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You may think herbal supplements are safe because they're labeled
"natural." But many herbal supplements contain active ingredients
that can harm you if taken with certain prescription or over-the-counter (OTC)
drugs. In addition, some medical situations increase your risk of adverse
effects if you take herbal products. Talk to your doctor before taking
any herbal products if you're pregnant or breast-feeding or if you have: It's a good idea to talk to your doctor about any herbal supplements you
take, no matter what type of medication you're using or the condition for which
you're being treated. Here are 14 herbs and the prescription and OTC drugs you shouldn't take with
them: Capsicum Capsicum may increase the absorption and the effect of these drugs. It may
also increase the likelihood of developing a cough if used with ACE inhibitors. Coenzyme Q-10 The use of warfarin and coenzyme Q-10 together increases your risk of
excessive bleeding. Coenzyme Q-10 may reduce the effectiveness of some
chemotherapy. Some drugs, such as those used to lower cholesterol (lovastatin,
pravastatin, simvastatin), blood sugar (glyburide, tolazamide) and blood
pressure (beta blockers such as Inderal, Lopressor), can alter coenzyme Q-10's
effectiveness. Also, people with diabetes should be aware that coenzyme Q-10 may
decrease their need for insulin. Dong quai The combination of dong quai and warfarin may increase your risk of bleeding.
Using St. John's wort or certain antibiotics with dong quai may increase your
skin's sensitivity to the sun. Echinacea Echinacea shouldn't be combined with other drugs that can cause liver damage.
And because this herb may stimulate the immune system, it may interfere with the
effects of immunosuppressants. Echinacea may also elevate the levels of HIV protease inhibitors, calcium
channel blockers and anti-anxiety drugs in the blood, increasing your risk of
side effects. Ephedra Ephedra by itself has been shown to increase your risk of heart attack,
stroke, seizures or death. Combined with the above drugs, it becomes even more
risky. Ephedra is a potent herb that's present in many products, especially
those designed to give you pep or help you lose weight. It goes by many names,
such as ma-huang, herbal ecstasy, mahuang, mahuanggen and ma huang root. Any
"natural" product that claims to cause weight loss or increase energy
may have ephedra in it. Carefully review the product's contents with your doctor
or pharmacist before assuming it doesn't. Feverfew These medications can reduce blood clot formation. Feverfew may increase this
effect, causing spontaneous and excessive bleeding. Garlic Combined with garlic, anticoagulant medications may cause spontaneous and
excessive bleeding. Garlic may decrease the effectiveness of immunosuppressants
and HIV protease inhibitors. Garlic may cause lower levels of blood sugar, which may decrease your need
for insulin if you have diabetes. If you take insulin and garlic together,
monitor your blood sugar carefully and report any changes to your doctor. Ginger Ginger may increase the effect of anticoagulants, which may cause excessive
bleeding. It may also increase the production of stomach acid, which could
counteract the effects of antacid medications. Ginger may lower your blood pressure or blood sugar levels, which may reduce
your need for blood-pressure-lowering medications or insulin if you have
diabetes. Monitor your blood pressure or blood sugar levels if you take these
medications and report any changes to your doctor. Ginkgo Ginkgo may increase the anticoagulant effect of these drugs and has the
potential to cause spontaneous and excessive bleeding when used in conjunction
with these medications. It can also increase the amount of antidepressant
medication in your blood. When combined with antipsychotic medications, ginkgo
may cause seizures. Ginkgo also affects insulin levels, so if you're taking the
two together, monitor your glucose levels carefully. Ginseng Used with warfarin, ginseng can increase your risk of bleeding problems.
Ginseng with phenelzine may cause headache, trembling and manic behavior.
Ginseng may interfere with digoxin's pharmacologic action or the ability to
monitor digoxin's activity. Ginseng can reduce blood sugar levels in people with type 2 diabetes
(formerly called adult-onset or noninsulin-dependent diabetes). Without careful
glucose monitoring, the use of ginseng with insulin or oral antidiabetic
medications may cause dangerously low blood sugar levels. Ipriflavone Ipriflavone affects the way these drugs are metabolized, usually increasing
the levels of the medications in the blood and the effects of the drugs. Kava Combined with these drugs, kava can produce deep sedation and, in some cases,
even coma. In late 2001, following reports from Europe of liver problems in
several people who used kava, the Food and Drug Administration started
investigating the safety of this herb. Until more is known, don't start taking
kava or products that contain kava. If you already do so, contact your doctor
for advice and ask if you need liver function tests to check for unexpected
liver problems. Don't take kava if you have a history of liver problems, if
you're depressed, or if you take antidepressants or prescription sedatives. Melatonin Melatonin may reduce nifedipine's ability to lower blood pressure, which
could lead to an increased heart rate and blood pressure level if these drugs
are taken together. Fluvoxamine slows the metabolism of melatonin, which may
result in excessive sleepiness. St. John's wort St. John's wort has been shown to affect your body's metabolism of all of
these drugs. Many other drugs are likely to be affected, too. Until more is
known about St. John's wort's ability to alter the metabolism of pharmaceutical
medications, it's probably best not to combine such medications with St. John's
wort. Also, the combination of St. John's wort with some antidepressants, such as
selective serotonin reuptake inhibitors, may cause an excess of serotonin (serotonin
syndrome). Typical symptoms include headache, stomach upset and restlessness. St. John's wort may reduce the effectiveness of some oral contraceptives. Use
another form of birth control while taking St. John's wort.
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Avoid taking with any prescription medications. In particular, avoid taking
St. John's wort and:
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