Last Updated
August 31, 1999

Bernd Wollschlaeger,M.D.   CEO&Medical Director Click here for E-mail

Advisory Board

Steve Chasens, A.P.   Click here for E-Mail

Paul Cooley, LMT    Click here for E-Mail

ØGrapefruit Juice (increased cyclosporine levels)

ØAvoid use with Aloe ( internal use of Aloe containing products may irritate the large intestine and exert a strong purgative effect, which may lead to a decrease in serum potassium levels and potentiation of cardiac glycosides)

ØAvoid herbs containing digoxinlike substances (Digitalis lanata –yellow foxglove; Eleutherococcus senticosus –Siberian ginseng etc.)

ØAvoid use with Quinine ( Increased digoxin levels)

ØAvoid use with Licorice ( diuretic effect can cause hypokalemia resulting in digoxin toxicity)

ØAvoid use with Kyushin (crossreacts with digoxin assay)

ØAvoid use with Psyllium (decreased digoxin absorption. Advise patient to take digoxin either two hours before or after consumption of psyllium containing products such as Metamucil)

ØHawthorn can potentiate digoxin action (synergistic effects with increased cardiac toxicity)

ØAvoid use with Siberian ginseng (increased digoxin levels or interference with digoxin assay)

 

ØHerbs containing diuretic components (e.g. broom, buchu, dandelion, juniper) may antagonize hypoglycemic effects.

ØHerbs containing hypo- or hyperglycemic components(e.g. chromium, fenugreek, ginseng) may antagonize or potentiate hypoglycemic effects.

ØKarela may improve glucose tolerance.

 

ØAvoid herbal medicinals containing thujones that lower seizure threshold

ØAvoid Wormwood ( Appetite Stimulant) which may potentiate phenobarbital effect.

ØEvening Primrose Oil contains gamolenic acid (GLA) that lowers seizure threshold.

ØHerbs containing diuretic components (e.g. broom, buchu, dandelion, juniper) may increase the effect of lithium and cause possible toxicity.

ØAvoid Shankapulshpi, an Ayurvedic preparation, which diminishes anti-epileptic effect.

ØAvoid Primrose Oil.which may lower seizure threshold.

ØSeveral herbal medicinals interact with Warfarin:

ØCayenne, Feverfew, Garlic and Ginkgo biloba may decrease platelet aggregation.

ØGinger may cause prolonged bleeding time resulting from inhibition of thrombozane synthetase.

ØGinseng may cause decreased anticoagulant activity or decreased INR

ØHerbs containing Vitamin K (e.g.Alfalfa, Green Tea) may cause decreased anticoagulant activity.

ØQuinine may cause increased anticoagulant activity.

ØAvoid use of Kava- Kava, which can potentiate the effect.

ØPyrone, the active component of kava, has been found to have weak effects on aminobutyric acid and benzodiazepine receptors in vitro.

Ø1994 German study group verified synergism between pyrones and other active sedatives with aminobutyric acid.

Cyclosporine

ØConcomitant use with the following immunostimulating herbal remedies (Astralagus, Echinacea, Licorice root, Alfalfa sprouts,Zinc Lozenges) may offset or minimize the immunosuppressive effects.

ØAvoid herbal medicinals with diuretic effect (ex.:Artichoke, Goldenseal, Selery seeds, Dandelion).

ØAquaretic herbs (water but no sodium excretion) can diminish effect of diuretic drug (hydrochlorothiazide) if sodium is retained.

ØHorseradish, used as antiseptic with circulatory and digestive stimulating effect, can depress thyroid function.

ØKelp diets, contain 0.7mg of iodine per tablet, may result in hyperthyroidism taken in conjunction with thyroid replacement.

Nonsteroidal Anti-inflammatory Drugs

ØAvoid use with herbal medicinals that are known to have adverse GI effects.

ØExamples: Gossypol (inhibits lactate dehydrogenase X found in sperm and male gonadal cells, exerting contraceptive activity), Coffee arabica, Cola acuminata,Uva-Ursi)

ØLicorice may offset effects.Antispasmotic and anti-inflammatory herb for use in gastritis and peptic ulcer disease.

ØThe hemisuccinate derivative of glycyrrhetainic acid, a component of licorice, is carbenoxolone, which is used allopathically for duodenal and gastric ulcers.Licorice renders the patient unable to convert 11-deoxycortisol or deoxycorticosterone into the active glucocorticoids, cortisol, and corticosterone, respectively.This acquired 11-beta-hydroxylase deficiency results in sodium retention, hypertension, and hypokalemia.