also do not mix with antidepressants, sedatives, and do not mix Kava with alcohol.

Licorice: used to treat coughs, colds and peptic ulcers. High doses can lead to increased blood pressure, water retention and potassium loss. Do not use with diuretics or digoxin because it could lead to further loss of potassium, essential for heart function.

St. John's wort: a natural anti-depressant for mild to moderate depression. Do not take with other anti-depressants, HIV medications, oral contraceptives, some heart/blood thinning medications and Tamoxifen (a cancer drug).

Valerian: a mild sedative with hypnotic effects, used to promote sleep, Should not be taken with alcohol or Valium.

Sources: Vancouver Sun July 27, 1998 (B10) and Mayo.com

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