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DRUG
SIDE EFFECTS PART II
Abbokinase
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied
Health
• Vitamin K levels are important to the
activity of this medication. The more vitamin K present, the greater
the chance of blood clotting. Since the purpose of this medication is
to lower clotting, foods high in vitamin K, such as spinach,
cauliflower, brussel sprouts, and egg yolk should be limited or used
with caution.1
• Consult with your pharmacist before
taking supplemental CoEnzyme Q10, which has a similar chemical
structure to vitamin K and may affect the effectiveness of this
medication.2
• Avoid high dosages of vitamin A (over
10,000 IUs) or vitamin E (over 400 Ius).3
• More than 5 gms (5,000 mg) of vitamin
C may reduce the absorption of this medication.4
• Absorption and activity of this
medication may be altered by supplemental use of iron, magnesium, and
zinc. Use of these minerals should be spaced at least two hours apart
from the taking of this medication.5
• Please consult with your physician or
pharmacist before taking nutritional supplements containing chondroitin
sulfate.6
• More than 60 grams of onions (2 oz’s)
may affect the activity of this drug.7
• Avoid excessive consumption of
garlic, ginger, and avocado, due to their blood thinning properties.8
• Taking high doses of Grapefruit juice
with this medication may interfere with drug therapy.9
• The following herbs may contribute to
blood thinning and should not be used with this drug: Angelica, anise,
arnica, asafoetida, bogbean, capsicum, celery, chamomile, danshen,
fenugreek, feverfew, garlic, ginger, ginkgo, ginseng (Panax), Gotu
kola, horse chestnut, licorice, meadowsweet, papain, prickly ash,
poplar, quassia, red clover, rue, and willow.10
• According to an Italian study, these
herbs: Passionflower, hydroalcoholic extracts, Juniper and Verbena
officinalis contain vitamin K and may interefere with drug therapy.
Avoid their use together.11
References
1 Weibert RT, Le DT, Kayser SR, et al.
Correction of excessive anticoagulation with low-dose oral vitamin K.
Ann Intern Med 1997;125:959-62
1 United States Pharmacopeia Drug Index (USPDI). 8th ed.
Rockville, Md: US Pharmacopeial Convention, Inc; 1988:259-268.
1 Harris JE. Interaction of dietary factors with oral
anticoagulants: Review and applications. J Am Dietet Assoc
1995;95:580-84 [review].
2 Harris JE. Interaction of dietary factors with oral
anticoagulants: Review and applications. J Am Dietet Assoc
1995;95:580-84 [review].
2 Landbo C & Almdal TP [Interaction between warfarin
and coenzyme Q10.] Ugeskr Laeger, 1998 May, 160:22, 3226-7.
2 Spigset O. Reduced effect of warfarin caused by
ubidecarenone. Lancet 1994;344:1372-73 [letter].
2 Heck AM, DeWitt BA, Lukes AL. Potential interactions
between alternative therapies and warfarin. Am J Health Syst Pharm.
2000 Jul 1;57(13):1221-7; quiz 1228-30
2 Holt GA. Food & Drug Interactions. Chicago: Precept
Press, 1998, 286.
3 Wells, PS et al., Interactions of Warfarin with drugs and
food. Ann. Int. Med. 1994, 121:676-683.
3 Heck AM, DeWitt BA, Lukes AL. Potential interactions
between alternative therapies and warfarin. Am J Health Syst Pharm.
2000 Jul 1;57(13):1221-7; quiz 1228-30.
3 Holt GA. Food & Drug Interactions. Chicago: Precept
Press, 1998, 286.
4 Holt GA. Food & Drug Interactions. Chicago: Precept
Press, 1998, 286.
4 Wells, PS et al., Interactions of Warfarin with drugs and
food. Ann. Int. Med. 1994, 121:676-683.
5 Wells, PS et al., Interactions of Warfarin with drugs and
food. Ann. Int. Med. 1994, 121:676-683.
5 Harris JE. Interaction of dietary factors with oral
anticoagulants: Review and applications. J Am Dietet Assoc
1995;95:580-84 [review].
5 Holt GA. Food & Drug Interactions. Chicago: Precept
Press, 1998, 286.
6 Chavez, M: Glucosamine sulfate and chondroitin sulfates.
Hospital Pharmacy, 1997, 52(9): 1,275-1,285.
7 Menon, I.S. et al: Effect of onions on blood fibrinolytic
activity. BMJ, 1968,3:351.
7 Pronsky, Z Food Medication Interactions, 11th edition, 1999
7 Holt GA. Food & Drug Interactions. Chicago: Precept
Press, 1998, 286.
8 Blickstein, D et al, "Warfarin antagonism by avocado",
1991, The Lancet 337:914-915.
8 Gadkari JV, Joshi VD. Effect of ingestion of raw garlic on
serum cholesterol level, clotting time and fibrinolytic activity in
normal subjects. J Postgrad Med 1991;37:128-31.
8 Burnham BE. Garlic as a possible risk for postoperative
bleeding. Plast-Reconst-Surg 1995;95:213.
