Q: I'm curious about interactions between herbs and drugs. Are there many that we should worry about? -- Nicole S.
In general, I think you're pretty safe taking most supplements, but you certainly should tell your doctor about anything you're taking regularly, particularly if you're also taking either prescription or over-the-counter drugs. Here's a quick rundown of some commonly used supplements and drugs that could interact to your detriment:
St. John's wort: May affect metabolism of antidepressants; HIV protease inhibitors used to treat HIV/AIDS; digoxin, a heart medication; theophylline, used to treat asthma; cyclosporine, an immunosuppressant; chemotherapy; birth control pills (it may reduce their effectiveness); the blood pressure and heart disease medications nifedipine and diltiazem; Coumadin, a blood-thinner; and non-nucleoside reverse transcriptase inhibitors for HIV/AIDS treatment.
Co-enzyme Q10, dong quai, feverfew, garlic, ginger, ginkgo, ginseng, vitamin E and St. John's wort: May increase the risk of bleeding if you're taking prescription anticoagulants such as Coumadin.
Echinacea: May increase levels of HIV protease inhibitors used to treat HIV/AIDS, calcium channel blockers used to treat high blood pressure, and anti-anxiety drugs.
Capsicum (red pepper, cayenne pepper): May increase the absorption and effect of ACE inhibitors used to treat high blood pressure, heart failure and kidney disease; theophylline (for asthma); sedatives; and antidepressants.
Garlic: May decrease the effectiveness of immunosuppressant drugs and HIV protease inhibitors. It also may reduce the need for insulin among diabetics (by lowering blood sugar).
Ginkgo: May increase the amount of antidepressant drugs in your blood; may cause seizures when combined with anti-psychotic drugs.
Ginseng: Can cause headache, trembling and manic behavior when combined with the antidepressant Nardil; may interfere with the action of the heart medication digoxin; may reduce blood sugar levels in people with Type II diabetes, thus affecting the need for insulin or other medication for diabetes.
Andrew Weil, MD
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