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8/11/2019 Drug-Herb Nutrient Interactions_Dr.dorothia Dayley
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DRUG-HERB-
B.Sc. , M.Sc. ,MB. BS.RD
JUNE 1, 2008
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Interaction Categories
Depletion or Interference
Side Effect Reduction / PreventionSupportive Interactions
/Bioavailability
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Depletion or Interference
Indicates where the drug may
absorption or function of thesupp emen or er
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Adverse reactions
Indicate that the supplement or
may result in undesirable effects
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Side Effect Reduction / Prevention
Indicates the supplement or herb
or severity of potential side effectcause y e rug
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Supportive Interactions
Indicates the supplement or herb
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Reduced Dru Absor tion /Bioavailability
Indicates that the Herb or
absorption and / or activity of therug n e o y
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ANTACIDS
um. y rox e a an gpreferred)
deplete folic acid and possibly copperand phosphate. If using these long term
u w umultivitamins
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ANTACIDS
PPIPPI takentaken withwith cranberrycranberry juicejuice oror otherother acidicacidic
liquids increased the uptake of Vit B-12 from foodsources
decreasedecrease absorptionabsorption ofof VitVit BB--1212 andand
Betacarotenes from food sources not fromSupplements
LansoprazoL lle
Proton Pump Inhibitors eg Omeprazole or
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ASA & NSAIDS
risk of GI bleeding leading to decr Iron
Vit-C levels
Vit-E + Asa or Nsaids likelihood ofbleeding
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ANALGESICS
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ANALGESICS
Cayenne (capasaicin) may protect againststomach damage by ASA
Licorice (deglycyrrhizinated licorice) is
rotective of stomach and intestines from
damage caused by ASA and Naproxen
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ANALGESICS
Acetominophen overdose can cause liveramage - ce y - cys e ne v ora can e
used to treat this.
-
Pretreatment with standardised Milk Thistle
-prevent liver damage
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ANALGESICS
g n pec n, gcarboh drate and lar e amountsof Cruciferous veg can interfere
ALCOHOL comsumption can
liver damage
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STATINS in randomised double-blind trialswere shown to significantly reduce the
eve s o o over wee s ence
should recomm. At least 100mgsupp emen
ANTACIDS containing Mg and Al decrease
levels of Statins by blocking absorption soseparate ingestion by 2 hours.
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CHOLESTEROL LOWERING DRUGSHMG-CoA reductase inhibitors
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Niacin (Vit-B3) together reduce Chol.Levels more effectively than each used
a one u can cause ncrease ver
problems and muscle disorders so bloodeve s mus e mon ore .
Vit A levels can be increased with long
term use over a 2-year period so monitorVit-A levels
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STATINS
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PROPRANOLOL Coenzyme Q10 suppl. Can overcome the
inhibition of enzymes dependent on CoQ10.
Black Pepper extract can increase the bloodeve s o e rug
FOOD increases drug absorption so ADVISE
.day always with or always without food
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ANTI - HYPERTENSIVES
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ANTI-HYPERTENSIVES
Alcohol can potentiate thedrowsiness and dizziness caused b
Propranolol
that in patients treated with propranolol
.
Phase cf. Non Smoking Phase
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ANTI-HYPERTENSIVES
THIAZIDE DIURETICS CALCIUM loss in urine
Depleted Mg. , K, Zn and Vit D (due to loss of
K can get an incr. in arrhythmias with Digoxinuse
SODIUM loss in urine (with low sodium diet
can reduce the amount of Diuretic given.
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ANTI-HYPERTENSIVES
DIURETIC HERBS like Uva Ursi,Dandelion, Juniper, Buchu, Cleavers,
orse a , rave oo can ncr e ure c
drugs Licorice can increase the effects of
potassium depleting diuretics whereas DGL
can be used safely with any diuretic
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ANTI-HYPERTENSIVES
ACE INHIBITORS
eg Captopril and Enalapril can lead to
.
Zn is lost in the urine so use multi minerals
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ANTICOAGULANTS
may cause hyperkalemia
Interferes vit-D activation (theorectically
could cause Osteoporosis with long termuse
Digitalis or Digoxin can reduce the
e cacy o epar n an eore ca yGinger could lead to increased bleeding
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ANTICOAGULANTS
oenzyme because of its similarityto Vit-K can decr. the efficacy of Warfarin Iron, Mg and Zn may bind with Wafarin
and
it effect (Advise to be taken At least
Vit-K supplements and large quantities of
Warfarin
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ANTICOAGULANTS
HERBS like Asian Ginseng, Dan Shen,
Devils Claw, Garlic ginger, Coumarin
er va ves, u n ne are a sa o ncr.
tendency to bleed.FOODS like green leafy veg. efficacy and
papaya enzyme can incr tendency to bleed.