9 Bartle, W. Grapefruit juice might still be factor in
warfarin response (letter). American Journal of Health-System Pharmacy
1999; 56 (April 1): 676.
9 Sullivan D, et al. Grapefruit juice and the response to
warfarin. American Journal of Health-System Pharmacy 1998; 55:
1581-1583.
10 Gadkari, et al. Effect of ingestion of raw garlic on serum
cholesterol levels, clotting time and fibrinolytic activity in normal
subjects. J Postgrad Med 1991;37:128-31.
10 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996.
10 Janetsky, K et al. Probably interaction between warfarin
and ginseng. Am J Health-Syst Pharm 1997;54:692-93.
10 Kleijnen J, Knipschild P. Ginkgo biloba. Lancet
1992;340:1136-39.
10 PDR for Herbal Medicines, 2nd edition, Medical Economics
Company, 2000
10 Heck AM, DeWitt BA, Lukes AL. Potential interactions
between alternative therapies and warfarin. Am J Health Syst Pharm.
2000 Jul 1;57(13):1221-7; quiz 1228-30.
11 Argento A, Tiraferri E, Marzaloni M. [Oral anticoagulants
and medicinal plants. An emerging interaction]. Ann Ital Med Int. 2000
Apr-Jun;15(2):139-43. Review. Italian.
Accolate
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied
Health
• Do not take this medication and fiber
supplements at the same time. Separate their use by at least two hours.1
• Food has been shown to reduce the
absorption of Accolate. Take Accolate two to four hours before or after
a meal.2
• Accolate may interact with a Japanese
herbal formula, Saiboku-to. This formula contains the herbs Ogon,
Koboku, and Kanzo.3
References
1 Adkins JC & Brogden RN:
Zafirlukast. A review of its pharmacology and therapeutic potential in
the management of asthma. Drugs, 1998 Jan, 55:1, 121-44.
1 Suissa S et al., Effectiveness of the leukotriene receptor
antagonist zafirlukast for mild-to-moderate asthma. A randomized,
double-blind, placebo-controlled trial. Ann Intern Med, 1997 Feb,
126:3, 177-83.
2 Adkins JC & Brogden RN: Zafirlukast. A review of
its pharmacology and therapeutic potential in the management of asthma.
Drugs, 1998 Jan, 55:1, 121-44.
2 Suissa S et al., Effectiveness of the leukotriene receptor
antagonist zafirlukast for mild-to-moderate asthma. A randomized,
double-blind, placebo-controlled trial. Ann Intern Med, 1997 Feb,
126:3, 177-83.
3 Kobayashi I et al., Saiboku-To, a herbal extract mixture,
selectively inhibits 5-lipoxygenase activity in leukotriene synthesis
in rat basophilic leukemia-1 cells. J Ethnopharmacol, 1995 Aug, 48:1,
33-41.
3 Kobayashi I et al., [Inhibitory effects of saiboku-to and
compornent herbs on the production of peptide leukotrienes (LTs) and
LTB4]. Arerugi, 1996 Jun, 45:6, 577-83.
Accupril
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied
Health
• The use of alcohol should be limited.1
• Accupril may contribute to zinc
deficiency with long term use. Discuss the need for supplementation
with a pharmacist.2
• Avoid consuming excessive potassium
in foods and supplements while taking Accupril. Ask your physician or
pharmacist for more information about electrolyte balance.3
• Some herbs possess cardiac activity
and they may interact with Accupril to increase side effects: black
hellebore, calamus, cereus, cola, coltsfoot, devil's claw, European
mistletoe, fenugreek, fumitory, digitalis leaf, hedge mustard, figwort,
lily of the valley roots, motherwort, pleurisy root, squill bulb leaf
scales, white horehound, mate, scotch broom flower, shepherd's purse,
and wild carrot4
• Avoid natural licorice products,
Ginseng, and Ephedra (Ma huang) which may interfere with
antihypertensive therapy.5
• These herbs may possess diuretic
properties which could result in additive effects with accupril. They
include: Alfalfa, Angelica, Astragalus, Basil, Bean Pod, Buckthorn,
Burdock, Butcher’s Broom, Buchu, Celery, Cleavers, Dandelion,
Elecampane, Elder, Goat's Rue, Hempnettle, Horsetail, Indian-Hemp,
Juniper, Marigold, Meadowsweet, Parsley, Rauwolfia, Sarsaparilla, Sweet
clover, Turmeric, and Vervain6
References
1 Pronsky, ZM: Food-Medication
Interactions, 11th edition, 1999
1 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer
Company, 2000
2 Golik A, Zaidenstein R, Dishi V, et al: Effects of
captopril and enalapril on zinc metabolism in hypertensives, J Am Coll
Nutr, 1998, 17(1):75-8.
2 Golik A, Modai D, Averbukh Z, et al: Zinc metabolism in
patients treated with captopril versus enalapril, Metabolism, 1990,
39(7): 665-7.
3 Burnakis TG & Mioduch HJ: Combined therapy with
captopril and potassium supplementation. A potential for hyperkalemia.
