{"id":4726,"date":"2018-09-27T11:56:53","date_gmt":"2018-09-27T03:56:53","guid":{"rendered":"http:\/\/jknjohor.moh.gov.my\/hsi\/?p=4726"},"modified":"2018-09-27T11:56:53","modified_gmt":"2018-09-27T03:56:53","slug":"think-your-supplement-is-safe-think-again","status":"publish","type":"post","link":"https:\/\/jknjohor.moh.gov.my\/hsi\/think-your-supplement-is-safe-think-again\/","title":{"rendered":"Think your supplement is safe? Think again"},"content":{"rendered":"

Herb-drug interactions that patients need to know<\/strong><\/p>\n

What is a Herbal Supplement?<\/strong><\/p>\n

Herbal supplements<\/a>\u00a0are sold in many different forms – dried leaves for teas, powdered, as capsules or tablets, or in solution.<\/p>\n

The use of\u00a0herbal supplements\u00a0has a long history – dating back thousands of years. Examples of important medicines extracted from botanicals include\u00a0reserpine<\/a>,\u00a0morphine<\/a>,\u00a0penicillin<\/a>, and\u00a0vinca alkaloid\u00a0anti-cancer drugs.<\/p>\n

Today, herbal supplements and\u00a0nutraceuticals<\/a>\u00a0can be purchased over-the-counter (OTC) and may be labeled “all-natural”, but that does not always mean they are safe. While these products are intended to boost health, and may make claims to that effect, robust clinical studies may be lacking.<\/p>\n

Patients need to understand that herbal medications are not completely safe, and that these preparations, when taken with other drugs,\u00a0can\u00a0alter the way that the drug is processed and excreted by the body, enhance a drug\u2019s side effects, or block the intended therapeutic effect of the drug.<\/strong><\/p>\n

    \n
  1. Coenzyme Q10<\/strong><\/li>\n<\/ol>\n

    Coenzyme Q10 protects the heart from damage from cancer medications. The use of coenzyme Q10 with warfarin decreases its blood thinning effects and may increase the risk for a blood clot.<\/p>\n

      \n
    1. John’s Wort supplements<\/strong><\/li>\n<\/ol>\n

      Supplements containing St. John\u2019s Wort are commonly used to treat symptoms of depression.\u00a0This should not be used concomitantly with other antidepressants, migraine medications, dextromethorphan, warfarin, birth control pills, and certain antiretroviral medications due to seriousness of drug interactions<\/strong>.<\/p>\n

        \n
      1. Ginseng<\/strong><\/li>\n<\/ol>\n

        Ginseng is commonly used to improve the body\u2019s resistance and vitality. There are four known types of ginseng, namely American, Korean, Siberian and Brazillian. Of these,\u00a0\u201cAmerican ginseng\u201d\u00a0is<\/strong>\u00a0known to decrease the effects of warfarin<\/strong>\u00a0and should not be used together with other anticoagulants,<\/strong>\u00a0though this cannot be conclusively said for the other three types. Different type of Ginseng have different interaction with Warfarin. Ginseng also has an effect in blood pressure and diabetic medications\u00a0like insulin or oral hypoglycemics.<\/p>\n

          \n
        1. Ginkgo\u00a0biloba<\/strong><\/li>\n<\/ol>\n

          Ginkgo biloba is used to enhance memory, and in improving symptoms of Alzheimer\u2019s and Parkinson\u2019s diseases. It can decrease effects of certain HIV medications, and alter the actions of drugs metabolized by the liver.<\/p>\n

            \n
          1. Cranberry<\/strong><\/li>\n<\/ol>\n

            Even the simple cranberry can have\u00a0drug interactions.<\/p>\n

            Cranberries are a fruit chock full of vitamin C, and some people drink cranberry juice to help prevent urinary tract infections (UTI). Although\u00a0data is conflicting<\/a>, some studies have shown cranberry can reduce recurrent UTIs in pregnant women, the elderly and hospitalized patients; but it is not helpful to\u00a0cure\u00a0a UTI.<\/p>\n

            Cranberry\u00a0<\/strong>may exert an\u00a0increased effect on blood thinners (anticoagulants) like\u00a0warfarin<\/a>\u00a0and lead to bruising or bleeding.<\/strong>\u00a0If you take an oral blood thinner, check with your doctor before consuming unusual amounts of cranberry or cranberry juice. You may need to have your International Normalized Ratio (INR) or other blood clotting lab test checked more frequently.<\/p>\n

              \n
            1. Evening Primrose Oil<\/strong><\/li>\n<\/ol>\n

              Evening primrose is a flowering plant known by other names such as Oenothera biennis, scabish, or king’s cureall.<\/p>\n

              Evening primrose oil<\/a>\u00a0provides fatty acids used by the body for growth. Evening primrose oil contains gammalinoleic acid that\u00a0may slow blood clotting and increase the likelihood of bruising or bleeding<\/strong>. If you take drugs or herbs that may have blood thinner effects, check with your health care provider before using evening primrose oil<\/p>\n

