Herb-Prescription Interactions

Herb-Prescription Interactions

By Donna S Barsky, D Ph., R Ph., TexasStar Pharmacy

Many fail to mention to their physician or pharmacist that they are taking an herbal medication and this can create problems with their prescription medication routine. Some of the more common products used and their effects follow.

Dong Quai is taken for menopausal symptom control. Do not mix Dong Quai with warfarin (anticoagulants), St John’s Wort and some antibiotics such as sulfonamides, quinolones.

Echinacea is mostly taken as an immune boost to prevent cold and flu. Do not mix Echinacea with some heart medications, antifungal medications, HIV medications and anti-anxiety medications.

Ephedra is a powerful decongestant that contains ephedrine, which can open up bronchial passages. It is controversial because it’s a powerful stimulant that can raise blood pressure, cause insomnia and high blood pressure. Do not mix with heart medications or if you are being treated for high blood pressure, glaucoma or thyroid problems.

Feverfew is taken to reduce the severity of migraines. Do not take with other migraine medications, as, it may raise heart rate and blood pressure. Feverfew has the potential to react with warfarin anti-coagulants, increasing the thinning of blood.

Ginkgo increases blood flow and circulation throughout the body, can also help improve memory. May interact with anti-coagulant medications such as aspirin, coumadin, heparin and warfarin, causing the blood to thin too much, and provoke a serious bleeding disorder. A recent report in the New England Journal of Medicine describes a case of a man who’d been taking aspirin to prevent a heart attack and had spontaneous bleeding into the eye from the iris within a week of taking a daily dose of ginkgo.

Garlic is thought to help lower cholesterol and prevent the formation of blood clots that could lead to heart attacks. Garlic capsules may increase blood thinning if you are already on anti-coagulants. Do not take with diabetes medication because it may cause a decrease in blood sugars.

Ginseng is used to help reduce stress, boost energy and improve stamina, and may also help lower cholesterol. Can cause nervousness and excitation, and overuse can lead to headaches, insomnia and heart palpitations. Can increase blood pressure. Should not be used if you are taking prescriptions for high blood pressure or coumadin.

Hawthorn is claimed to be effective in helping reduce angina attacks by lowering blood pressure and cholesterol levels. Should not be taken with digoxin, a heart medication. The mix may lower heart rate too much.

Kava is used to treat anxiety. It is also used to relieve insomnia and nervousness. Do not take Kava if you have a history of liver problems. Also do not mix with antidepressants, sedatives, and do not mix Kava with alcohol.

Licorice is used to treat coughs, colds and peptic ulcers. High doses can lead to increased blood pressure, water retention and potassium loss. Do not use with diuretics or digoxin because it could lead to further loss of potassium, essential for heart function.

St John’s wort is a natural anti-depressant for mild to moderate depression. Do not take with other anti-depressants, HIV medications, oral contraceptives, some heart/blood thinning medications and Tamoxifen (a cancer drug).

Valerian is a mild sedative with hypnotic effects, used to promote sleep, Should not be taken with alcohol or Valium.

If your physician does not know about interactions with your medications, ask your pharmacist. Bookstores also have entire shelves devoted to herbalism these days, and many outline possible drug interactions. Since herb drug interactions aren’t predictable, and are possible, especially if you’re taking a range of prescriptions and herbal remedies, it’s best to play it safe and study the herbal medicine before adding it to your pillbox.

On a secondary note, if you have not received your influenza, pneumonia, and shingles vaccine yet, it would be wise to think about. Pneumonia vaccine only needs to be given once every 5-7 years, and the Shingles vaccine is a one time immunization.

Most influenza vaccine companies will no longer be making the regular flu vaccine because of the need to focus on Swine flu vaccine. The CDC has recommended that we received the regular influenza vaccine as soon as possible. Swine flu vaccine is now being produced and tested. Check with us at 972-519-8475 to see if you need any or all of these immunizations for your health.