Arch Intern Med 1984; 144:2371-2372.
3 Good CB, McDermott L, McCloskey B. Diet and serum potassium
on ACE inhibitors. JAMA 1995;274:538.
3 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer
Company, 2000
4 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996.
4 The Review of Natural Products, Clinisphere 2.0, Wolters
Kluwer Company, 2000
4 Blumenthal M, et al. ed. The Complete German Commission E
Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein.
Boston, MA: American Botanical Council, 1998.
4 PDR for Herbal Medicines, 2nd edition, Medical Economics
Company, 2000
5 Pronsky, ZM: Food-Medication Interactions, 11th edition,
1999
5 Brinker, F Herb Contraindications and Drug Interactions,
Eclectic Medical Publications, 1998
6 PDR for Herbal Medicines, 2nd edition, Medical Economics
Company, 2000
6 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996.
6 Blumenthal M, et al. ed. The Complete German Commission E
Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein.
Boston, MA: American Botanical Council, 1998.
Accutane
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied
Health
• Take with food or milk to avoid
stomach upset.1
• Avoid alcohol2
• Avoid vitamin A, beta carotene or multivitamin supplements
with this drug.3
• Use with caution in diabetes4
• There are no known herbal
considerations at this time.5
References
1 Facts and Comparisons, Clinisphere
2.0, Wolters Kluwer Company, 2000
1 Pronsky, Z Food Medication Interactions, 11th edition, 1999
2 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer
Company, 2000
2 Pronsky, Z Food Medication Interactions, 11th edition, 1999
3 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer
Company, 2000
3 Pronsky, Z Food Medication Interactions, 11th edition, 1999
4 Pronsky, Z Food Medication Interactions, 11th edition, 1999
Aceon
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied
Health
• Avoid consuming excessive potassium
in foods and supplements when taking this medication, including salt
substitutes1
• Alcohol intake should be limited2
• This medication may contribute to a
deficiency in zinc. Supplementation may be considered3
• Avoid arginine in conjunction with
these agents, because there is a potential for hyperkalemia to develop4
• N-acetylcysteine may have additive
blood pressure lowering effects with this medication5
• Olive oil has been shown to reduce
blood pressure, if used on a regular basis, antihypertensive drug
dosage adjustment may need to be made6
• CoQ10 may decrease blood pressure,
therefore if combining this supplement with this medication, a dosage
adjustment may need to be made.7
• Some herbs possess cardiac properties
that may interact with the action of this drug and may result in an
excessive lowering of blood pressure or increased side effects. Such
herbs include: black hellebore, calamus, cereus, cola, coltsfoot,
devil's claw, European mistletoe, fenugreek, fumitory, digitalis leaf,
hedge mustard, figwort, lily of the valley roots, motherwort, pleurisy
root, squill bulb leaf scales, white horehound, mate, and shepherd's
purse.8
• Avoid natural licorice products,
Ginseng, and Ephedra (Ma huang) which may contribute to high blood
pressure9
References
1 Good CB, McDermott L, McCloskey B.
Diet and serum potassium in patients on ACE inhibitors. JAMA
1995;274:538
1 Burnakis TG & Mioduch HJ: Combined therapy with
captopril and potassium supplementation. A potential for hyperkalemia.
