Herbalphytochemicaldrug interactions

Man Tea Rock-Hard Formula

Mental Impotence Homeopathic Treatment

Get Instant Access

Due to the revised interest in herbal medicine, people are favoring nutraceuticals and botanical supplements. As the same time several companies have introduced designed or pharma foods in the market. These are a rich source of phytochemicals having antioxidant, anti-aging and chemo protective effects. Recent studies have reported that phytomedicines have a modulatory effect on drug-metabolizing enzymes, (particularly cytochrome 450) leading to potential drug interactions. Phytochemicals have the tendency to elevate as well as suppress the cytochrome 450 system.

Sales of over-the-counter (OTC) products in 1998 soared to US$46.6 billion, with pharmacies capturing approximately 33%, or US$15.4 billion of the sales. Likewise, the sale of herbal supplements rose to approximately US$5 billion in 2000. Pharmacists routinely advise patients on the use of OTC medicines, and with an increased use of herbal medicines among patients, knowledge of appropriate potential interactions between pharmaceutical drugs, including OTC medications, and herbal supplements is becoming increasingly important.

Some of the best-selling herbal supplements are ginkgo (Ginkgo biloba, used for increasing peripheral blood flow and in senile dementia), Asian/ Korean ginseng (Panax ginseng, used as an 'adaptogen' to help regulate the body's reaction to various stresses), garlic (Allium sativum), used for cardiovascular health including hypercholesterolemia), echinacea (Echinacea purpurea/ angustifolia), used to support the immune system, especially in the prevention and treatment of colds and influenza), St. John's wort (Hypericum perforatum), used in the management of mild to moderate depression), and saw palmetto (Serenoa repens), used in the management of benign prostatic hyperplasia (Fig. 6.18). Despite the widespread concurrent use of conventional medicines and herbal supplements, documented herb-drug interactions (HDIs) are still sparse and consist mainly of isolated case reports and laboratory studies. For most potential interactions of herbs and drugs that are reported, the theories are based on very high doses of isolated phytochemicals in laboratory models, or conclusions are drawn from similarities in the pharmacology of constituents in the herb and a particular drug. A customer may say, "Herbs have been used safely for thousands of years." While this may be true, the people using those herbs were not on several medications at the same time (Fig. 6.19).

Below is a reference chart listing potential Herb-OTC interactions. Pharmacists should be always aware of the documented or potential interactions between herbal supplements and prescription drugs. Potential interactions are classified by one of the 3 numerals, according to the following key: 1 = Use of these supplements with the listed OTC category may have health benefits. 2 = Recommend caution to individuals taking these herbal supplements in connection with the corresponding OTC

Phytochemicals Research-Emerging Concepts 237 BOTANICAL US Mass Market, 1998 (US Million)_

Ginko St. john wort Ginseng Garlic Echinacea Saw Palmetto Grape seed Kava

Evening primerosa Echinacea/golden.. Cranberry Valerian All others

J

-J

L

I Series2 I Seriesl

Fig. 6.18 Best selling herbs in US market in 1998.

Color image of this figure appears in the color plate section at the end of the book.

£ consumer user for herbs

£ consumer user for herbs

Health Benefits Henbane

Fig. 6.19 Consumer perception of benefits of herbs.

Color image of this figure appears in the color plate section at the end of the book.

categories.3 = Do not recommend using these herbal supplements with listed OTC categories unless the patient is under the direct supervision of a healthcare professional.

Chart 6.1 Potential Herb-OTC Interaction Chart.

OTC Drug

Herbal Category

Interaction Classification

Category

Acetaminophen

Milk thistle (Silybum marianum)

1

Picrorrhiza (Picrorrhiza kurroa)

1

Schisandra (Schisandra chinensis)

1

Antihistamines

Belladonna (Atropa belladonna)

3

Bittersweet (Solanum dulcamara)

3

Henbane (Hyoscyamus niger)

3

Hops (Humulus lupulus)

2

Jimson weed (Datura stramonium)

3

Kava kava (Piper methysticum)

2

Passionflower (Passiflora incarnata)

2

Stinging nettle leaf (Urtica dioica)

1

Valerian (Valeriana officinalis)

2

Aspirin

Bilberry (Vaccinium myrtillus)

2

Aspirin

Cat's claw (Uncaria tomentosa)

2

Coleus (Coleus forskohlii)

2

Cordyceps (Cordyceps sinensis)

2

Dong quai (Angelica sinensis)

2

Evening primrose oil (Oenothera biennis)

2

Feverfew (Tanacetum parthenium)

2

Garlic (Allium sativum)

2

Ginger (Zingiber officinale)

2

Ginkgo (Ginkgo biloba)

2

Ginseng, Asian/Korean (Panax ginseng)

2

Grape seed (Vitis vinifera)

2

Green tea (Camellia sinensis)

2

Horse chestnut (Aesculus hippocastanum)

2

Reishi mushroom (Ganoderma lucidum)

2

St. John's wort (Hypericum perforatum)

2

Decongestants

Bitter orange (Citrus aurantium)

2

Cayenne (Capsicum annuum)

2

Coffee (Coffea arabica)

2

Ginseng, Asian/Korean (Panax ginseng)

2

Guarana (Paullinia cupana)

2

Ma huang (Ephedra sinica)

3

Muira puama (Ptychopetalum sp.)

2

Night-blooming cactus (Selenicereus

2

grandiflorus) Yohimbe (Corynanthe yohimbe)

Chart 6.1 contd...

OTC Drug Category

Herbal Category

Interaction Classification

Diuretics

Celery seed (Apium graveolens)

2

Couch grass rhizome (Agropyron or Triticum repens)

2 2

Dandelion leaf (Taraxacum officinale)

2

Elder flower (Sambucus canadensis)

2

Horsetail shoots (Equisetum arvense)

2

Juniper berry (Juniperus communis)

Insulin

Aloe (Aloe vera)

2

Bilberry (Vaccinium myrtillus)

2

Bitter melon (Momordica charantia)

3

Fenugreek (Trigonella foenum-graecum)

2

Garcinia (Garcinia cambogia)

3

Garlic (Allium sativum)

2

Ginseng, American (Panax quinquefolius)

2

Gymnema (Gymnema sylvestre)

3

NSAIDs

Cayenne (Capsicum annuum)

2

Coleus (Coleus forskohlii)

3

Bilberry (Vaccinium myrtillus)

2

Boswellia (Boswellia serrata)

2

Devil's claw (Harpagophytum procumbens)

2

Garlic (Allium sativum)

2

Grape seed (Vitis vinifera)

2

Green tea (Camellia sinensis)

2

Licorice root (Glycyrrhiza glabra)

2

Milk thistle (Silybum marianum)

1

Turmeric (Curcuma longa)

1 1

Source: Intramedicine, Inc.Cincinnati, Ohio.

Source: Intramedicine, Inc.Cincinnati, Ohio.

Was this article helpful?

0 0
The Complete Compendium Of Everything Related To Health And Wellness

The Complete Compendium Of Everything Related To Health And Wellness

A lot of us run through the day with so many responsibilities that we don't have even an instant to treat ourselves. Coping with deadlines at work, attending to the kids, replying to that demanding client we respond and react to the needs of other people. It's time to do a few merciful things to reward yourself and get your health in order.

Get My Free Ebook


Post a comment