2017 HCHB_digital
You also want an ePaper? Increase the reach of your titles
YUMPU automatically turns print PDFs into web optimized ePapers that Google loves.
Herbal Supplements: Interactions<br />
Herbal Supplements – Interactions<br />
Herb/herb group Possible interacting drugs Possible interaction(s) References<br />
Broom<br />
(Cytisus scoparius)<br />
Buckthorn<br />
(Rhamnus frangula)<br />
Bugleweed<br />
(Lycopus virginicus; Lycopus<br />
europaeus)<br />
Antihypertensive drugs Possible interference with hypotensive activity 20<br />
Cardiac glycosides + antiarrhythmic<br />
agents<br />
Use of large doses may product hypokalaemia, which potentiates drug toxicity 3, 4<br />
Antithyroid agents (carbimazole, Possible potentiation of anti-thyroid effects 21, 22<br />
propylthiouracil, etc)<br />
Thyroxine Possible antagonism of thyroxine activity 21, 22<br />
Bupleurum spp. Corticosteroids (eg, prednisone) Theoretical potentiation of anti-inflammatory action of corticosteroids 23<br />
Butterbur<br />
Corticosteroids Enhanced anti-inflammatory effects in asthma 24<br />
(Petasites hybridus)<br />
Carica papaya Amiodarone Increased bioavailability reported in rats 244<br />
Cascara<br />
(and other anthraquinone<br />
laxatives)<br />
Digoxin, quinidine and other<br />
antiarrhythmic drugs<br />
Possible hypokalaemia with long-term laxative use, possibly potentiating<br />
cardiac glycoside and antiarrhythmic toxicity<br />
Cassia auriculata Carbamazepine Increased bioavailability likely 25<br />
Capsicum / cayenne<br />
pepper<br />
Theophylline Increased bioavailability likely 26<br />
Antacids<br />
Possible antagonism of gastroprotective action<br />
Aspirin Reduced salicylic acid bioavailability in rats following large doses of chilli 27<br />
Theophylline Increased bioavailability possible 28<br />
Chamomile Antihistamines Potentiation of antipruritic effects 29<br />
Chaste tree<br />
(Vitex agnus castus)<br />
Cinchona bark<br />
(contains quinine)<br />
Haloperidol, chlorpromazine,<br />
metoclopramide and other dopamine<br />
receptor antagonists<br />
Progesterone drugs, oral contraceptives,<br />
HRT, clomiphene<br />
Possible antagonism of antipsychotic or anti-emetic effects, due to possible<br />
dopaminergic action of Chaste Tree<br />
Possible interference with activity of hormonal drugs, by as yet unknown<br />
mechanisms<br />
Antiarrhythmics Plasma concentration of flecainide increased 32<br />
Antihistamines Ventricular arrhythmias with astemizole and terfenadine 33<br />
Cardioactive glycosides Plasma concentration of digoxin increased 34<br />
Cimetidine Increased plasma levels quinine due to inhibition of metabolism by cimetidine 35<br />
Cinnamon Insulin Possible potentiation of hypoglycaemic effect 36<br />
Oral hypoglycaemic drugs<br />
Possible potentiation of hypoglycaemic effect<br />
Cochinchina momordica Foot and mouth disease vaccine Enhancement of immune response to vaccine shown in pigs 37<br />
Influenza vaccination (H5N1) Enhancement of immune responses shown in chickens 38<br />
Coleus<br />
Anticoagulants and antiplatelet agents Potentiation of anticoagulant or antiplatelet effect theoretically possible 39<br />
(Coleus forskohlii)<br />
Cola Caffeine Enhanced stimulant effects possible with large doses 40<br />
Phenytoin Increased bioavailability of phenytoin reported in rabbits 41<br />
Cordyceps sinensis Gentamicin and other aminoglycosides Protection against nephrotoxicity in rats 42<br />
Cranberry Warfarin Several case reports of increased anticoagulant effects; similar effects in one<br />
out of three studies on healthy volunteers; avoid ingestion of large amounts<br />
Cumin (Cuminum cyminum) Rifampicin Enhancement of plasma levels by aqueous extract reported 55<br />
Curcumin (from turmeric) Ethanol Possible protection against alcohol-induced neurological disorders 57<br />
Gliclazide<br />
Multiple doses of curcumin enhanced the hypoglycaemic effects of gliclazide in 262<br />
rats and rabbits<br />
Vinblastine and other cytotoxics Possible enhanced cytotoxic effects due to reversal of multidrug resistance 56<br />
Dandelion leaf Diuretics Theoretical potentiation of diuretic effects with large doses<br />
Da-Cheng-Qi<br />
(Rheum tanguticum, Citrus<br />
aurantium)<br />
Dan shen<br />
(Salvia miltiorrhiza)<br />
Ranitidine Increased drug bioavailability reported in rats 58<br />
Anticoagulants Potentiation of anticoagulant effects likely 59<br />
Cyclosporin Protection against nephrotoxicity from parenteral Salvia in rats 60<br />
3, 4<br />
30<br />
31<br />
43, 44, 45, 46,<br />
47–54<br />
Page 198 HEALTHCARE HANDBOOK <strong>2017</strong>-2018 References Charts
Change language