Arch Intern Med 1984; 144:2371-2372
2 Pronsky, ZM: Food-Medication Interactions, 11th edition,
1999
3 Golik A, Modai D, Averbukh Z, et al: Zinc metabolism in
patients treated with captopril versus enalapril, Metabolism, 1990,
39(7): 665-7
3 Golik A, Zaidenstein R, Dishi V, et al: Effects of
captopril and enalapril on zinc metabolism in hypertensive s, J Am Coll
Nutr, 1998, 17(1):75-8
4 McKevoy GK, ed. AHFS Drug Information. Bethesda, MD:
American Society of Health-System Pharmacists, 1998
5 Ruiz FJ, Salom MG, Ingles AC, Quesada T, Vicente E,
Carbonell LF.N-acetyl-L-cysteine potentiates depressor response to
captopril and enalaprilat in SHRs. Am J Physiol. 1994 Sep;267(3 Pt
2):R767-72
5 Suárez C, Del Arco C, Lahera V, Ruilope LM.
N-Acetylcysteine potentiates the antihypertensive effect of angiotensin
converting enzyme inhibitors [letter]. Am J Hypertens. 1995;8:859-861
6 Ruiz-Gutierrez V, Muriana FJ, Guerrero A, Cert AM, Villar
J. Plasma lipids, erythrocyte membrane lipids and blood pressure of
hypertensive women after ingestion of dietary oleic acid from two
different sources. J Hypertens 1996 Dec;14(12):1483-90
6 Baroni SS, Amelio M, Sangiorgi Z, Gaddi A, Battino M. Solid
monounsaturated diet lowers LDL unsaturation trait and oxidisability in
hypercholesterolemic (type IIb) patients. Free Radic Res. 1999
Apr;30(4):275-85
6 Ferrara LA, Raimondi AS, d'Episcopo L, et al. Olive oil and
reduced need for antihypertensive medications. Arch Intern Med
2000;160(6):837-842
7 Langsjoen P, Langsjoen P, Willis R, Folkers K. Treatment of
essential hypertension with coenzyme Q10. Mol Aspects Med. 1994;15
Suppl:S265-72
8 PDR for Herbal Medicines, 2nd edition, Medical Economics
Company, 2000
8 Facts and Comparisons, The Review of Natural Products,
Clinisphere 2.0, Wolters Kluwer Company, 2000
8 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996
9 PDR for Herbal Medicines, 2nd edition, Medical Economics
Company, 2000
9 Brinker, F Herb Contraindications and Drug Interactions,
Eclectic Medical Publications, 1998
9 Pronsky, ZM: Food-Medication Interactions, 11th edition,
1999
Acetaminophen
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied
Health
• N-acetyl cysteine has been shown to
improve liver damage caused by acetaminophen overdose.1
• Use of over three grams of vitamin C
has been associated with decreased acetaminophen clearance time.2
• Foods high in carbohydrates, pectin
and vegetables like broccoli, brussel sprouts, cabbage, etc. can
interfere with acetaminophen absorption.3
• Acetaminophen consumption is
especially risky for individuals who regularly consume excess amounts
of alcohol as they can develop liver toxicity at lower levels of
acetaminophen intake.4
• Individuals taking acetaminophen
should refrain from fasting, Being in a fasting state greatly increases
the chance of liver damage5
• In a study involving five healthy
adult volunteers Houston and Levy found that oral administration of 3 g
of ascorbic acid 1.5 hours after an oral dose of 1 g of acetaminophen
caused a rapid and pronounced decrease in the excretion rate of
acetaminophen sulfate. Later research by Mitra et al using rodents
supported the conclusion that ascorbyl stearate provided protection
against acetaminophen-induced hepatotoxicity by reducing the reactive
intermediate back to the parent compound. They also note that the
combination enhanced therapeutic efficacy against fever.These initial
studies indicate that individuals with conditions commonly treated by
acetaminophen might be able to use lower doses of the drug, achieve
equal or superior clinical results, and reduce side effects from the
drug by combining it with some form of vitamin C. In fact, a survey of
current clinical reality might reveal that such a combination is often
the unsupervised practice of many patients. Nevertheless, individuals
taking acetaminophen should consult with their physician and/or
pharmacist before reducing doses of the drug based on simultaneous use
of vitamin C.6
• Many studies have looked into the
efficacy and appropriateness of using NAC to treat patients suffering
from acute toxic effects of acetaminophen. Such treatment of
acetaminophen intoxication with N-acetylcysteine (NAC), both oral and
intravenous, is standard hospital protocol in many countries. NAC is
generally considered safe with relatively few side effects. However,
individuals suffering from acetaminophen intoxication require emergency
care and use of NAC in this capacity is only appropriate in such a
setting7
• Acetaminophen is generally well
tolerated with few short-term side effects. However, the drug is
inherently toxic to the liver, and to some degree the kidneys also, and
an overdose of acetaminophen can result in liver toxicity, liver
failure, and even death. The signs and symptoms of liver toxicity may
not become apparent for 2-3 days after a toxic overdose. Patients with
liver and kidney disease should exercise special caution in taking
acetaminophen to avoid toxicity.8
• Overdosage of acetaminophen causes
fatal hepatic failure and acute renal failure.9
• Acetaminophen may interfere with home
blood-glucose-measurement systems.10
• Oral administration of 3 g of
ascorbic acid 1.5 hr after an oral dose of 1 g of acetaminophen caused
a rapid and pronounced decrease in the excretion rate of acetaminophen
sulfate in five healthy adult volunteers. There was a statistically
significant increase in the fractions of the dose of acetaminophen
excreted as such as as acetaminophen glucuronide but a decrease in the
fraction excreted as acetaminophen sulfate. Ascorbic acid, which itself
is metabolized in part to the sulfate, inhibits the conjugation of
acetaminophen with sulfate by competing for available sulfate in the
body.11
• Avoid or limit alcohol intake Those
who take acetaminophen more than occasionally should avoid drinking
alcohol because of the increased risk of liver damage.12
• Milk Thistle Extract helps prevent
liver damage from hepatotoxins, including acetaminophen research:
Acetaminophen exerts several toxic effects upon the liver, perhaps most
importantly through lipid peroxidation and its depletion of
glutathione. Numerous studies, primarily with animals, have
demonstrated that Silybum marianum, particularly silymarin, a key set
of flavonoids, can reduce oxidative stress, inhibit lipid peroxidation
and support glutathione levels. Several teams of researchers have found
positive results when focusing on the efficacy of Silybum and its
constituents in reducing or reversing the toxic effects of
acetaminophen on the liver.herbal support: Silymarin appears capable of
providing specific benefits against the types of liver damage most
closely associated with long-term use of acetaminophen. However, as of
yet, no clinical studies involving humans have confirmed the efficacy
of such a therapeutic approach or established protocols for dosage.
