Herb and Drug Interactions More than 18% of Americans take herbs and drugs concurrently. Many people assume that since herbs are "natural" they are not dangerous and pose no risk with other medications. Others feel that since herbs havenšt been put through the Western model of clinical trials that they are not safe and/or effective. Both of these are naďve views. In my practice I use herbs conservatively and try to err on the side of caution, especially when prescribing herbs to patients on prescription medication. Absorption in the Body There are some interactions that we know about or that can be predicted based on the mechanisms of either the herb or the prescription drug. How the drugs and herbs are absorbed into our system is an important factor in interactions. Many of the antacid and cholesterol-lowering drugs will slow the absorption of food and nutrients. They will also decrease the absorption of herbs. If you take prescription drugs and herbs separately, by at least 2 hours, youšll get better absorption of the herbs. Otherwise, the dosage will need to be increased for the herbs to be effective. Danger... Coumadin, which many people take to prevent blood clots, has a very narrow range of safety. It also has negative interactions with many drugs, herbs, vitamins and foods. If youšre taking Coumadin you need to be very careful if you are taking herbs. Liver and kidney metabolization also play a large role in drug and herb interactions. Some drugs such as Dilantin and phenobarbitals increase liver metabolism, so herbs will be less effective and their dosage may need to be increased. Other drugs such as Tagamet and erythromycin slow liver metabolism, therefore herb dosages may need to be lowered. The kidneys are responsible for eliminating herbs and drugs from the body. If the kidneys are damaged, herb doses may need to be lessened. Inside the Body Another factor in herb and drug interactions is how they actually work inside the body. Many people are on diuretic drugs to control high blood pressure. There are several Chinese herbs that are also diuretics, and careful monitoring is necessary if they are given together. Ma Huang Caution: Some drugs and herbs can speed up or slow down respiration, heart rate and blood pressure. The most abused herb in this category is herba ephedrae or ma huang. In Chinese medicine we use this herb sparingly for asthma and other respiratory conditions. Pseudoephedrine is derived from the active ingredients in ma huang and is the main ingredient in Sudafed, which is used for sinus congestion. However, ephedra is also used in the West for weight loss and as a "natural" energy enhancer. The doses are much higher than used in a Chinese formula and I strongly advise against using ma huang for these purposes. Ephedra is also used illegally in the manufacture of methamphet-amine (speed) and in the so-called party or designer drugs like ecstasy. For anyone suffering from hypertension, seizures, diabetes or thyroid conditions, ma huang should be used with caution or not used at all. In general, be cautious when combining herbs and drugs. It is important to let your doctors and pharmacists know what herbs and prescription drugs you are taking. A few precautionary steps such as separating herbs and drugs by 2-4 hours, starting with low dosages and paying special attention to any unwanted side effects can also help reduce or eliminate unwanted herb and drug interactions. Back to Different Drummer Acupuncture Portland Newsletter Index |
|