ALCOHOL esp. heavy usage. Efficacy
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ANTIBIOTICS
PROBIOTICS egc op us sp.
And
Bifidobacteria can restore gut florapreven ng arr oea an ecreaseabsorption of nutrients
acc aromyces ou ar harmlessYeast in a double blinded study was shown
induced by Vancomycin
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ANTIBIOTICS
Vit-C has been shown to incr. absorption of
Tetracycline in a study and to increase the
e cacy o r me opr m- u ame oxazo e
in cystic fibrosis Vit-K production is. Because K
producing bacteria are killed. Vit- K1
production returns in a few weeks.
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DIABETIC DRUGS
SULPHONYLUREAS eg Glipizide and
Glyburide
Gli izide can cause incr. Ma nesiumLevels and Mg levels can cause incr.
Glyburide levels therefore ( therapeutic or
detrimental )
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DIABETIC DRUGS
HERBS like Fenugreek, Gymnema andAloe Vera can decr. Blood Sugar levelsand improve control. Fenugreek works in
both Type 1 and Type 2 .Dosage reductions must be made if these
are bein taken with meds to avoid
Hypoglycemia
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DIABETIC DRUGS
p z e wor s es w en a en m ns.Before meals and Glyburide may be taken
Serum Vit-B12 levels but not folate
. Mg loss from kidneys ? Clinical signif.
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DIABETIC DRUGS
FOOD interferes with Metformin absorption
would be best on an empty stomach but
ue o e nc en s o s e e ec s we
often advise it with food
ALCOHOL can potentiate the Lactic Acidosis
that can occur
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CHEMOTHERAPY
NAUSEA can be controlled by anti nausea
drugs or using Herbs and Food Suppl.
One trial suggests that N-Acetyl Cysteine
1800m dail ma reduce chemo inducednausea. Gingercan also be helpful inreducin nausea and vomitin
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CHEMOTHERAPY
A Trial giving large doses of Betacarotene, n v e oses or wee s
then 125,000 daily for another 4 weeks
and their severity cf Chemo alone
-speeded up their resolution cf Placebo
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CHEMOTHERAPY
FOOD AVERSIONS
can use a scapegoat stimulus to direct
aversion to the scapegoat. One trial
showed that fruit drinks protected betteragainst development of aversions cf other
foods
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CHEMOTHERAPY
Controlled French Trial showed that high dose
, - ,
Remission rates in late stage Post. Menopausal
ANTIOXIDANTS in general. Chemo works bycreatin Oxidative Dama e to kill cancer cells.
Most Oncologists do not support their useduring Chemo
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CHEMOTHERAPY
In Vitro and Double blinded studies done by
Japanese Researchers do not support these
restrictions . Findings Suggest that
combining Vit-C, Vit-E and N-AcetylCysteine protect against chemo induced
Heart damage without interfering with
Chemo action
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CHEMOTHERAPY
GLUTAMINE
In human studies d/n stimulate cancer growth
u es suppor ncrease suscep y o cancer
to radiation and chemo.
- ecr a er ox c y oIfosfamide
n g oses - mg ecr. anincr. effectiveness of the Chemo Drugs
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CHEMOTHERAPY
HERBS or o us vers co orextract PSK apolysacc added to Chemo incr. survival rate
. .with Cisplatin and Doxorubicin in vitro
Eleutherococcus senticosus Russian researchshowed when combined with Chemo
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CHEMOTHERAPY
ess ox c y n me anoma, a e o o era e more
Chemo in inoperable breast Ca. and improvedimmune function when Chemo and radiationwas combined
THYMUS PEPTIDESProteins derived from the thymus gland injected
lead to increased survival times,. SE from
Natural Killer cells
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CHEMOTHERAPY
- .
Methotrexate works by blocking Folic Acidac va on ere ore g ve o n c c rescue
Food can interfere with oral absorption and
Doxorubicin Carnithine (animal res)
prevent toxicity
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CHEMOTHERAPY
Methotrexate Vit-C, Vit E Riboflavin and N AcetylCysteine can protect against Cardiotoxicity.
Cisplatin depletes Calcium, Phos, Mg and Kbecause of kidney damage high doses ofSelenium protect against kidney damage.
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SUMMMARY
INFORMATION ON HOW SOME HERBS OR
DRUGS WORK BETTER, WHICH DRUGS
AND SUPPLEMENTS SHOULD NOT BE
SIDE EFFECTS CAN BE MINIMIZED BYTAKING THE RIGHT SUPPLEMENT OR
HERB
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REFERENCES
- - -
Interactions. Edited by Schuyler W..
,Database (2006).Compiled by editors ofPharmacists Letter and Prescribers letter
also available as PDA Version with webaccess.
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