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Herb/Drug/Vitamin Interactions and Information10/25/03Medicine Plants™ commitment to health education is paramount. We feel that taking personal responsibility for your health education is the key to maintaining optimal health and reducing the rising costs of health care. Below are some common drug/herb/vitamin interactions. All matters regarding your physical health should be supervised by a trained professional. Be sure to give your doctor a list of the herbs and supplements you are taking. Be sure to bookmark this site before you leave. You don't want to miss out on the newest information about your health choices! Visit Vitamins and Nutrition Center, it's the leading authority on vitamins and nutrition. Explore the latest vitamins research, detailed profiles on every vitamin, what to look for in a multivitamin, and thousands of informative articles on what you should look for when evaluating vitamins. Herb/Drug Interaction Kava: Adverse drug interaction with Benzodiazepines Ativan, BusparBuspirone, Clonazepam, Flurazepam, Librium, Restoril, Triazolam, Valium, Xanax, etc. Psyllium: Adverse Drug Reaction with Lithium Eskalith, Lithobid, Lithonate, Lithotabs May interfere with drug function by decreasing Lithium blood levels. Answers to Interaction/Reaction QuestionsQUESTION: I have a question: On bottles of Echinacea capsules there is a warning against its use while nursing. Why? Response By: Mitch Stargrove, ND, LAc ANSWER: There is no known toxicity. While some people may have allergies to Echinacea, it is not contraindicated during pregnancy or lactation. Simply for caution's sake labels will say to avoid most any herb while nursing. In fact, some herbs can be beneficial for you and your baby during this precious time and such practice was an integral part of midwifery and traditional medicine around the world in the past. However, supervision by a health care professional trained in herbal medicine would be advised if one wants to use herbs during pregnancy or while nursing. QUESTION: Hello, I am currently taking 240mg of verapamil, once a day for high blood pressure. I have recently, starting taking an odorless organic garlic tab to supplement my prescription, with the hope of getting off of it eventually. Is it safe and worth my time to take this herb for high blood pressure? Please advise! Response By: Interactions Team ANSWER: Verapamil (spelling) is a calcium channel blocking drug and is unlikely to directly interact with garlic products. Garlic is an excellent all-round herb for cardiovascular health but is best as one part of a comprehensive plan to help reduce elevated blood pressure. Individuals wishing to reduce or eliminate prescription drugs should consult a healthcare professional experienced in nutritional and botanical medicine to develop a comprehensive individual program before considering withdrawal from pharmaceutical support. Back to Top QUESTION: Can St. John's Wort decrease the efficacy of Prilosec? Response By: Interactions Team ANSWER: Theoretically - this is possible. Recent studies have shown that St. John's Wort extracts can accelerate the rate at which the body metabolizes various pharmaceutical drugs, either by improving liver metabolism or by enhancing cellular transport mechanisms which speeds elimination eg via the kidneys. Studies are not available for Prilosec but it is possible that adding St. John's Wort to your regime may lower the circulating levels of the drug, hence reducing its effectiveness. QUESTION: My wife was diagnosed with breast cancer in August. We have completed chemo, and radiation treatment. Her prognosis in good. Her tumor was small, with estrogen positive receptors. There was micrometastasis in one node. We were considering adding Flax Seed into our diets, but have seen that there are some warnings about Tamoxifen and flax seed. see: http://www.oncolink.upenn.edu/support/nutrition/faq/. A physician, friend has indicated that he does not understand that warning, and the benefits outweigh any potential harm. Your suggestion and help is most appreciated. Response By: Interactions Team ANSWER: Michael, on balance we would agree with your physician. The site you mention is unfortunately not very helpful. Firstly, fresh *whole* flax seed is a very weak phytoestrogen. There is no evidence that weak phytoestrogens are harmful following estrogen positive tumors. Epidemiological evidence suggests that phytoestrogens reduce breast cancer incidence. The precise mechanism of action of phytoestrogens at the estrogen receptor is not yet understood. Clinical experience suggests that in some circumstances herbal phytoestrogens block the receptor and prevent the symptoms of excessive estrogen activitation. Secondly, flax oil (extracted from the seeds) is a rich source of polyunsaturated essential fatty acids (PUFA) which are not phytoestrogens. There is some evidence that PUFA's are anti-neoplastic, and they are known to reduce the release of pro-inflammatory messenger molecules (cytokines) and increase the production of anti-inflammatory cytokines. Many practitioners with experience of nutritional therapeutics include both whole flax seed and PUFA's in protocols for breast cancer. Back to Top QUESTION: My mother is on coumadin and takes several supplements including coenzyme q10, vitamin c and vitamin e. Are there any interactions? Thanks. Response By: Interactions Team ANSWER: There have been suggestions in the medical literature that each of the supplements you mention may diminish the effectiveness of coumadin. The evidence is not strong or conclusive, and since it is most likely that the supplements are beneficial, a good course of action would be to continue taking them but to advise the prescribing physician and be sure to monitor INR (bleed times) regularly. QUESTION: I recently have heard that the safety of Ginkoba (Reg. trademark) or Ginkobiloba has been questioned. Can you inform me of any "safety concerns" since I have been a regular user of this for about a year. Response By: Interactions Team ANSWER: The primary safety issue with Ginkgo extracts is their ability to affect the blood clotting process. This is only a particular concern for individuals taking blood thinning drugs such as Warfarin, aspirin and others, or for individuals undergoing surgical procedure. In such cases, the prescribing physician (or surgical team) should be informed about Ginkgo usage. QUESTION: Are there any interaction