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Things you should know about Herb and Drug Interactions

Many people take prescription and over-the-counter (OTC) drugs at one time or another. These drugs often have side-effects that you may or may not know about. In order to avoid potential problems or to insure that the herbs you are taking achieve the desired effect it is good to know a few things about herb/drug interactions. First of all, herbs and prescription drugs should not be taken at the same time. Because no one knows all the potential interactions it is best be cautious and to separate taking them by 2-3 hours to avoid any problems. Below we have listed some potential problems that may affect the results of the herbs you are taking.

Some prescription drugs and OTC drugs interfere with absorption which may decrease the effectiveness of the herbs you are using. For example, some drugs used to reduce cholesterol levels work by binding to fats so the fats can't be absorbed. If you are taking a formula that has seeds in it you may not receive the full medicinal effect because seeds have a high fat content and the fats will not be absorbed while taking these drugs. Some medication for stomach ulcers form a protective barrier on the stomach lining which inhibits absorption of what you are taking. Even over the counter anti acids such as Tums which neutralize stomach acids will decrease absorption. Once again, the herbs you take may not work as well as anticipated. Drugs for acid reflux or heartburn such as Prilosec (omeprazole) and Pravacid (lansoprazole) have a much longer lasting effect. If you are taking these medications you should take your herbs first thing in the morning, then take your medication one hour later or take the herbs 2-3 hours afterwards. If you have no effect from the herbs after 2-3 days you may need to increase the dosage.

Some prescription drugs such as Reglan (metoclopramide) stimulate the gastrointestinal (GI) tract. In this case, because of speeded up GI movement there is less time for the herbs to be absorbed. You may need to increase dosage 10-20% to get an effect.

Other drugs like Haldol (haloperidol) will slow down the intestinal motility. In this case someone may absorb too much of the herb so you should reduce the dosage of the herbs.

Drugs that inhibit liver enzymes such as Tagamet (cimetidine) or erythromycin may inhibit the absorption of herbs. Erythromycin is normally taken short term so it won't be as much of a problem but with Tagamet it will take several weeks to get the desired effect.

Coumadin is an anti-coagulant medication. Salvia has been shown to increase the effect of Coumadin. Herbs like Artemesiae argyi (mugwort) and Biota leaf may decrease the effect. If you are using Coumadin we recommend that you consult with your doctor before taking herbs.

Other noted herb-drug interactions are: St. John's Wort and anti-depressants. Wait two weeks before the end of using the drugs and starting St. John's Wort.

Be cautious with taking Garlic, ginkgo, ginger or Vitamin E with anticoagulants.

Don't take Kava and Valerian root with sedatives (alcohol, sleeping pills, etc)

Because of a potential negative interaction Xiao Chia Hu Tang (Minor Bupleurum Formula) should not be taken with interferon.

If you are taking any prescription medicines or over-the-counter medications you should check with your doctor, pharmacist, or PDR (Physician's Desk Reference) to see if there are any possible side-effects that may interfere with the herbs you are taking or if the herbs may interfere with the drugs you are taking. If you want to switch from using a prescription drug to herbal alternatives do so cautiously. We recommend having a doctor or licensed health professional supervise and advise on the transition.

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