Herbs are an important part of health care and millions of people take them to maintain wellness or treat symptoms. Herbs should be thought of as medicine and treated with respect. When used in combination with pharmaceuticals, herbs can increase or decrease the effectiveness of the prescribed drugs. There are hundreds of common herbs but you are taking only a few pharmaceuticals. Learn which herbs interact with your pharmaceuticals and discuss any questions with your pharmacist or physician. Blood thinners such as warfarin are the pharmaceuticals most often affected by herbal remedies.
All herbs and pharmaceuticals are processed by the liver and put some level of stress on that organ. People with known liver disease should discuss their herbs, over-the-counter meds, and pharmaceuticals with their primary health-care provider.
Here are a few common herbs and the pharmaceuticals that may be affected. This is not a complete list.
- Dong Quai is taken for menopausal symptom control and to adjust female hormones for various reasons. Don't mix Dong Quai with warfarin (anticoagulants), St John's Wort or antibiotics such as sulfonamides or quinolones.
- Echinacea is taken to boost the immune system and prevent cold and flu. Don't mix Echinacea with some heart medications, antifungal medications, HIV medications and anti-anxiety medications. It can cause liver toxicity so avoid combining it with other medications that can affect the liver such as ketaconazole (Nizoral, Extina, Xolegel, Kuric), leflunomide (Arava), methotrexate (Rheumatrex), isoniazid (INH, Nydrazid, Laniazid).
- Ephedra is a decongestant which contains ephedrine to open up bronchial passages. It's controversial because it's a powerful stimulant that can raise blood pressure or cause insomnia. Don't mix it with heart medications or if you have high blood pressure, glaucoma or thyroid problems.
- Feverfew is taken for fever and to reduce the severity of migraines. Don't take it with other migraine medications since it may raise heart rate and blood pressure. Feverfew can react with warfarin and increase the thinning of blood.
- Ginkgo increases blood flow and circulation throughout the body, including the brain, and so can help improve memory. It may interact with anti-coagulant medications such as Aspirin, Coumadin, heparin and warfarin, causing excessive blood-thinning thus provoking a serious bleeding disorder. Ginkgo should be avoided in patients with epilepsy who take seizure medicines, such as phenytoin (Dilantin), carbamazepine (Tegretol), and phenobarbital.
- Garlic lowers cholesterol and prevents the formation of blood clots that could lead to heart attacks. Garlic capsules may increase blood thinning if you are already on anti-coagulants. Don't take garlic with diabetes medication because it may cause a decrease in blood sugars.
- Ginger is used for nausea and bowel spasms. Ginger may lead to blood thinning. It is not recommended to be taken with medications that prevent blood clotting (anticoagulants) such as warfarin (Coumadin).
- Ginseng is used to help reduce stress, boost energy and improve stamina, and may also help lower cholesterol. Ginseng can cause elevation in blood pressure, headache, vomiting, insomnia, and nose bleeding. Ginseng can produce false readings in blood tests for digoxin (Lanoxin) levels in persons taking the drug for heart disease. Ginseng may affect normal blood clotting. It should be avoided in patients taking aspirin, nonsteroidal antiinflammatory drugs such as ibuprofen (Advil), naproxen (Aleve) or Motrin, or medications to prevent blood clotting such as warfarin (Coumadin). Ginseng may also cause headaches, tremors, nervousness, and sleeplessness. It should be avoided in persons with manic disorder and psychosis.
- Hawthorn is a general heart tonic that lowers blood pressure and cholesterol levels. It should not be taken with digoxin, a heart medication. The mix may lower heart rate too much. Hawthorn should always be approved by your cardiologist if you are taking any heart medication.
- Kava is used to treat anxiety, insomnia and nervousness. Don't take Kava if you have a history of liver problems. Obviously avoid Kava if you are using antidepressants, sedatives or alcohol.
- Licorice is used to treat coughs, colds and peptic ulcers. High doses can lead to increased blood pressure, water retention and potassium loss. Don't use with diuretics or digoxin because it could lead to excessive loss of potassium which is essential for heart function.
- St. John's wort is a natural anti-depressant for mild to moderate depression. Don't take with other anti-depressants, HIV medications, oral contraceptives, blood thinning medications and Tamoxifen (a cancer drug). This herb can make the patient more sensitive to sunlight so it should not be used in combination with medications that affect sun sensitivity such as tetracycline/Achromycin, sulfa-containing medications, or piroxicam (Feldene). St. John's wort can also cause headaches, dizziness, sweating, and agitation when used in combination with serotonin reuptake inhibitor medications (SSRIs) such as fluoxetine (Prozac) and paroxetine (Paxil).
- Valerian is a mild sedative with hypnotic effects. It is used to promote sleep but should not be combined with other sedatives or alcohol.
Please note: The information here is not to be followed as medical advice, diagnosis or treatment. Please consult with your physician or primary health practitioner for information regarding your own personal health and necessary treatments.
