Adults often take a prescription medication with a dietary supplement. St. John's Wort and golden seal are known to cause clinically important drug interactions and should be avoided by most patients receiving any drug treatment. However, many other supplements may cause interactions based on in vitro studies that have not been confirmed or refuted in human clinical trials.
Some supplements may interact with some medications, but are likely to be safe with other medications. Certain supplements have a low chance of drug interactions and, with certain caveats, can be safely taken with most medications. Physicians should consult reliable resources on dietary supplements, or from clinical or pharmaceutical pharmacists to help evaluate the safety of specific combinations of medications and herbal supplements. Since most patients do not disclose the use of supplements to doctors, the most important strategy for detecting herbal and drug interactions is to develop a relationship of trust that encourages patients to discuss the use of dietary supplements.
The use of herbal supplements has a long history, dating back thousands of years. Examples of important drugs extracted from botanicals include reserpine, morphine, penicillin, and anticancer drugs with vinca alkaloids. Herbal supplements are not subject to review by the FDA and their use can often be risky. The FDA does not apply the same efficacy and safety studies used for prescription drugs to herbal products, dietary supplements, and their manufacturers.
Even though herbal supplements can come from plants or herbs, the active ingredients can still be potent chemicals. Because of this, herbal supplements can have drug interactions, including with each other or with food or alcohol. Unfortunately, these products are not often labeled with safety warnings and it's difficult for the consumer to know if an interaction might occur. You can look up interactions between herbal supplements and medications here and always check with your doctor or pharmacist for more information.
Please note that all possible interactions may not be listed. Let's face it, drug interactions are complicated, so ask your pharmacist to test all your medications, including herbal products, vitamins, and other over-the-counter medications, to check for drug interactions with black cohosh. Coenzyme Q10 (also known as ubiquinone or CoQ10) is an antioxidant found naturally in the heart, kidneys, liver and pancreas; however aging and smoking can deplete these natural reserves. The dietary supplement will most likely be effective for coenzyme Q-10 deficiency or for reducing the symptoms of mitochondrial disorders, which are conditions that affect energy production in cells.
Blueberries may have a greater effect on anticoagulants (anticoagulants) such as warfarin and cause bruising or bleeding. Call your doctor right away if you have signs of an interaction, such as unusual bleeding or bruising, vomiting, blood in your urine or stool, headache, dizziness, or weakness. If you are taking an oral anticoagulant, check with your doctor before consuming unusual amounts of cranberry or cranberry juice; you may need to have your international standard quotient (INR) or other laboratory test on blood clotting checked more often, or to have your warfarin dose changed. Echinacea is also known as American cone flower, black Susan, or purple coneflower; it has been used to boost the immune system and is most commonly used in the treatment of the common cold.
Echinacea can also change the way the body metabolizes many drugs that pass through the liver; these are somewhat complicated interactions that can cause side effects or reduce the effectiveness of your medication; always check with your pharmacist if there are drug interactions with herbal supplements. Valerian has been used to treat insomnia and anxiety; people often use it for this purpose; it is also promoted for depression, premenstrual syndrome (PMS), menopausal symptoms, and headaches; most clinical research supports the use of valerian to alleviate insomnia and improve sleep quality; the German Commission E has approved valerian as a mild and effective sedative and is used for insomnia. John's Wort is a popular herbal supplement that is widely used to help with symptoms of depression; there are more than 500 drug interactions with St. John's Wort and some can be dangerous; because of the seriousness of many drug interactions you should check with your healthcare provider before using St.
There are many other possible interactions; consult your doctor or pharmacist for a review of drug interactions with St. John's Wort if you take prescription, over-the-counter, vitamin, or other herbal or dietary medications. More than 20 interactions with saw palmetto are listed but most of them are minor interactions; however always check with your doctor or pharmacist for a drug interaction test; saw palmetto is popular for benign prostatic hypertrophy (BPH), a non-cancerous enlargement of the prostate; if saw palmetto is combined with estrogens or oral contraceptives the effectiveness of hormone therapies may be reduced; examples of other herbs that can also cause drowsiness include 5-HTP kava and St. Kava native to the South Pacific is a member of the pepper family; it has been used to improve sleep reduce anxiety and control nervousness stress and restlessness.
Ginseng has been used in Asian countries for its therapeutic effects for centuries; now it is reported to improve the body's resistance to stress and increase vitality among other uses. Using yohimbine with an MAOI may cause an increase in blood pressure; it is important that at least 14 days elapse between the interruption of treatment with MAOIs (a rarely used treatment for depression) and the start of treatment with yohimbine; yohimbine treatment is generally not recommended for patients with hypertension angina or heart disease because it has a stimulating effect and can cause high blood pressure and a rapid heart rate; you can find other yohimbine interactions here; discuss the use of this supplement with your doctor to be on the safe side. Ginkgo interacts with more than 290 drugs; ask a doctor before taking any supplement.
