Share your herbal supplement use with your doctor: research shows that some popular supplements may be dangerous for people with cardiovascular diseases.
So, which supplements should you avoid? "It depends on what condition the patient has," says Leslie Cho, MD, FACC, Editor-in-Chief of Cleveland Clinic's Heart Advisor. "In general, doctors don't like patients taking red yeast rice because it can increase liver dysfunction if they are on statins or other medications like amiodarone that can also cause liver dysfunction. Also, patients who are on Coumadin should avoid products that contain vitamin K."
She goes on to say that patients who have renal dysfunction should avoid taking potassium and magnesium supplements, unless they clear it with their doctors first. "Diet medications and weight loss supplements often contain substances that can increase heart rate and blood pressure and can be very dangerous for some of our cardiac patients," adds Dr. Cho.
Herbal remedies can interact with prescription heart medications by either reducing their effectiveness or increasing their potency. In addition, some herbs and food products can cause cardiovascular side effects, which can be especially dangerous for people who already have been diagnosed with heart problems.
Herbal supplements are often seen as safe because they are marketed as "natural" remedies. But they aren't regulated the way prescription medications are and their potential side effects do not always appear on their labels.
The herbs and foods you should avoid really depend on your condition and themedications you take. "The bottom line is to clear it with your doctor first," Dr. Cho says.
COMMON HERB-DRUG INTERACTIONS HERB DRUG OR DRUG CLASS INTERACTION COMFREY Phenobarbital Increases metabolism and can lead to severe hepatotoxicity DANSHEN Anticoagulant or Increases bleeding due to antiplatelet agents additive effects Digoxin Increases side effects of digoxin ECHINACEA Amiodarone or ibutilide Increases QT interval Statins, fibrates, niacin Increases risk of hepatotoxic effects EVENING Phenobarbital Decreases seizure threshold PRIMROSE OIL GARLIC Aspirin, clopidogrel, Increases bleeding risk warfarin, or heparinoid Antidiabetes drugs Increases hypoglycemia GINKGO Aspirin Increases bleeding BILOBA Warfarin Inhibits platelet-activating factor (PTF) hemorrhage GINSENG Antidiabetes drugs Increases hypoglycemia Digoxin Interferes with digoxin assay, leading to falsely increased levels Warfarin Decreases effectiveness of warfarin Phenelzine sulfate Headache, Irritability, Insomnia HAWTHORN Digoxin Increases effects of digoxin Calcium-channel blockers Increases vasodilatory or nitrates effects KAVA Alprazolam Increases central nervous system (CNS) depression. Increases effects of alcohol LICORICE Spironolactone Increases effects of spironolactone SAW PALMETTO Anticoagulant or Increases bleeding antiplatelet agents SOY MILK Warfarin Decreases effectiveness of warfarin Digoxin Decreases serum digoxin concentration Clopidogrel Increases activity of clopidogrel. Increases bleeding Warfarin Decreases warfarin bioavailability and effectiveness Simvastatin Decreases effectiveness of simvastatin ST. JOHN'S Paroxetine Nausea, Lethargy, WORT Incoherence Class IA and III Decreases effectiveness antiarrhythmic agents (precipitating arrhythmias) Cyclosporine Decreases cyclosporine concentration due to increased clearance (transplant rejection) Theophylline Decreases serum concentration YOHIMBINE Clonidine, Guanabenz Decreases blood pressure reduction effect of centrally active agents CNS stimulants (e.g., Risk of hypertensive crisis amphetamines) due to its monoamine oxidase inhibitor activity ACE inhibitors Decreases effectiveness of ACE inhibitors. Hypertension Beta-blockers Decreases effectiveness of beta-blockers. Hypertension. Increases heart rate HERBAL PRODUCTS TO AVOID IN PATIENTS WITH CARDIOVASCULAR DISEASES HERB PURPORTED USE CARDIAC ADVERSE EFFECT OF INTERACTION ALOE VERA Wounds (topical), diabetes Hypokalemia (low (oral) potassium) causing digitalis toxicity and arrhythmia. FENUGREEK High cholesterol Increases bleeding risk with warfarin, hypoglycemia (low blood sugar). GINKGO Poor circulation, Potential risk of cognitive disorder seizures. GINSENG Aging, diminished Increases blood pressure. immunity, improves mental Hypoglycemia. and physical capacity and stress tolerance GOSSYPOL Male contraceptive Increases effects of diuretics. Hypokalemia. GRAPEFRUIT Weight loss, to promote Increases effects of JUICE cardiovascular health statins, calcium-channel blockers, and cyclosporines. GREEN TEA Improve cognitive Decreases effects of performance, mental warfarin (contains vitamin alertness, weight loss, K). diuretic LICORICE Ulcer, cirrhosis, cough, Increases blood pressure. sore throat, infections Hypokalemia. May potentiate digoxin toxicity. MA-HUANG Obesity, cough Increases heart rate and (EPHEDRA) blood pressure. OLEANDER Muscle cramps, asthma, Heart block. Hyperkalemia. cancer, congestive heart Arrhythmia. Death. failure, hepatitis, psoriasis, arthritis YOHIMBINE Impotence Increases heart rate. Increases or decreases blood pressure.
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|Date:||Apr 1, 2010|
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