pharmacists planning service, inc.
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.