Nevertheless, in such circumstances, many practitioners of natural
medicine advise taking 200 mg Silybum, standardized to contain 70-80%
silymarin, three times per day. Individuals using acetaminophen on a
regular basis for extended periods of time, especially over one year,
should consult their prescribing physician and/or a healthcare
professional trained in herbal medicine to discuss possible benefits of
taking Silybum, or an extract such as silymarin.13
• Tobacco decreases blood levels of
acetaminophen14
• Several studies have been conducted
examining the hepatoprotective effects of various species of Artemesia
used in Chinese medicine, specifically an extract identified as
DA-9601. Using rats Ryu et al found that DA-9601, from Artemisia
asiatica, reduced liver damage induced by acetaminophen (APAP) and
carbon tetrachloride (CCl4) as evidenced by serum ALT, AST, LDH and
histopathological changes such as centrilobular necrosis, vacuolar
degeneration and inflammatory cell infiltration dose-dependently. They
also found that DA-9601 also prevented APAP-induced hepatic glutathione
(GSH) depletion in a dose-dependent manner.While these research
findings are encouraging and consistent with other studies of Artemisia
species, inadequate clinical research with human subjects has been
conducted to confirm the value of Artemisia as a therapy against the
toxic side effects of acetaminophen. Individuals using acetaminophen on
a regular basis for extended periods of time, especially over one year,
should consult their prescribing physician and a healthcare
professional trained in Chinese herbal medicine to determine whether
the use of Artemisia, alone or as part of a traditional formula, would
be appropriate. However, the particular species of Artemesia used in
this study are not typically used in Chinese herbal medicine, or at
least not known by the names cited.15
• Acetaminophen is well known for its
toxic effects, especially upon the liver. Specifically acetaminophen
induces elevation of serum aminotransferase activity and hepatic
lipoperoxides content. It is also associated with observable
histological damage to the liver cells. Schisandra is an herb commonly
used in Chinese herbal medicine. Researchers have investigated the use
of gomisin A, a lignan component of Schisandra fruits, in the treatment
of acetaminophen-induced liver damage. Using rats, Yamada found that
gomisin A inhibited the elevation of serum aminotransferase activity
and hepatic lipoperoxides content and reduced the occurrence of adverse
changes such as degeneration and necrosis of hepatocytes. Lin et al
found that pathological changes of hepatic lesions in rats caused by
three hepatotoxicants were improved after administration of certain
fractions of Schisandra. However, gomisin A did not prevent
gluatathione depletion as compared to Silymarin which provided such
protection. Takeda et al have suggested that gomisin A facilitates
liver protein synthesis and causes liver enlargement as an adaptive
response involving the induction of drug-metabolizing enzymes.herbal
support: While these research findings are encouraging and consistent
with other studies of Schisandra, inadequate clinical research with
human subjects has been conducted to confirm the value of Schisandra as
a therapy against the toxic side effects of acetaminophen. Individuals
using acetaminophen on a regular basis for extended perioods of time,
especially over one year, should consult their prescribing physician
about alternatives methods of addressing the symptoms and their
underlying cause. Further, a healthcare professional trained in Chinese
herbal medicine might help determine whether the use of Schisandra,
alone or as part of a traditional formula, would be appropriate.16
References
1 Vale JA, Proudfoot AT. Paracetamol
(acetaminophen) poisoning. Lancet 1995;346:547-52
2 Houston JB, Levy G. Drug biotransformation interactions in
man. VI: Acetaminophen and ascorbic acid. J Pharm Sci 1976;65:121-21.
3 Holt GA. Food & Drug Interactions. Chicago: Precept
Press, 1998, 2.
4 Whitcomb DC, Block GD. JAMA 1994 Dec 21;272(23):1845-1850
5 Whitcomb DC, Block GD. JAMA 1994 Dec 21;272(23):1845-1850
6 Houston JB, Levy G. J Pharm Sci 1976;65:1218-1221; Mitra A,
et al. J Biochem Toxicol. 1991 Summer;6(2):93-100; Mitra A, et al.
Toxicol Lett. 1988 Nov;44(1-2):39-46.)
7 Zed PJ, Krenzelok EP. Am J Health Syst Pharm 1999 Jun
1;56(11):1081-1091; Salgia AD, Kosnik SD. Postgrad Med. 1999
Apr;105(4):81-84, 87, 90; Montoya-Cabrera MA, et al. Gac Med Mex. 1999
May-Jun;135(3):239-243; Schmidt LE, Dalhoff KP. Ugeskr Laeger. 1999 May
3;161(18):2669-2672
8 Brzeznicka EA, Piotrowski JK. Pol J Occup Med.
1989;2(1):15-22; Kamiyama T, et al. Toxicol Lett. 1993 Jan;66(1):7-12;
Vale JA, Proudfoot AT. Lancet 1995;346:547-552; Fairhurst S, et al.
Toxicology. 1982;23(2-3):249-259.)