problems between St. John's Wort and Benazepril (Lotensin) for high blood pressure? Response By: Interactions Team ANSWER: None that have been reported at this time. QUESTION: What, if any herbs, interact with typical asthma medications such as Albuterol, Ipratroplum bromide, inhaled steroids, and oral steroids? Response By: Interactions Team ANSWER: Ephedra-containing products should be avoided especially with Albuterol. Licorice root can slow the natural process of steroid drug removal from the body - an interaction sometimes used deliberately to help lower the dose of steroidal drugs. QUESTION: My daughter suffers from M.E. She has been prescribed anti-depressants, we give her several supplements one of which is st. johns wort, is this supplement safe to take along with the anti-depressants? Response By: Interactions Team ANSWER: If the antidepressant drug is in the SSRI class (selective serotonin reuptake inhibitors) one should be especially concerned about combining it with St John's Wort. In general, health care professionals trained in herbal medicine do not recommend combining St. John's Wort with pharmaceutical drugs. Back to Top QUESTION: I am very concerned about the potentially life-threatening interaction and long-term dangerous effects of taking St. John's Wort combined with other SSRI's, especially Serzone. Serzone is a new SSRI structurally different from prozac, zoloft, paxil. I had been taking St. John's Wort when I was prescribed Serzone (150mg). The doctor asked no questions about whether I had taken St. John's Wort before, and I did not think to tell him. Several days prior to taking the Serzone, I had been prescribed "Celexa." I took only one, and it seemed to give me a headache and a tight jaw. I was switched to Paxil, and I took one, and had the same kind of reaction as to the Celexa, but milder. The doctor then switched me to Serzone because he said it's structurally different than Celexa. Later, I was told by a friend that Serzone is much more powerful than Celexa or Paxil. I took one Serzone pill and had a massive reaction. I nearly stopped breathing, almost passed out, and was taken by ambulance to the emergency room. The unique and bizzare effects of the serzone remained acute for the next 3-4 days. The symtoms included extreme difficulty breathing, extreme dizziness, extreme fatigue, headache, chest pain, and confusion. It was as if my entire nervous system were shutting down. This occurred about three weeks ago. Since then, I have not regained my relatively normal state of functioning. I continue to be extremely dizzy, exhausted, and slow. The head-aches and chest pain have continued. My memory and concentration have precipitously deteriorated and not improved. My sleeping has been disrupted, and I either need to sleep all the time, or I can't sleep at all. I was somewhat "depressed" prior to taking the serzone. But that was nothing compared to what I am facing now. At first, the doctors in the ER reflexively thought I was having a panic attack. Then they put me on oxygen and an IV as a precaution. Finally, one doctor thought I was having a serotonin reaction after I told him about the previous herb and medications I have taken--all recommended by my doctors. I am absolutely certain it was not a panic attack. The chemical effects of the drug were so unique, so powerful, and lasted for several days in an acute phase. The symptoms have never worn off fully. It is a tremendous effort just to maintain ordinary function. I have always been very sensitive to medications, and I am very aware of my cognitive functioning. I do not drink or smoke or take other drugs. I exercise and eat well, but recent emotional traumas in my life led others to recommend taking an anti-depressant drug. I resisted but then did so against my bettern judgement. The results have been a disaster. I am afraid there has been some kind of long-term damage, but nobody seems to know anything about this. Please provide any information you have about so-called "serotonin syndrome" or other consequences of taking St. John's wort with serzone or other SSRI's. Thank you. Response By: Interactions Team ANSWER: "Serotonin Syndrome" is a cerebrotoxic response that was initially described in relation to interactions between MAO Inhibitors and drugs such as TCA's (Tricyclic Anti-depressants) or SSRI's. Some reports have been made in the literature associating concurrent use of St. John's Wort with SSRI's such as Serzone leading to symptoms resembling those of serotonin syndrome. It is possible that some individuals such as yourself have an idiosyncratic sensitivity to St. John's Wort and in combination with the SSRI drug can experience a strong adverse reaction. The neurotransmitter effects of St. John's Wort alone are not nearly as powerful as those of pharmaceutical drugs, which is why individual hypersensitivity is considered to play a role in such responses. The mechanism of the so-called serotonin syndrome is not understood, and in some cases coma has been reported. Back to Top QUESTION: Which herbs or nutritional supplements should not be used along with ACE inhibitors and thiazide diuretics and alpha blockers? e.g Zestoretic and Minipress Response By: Interactions Team ANSWER: If you are taking combinations of cardiac drugs it is always prudent to seek advice from the prescribing physician concerning interactions. Thiazide diuretics can affect electrolyte levels and specific supplementation may be needed in individual cases. ACE inhibitors may be affected by Capsicum (cayenne), as may vasodilator blood pressure drugs like Minipres. Excessive doses or long term use of licorice root should be avoided with diuretics. QUESTION: What is the significance of taking grapefruit juice and its interaction with herbs:"do not start or stop taking grapefruit juice with herbs or other medications"? Is eating or drinking grapefruit juice harmful to our health? I love to substitute a grapefruit versus some sweet dessert after supper. I take extra vitamins: B, C, E, selenium, beta caratine, grapeseed, calcium, and garlic along with 10 mg. Prinivil for hypertension and .9 mg. Premarin. Response By: Interactions Team ANSWER: No, grapefruit juice is not harmful to health. The potential exists for grapefruit juice inhibit the detoxification of certain drugs by enzymes in the cells of the liver and intestine wall and this can affect the levels of these drugs in the body. Some drugs require a narrow range of blood concentration to