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Drug Interactions with Nutritionals

Natural products and herbal supplements are classified as dietary supplements and are not approved by FDA to be used as drugs. There have been reported listings in the literature regarding adverse drug reactions with the concomitant use of anticoagulants such as Coumadin® (warfarin), and antiplatelet drugs such as aspirin (ASA), Ticlid® (ticlopidine), Plavix® (clopidogrel) and other similar drugs with the alternative medicines, herbs and nutritionals. Clinical considerations and adverse drug effects when used with prescription drugs should be noted and supervised by an appropriate healthcare professional. Caution and awareness should be used with such herbs and natural medicines when taken with some of the following:

Aloe

May potentiate effects of cardiac glycosides and anti-arrythmics

Bilberry

Inhibits platelet aggregation (IPA), monitor patients on anti-platelet drugs and warfarin, (MPAPDW)

Cayenne

Reduces platelet aggregation and increases fibrinolytic activities.

Dong Quai

Possible synergism with calcium channel blockers (IPA), (MPAPDW).

Feverfew

Reduces platelet aggregation and increases fibrinolytic activity, (MPAPDW).

Garlic

Inhibits platelet aggregation and increases fibrinolytic activity, (MPAPDW).

Ginger

Inhibits platelet aggregation, (MPAPDW)

Ginkgo

Can increase the risk of bleeding with anticoagulant and anatiplatelet drugs, (MPAPDW).

Ginseng

Monitor patients taking anticoagulants, variable effects on INR, (MPAPDW).

Hawthorn

May result in decreased dose requirement of ACE inhibitor drug, potentiates cardiac glycosides.

Licorice

Avoid in patients with hypertension and cardiovascular disease.


The above natural products are from the Herbal Chart for Healthcare Professionals from June H McDermott, MSPharm., and Peter Curtis, M.D. These are some of the currently reported dietary supplements with some of their adverse drug reactions.



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