9 Fukuoka Igaku Zasshi 1997 Nov;88(11):352-7 -- The risk
factors of death from the acetaminophen poisoning with
antipyretic-analgesic drugs in Japan. -- Washio M, Inoue N.
10 Am J Hosp Pharm 1985 Oct;42(10):2202-7 -- In vitro drug
interference with home blood-glucose-measurement systems. -- Rice GK,
Galt KA.
11 J Pharm Sci 1976 Aug;65(8):1218-21 -- Drug
biotransformation interactions in man VI: acetaminophen and ascorbic
acid. -- Houston JB, Levy G.
12 Pronsky, Z Food Medication Interactions, 11th edition, 1999
12 Whitcomb DC, Block GD. JAMA 1994 Dec 21;272(23):1845-1850
13 Brinker, F Herb Contraindications and Drug Interactions,
Eclectic Medical Publications, 1998
13 Campos, R. et al. Silybin Dihemisuccinate protects against
glutathione depletion and lipid peroxidation induced by acetaminophen
on rat liver. Planta Medica. 1989: 55:417.
13 Campos R, et al. Prog Clin Biol Res. 1988;280:375-378;
Campos R, et al. Planta Med. 1989 Oct;55(5):417-419; Garrido A, et al.
Pharmacol Toxicol. 1991 Jul;69(1):9-12; Muriel P, et al. J Appl
Toxicol. 1992 Dec;12(6):439-442; Chrungoo VJ, et al. Indian J Exp Biol.
1997 Jun;35(6):611-617
14 Brinker, F Herb Contraindications and Drug Interactions,
Eclectic Medical Publications, 1998
15 Janbaz KH, Gilani AH. J Ethnopharmacol 1995 Jun
23;47(1):43-47; Ryu BK, et al. Arch Pharm Res 1998 Oct;21(5):508-513.)
16 Takeda S, et al. Nippon Yakurigaku Zasshi. 1986
Feb;87(2):169-187; Yamada S, et al. Biochem Pharmacol
1993;46:1081-1085; Shiota G, et al. Res Commun Mol Pathol Pharmacol.
1996 Nov;94(2):141-146; Lin CC, et al. J Ethnopharmacol 1997
May;56(3):193-200
Acetaminophen-Codeine
Phosphate
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied
Health
• Drinking alcohol can dangerously
interact with this medication.1
• Codeine can cause constipation and
increased fiber in the diet can help with this condition, however
separate their use by at least two hours.2
• Take with food to avoid stomach upset.3
• Herbs with sedative properties may
intensify the effects of codeine and should not be used concurrently.
These herbs include Chamomile, Black cohosh, Hops, Kava kava, Lobelia,
Motherwort, Passion flower, Skullcap, St. John’s wort, and Valerian.4
References
1 Graedon J, Graedon T: The People’s
Guide to Deadly Drug Interactions, 1995, 234.
1 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer
Company, 2000
2 Pronsky, Food-Medication Interactions, 11th edition, 1999.
2 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer
Company, 2000
3 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer
Company, 2000
4 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996.
4 Facts and Comparisons, The Review of Natural Products,
Clinisphere 2.0, Wolters Kluwer Company, 2000
4 PDR for Herbal Products, 2nd edition, Medical Economics
Company, 2000
Actonel
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied
Health
• Calcium supplementation
may affect the absorption of this medication. Conversely, people being
treated with this medication may have low calcium blood
levels. Check with your physician or pharmacist prior to taking
supplements containing calcium or vitamin D
and, if taking, make sure to take the supplement at least two hours
prior to or after taking this medication.1
• Taking any antacid containing calcium or magnesium
may also affect the absorption of this medication and should be
separated by at least two hours prior or after the taking of this
medication.2
• As many foods also contain high
levels of minerals, taking this medication at the same time may reduce
the absorption of the medication. Separate the taking of this
medication from your food intake, according to the advice of your
physician or pharmacist.3
• Magnesium, zinc, iron and other trace
minerals may affect the absorption of this medication. When taking this
or other medications, it is wise to consult your physician or
pharmacist about your supplements and to separate the taking of all
supplements at least two hours prior or after taking the medication.4
• Herbs containing high levels of
certain minerals may affect the absorption of this medication. Ask your
pharmacist if your herbal supplements may interact with this medication.5
References
1 Reasner CA, Stone MD, Hosking DJ, et
al. Acute changes in calcium homeostasis
during treatment of primary hyperparathyroidism with risedronate. J
Clin Endocrinol Metab 1993;77:1067-71
1 Sifton DW, ed. Physicians’ Desk Reference. Montvale, NJ:
Medical Economics Company, Inc., 2000, 2504-6.
2 Reasner CA, Stone MD, Hosking DJ, et al. Acute changes in calcium homeostasis
during treatment of primary hyperparathyroidism with risedronate. J
Clin Endocrinol Metab 1993;77:1067-71.
2 Sifton DW, ed. Physicians’ Desk Reference. Montvale, NJ:
Medical Economics Company, Inc., 2000, 2504-6.
3 Reasner CA, Stone MD, Hosking DJ, et al. Acute changes in calcium homeostasis
during treatment of primary hyperparathyroidism with risedronate. J
Clin Endocrinol Metab 1993;77:1067-71.