be effective or not cause side effects, and these medications are usually prescribed with warnings about grapefruit juice consumption if relevant. Grapefruit juice would affect the metabolism of Premarin, but this interaction is unlikely to be significant. QUESTION: I am 45 years old, premenopausal, with osteoporosis and hashimoto's disease. I take Fosamax first thing in the morning with 12 oz. water, wait 30 minutes upright, and then take .75mg of Levoxyl with another large glass of water, and follow that with my morning cup of tea, minocycline for a skin condition and Valtrex to prevent cold sores. I have had no adverse side effects from this regime, but I do enjoy eating grapefruit and drinking grapefruit juice. However, since I have read about interactions with grapefruit juice I have avoided those products, and I miss them--do you see any problem with eating grapefruit or drinking the juice when taking these meds? I am also considering St. John's Wort for my perimenopausal mood swings, but am afraid of an interaction with my other meds. Response By: Interactions Team ANSWER: There are is no special reason to avoid grapefruit juice consumption with these medications. St. John's Wort has been shown to increase metabolism of some drugs, in the opposite way to grapefruit juice. The effects are likely to be minimal in the case of your regime, but you should notify your prescribing physician before you begin taking St John's Wort. Back to Top QUESTION: Does licorice interact with any of the following: doxycycline, Prilosec, Vioxx, Cardura, Wellbutrin? I had this question asked of me at the pharmacy where I work. Real licorice is in low amounts in black licorice sold as candy, but I was not sure of any interaction with either product. Response By: Interactions Team ANSWER: You are right that candy products contain little real licorice. Licorice root is an ingredient in many herb teas, but there no medical reports of interactions with normal doses of licorice-containing teas. Concentrated licorice extracts are used for flavoring some products (such as chewing tobacco) and excessive consumption of such products may cause licorice induced interactions, however these would affect electrolyte balance and steroid drug metabolism. Long term or excessive use of licorice should be avoided with diuretics and with high blood pressure individuals. QUESTION: Are there any drugs or medicines to avoid while taking furosimide (lasix)... we currently soak 40mg of furosimide with sennacot, chewable calcium, vitamin c, folic acid and 6cc of dilantin...could anything be negatively reacting with the furosimide? Response By: Interactions Team ANSWER: Dilantin can reduce body levels of essential B vitamins, especially B1, B6 and Folic acid. Supplementation of these vitamins is essential in long term Dilantin therapy. Dilantin absorption is decreased by calcium, so calcium supplements should be taken at least three hours from ingestion of dilantin. Furosemide also causes Vitamin B1 depletion. QUESTION: I read that grapefruit causes some vitamins and supplements not to be absorbed properly. Can you give me a source; I can no longer find this information and need to know which vitamins, minerals and supplements (as well as pharmaceuticals) are affected by grapefruit consumption. email=B.......@aol.com Response By: Interactions Team ANSWER: Grapefruit juice does not affect the absorption of vitamins and supplements at all. It inhibits enzymes in the liver and intestine that detoxify a number of diverse pharmaceutical agents, and so may increase blood levels of those drugs, but this does not apply to vitamins and minerals which do not undergo detoxification in the liver. QUESTION: I am currently taking a dietary supplement with the following ingredients: Chromium 40 mcg (as Chromium Chelate/Chromium Picolinate); Proprietary Blend 530 mg. of the following: Sida Cordifolia Concentrate; White Willow (bark); Siberian Ginseng (root); Ginkgo Biloba (leaf); Ginger (root); Gotu Kola (aerial part); Beet(root); Hawthorne (fruit); Saw Palmetto(fruit); Kelp(thallus); L-Carnitine Tartrate and Boron Chelate. Do any of these things have dangerous side effects or are there any prescription drugs that they might interact with. I know the Sida Cordifolia contains 12 mg naturally-occurring ephedrines and should not be taken if getting surgery or taking blood thinners. Thank you. Response By: Interactions Team ANSWER: This is a typical "herbal weight loss" product formulation, containing caffeine, aspirin like compounds, and ephedrine. It also contains herbs that interact with blood clotting mechanisms. Depending on your constitution and general health these kind of products may cause adverse effects such as anxiety and palpitations. They may also cause significant drug interactions. Although popular in the retail and multilevel markets, natural healthcare practitioners rarely recommend these products. QUESTION: If I take a soy supplement while taking Synthroid will this decrese the effectiveness of the Synthroid? Response By: Interactions Team ANSWER: There is no data suggesting such an interaction, and little reason to expect that there might be one. Back to Top QUESTION: I am an RN and recently had and MS patient who was on Avonex ask me if there are any herbs she should avoid because of her MS. She said she was told some of them that boost your immune system she should stay away from. But her Dr. stated he did not know. Do you know of any? Response By: Interactions Team ANSWER: Physicians often state that echinacea and "immune stimulants" should not be given in autoimmune conditions. This general statement is without foundation, and has no basis in the medical literature, adverse drug reactions or pharmacovigilance reports. As you know, the pathophysiology of MS is still not fully understood, and herbal and natural therapies can be useful as an adjunct or alternative to conventional treatments. However, herbal medicines, including immune modulating herbs, for serious conditions such as MS should only be used in consultation with a practitioner trained and experienced in botanical medicine. QUESTION: I have been taking mincocyline for acne vulgarius for about 12 years, I have also been taking Prozac and various vitamin supplements for 6 years. Recently I have come off the prozac (about 5 months ago), and started taking St Johns Wort, I am also taking Vitamin E, Beta Carotene, Acidophilus, B complex, vitamin C. About 4 weeks ago I started taking