Saturday, July 7, 2012

Can My Herbal Supplements Harm Me?

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Can My Herbal Supplements Harm Me?

Unknown to most population is the fact that everyday foods and Herbal supplements can and do interact with beloved designate medications. I became curious while talking to my Pharmacist that my son couldn't take decongestant cold medications with his heart medication. Well, I knew about interactions in the middle of two drugs, but when the Pharmacist told me he couldn't have grapefruit juice, I was stunned. Seems that grapefruit juice increases the blood concentrations of the drug. Basically that means that it greatly enhances the effects of the drug which could effect in an overdose of the medication. This is everyday grapefruit juice! It got me wondering about other everyday foods and Herbs we take. Below are a few foods and Herbs that have an effect on your medications.

Can My Herbal Supplements Harm Me?

This list is a basic guide, and is by no means the meant to replace your physician or Pharmacist. Consult with them about any prescriptions you are taking and the foods and Herbs that will interact with them. Although I have taken this information from a handout from a local Hospital, Use this information at your own risk. Again, I am not a physician or Pharmacist, and I have had No medical training, so please consult with yours for more information.

People commonly ask if Herbal supplements change the way their designate drugs work. The riposte is Yes! Some medications should never be taken with Herbal supplements. Some can cause unwanted side effects or cause the medication to stop working to their full effect.

Another misconception about supplements is that they are thoroughly safe because they are natural. Yes, they may be from plants, but they are not natural to your body. Herbal supplements are not tested or inspected like designate drugs are tested, so the supplements vary in ability and drive from pill to pill and bottle to bottle.

Just like supplements, foods can change the way your body responds to medications. One example is grapefruits and grapefruit juice. Many population aren't aware that grapefruit juice can increase the drug levels of clear medications. An increase in the levels will also increase the side effects of the drug.

Things to Remember

1. Herbal supplements and foods can change the way your medications work.
2. Tell your caregiver what Herbal supplements you take and what foods you eat often.
3. Ask your physician or Pharmacist what Herbal supplements or foods will interact with your medications.
4. All the time talk with your physician or Pharmacist First before taking any Herbal supplements.

Disclaimer: The following charts are not all inclusive and do not comprise every interaction of drugs with foods and herbs. It serves as a guide only. Consult with your Doctor, Pharmacist or a registered dietician if you have any questions.

Analgesics (Pain Relievers)

Aspirin
Celecoxib (Celebrex)
Ibuprofen (Advil, Motrin)
Naproxen

Food: Avoid alcohol. Avoid large amounts of orange juice and vitamin C.
Herbs:Avoid Black Cohosh, Dong Quai, Evening Primrose, Feverfew, Flaxseed Oil, and Ginko as it increases the risk of bleeding.

Narcotics
Codeine (Tylenol #2, 3, 4)
Morphine (Ms Contin)
Oxycodone (Oxycontin/Percocet)

Foods:Avoid alcohol.
Herbs:Do not take with Kava or Valerian as it may make you feel drowsy.

Antibiotics

Ciproflaxacin (cipro)
Levofloxacin (Levaquin)

Food: Take 2 Hrs before or 6 Hrs after antacids, dairy products amd multi-vitamins that comprise calcium, iron, zinc, or magnesium. Avoid large amounts of caffeine.See Chart 3 below.
Herbs:

Methronidazole

Foods:Avoid alcohol during and 3 days after taking this medication to avoid nausea and vomiting.
Herbs:

Penicillin

Foods:Citrus fruits/juices and carbonated beverages will decrease desired effect.
Herbs:

Tetracycline

Foods:Take 2 Hrs before or 6 Hrs after antacids, dairy products amd multi-vitamins that comprise calcium, iron, zinc, or magnesium.
Herbs:Dong Quai or St. John's Wort increase the risk of sunburn.

Trimethoprim/Sulfamethoxazole (Bactrim, Septra)

Foods:May cause rash if taken with alcohol.
Herbs:Dong Quai or St. John's Wort increase the risk of sunburn.

Anticoagulants (Blood Thinners)

Warfarin (Coumadin)

Food: Avoid alcohol. Avoid foods high in Vitamin K: beef liver, oils and green leafy vegetables (broccoli, brussel sprouts, cabbage, collards, spinach).
Herbs: Avoid Black Cohosh, Dong Quai, Evening Primrose, Feverfew, Flaxseed Oil and Ginko as they increase the risk of bleeding. Do not take St. John's Wort as it may decrease the desired effect.

