Few interactions...

[crazyfool405]

Herb/​drug interactions: a literature review.

Hu Z, Yang X, Ho PC, Chan SY, Heng PW, Chan E, Duan W, Koh HL, Zhou S.

Department of Pharmacy, Faculty of Science, National University of Singapore,
Singapore.

Herbs are often administered in combination with therapeutic drugs, raising the
potential of herb/​drug interactions. An extensive review of the literature
identified reported herb/​drug interactions with clinical significance, many of
which are from case reports and limited clinical observations.Cases have been
published reporting enhanced anticoagulation and bleeding when patients on
long/​term warfarin therapy also took Salvia miltiorrhiza (danshen). Allium
sativum (garlic) decreased the area under the plasma concentration/​time curve
(AUC) and maximum plasma concentration of saquinavir, but not ritonavir and
paracetamol (acetaminophen), in volunteers. A. sativum increased the clotting
time and international normalised ratio of warfarin and caused hypoglycaemia
when taken with chlorpropamide. Ginkgo biloba (ginkgo) caused bleeding when
combined with warfarin or aspirin (acetylsalicylic acid), raised blood pressure
when combined with a thiazide diuretic and even caused coma when combined with
trazodone in patients. Panax ginseng (ginseng) reduced the blood concentrations
of alcohol (ethanol) and warfarin, and induced mania when used concomitantly
with phenelzine, but ginseng increased the efficacy of influenza vaccination.
Scutellaria baicalensis (huangqin) ameliorated irinotecan/​induced
gastrointestinal toxicity in cancer patients.Piper methysticum (kava) increased
the 'off' periods in patients with parkinsonism taking levodopa and induced a
semicomatose state when given concomitantly with alprazolam. Kava enhanced the
hypnotic effect of alcohol in mice, but this was not observed in humans. Silybum
marianum (milk thistle) decreased the trough concentrations of indinavir in
humans. Piperine from black (Piper nigrum Linn) and long (P. longum Linn)
peppers increased the AUC of phenytoin, propranolol and theophylline in healthy
volunteers and plasma concentrations of rifamipicin (rifampin) in patients with
pulmonary tuberculosis. Eleutheroccus senticosus (Siberian ginseng) increased
the serum concentration of digoxin, but did not alter the pharmacokinetics of
dextromethorphan and alprazolam in humans. Hypericum perforatum (hypericum; St
John's wort) decreased the blood concentrations of ciclosporin (cyclosporin),
midazolam, tacrolimus, amitriptyline, digoxin, indinavir, warfarin,
phenprocoumon and theophylline, but did not alter the pharmacokinetics of
carbamazepine, pravastatin, mycophenolate mofetil and dextromethorphan. Cases
have been reported where decreased ciclosporin concentrations led to organ
rejection. Hypericum also caused breakthrough bleeding and unplanned pregnancies
when used concomitantly with oral contraceptives. It also caused serotonin
syndrome when used in combination with selective serotonin reuptake inhibitors
(e.g. sertraline and paroxetine).In conclusion, interactions between herbal
medicines and prescribed drugs can occur and may lead to serious clinical
consequences. There are other theoretical interactions indicated by preclinical
data. Both pharmacokinetic and/or pharmacodynamic mechanisms have been
considered to play a role in these interactions, although the underlying
mechanisms for the altered drug effects and/or concentrations by concomitant
herbal medicines are yet to be determined. The clinical importance of herb/​drug
interactions depends on many factors associated with the particular herb, drug
and patient. Herbs should be appropriately labeled to alert consumers to
potential interactions when concomitantly used with drugs, and to recommend a
consultation with their general practitioners and other medical carers.

 

[JaredGalloway]

Good post.... Very informative... but u may wanna move this to the Supplement Article's Section

 

[crewchief182]

Definitely worth thinking about!

 

[matthias7]

but ginseng increased the efficacy of influenza vaccination

I doubt that very much. If so it is incredible how a vasodilating agent can increase the efficacy of first generation (inactivated) vaccine (influenza virus). I'd need to see the paper making this claim. What I think these authors might be doing is taking marginal results and presenting them as major contraindication.

 

[crazyfool405]

For sure u can make anystudys outcome to look how u want it to look.

I was just showing it as something to think bout

 

[matthias7]

Still its a big claim against known factors such as just being healthy.

In fact it really is a big claim, adjuvinants (alum) do promote vaccine efficacy but there's a known interaction.

When you've a supplement firing at the same thing (e.g antagonising a receptor) as a prescription drug then sure causes problems.

On the whole its thought provoking I guess. I dunno enough about the rest to comment.