Gingko Biloba to boost my energy levels which have suffered since coming off prozac. For two weeks now my acne has become increasingly bad, and it is evident that for some reason the minocycline is not working. Which of these herbs/vitamins could be interferring with the antibiotic. Hope you can help me. Response By: Interactions Team ANSWER: It may be sensible to do a trial and stop the Ginkgo for a while to see if the acne improves, and then restart it to see if it worsens; then you might reasonably suspect the Ginkgo. There are no interactions between Gingko and tetracycline, however many things can contribute to acne, including dietary factors. QUESTION: I would like to know if there are any possible side effects/reactions to using both St. John's Wort and L-Tyrosine together. Response By: Interactions Team ANSWER: There is no direct medical evidence of St. John's Wort and L-tyrosine interaction. There is a suggestion that in laboratory experiments SJW may have very slight monoamine oxidase inhibitor (MAOI) activity but this has not been confirmed at normal physiological dose levels in humans. MAOI's and L-tyrosine are contraindicated due to potential negative interaction. This is very unlikely to apply to St. John's Wort taken at therapeutic doses. QUESTION: I heard that there may be a problem taking antihistamines while taking St. John's Wort. Could you please explain this and let me know if one should be discontinued. Thank you. Response By: Interactions Team ANSWER: It is theoretically possible that St.. John's Wort may reduce the levels of terfanadine (Seldane¨) in the body because this herb can increase the rate of metabolism of that drug. However if you are taking SJW regularly, there will be no detectable effect as far as your Seldane dose is concerned. If you stop taking the herb, you may theoretically need to use less Seldane, but in practice the difference may be negligible. There is no need to discontinue the herb. QUESTION: Currently taking Prozac 40mg a day and Klonopin .25mg at night. Is it safe to take Ginkgo Biloba with the Klonopin? Thank You Response By: Interactions Team ANSWER: Yes, you can presume so. There are no known interactions between Ginkgo and Klonipin. QUESTION: My husband would like to try SAM-e and is currently taking 40 mg. of Prozac and 3-4 mg. of Xanax daily. His psychiatrist does not know anything about SAM-e. Could this be taken concomitantly with his meds? If he feels the results within the 4-10 as it claims, then he can begin the weaning process. Thank you. Karen Response By: Interactions Team ANSWER: There are no known interactions of SAMe. This substance does have multiple roles in the body, and may enhance liver metabolism of certain drugs, however the significance of this is not known at present. It is possible that the powerful serotonin effects of Prozac and Xanax may mask any trial with SAMe which only indirectly impinges on neurotransmitter chemistry. Back to Top QUESTION: I am currently on Prozac for Obsessive/Compulsive Disorder and Clomid for Infertility/ PCOS. I also have problems with my sugar (hypoglycemia) and am having an awful time trying to lose weight. A friend of mine recommended Thermogenics by Herbalife, which is a high-protein, low-carb supplement. Do you think that this would be safe for me to take while I'm on Prozac and trying to conceive? I had thought about waiting until after I had a baby to try it, but I heard that going on a high-protein low-carb diet could help and alleviate some of the Poly-Cystic symptoms I'm experiencing. I've tried to do this diet on my own, but to no avail. Response By: Interactions Team ANSWER: Healthcare professionals do not recommend the kind of herbal products you describe. PCOS and hyperinsulinemia are associated, and have been effectively treated with natural therapies, including herbal medicine. Clomid does not address the underlying issues of PCOS associated infertility and you may wish to consult a qualified natural healthcare practitioner to address these issues more fully, either now or after you become pregnant following successful Clomid therapy. In any event, herbal weight loss products are really not appropriate for your health needs at this time. QUESTION: Is there any evidence Ginko Biloba should not be used along with Prozac? Response By: Interactions Team ANSWER: No, none at this time. QUESTION: I take feverfew to prevent migraines, the doctor recently put me on prozac. Are there any known interactions for this combination?? Response By: Interactions Team ANSWER: No, none at this time. QUESTION: My son, age 11, has bipolar disorder. In the long process of getting a correct diagnosis, and then finding the correct medicine, he's taken about 20 different drugs. At one point, he nearly died from depakote-induced pancreatitis. After that, we tried (with doc's permission) a combination of St. John's Wort and Valerian Root (and also ritalin, which he has taken for years). I was quite surprised to find that his behavior was much more controllable on this regimen. He still had real anger and impulsivity problems, so eventually we moved on to other drugs. So....now he is taking Lithium and ritalin. This helps pretty much, but the doc has tried a variety of "mood stabilizing" drugs in conjunction...all of which have had terrible side effects. I was wondering if perhaps we could try either St. John's or Valerian or both in conjunction with the lithium/ritalin. Any help you can give would be greatly appreciated! Response By: Interactions Team ANSWER: While there are no known interactions between Lithium and Ritalin and St. John's Wort or Valerian, the use of herbal medicines in a case such as your son's is best dealt with in consultation with a practitioner qualified and experienced in the use of botanical medicines. Back to Top QUESTION: what interactions could occur with Prozac and Kava kava or st johns wort? Response By: Interactions Team ANSWER: In general, natural healthcare practitioners do not recommend combining herbal sedatives and anxiolytics with prescription medications. There are several medical reports of negative interactions between high doses of St. John's Wort and SSRI drugs such as Prozac. There are no reliable reports of interactions between kava kava and Prozac. It is best to try herbal agents or pharmaceutical agents separately. QUESTION: I am a 33 year old female. I am over 100lbs over weigh and in good health. I swim a mile a day and am eating a low calorie diet according to the