Cholesterol Lowering Agents

Atorvastatin (Lipitor)
Pravastatin (Pravachol)
Rosuvastatin (Crestor)
Simvastatin (Zocor)

Food: Avoid alcohol. Do not take with grapefruit juice.
Herbs: St. John's Wort may decrease desired effect.

Diabetes Medications

Glipizide (Glucotrol, Glucotrol Xl)
Glyburide (Glynase, Micronase)
Metformin (Glucophage)

Food: Avoid alcohol.
Herbs: Do not take with Ephedra as it may increase blood sugar and decrease desired effect.

Erectile Dysfunction

Sildenafil (Viagra)
Tadalafil (Cialis)
Vardenafil (Levitra)

Food: Do not take with grapefruit juice.
Herbs: Do not take with Yohimbe as it may increase side effects.

Gastrointestinal Agents (Stomach Meds)

Prochlorperazine (Compazine)

Food: Do not take with alcohol.
Herbs: Do not take with Dong Quai, Kava, St. John's Wort or Valerian as they may make you drowsey.

Cimetidine (Tagamet)

Foods: Avoid alcohol. Take 1 hour before or 2 hours after antacids. Limit caffeine intake; see Chart 3.
Herbs: St John's Wort may decrease desired effect.

Lansoprozole (Prevacid)
Omeprazole (Prilosec)
Pantoprazole (Protonix)
Rabeprazole (Aciphex)

Foods: Avoid alcohol as it may cause upset stomach.
Herbs: St. John's Wort may decrease desired effect.

Heart and Blood Pressure Medications
*Note: The following herbs may cause an increase in blood pressure and decrease desired effect of any blood pressure medications: Black Cohosh, Dong Quai, Ephedra, Hawthorn, Quassia, Vervain and Yohimbe.

Angiotensin Converting Enzyme (Ace) Inhibitors-
Captopril (Capoten)
Linisopril (Prinivil, Zestril)

Food: Avoid salt substitutes that comprise potassium and potassium rich foods; see Chart 1.
Herbs: See *Note above

Beta Blockers-
Atenolol (Tenormin)
Metoprolol (Lopressor, Toprol Zl)
Propranolol (Inderal)

Foods: Avoid alcohol.
Herbs: See *Note above.

Calcium Channel Blockers-
Diltiazem (Cardizem, Tiazac)
Verapamil (Calan, Verelan)

Foods: Do not take with grapefruit juice. A low sodium diet may be recommended.
Herbs: See *Note above.

Digoxin (Lanoxin)

Foods: Avoid antacids. Limit caffeine intake; see Chart 3 below.
Herbs: Avoid Ma Huang and St. John's Wort as they may decrease desired effect.

Nitrates-
Isosorbide (isordil, Imdur)
Nitroglycerin Patch (Nitrol)

Foods: Avoid alcohol.
Herbs: See *Note above.

Diuretics (Water Pills)

Furosemide (Lasix)
Hydrochlorothiazide

Food: comprise potassium rich foods in diet; see Chart 1 below.
Herbs: See *Note above under Heart and Blood Pressure Medications.

Hormone replacement Therapy

Estrogen (Premarin, Premphase, Prempro)

Food: Avoid alcohol.
Herbs: St John's Wort may decrease desired effect. Do not take Black Cohosh Dong Quai, Red Clover or Saw Palmetto because of the possible side effects.

Mood Disorders

Aripiprazole (Abilify)
Clozapine (Clozaril)
Olanzapine (Zyprexa)
Risperidone (Risperdal)

Food: Avoid alcohol. Do not take grapefruit juice. Limit caffeine intake; see Chart 3.
Herbs: Do not take with Kava, St. John's Wor or Valerian as they may make you feel drowsy.

Benzodiazepines-
Alprazolam (Zanax)
Clonazepam (Klonopin)
Diazepam (Valium)
Lorazepam (Ativan)

Foods: Avoid alcohol. Do not take grapefruit juice. Limit caffeine intake; see Chart 3 below.
Herbs: Do not take with Kava, St. John's Wor or Valerian as they may make you feel drowsy.

Lithium (Eskalith, Lithobid)

Food: Avoid alcohol. Limit caffeine intake; see Chart 3 below.
Herbs: Avoid Green Tea.