3 Sifton DW, ed. Physicians’ Desk Reference. Montvale, NJ:
Medical Economics Company, Inc., 2000, 2504-6.
4 Sifton DW, ed. Physicians’ Desk Reference. Montvale, NJ:
Medical Economics Company, Inc. 2000, 2504-6.
5 Sifton DW, ed. Physicians’ Desk Reference. Montvale, NJ:
Medical Economics Company, Inc. 2000, 2504-6.
Adalat
CC
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied
Health
• Avoid or limit alcohol use.1
• Grapefruit and grapefruit juice may
increase the effects of calcium channel
blockers and possibly cause an excessive lowering of blood pressure.2
• Magnesium and potassium supplements
may contribute to lowering of blood pressure when used with this
medication. Discuss supplementation with a pharmacist.3
• Avoid natural Licorice products,
Ginseng and Ephedra (Ma huang), which may interfere with
antihypertensive therapy.4
• Some herbs possess cardiac activity
which may interact with Adalat: black hellebore, calamus, cereus, cola,
coltsfoot, devil's claw, European mistletoe, fenugreek, fumitory,
digitalis leaf, hedge mustard, figwort, lily of the valley roots,
motherwort, pleurisy root, squill bulb leaf scales, white horehound,
mate, scotch broom flower, shepherd's purse, and wild carrot.5
References
1 Mindell, E, Hopkins V: Prescription
Alternatives. New Canaan, CT: Keats Publishing, Inc, 1998; p 143.
1 Pronsky, Z Food Medication Interactions, 11th edition, 1999
2 Edgar, B et al: Acute effects of drinking grapefruit juice
on the pharmacokinetics and dynamics of Felodipine - and its potential
clinical relevance. Eur. J. Clin. Pharm. 1992, 42:313-317.
2 Bailey DG, et al. "Interaction of citrus juices with
felodipine and nifedipine." Lancet, 1991; 337: 268-69.
2 Fuhr U. "Drug Interactions with Grapefruit Juice." Drug
Safety 1998; (4): 251-272.
3 Rybacki, JJ. The Concise Essential Guide to Prescription
Drugs, 1997. HarperCollins.
3 Ono A, Shibaoka M, Yano J, Asai Y, Fujita T. Eating habits
and intensity of medication in elderly hypertensive outpatients.
Hypertens Res. 2000 May;23(3):195-200.
3 Geleijnse JM, Witteman JC, den Breeijen JH, Hofman A, de
Jong PT, Pols HA, Grobbee DE. Dietary electrolyte intake and blood
pressure in older subjects: the Rotterdam Study. J Hypertens. 1996
Jun;14(6):737-41.
3 Van Leer EM, Seidell JC, Kromhout D. Dietary calcium,
potassium, magnesium and blood pressure in the Netherlands. Int J
Epidemiol. 1995 Dec;24(6):1117-23.
4 Farese, RV et al., Licorice-induced
hypermineralcorticoidism. NEJM. 1991, 325:1,1223-1,227.
4 Pronsky, Z Food Medication Interactions, 11th edition, 1999
4 Brinker, F Herb Contraindications and Drug Interactions,
Eclectic Medical Publications, 1998
5 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996.
5 Facts and Comparisons, The Review of Natural Products,
Clinisphere 2.0, Wolters Kluwer Company, 2000
5 Blumenthal M, et al. ed. The Complete German Commission E
Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein.
Boston, MA: American Botanical Council, 1998.