weight watchers plan.I have began taking Ephedrine, Creatin, and ST Johns Wort. I am aware of and understand the risks of these products individualy but i cannot find any information on the risks of combining any of these suppplements can you please tell me of any known side affects or interaction precautions? Response By: Interactions Team ANSWER: Ephedrine is a naturally occurring stimulant and if you have high blood pressure or any weight related or other cardiac condition it should not be used. It should not be used long term, and is best taken under the supervision of a natural healthcare practitioner. Although used in combination with other substances by body builders for short periods of "fat cutting", it is not appropriate for long term use to lose weight by people outside the competitive body builder environment. There is no specific interaction between Ephedrine and St. John's Wort. Creatine is not an interacting agent. QUESTION: I have heard from an oncologist that vitamin C and selenium supplementation aside what is present in the diet is contraindicated for a patient with melanoma. Is this true? Response By: Interactions Team ANSWER: There is some dispute over the role of selenium in the causation of melanoma, with some epidemiological evidence that high levels of selenium in water supplies may be associated with increased melanoma incidence. However, there is no evidence hat supplementation with selenium is harmful to those with melanoma, and other studies suggest high levels are protective. There is no evidence that vitamin c supplementation is harmful to melanoma patients, and several studies that suggest ascorbate and ascorbate derivatives may be effective against melanoma cell lines. Oncologists can sometimes be conservative when advising patients on herbs and nutritional supplements, and it is best to seek advice from a natural healthcare practitioner familiar with the use of herbs and supplements in oncological contexts who can work as part of a team of healthcare providers with the cancer patient. QUESTION: I had a liver transplant a little over 2 months ago. Before this I was taking milk thistle, dandelion root, and herbal tea with gotu kola in it. But now, I am on prograf and prednisone and was wondering if my herbs would be harmful with these new drugs. I still have hep B and C in my blood and would like to protect my new liver. Thank you Response By: Interactions Team ANSWER: You are right in thinking that herbs can help protect your new liver, and milk thistle in particular is hepatoprotective. Far from being dangerous you can actually use herbs to protect against the side effects of drugs such as Prograf, for example by protecting the kidney against the nephrotoxicity of the drug. Consult an experienced natural healthcare provider because this is a specialized area. QUESTION: I had a liver transplant a little over 2 months ago. I am now taking prograf and prednisone. Since i still carry the hep. Band C, I was wondering if I could still take my milk thistle and dandelion root, and drink my JWTea with Gotu Kola in it. Thank you... Response By: Interactions Team ANSWER: Milk Thistle can increase hepatic clearance of immunosuppressive drugs by improving liver function; therefore it is important to notify your prescribing physician of your herbal regime and to monitor your drug levels regularly. Consistency and regularity of herb dose and frequency are very important to maintain a stable situation. QUESTION: Is there a drug interaction between Adderall for ADHD andSt. Johns Wart? Response By: Interactions Team ANSWER: There is no documented interaction. St. John's Wort has multiple neurotransmitter actions and therefore practitioners of natural medicine and herbalists do not recommend combining the herb with centrally acting drugs. QUESTION: Are there any known adverse cardiac effects of taking kava(piper methysticum) in material dose? In taking it myself I haveexperienced a sensation as if someone was lightly squeezing my heartin his hand. It could be called "cramp," and accompanied a sensationin my heart every few seconds as if there were suddenly a vacuumbetween beats, analogous to the feeling you get in an elevator whenit suddenly begins rapid descent and the floor seems to drop awayunder your feet. I've looked through a great deal of literature onkava and can't find any mention of these effects. Response By: Interactions Team ANSWER: There are no documented direct cardiac effects and the subtle symptoms you describe are not usually detected with normal dose. There is a relaxing action on striated muscle, however, this is thought to involve changes in sodium channel conductivity which theoretically may translate to myocardial muscle cells since these are also striated muscle. QUESTION: I have depression I have taken Prazac and Zyprexa from ayear. Six months ago I changed my medicine to Wellbutrin andZyprexa. Two Weeks ago I got off my Zyprexa and started doing accupunture. Now I am still on Wellbutrin I have Been taking all ofthese Meds, Valerine and Melatonin for sleep. St Johns Wart for depression Ginko Baloba For Mental Alertness. Today I taked to the intergrated Med Doctor and we agreed that I should go on a Homeopathic Med called Lycopodium 30c. Also to take Taurine to helpwith my propper brain funtion. I have talked to my doctor and a pharmasist They said that I shouldn't take Valerine with the GinkoBaloba. So ok I will just take the Melatonin. They also said no StJohns Wart with the Wellbeutrin. Ok . So How will all of the otherHerbs React with the Wellbeutrin. Taurine, Ginko, Lycopodium, andregular vitamins? I would like to keep taking all of the ones I justmentioned if you can tell me any other reason not to or what might begood about taking them Please do. The reason why I am kind of makingthis an emergency is because my dad told me that one of his freindsfrom work said that his cousin was taking anti depressants and otherherbal remebies and died because of this. So I am kind of worriedabout the effects they might have Please Let me know as soon aspossible if you can. Send me any information you might have on anyof these Herbs and their effects. Oh ya I read about Lycopodium andit didn't even mention that it might help with my depression,anxiety, insomnia could you tell me what homeopathic med will helpwith that one that won't kill me because of the combinations Please. Thank You Very Much Suzanne Helmrich Phone # 703-xxx-xxxx Use this number only if you have some