RE: Herb - drug interactions from Lancet

[Guest guest]

FYI:

 

Lancet 2000; 355: 134 - 138 Volume 355, Number 9198 8 January 2000

 

Herb-drug interactions

 

Adriane Fugh-Berman

 

George Washington University School of Medicine and Health Sciences,

Department of Health Care Sciences, 2150 Pennsylvania Avenue, NW 2B-417,

Washington, DC 20037, USA (A Fugh-Berman MD) (e-mail: fughberman)

 

Source and extent of review

Misidentification, adulteration, and contamination

Counselling of patients about herb-drug interactions

References

 

Concurrent use of herbs may mimic, magnify, or oppose the effect of drugs.

Plausible cases of herb-drug interactions include: bleeding when warfarin is

combined with ginkgo (Ginkgo biloba), garlic (Allium sativum), dong quai

(Angelica sinensis), or danshen (Salvia miltiorrhiza); mild serotonin

syndrome in patients who mix St John's wort (Hypericum perforatum) with

serotonin-reuptake inhibitors; decreased bioavailability of digoxin,

theophylline, cyclosporin, and phenprocoumon when these drugs are combined

with St John's wort; induction of mania in depressed patients who mix

antidepressants and Panax ginseng; exacerbation of extrapyramidal effects

with neuroleptic drugs and betel nut (Areca catechu); increased risk of

hypertension when tricyclic antidepressants are combined with yohimbine

(Pausinystalia yohimbe); potentiation of oral and topical corticosteroids by

liquorice (Glycyrrhiza glabra); decreased blood concentrations of

prednisolone when taken with the Chinese herbal product xaio chai hu tang

(sho-saiko-to); and decreased concentrations of phenytoin when combined with

the Ayurvedic syrup shankhapushpi. Anthranoid-containing plants (including

senna [Cassia senna] and cascara [Rhamnus purshiana]) and soluble fibres

(including guar gum and psyllium) can decrease the absorption of drugs. Many

reports of herb-drug interactions are sketchy and lack laboratory analysis

of suspect preparations. Health-care practitioners should caution patients

against mixing herbs and pharmaceutical drugs.