It is the month of December and this is the time for goodwill, good gifts and good drinks. This is the time, when some people deprive themselves of certain things in order to enjoy the season. Unfortunately some of these things are their medicines, as sometimes it is either the medication or alcohol.
I will spend this time though just going through some interactions that can be expected when we use herbs with our medication. This may not be seasonal, but it is important — well at least I think so.
The medical profession knows that people use herbal medicines along with their medication, so hiding it makes no sense. Disclose and discuss, your doctor if he/she is treating to you as an individual and listening to you, should be able to come up with a solution, once it is safe to do so.
The important thing to understand about those herbal preparations is that they have no official FDA seal of approval. In fact, the term “dietary supplement” was created as a compromise with the herbal industry and the FDA.
In 1994, the Food and Drug Administration passed the Dietary Supplement Health and Education Act. Under this law, dietary supplements may be marketed without FDA approval unless the supplement contains a “new dietary ingredient”, defined as a product that contains “vitamins, minerals, herbs, or other botanicals, amino acids, and substances such as enzymes, organ tissues, glandulars, and metabolites”.
The FDA may not take action on an herbal supplement unless the product is deemed unsafe; only then can it be removed from the market. The other stipulation is that the manufacturer may only make claims referring to health, nutrients, or structure or function of the body.
Therefore, the product must contain the following statement on the label if it purports to affect structure or function: “This statement has not been evaluated by the FDA. This product is not intended to diagnose, treat, cure, or prevent any disease.”
According to the FDA, only a prescription drug can treat a disease. A product would be considered an illegal drug if it stated claims such as “treatment, prevention, or cure” for a specific disease or condition on the label. So in order to be able to come to market, the manufacturers were permitted to produce these herbals without FDA scrutiny, as long as they put “dietary supplement” on the label. In other words the manufacturers do not have to prove that they have what they have in the bottles.
When choosing to treat yourself with a natural product, there are a few tips to follow or observe;
1. Herbal supplements should never be a substitute for treatment without medical consultation.
2. Consumers and health care providers should investigate the individual evidence for each herbs’ beneficial claims or effects.
3. Learn as much as you can about a product before starting any herbal supplement because some herbals can interact with prescription and nonprescription medicines.
4. If you have a blood clotting disorder, diabetes, heart disease, high blood pressure, Parkinson’s disease, an enlarged prostate gland, a psychiatric problem, an autoimmune disease or other serious medical conditions, you should avoid taking herbal products unless under the supervision of a physician.
5. Price is not necessarily an indication of the products quality or effectiveness.
6. Look on the label for the words “meets USP standards”, which is increasingly seen as a sign that the product has been tested for quality and purity.
7. Herbals and other “natural” medicine should be considered drugs that can cause side effects.
8. Do not use herbal supplements during pregnancy and lactation unless directed by a physician.
9. Do not give herbal supplements to infants or young children.
COMMON HERB-DRUG INTERACTIONS
1. Diabetics — Caution should be exercised in patients with diabetes because of hypoglycemia.
2. Persons with bleeding disorders.
3. Persons on warfarin or similar drugs.
4. NSAIDs — increased risk of stomach bleeding.
5. Patients with “hormone-sensitive conditions such as breast cancer, uterine cancer, or endometriosis.
6. Diuretics-Lasix causing drug resistance.
7. Opioids (possible inhibition of analgesic effects).
8. Digoxin (increased digoxin levels).
9. Calcium channel blockers, such as Norvasc, Amlodipine Verapamil.
10. Drugs used in hypercholesterolemia, such as Crestor chemotherapy drugs.
12. Antipsychotic medications.
1. Saw palmetto should not be used in combination with other androgens, such as finasteride, or flutamide.
2. NSAIDS — increased risk of stomach bleeding.
1. For use in pregnancy, it may be safe at low doses for a short period of time, but more data are required to verify safety in this population. Ginger does have antiplatelet effects because it inhibits thromboxane synthetase, which is evidence against its use in pregnancy.
2. As with many other herbals discussed here, using ginger with NSAIDs, warfarin, and clopidogrel (Plavix) increases the risk of bleeding.
3. Potential interactions exist with antacids, Ranitidine and Alocid and other proton pump inhibitors.
6. Hypotensive medications (either increasing or decreasing blood pressure).
1. Cranberry may increase the excretion of some drugs in the urine.
2. Cranberry may interact with diabetic drugs, Alzheimer drugs, antifungals, and antiulcer drugs, drugs used to lower cholesterol, antivirals, chemotherapy drugs, clarithromycin, diuretics, and those drugs that are eliminated by the liver or kidneys.
1. Consuming acai might affect MRI test results. If you use acai products and are scheduled for an MRI, check with your health care provider.
Calcium can reduce the absorption of these drugs when taken together.
1. Bisphosphonates (to treat osteoporosis)-Actonel, Fosamax.
2. Antibiotics of the fluoroquinolone and tetracycline families.
4. Phenytoin( Dilantin).
5. Mineral Oil and stimulant laxatives.
From the above list it can be seen that herbs do have an effect on our bodies and must be considered to have drug like effects. So even when taking herbal alternatives, be conscious of how they behave in your body and seek advice from a knowledgeable source. In some cases taking the herb and your medicine at different times of the day can prevent the interaction. Talk to your pharmacist about the best times to use your treatments.