benifical Info and call collect. Response By: Interactions Team ANSWER: You are not only combining several different medicines, but also several different therapeutic modalities (herbs, accessory nutrients, homeopathy, acupuncture) This makes it difficult to analyze your case, and we would recommend you select one practitioner to head the development of your treatment plan which needs to be simplified. QUESTION: Is there a possible interaction whith prednisone and valerian root? Response By: Interactions Team ANSWER: No interaction has been documented, and is theoretically unlikely. Back to Top QUESTION: What effect does acidophilus have on dilantin and coumadin? Response By: Interactions Team ANSWER: Acidophilus may alter the composition of the resident microbial population of the large bowel. Theoretically this could then alter the absorption of certain drugs, and affect serum levels, although published evidence of this occurring with dilantin or coumadin is not available. Coumadin levels should be monitored regularly. QUESTION: I have been taking coumadin and dilantin for several years.Recently, after having been on vancomyacin antibotic for 28 days, Ihave been having problems with bleeding from the rectum and have beenput on predisone. I also began taking acidophilus supplement (ratherthan just eating yogurt) to treat this condition which apparently is related to long term use of antibiotics. However, I suffered a seizure after being on acidophilus for three days and upon examination it was discovered that my dilantin reading was 0 and my protime had jumped from under 3 up to 6. What interactions are likely to occur by being on dilantin, coumadin, predizone and acidophilus? Thank you. Response By: Interactions Team ANSWER: This is a complex situation. Dilantin inhibits Vitamin K (essential for coagulation) and coumadin is a Vitamin K antagonist. Antibiotics reduce the level of Vitamin K produced by normal bowel flora by destroying them. Acidophilus does not produce Vitamin K however. Given the prescription of vancomycin, you presumably had a serious gastro-intestinal infection, and this could well have altered the normal absorption of your drugs in itself. QUESTION: I am a 22 year old female taking Oral Contraceptives as well as Milk Thistle. I recently read that the herb may have an adversereaction to the effectiveness of the OC's. Should I stop taking itall together? Is it safe for me to take it during the week when I amnot taking the hormone pills? Response By: Interactions Team ANSWER: If you take Milk Thistle and are using oral contraceptives, then the herb can help the liver clear the hormones from the system. Theoretically this may depress the serum levels of the drug. Reports of unwanted pregnancy associated with concomitant use of Milk Thistle and Oral contraceptives are not available. The time lag involved in the liver enzyme effects will not correspond to the periodic use of the hormone, so stopping and starting is much more of a problem than maintaining steady dose and regular frequency of use of the herb. QUESTION: I am concerned about possible adverse interactions between the cholesterol-lowering drug Lipitor and certain nutritional supplements, specifically vitamin B3. I have been taking a B-complexsupplement (Solgar B-Complex "100") for about two years; according tothe label, one capsule contains 100 mg of niacinamide (plus other Bvitamins). My multiple vitamin (Solgar Solovite, Iron-Free) contains100 mg of niacinamide per capsule. Will this level of vitamin B3consumption interact adversely with a daily dose of 10mg of Lipitor?I have read that the interaction can cause heart problems, as well ascausing muscle and kidney damage, but the source did not provideinformation about dosages or duration. Thank-you. Response By: Interactions Team ANSWER: Niacin will increase the possibility of adverse effects, particularly muscle aches, from Lipitor. The matter of dosage in this combination should be referred to your prescribing physician. QUESTION: Is it unsafe to take ZOLOFT (SSRI) with the weight loss herbal supplement, METABOLIFE 356 ? METABOLIFE contains the following combination of herbs andvitamins: VIT.E, MAGNESIUM, ZINC, CHROMIUM PICOLONATE, GUARANA, MAHUANG, BEE POLLEN, SIBERIAN GINSENG, GINGER, LECITHIN, BOVINECOMPLEX, DAMIANA, SARSAPARILLA, GOLDENSEAL, NETTLE, GOTU KOLA,SPIRULINA, ROYAL JELLY. Response By: Interactions Team ANSWER: The product you are taking contains stimulants including caffeine and ephedrine. These can cause anxiety, insomnia and restlessness. There is therefore a possible conflict, rather than interaction with Zoloft. Back to Top QUESTION: Is there any drug interaction while taking ginko biloba with the following prescription drugs: Levoxyl, Reglan, Humulin Insulin, Premarin, Prevacid, Glucophage, and Vioxx? Response By: Interactions Team ANSWER: There is no reported interaction or theoretical reason for one between Ginkgo and these drugs. QUESTION: I am Hypothyroid and on Levothroid to treat it. I heard a rumor that because I am on Thyroid medication I should avoid Soy products. But Soy is supposedly so good for all of us! Is thistrue? Why should I be avoiding soy? Is there a natural way to treat hypothyroidism other than prescription medication? Please advise andthank you for this service! Response By: Interactions Team ANSWER: There is some evidence from animal experiments that some soy isoflavones inhibit an enzyme involved in thyroid hormone synthesis. Since you are taking thyroid hormone, this potential interaction is not an issue in your case. QUESTION: Is there any reason that Slippery Elm capsules and/or drinkshould not be taken whilst a drug from the 'Proton Pump Inhibitor' family is also being taken? Response By: Interactions Team ANSWER: Yes. Slippery Elm contains mucilage - this will tend to decrease the bioavailability of any drug consumed orally at the same time. QUESTION: MY 15 YR OLD DAUGHTER HAS BEEN TAKING ZOLOFT FOR 6 MONTHS NOW, BUT EVEN WITH ALL THE HELP THE MEDICATION HAS DONE SHE STILL SUFFERS ANXIETY ATTACKS AND GROUCHINESS. I TAKE KAVA KAVA AND WAS WONDERING IF SHE COULD TAKE AS I DONT WANT THE DOCTOR TO PRESCRIBE AND ANTI ANXIETY MEDICATION. Response By: Interactions Team ANSWER: Combining prescription psychiatric drugs with herbs that act on the nervous system is not necessarily safe and generally inadvisable. QUESTION: Is there a problem with taking Kava if I am already taking Cardizem CD daily? Response By: Interactions Team ANSWER: