Drug-Herb Interactions & the fight for the survival of herbal medicine

[Guest guest]

Hi All,

 

See the abstract, below: (Ginger-associated overanticoagulation by

phenprocoumon).

 

This is a report on a single case report only! The evidence for

ginger causing bleeding by interacting with a coumarin-type

anticoagulant is far from conclusive.

 

Nevertheless, the enemies of herbal medicine will cite this case as

another " Adverse Effect " of HM.

 

Much more research (preferably in RCTs) is needed before one can

say with fair certainty that: " one should refrain from ingesting ginger

and other herbals like garlic or ginkgo biloba in situations where

bleeding may be critical " .

 

Unfortunately, the intrinsically HIGH COSTS of research, plus the

clear intention of the FDA and EU to clamp down on supplements

and herbal use, will mitigate more and more against largescale

unbiased research on herbs.

 

See also the other abstracts: " Herbals and asthma: Usage

patterns among a border population " , and " The effects of Cassia

auriculata and Cardiospermum halicacabum teas on the steady

state blood level and toxicity of carbamazepine "

 

The Medical/Pharma camp clearly is interested in herb-drug

interaction. Some herbalist colleagues consider this to be a red

herring. I do not. IMO, it is simply another " block " that the

establishment will (indeed MUST) use to raise the ante fpr those of

us who would like the freedom to prescribe herbal medicines.

 

Whether we like it or not, WM (the dominant Western Medical

system) is becominng more and more regulated. It is becoming

fixated rapidly on so-called Evidence Based Medicine (EBM).

 

In turn, EBM demands largescale and very costly research. We are

in the wilderness here. The number of titles on oriental herbalism in

Medline (? 50,000 titles) is a fleabite compared to the number on

other aspects of allopathic/surgical medicine (?12,000,000+ titles).

 

That is our dilemma, and wishful thinking will not change it.

 

What we need is investment of BILLIONS of dollars in research. I

do not foresee this happening in my lifetime. Our only chance for

survival, IMO, is to pursue the LEGAL (monopolies & freedom of

choice issues) and POLITICAL agenda, to win over goodwill from

policy-makers and the general public.

 

Best regards,

Phil

 

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

 

Krueth, P; Brosi, E; Fux, R; Moerike, K; Gleiter, CH. Ginger-

associated overanticoagulation by phenprocoumon. Annals of

Pharmacotherapy (USA) VOL. 38 NO. 2 2004 PP. 257-260. We

report a case of ginger-phenprocoumon interaction resulting in an

elevated international normalized ratio (INR) and epistaxis. A 76-

year-old white European woman on long-term phenprocoumon

therapy with an INR within the therapeutic range began using

ginger products. Several weeks later, she developed an elevated

INR up to 10 and epistaxis. The INR returned to the normal range

after ginger was stopped and vitamin K1 was given. DISCUSSION:

An objective causality assessment revealed that the adverse drug

event probably was as a result of the phenprocoumon and ginger

interaction. A number of investigations resulted in conflicting

opinions on the effect of ginger on hemostasis, specifically, platelet

inhibition.. Nevertheless, based on these investigations,

recommendations have been issued to refrain from ingesting ginger

and other herbals like garlic or ginkgo biloba in situations where

bleeding may be critical. CONCLUSIONS: This isthe first case

report that MAY support an interaction between an oral

anticoagulant and ginger together with a brief review of the literature

on ginger and hemostasis. As this interaction was observed only

by chance, this case highlights the importance of self-control of

anticoagulation with coumarins particularly for the detection of

unknown interactions.

 

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

 

Rivera, JO; Hughes, HW; Stuart, AG. Herbals and asthma: Usage

patterns among a border population. Annals of Pharmacotherapy

(USA) 38 (2), 2004 , 220-225 Univ Texas, UTEP, 1100 N

Stanton,Suite 301, El Paso, TX 79968, USA jrivera The

use of herbal products (HP) is rising in the US. Higher rates of HP

use have been documented in the US/Mexico border population, as

well as increasing concerns about herbal-related adverse events.

OBJECTIVE: To evaluate the prevalence of HP use in adult

asthmatic patients requiring hospitalization and the frequency of

HP documentation in medical records. METHODS: We conducted

a retrospective chart review of admissions for asthma to determine

the frequency of HP documentation. Additionally, during a 12-

month period, a bilingual interviewer conducted prospective,

semistructured interviews with patients with asthma exacerbations

to record data on HPs used specifically for the treatment of

asthma. RESULTS : A total of 67 cases were chart-reviewed

retrospectively; 60 patients were interviewed prospectively. We

found no documentation of HP use by chart review, while

prospective interviews showed that 42% of patients reported using

HPs for the treatment of asthma. The most common HPs used

were oregano 28%, chamomile 20%, garlic 16%, eucalyptus 12%,

and lime 12%. Ten patients reported taking an HP that could

potentially exacerbate their asthma and 18 patients reported using

an HP that could interact with other medications or cause other

types of adverse events. CONCLUSIONS: An obvious lack of

documentation for HP use was observed in the medical records

reviewed. Because a number of HPs that are commonly used by

residents along the border can interact with antiasthmatic agents

and/or result in compromised asthma control, questions about HP

use should be included in routine history taking.

 

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

 

Thabrew, I; Munasinghe, J; Chackrewarthi, S; Senarath, S. The

effects of Cassia auriculata and Cardiospermum halicacabum teas

on the steady state blood level and toxicity of carbamazepine.

Journal of Ethnopharmacology (Ireland) 90 (1), 2004, 145-150. Univ

Kelaniya, Fac Med, 6 Talagolla Rd, Ragama, Sri Lanka

mrthab A study was conducted using male Wistar

rats as the experimental model, to compare the effects of

concurrent administration of herbal tea prepared from dried flowers

of Cassia auriculata or aerial parts of Cardiospermum halicacabum

and carbamazepine, on (a) steady state serum levels of the

prescription drug, and (b) changes in toxicity (as assessed by

changes in general behaviour, haematological parameters, and liver

and kidney function) that may occur due to drug interaction.

Results demonstrate that in rats receiving the Cassia auriculata tea

and carbamazepine, the blood levels of the prescription drug were

significantly enhanced by 47.1% (P < 0.04), when compared with

the levels in animals receiving only carbamazepine for the same

time period, with no apparent changes in toxicity. In animals

receiving the Cardiospermum halicacabum tea, there were no

significant changes in the blood levels of carbamazepine or drug-

related toxicity. Cassia auriculata tea has therefore the potential to

influence the bioavailability of carbamazepine, and hence its

therapeutic actions. Concurrent ingestion of carbamazepine with

herbal teas containing Cassia auriculata is therefore best avoided

by patients under treatment for epilepsy. © 2003 Elsevier Ireland

Ltd. All rights reserved.

 

>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>>

 

 

Best regards,

 

Email: <

 

WORK : Teagasc Research Management, Sandymount Ave., Dublin 4, Ireland

Mobile: 353-; [in the Republic: 0]

 

HOME : 1 Esker Lawns, Lucan, Dublin, Ireland

Tel : 353-; [in the Republic: 0]

WWW : http://homepage.eircom.net/~progers/searchap.htm