              Use of evening primrose oil may increase the risk for seizures if you take\u00a0anti-seizure medications<\/a>\u00a0or\u00a0phenothiazine<\/a>\u00a0drugs.<\/p>\n

                \n
              1. Garlic<\/strong><\/li>\n<\/ol>\n

                Garlic<\/a>\u00a0is a commonly used flavoring agent, food product and herbal supplement. There are many conditions garlic has been used for – to reduce cholesterol and triglycerides, to prevent cancer, to lower blood sugar levels, and to reduce menstrual pain, among other uses.<\/p>\n

                Garlic has been reported to moderately affect blood clotting and blood sugar levels and may affect people who take\u00a0blood thinning agents<\/a>\u00a0like aspirin, warfarin, or clopidogrel (Plavix).<\/strong>\u00a0Use of garlic supplements with HIV protease inhibitors (PI) may decrease the PI blood levels.<\/strong><\/p>\n

                  \n
                1. Green Tea<\/strong><\/li>\n<\/ol>\n

                  Green tea<\/a>\u00a0is a popular drink that originated in China and has been promoted for stomach disorders, to lower cholesterol, as an anti-cancer antioxidant, as a stimulant, and to lessen belly fat, among other uses.<\/p>\n

                  In the U.S., it has gained recent popularity due to claims it can boost metabolism and aid in weight loss. Dried green tea leaves contain vitamin K, which can increase blood clotting. Large amounts of vitamin K may interfere with the activity of some\u00a0blood thinners<\/a><\/strong>.<\/p>\n

                  A substantial decrease in the INR (a measure of blood clotting) has been reported in a patient treated with warfarin after he began consuming large quantities (1\/2 to 1 gallon daily) of green tea. Patients treated with\u00a0warfarin<\/a>\u00a0should probably avoid large amounts of green tea as it can interfere with the blood-thinning capabilities of warfarin.<\/strong><\/p>\n

                    \n
                  1. Ginger<\/strong><\/li>\n<\/ol>\n

                    Ginger<\/a>\u00a0is a commonly used flavoring agent, food product, and herbal supplement. Ginger has been used in the treatment and prevention of motion sickness, vertigo, to increase appetite, and to reduce stomach acidity. Ginger has also been used by some women under medical supervision to reduce severe nausea and vomiting in pregnancy.<\/p>\n

                    It is known to inhibit thromboxane synthetase, which can prolong bleeding time and may cause interactions<\/strong> with anticoagulants like\u00a0warfarin<\/a>,\u00a0aspirin<\/a>, or other\u00a0blood thinners<\/a>.<\/p>\n

                     <\/p>\n

                    There are many other herbs that can interact with medications.<\/strong><\/p>\n

                    “It is important that patients consult first with a physician before taking any herbal supplements, or inform their physician if they are taking herbal preparations if they are prescribed with medications.”\u00a0<\/strong><\/p>\n

                    Thank you for reading \ud83d\ude42<\/p>\n","protected":false},"excerpt":{"rendered":"

                    Herb-drug interactions that patients need to know What is a Herbal Supplement? Herbal supplements\u00a0are sold in many different forms – dried leaves for teas, powdered, as capsules or tablets, or in solution. The use of\u00a0herbal supplements\u00a0has a long history – dating back thousands of years. Examples of important medicines extracted from botanicals include\u00a0reserpine,\u00a0morphine,\u00a0penicillin, and\u00a0vinca alkaloid\u00a0anti-cancer […]<\/p>\n","protected":false},"author":8,"featured_media":4729,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[6],"tags":[],"class_list":["post-4726","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-wordpress"],"_links":{"self":[{"href":"https:\/\/jknjohor.moh.gov.my\/hsi\/wp-json\/wp\/v2\/posts\/4726","targetHints":{"allow":["GET"]}}],"collection":[{"href":"https:\/\/jknjohor.moh.gov.my\/hsi\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/jknjohor.moh.gov.my\/hsi\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/jknjohor.moh.gov.my\/hsi\/wp-json\/wp\/v2\/users\/8"}],"replies":[{"embeddable":true,"href":"https:\/\/jknjohor.moh.gov.my\/hsi\/wp-json\/wp\/v2\/comments?post=4726"}],"version-history":[{"count":2,"href":"https:\/\/jknjohor.moh.gov.my\/hsi\/wp-json\/wp\/v2\/posts\/4726\/revisions"}],"predecessor-version":[{"id":4730,"href":"https:\/\/jknjohor.moh.gov.my\/hsi\/wp-json\/wp\/v2\/posts\/4726\/revisions\/4730"}],"wp:featuredmedia":[{"embeddable":true,"href":"https:\/\/jknjohor.moh.gov.my\/hsi\/wp-json\/wp\/v2\/media\/4729"}],"wp:attachment":[{"href":"https:\/\/jknjohor.moh.gov.my\/hsi\/wp-json\/wp\/v2\/media?parent=4726"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/jknjohor.moh.gov.my\/hsi\/wp-json\/wp\/v2\/categories?post=4726"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/jknjohor.moh.gov.my\/hsi\/wp-json\/wp\/v2\/tags?post=4726"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}