No, None that is known, and none that is theoretically obvious. QUESTION: I have been taking St.Johns Wart for 6 months. I have been taking Response By: Interactions Team ANSWER: St. John's Wort should not be combined with prescription anti-depressants. There is a potential for additive adverse effects. Back to Top QUESTION: Is there any interactions &/or contraindications to taking St. John's wort while taking beta-blocking drugs? Is there any difference between taking a liquid or tablet form of St. John's wort, in the above scenario? Thanks Response By: Interactions Team ANSWER: St John's Wort has the ability to affect bioavailability of a few drugs, although nothing has been reported about beta blockers. A "steady state" of regular dose levels of the herb will avoid possible fluctuations of drug level. There are no direct interactions. QUESTION: Are there any herb's that interact with (Fluoxetine Hydrochloride)or Prozac? Response By: Jonathan Treasure, MNIMH. ANSWER: SSRI drugs should not be combined with sedative or "nervine" herbs, because there is a risk of additive sedative effects, and especially St John's Wort, with which there is a risk of excessive serotonin side effects. Generally there is no benefit in combining antidepressant drugs with herbs that act on the CNS. QUESTION: Could the new depression therapy, SAM-e, be safely taken along with very low doses (.05mg 3xday) of the drug, Klonopin? Also, if I wanted to try SAM-e, would it be best to discontinue the Klonopin all together? Response By: Interactions Team ANSWER: Probably best yes; you will very likely be unable to determine the effect of SAMe while taking Klonopin, even at very small doses. QUESTION: Prescription Drugs taken: Spironolactone, prinzide, and premarin. Vitamins and supplements taken: All B + C, garlic, L. Arginine, Taurine, Vitamin C, Vitamin E, Selenium, Calcium and Magnesium. Over the counter drugs: aspirin. Do any of these drugs interact unfavorably? Response By: Interactions Team ANSWER: The effects of garlic and aspirin on coagulation are likely to be additive. That could be considered favorable or unfavorable. QUESTION: I am currently taking essiac tea, milk thistle, naturalax 2 (main herb cascara sagrada bark) and primadophilus along with an array of vitamins. I was recently given a prescription for combivent (ipratropium bromide and albuterol sulfate) as well as a prescription for claritin. Is there any reason to think any of this will interact? Thank you! Response By: Interactions Team ANSWER: Without dosage and frequency of use information it is hard to say. Anti-asthma and anti-allergy medications in chronic doses can have adverse effects in extended use. QUESTION: Is there an herb or vitamin reaction that I need to watch for with the drug tamoxifen? Are there any that inhibit tamoxifen or affect its strength? Response By: Interactions Team ANSWER: There are several dietary supplements which may augment the effect of tamoxifen. You should definitely consult a qualified natural healthcare practitioner experienced in adjunctive support for oncology therapies. QUESTION: Hi. I use marijuana for medicinal purposes and I'm worried about it interacting with a prescription allergy medication that I'm taking. It is called Claritin. Do you know of any interactions between Claritin and marijuana? Thanks. Response By: Interactions Team ANSWER: There are none that have been reported. Back to Top QUESTION: I am currently taking the oral contraceptive "Diane -35". Is there any dug interaction between that and the use of the herb St. John's Wort (Hypericum) ? Thank you. Response By: Jonathan Treasure, MNIMH. ANSWER: Although there is no clear evidence to support the idea of possible contraceptive failure with concomitant administration of St. john' Wort and oral contraceptives, it may be prudent to change contraceptive method if you wish to continue using the herb. QUESTION: Is there any interaction between St. Johns Wort and Lipitor? Response By: Jonathan Treasure, MNIMH ANSWER: Lipitor is metabolized in the liver by an enzyme (cyp4503A4) that may be affected by St John's Wort. (Some foods, like grapefruit juice have a similar effect). However, maintaining a steady regime of herb and drug would tend to eliminate any variation in drug levels due to bioavailability fluctuations caused by the interaction. QUESTION: I am a 40 year old man who is taking a supplement that combines Saw Palmetto with vitamin E and zinc. I am also taking doctor prescibed Yohimbine. Are there any interactions I should be aware of or precautions I should be taking? Response By: Jonathan Treasure, MNIMH. ANSWER: Yes. Yohimbine may worsen symptoms of urinary difficulty which are sometimes a reason for using the herb Saw Palmetto. QUESTION: I have tension headaches quite often and taking a pain reliever never works for me. Are there any side affects to taking Valerian root and ibuprofen together? Response By: Interactions Team ANSWER: None that are known. QUESTION: What if any are the drug interactions between a combination of glucosamine HCl and chondroitin Sulfate with 1)lithium 2)welbrutin and 3)risperdal Response By: Interactions Team ANSWER: These fairly inert substances do not tend to interact with prescription medications. QUESTION: Hi, I have a six-year-old daughter who is on four primary medications for growth-hormone deficiency and attention deficit hyperactive disorder: Genetropin--human growth hormone, .09mg 1x per day Adderall, 7.5mg 1x per day Cyproheptadine, 2 mg 3x per day Clonidine, .5 mg 1x per day For sinus infections, she has also recently been on repeated doses of antibiotics. I don't think she tolerates this well--it seems to aggravate her hyperactivity, and as the number of antibiotic rounds increase, she tends to get sick more often. I am currently looking at some alternative herbal therapies to treat infections--specifically echinacea and golden seal. Are there any dangerous interactions between these two herbs and the above prescription drugs? Please let me know. Thank you. Response By: Interactions Team ANSWER: No, none that are known, nor are there theoretically likely to be. QUESTION: I am presently taking choline magn. 750mg and carisoprodol 350mg for cervical radiculopathy.I've been on these for a month and haven't seen any results as of yet. So it's been a week since I started taking vitamin C 1000mg, vitamin B-complex 100mg, vitamin B6 50mg and vitamin E 100iu along with my prescribed medication. My question is if any