Monoamine Oxidase Inhibitors (Maoi's)-
Phenelzine (Nardil)
Tranylcypromine (Parnate)

Foods: Avoid alcohol. Avoid tyramine-rich foods see Chart 2 below.
Herbs: Do not take with Ephedra, Kava, Ginko, St. John's Wort or Yohimbe as they may increase effect and cause a serious increase in blood pressure.

Selective Seratonin Reuptake Inhibitors (Ssri's)-
Citalopram (Celexa)
Escitalopram (Lexapro)
Fluoxetine (Prozac)
Paroxetine (Paxil)

Food: Avoid alcohol.
Herbs: Do not take with Ephedra, Kava, Melatonin, Valerian or Yohimbe as they may make you drowsy. Do not take with St. John's Wort as it may increase effect of drug and risk of side effects.

Tricyclic Antidepressants (Tca's)-
Amitriptyline (Elavil)
Desipramine (Norpramin)
Nortriptyline (Pamelor)

Foods: Avoid alcohol. Do not take with grapefruit juice.
Herbs: Do not take with Kava, St. John's Wort or Valerian as they may make you feel drowsy.

Oral Contraceptives (Birth Control)

Estradiol Cypionate
Ethinyl Estradiol
Mestranol

Food: Avoid smoking.
Herbs: Do not take with Chaste Tree Berry, Red Clover, Saw Palmetto or St. John's Wort as they may decrease desired effect.

Osteoporosis

Alendronate (Fosomax)
Risendronate (Actonel)

Food: Take only with plain water. Do not take whatever else within 30 minutes of taking these drugs as they may decrease desired effect.
Herbs:

Seizure Medications

Carbamazepine (Carbatrol, Not Tegretol)
Divalproex (Depakote)
Oxcarbazepine (trileptal)
phenytoin (Dilantin)

Food: Avoid alcohol. Do not take with grapefruit juice.
Herbs: Evening Primrose increases risk for seizures. Do not take with Kava or Valerian as they may make you feel drowsy. St. John's Wort may decrease desired effect.

Thyroid Medications

Levothyroxine (Levoxyl, Synthroid, Unithroid)
Thyroid (Armour Thyroid)

Food: Limit intake of Brussel Sprouts, cabbage, kale, greens, rutabaga, soybeans and turnips.
Herbs: Do not take with Lemon Balm.

Miscellaneous

Antihistamines-
Chlorpheniramine (Chlor-Trimeton)
Diphenhydramine (Benadryl)

Food: Do not take with alcohol.
Herbs: Do not take with Kava or Valerian as it may make you feel drowsy.

Cyclosporine (Neoral, Sandimmune)

Foods: Do not take with grapefruit juice.
Herbs: Do not take with Echinacea or St. John's Wort as they may decrease desired effect.

Prednisone
Methylprednisolone

Food: Avoid alcohol. Calcium supplements may be recommended to forestall Osteoporosis.Limit caffeine intake; see Chart 3 below.
Herbs: Avoid Echinacea or St. John's Wort as they may decrease desired effect.

Theopylline (theo-Dur)

Foods: Avoid alcohol.Limit caffeine intake; see Chart 3 below.
Herbs: Do not take with Ephedra or Green Tea as it may increase effect of drug.

Foods:
Herbs:

Chart # 1

High potassium rich foods comprise the following:

Apricots, Artichokes, Asparagus, Avacado, Banana, Broccoli, Brussel Sprouts, Carrots, Celery,
Chocolate, Dates, Dried Beans, Dried Fruit, Figs, Greens, Honeydew, Milk, Orange Juice, Potato,

Pumpkin, Prune Juice, Raisins, Rhubarb, Spinach, Squash, Tomato, V-8 Juice

Chart # 2

High tyramine-content foods comprise the following:
Aged Cheese*, Aged Meat,Anchovies, Avacados, Bananas, Beer, Broad Beans, Caffeine

Chicken Liver, Chocolate, Cola Drinks, Canned Figs, Mushrooms, Raisins, Sausages, Sour Cream
Soy Sauce, Wine (Chianti, Sherry), Yeast, Yogurt

*Camembert, Chedder, Gruyer, processed American and Stilton

Chart # 3

High caffeine-content foods comprise the following:
Chocolate (milk and dark, Coffee (brewed, cappuccino, expresso)
Caffeinated water (Java, Kank, Aqua Blast), Ice Cream (coffee, chocolate)
Soft Drinks (Mountain Dew, Coca Cola, Pepsi, Root Beer, Sunkist Orange Soda)
Teas (green Tea, Ginseng, Snapple Iced Tea, Lipton)

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