of these vitamins interact with my prescriptions? Thanking you in advance. Response By: Interactions Team ANSWER: None known; but some depletion of certain nutrients is common with strong nervous system drugs. Back to Top QUESTION: WHAT IS THE REACTION IF ANY BETWEEN VALERIAN ROOT AND ZOLOFT? Response By: Interactions Team ANSWER: There is no obvious or known neurochemical interaction but the agents might have additive sedative effects. Combining the two kinds of medication is not generally recommended. QUESTION: I would like to know any complications that could arise from taking Padma 28 (thibetan medicine) and Lipitor ( medicine for reducing cholestral)? Response By: Interactions Team ANSWER: Lipitor is metabolized by the liver and that may affect the rate of clearance of Padma 28 from the body , however this is speculative. QUESTION: Could you please tell me if I can safely take Kava Kava with Terazol and the antibiotic Metronidazole? Thank you. Response By: Interactions Team ANSWER: The drug does affect liver metabolism, which may alter the dynamics but not the effect of kava kava. You are unlikely to notice a problem. QUESTION: i am on prednesone - 15mg a day for cervical myelitis and my homocysteine rate came back as 15.1. i would like to take folic acid to combat that. is that ok? what about b-6 or b-12? i don't like that rate to be up so high. i'm only 30 years old. Response By: Interactions Team ANSWER: Corticosteroids are known to deplete folic acid, so it is wise to supplement that in any event. The dose should be increased to allow for this depletion. QUESTION: Are the any interactions btween St. Johns wort and neurontin? Also are there any detrimental side effects I should be aware of while taking neurontin by itself? Response By: Interactions Team ANSWER: While there are no recorded interactions, it is generally considered inadvisable to combine herbs that have CNS effects with strong pharmaceutical drugs that also act on the CNS. Back to Top QUESTION: On May 13, 2000 HEALTHWEEK (PBS), A STATEMENT WAS MADE, "SOY PRODUCTS SHOULD NOT BE USED WITH THYROID MEDICATION". I'D LIKE MORE INFO. WHY? WHERE DID THIS COME FROM? WAS THERE A STUDY DONE? DOES IT APPLY TO NATURAL THYROID LIKE ARMOUR THYROID OR SOMETING LIKE SYNTHROID (A PHARMACEUTICAL), OR BOTH. WOULD LIKE TO HAVE HEARD MORE ABOUT THIS ON HEALTHWEEK BUT IT WAS JUST THAT ONE STATEMENT. THANKS SO MUCH FOR YOUR EFFORTS AND THANKS FOR BEING THERE. DOUBT i'LL FIND THE ANSWER IN YOUR ARCHIVES. IT SOUNDS LIKE SOMETHING NEW. Response By: Jonathan Treasure, MNIMH ANSWER: The facts have been known for some time. Laboratory experiments have shown that soy isoflavones can inhibit an enzyme involved in thyroid hormone synthesis. The significance of this is not known in humans, there being only one human study which should normal thyroid tests after three months soy diet. Also, several essential dietary amino acids inhibit the same enzyme. There is no evidence to suggest an interaction between thyroid medication and soy products. There is a possible depletion of endogenous thyroid hormone in very high soy diets, but not in at normal levels eg one portion of soy per day. QUESTION: Are there any interactions I should be aware of when taking Lipitor and Sam-e. Also are there any problems taking Lipitor and a Glucosamine / Chondroitin combination? Response By: Interactions Team ANSWER: None that are known, nor theoretically plausible. QUESTION: I am currently taking 10 mg of Prozac in the morning and 200 mg of Celebrex at night. I also take Remifemin which is the herb Black Cohosh. Is there any danger of adverse side effects from this combination? Thank you. Response By: Interactions Team ANSWER: None that are known, nor theoretically plausible. QUESTION: Have you any information on interactions or adverse reactions to the taking of aspirin and gingko biloba, after a very severe stroke? With Thanks, Sheri Dixon Response By: Jonathan Treasure, MNIMH. ANSWER: There have been some case reports associating Ginkgo use with cerebrovascular accidents of various kinds. One report included concomitant aspirin use. The evidence is hard to evaluate due to the statistical likelihood of stroke among risk groups, however it would be most prudent to avoid the herb in the situation you describe. Back to Top QUESTION: presently my meds are: lithium 600mg. @hs, prozac 20mg. qd, accutane alternating 40mg /80mgqod, orthotricycline 28, and yclosporin 100 mg bid. are there any herbs that will interact with my meds? i was taking st. john's wort and ashwaganda,would they? also presently taking,,ginger root, licorice,yucca,msm, b-6,vitc-1000mg,bee pollen, horse chestnut, magnesium and garlic..have been taking these for aprox 3 years,,had a car accident and fractured my left hip and tore my left pcl,,both repaired (12/95) physically doing great,,just started the prozac and the lithium for anger management/depression and was concerned with the herbs interactions if any,,thank you Response By: Jonathan Treasure, MNIMH. ANSWER: St John's Wort has been shown to lower cyclosporine levels in one study. If you have a steady maintenance regime this should not be a problem, since stopping or starting the herb will cause variation in drug bioavailability. You should advise your prescribing physician that you are taking SJW along with cyclosporine. Serum levels of the drug should be monitored closely. Don't miss out on new articles. Bookmark the Medicine Plants™ website. Come back to read the newest information about these important herbs. We regularly publish new articles. Back to Top MACA750™ drug interactions: There are no known drug/herb contraindications to using MACA750™ for menopause, hot flashes and other hormonal imbalance health issues. Until the studies are completed we CANNOT advise using MACA750™ for those who have had a hormonally related cancer such as breast or prostate cancer. Be well always, Medicine Plants™ Health Disclaimer! The information presented on this site should not be construed as personal medical advice or instruction. You should consult appropriate health professionals on any matter relating to your health and well-being. The information and opinions provided here are believed to be accurate and sound, based on the best judgment available to the authors, but readers who fail to consult appropriate health authorities assume the risk of any injuries. The publisher is not responsible for errors or omissions. |
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