5 PDR for Herbal Medicines, 2nd edition, Medical Economics
Company, 2000
Adderall
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied
Health
• Large doses of caffeine should be
limited or avoided with this medication.1
• Magnesium Dextroamphetamine can
increase blood levels of magnesium, which causes significant lowering
of the calcium to magnesium
ratio in the blood. The change in this ratio may in part explain the
effectiveness of stimulants like dextroamphetamine in hyperactive
boys.1 Another magnesium-amphetamine interaction involves supplements
of magnesium hydroxide, which are known to cause retention of
amphetamines in the body.2 This could theoretically result in increased
blood levels of these drugs. Finally, animal studies have suggested
that magnesium supplements can increase learning and enhance the
behavioral response to stimulants.3 For these reasons, the use of
magnesium along with amphetamines may enhance the effectiveness of
these drugs in the treatment of ADD, but controlled studies of this
possibility are needed.2
• Vitamin C Ingestion of some types of
vitamin C results in acidification of the intestinal contents and thus
a decreased absorption of amphetamines.4 Supplements containing vitamin
C should be taken an hour before or two hours after taking amphetamines.3
• Tyrosine is an amino acid used by the
body to produce brain chemicals stimulated by amphetamines. Reduced
stimulant effects of amphetamines were observed in individuals who had
been made tyrosine deficient.5 It is possible that a dietary deficiency
of tyrosine may reduce the effectiveness of amphetamines. Tyrosine
deficiency is not common unless a protein deficiency exists. Adequate
tyrosine intake from dietary protein or supplements is necessary in
individuals taking amphetamines.4
• Lithium is a mineral that may be
present in some supplements and is also used in large amounts to treat
mood disorders such as bipolar disorder (manic depression). Taking
lithium at the same time as amphetamines may inhibit the appetite
suppressant and stimulatory effects of the amphetamines.6 Therefore,
people taking amphetamines should take lithium only under the
supervision of a doctor.5
• Vitamin B6 Occasionally, individuals
taking amphetamines develop compulsive behavior and anxiety, even after
the drug is discontinued. When this side effect occurred in an
eight-year-old boy,7 supplementation with 200 mg vitamin B6 each day
for one week followed by 100 mg daily, reduced the compulsive behavior
and anxiety within three weeks. The symptoms were eliminated after a
few months of treatment. Controlled research is needed to determine
conclusively the usefulness of vitamin B6 supplementation for
preventing and treating this side effect.6
• L-tryptophan In an uncontrolled study
of schizophrenic patients, 200 mg per day of L-tryptophan reduced
disturbances in thinking, as well as hallucinations caused by
dextroamphetamine.8 Symptoms of psychosis rarely occur in people who
take amphetamines and are not schizophrenic. Controlled research is
needed to establish the benefits of L-tryptophan and related
supplements for people taking amphetamines.7
• Fruit juices may acidify the
intestinal contents, causing reduced absorption of amphetamines.11
Therefore, juices should be consumed an hour before or two hours after
administration of amphetamines.8
• The combination of alcohol and
methamphetamine makes the heart work harder and consume more oxygen,
which may produce unwanted effects.12 Alcohol consumption may also
suppress the breakdown of amphetamines, causing elevations in blood
levels of the drug.13 Individuals taking amphetamines should avoid
alcoholic beverages, especially if they have known heart problems.9
• The following herbs may have
cardioactive or sedative properties that could interact dangerously
with Adderall: Astragalus, Catnip, Dong quai, Feverfew, Fo-ti, Guarana,
Kava, Kelp plant, Lady’s slipper, Lavender, Linden tree, Lobelia,
Marigold, Passion flower, Chamomile, Slippery elm, St. John’s wort, and
Yohimbe.10
• Eucalyptus may decrease the
effectiveness of drugs like Adderall by increasing its clearance from
the body.11
• It may be advisable to avoid ginseng
with Adderall due to its stimulant properties.12
• Ephedra sinica contains a compound
called ephedrine. A seven-year-old boy who had 12 mg of ephedrine twice
daily added to his dextroamphetamine therapy experienced improvement in
hyperactive behavior.9 He also experienced relief from symptoms, such
as headaches and spots before his eyes, that may have been caused by
dextroamphetamine. However, concurrent use of amphetamines with other
stimulants such as ephedrine or Ephedra sinica could cause excessive
stimulation of the heart or nervous system. For this reason, such
combinations should be used with great caution, and only under the
supervision of a doctor.13
• Veratrum (Hellebore) is an herb used
by doctors of natural medicine to treat high blood pressure;however,
amphetamines can inhibit this effect.10 Therefore, people taking
veratrum to treat hypertension should avoid amphetamines.14
References
1 Pronsky, Z Food Medication
Interactions, 11th edition, 1999
2 1. Schmidt ME, Kruesi MJ, Elia J, et al. Effect of
dextroamphetamine and methylphenidate on calcium and
magnesium concentration in hyperactive boys. Psychiatry Res
1994;54:199–210.
2 2. Hurwitz A. Antacid therapy and drug kinetics. Clin
Pharmacokinet 1977;2:269–80
2 3. Reviewed in Schmidt ME, Kruesi MJ, Elia J, et al. Effect
of dextroamphetamine and methylphenidate on calcium and
magnesium concentration in hyperactive boys. Psychiatry Res
1994;54:199–210.
3 4. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ:
Medical Economics Company, Inc., 2000, 2953–4.
4 5. McTavish SF, McPherson MH, Sharp T, Cowen PJ.
Attenuation of some subjective effects of amphetamine following
tyrosine depletion. J Psychopharmacol 1999;13:144–7.
5 6. Sifton, DW, ed. Physicians Desk Reference. Montvale, NJ:
Medical Economics Company, Inc., 2000, 2953–4.
6 7. Frye PE, Arnold LE. Persistent amphetamine-induced
compulsive rituals: response to pyridoxine (B6). Biol Psychiatry
1981;16:583–7.
7 8. Irwin MR, Marder SR, Fuentenebro F, Yuwiler A.
L-5-hydroxytryptophan attenuates positive psychotic symptoms induced by
D-amphetamine. Psychiatry Res 1987;22:283–9.
8 11. Sifton DW, ed. Physicians Desk Reference. Montvale, NJ:
Medical Economics Company, Inc., 2000, 2953–4.
9 12. Mendelson J, Jones RT, Upton R, Jacob P 3rd.
Methamphetamine and ethanol interactions in humans. Clin Pharmacol Ther
1995;57:559–68.
9 13. Shimosato K. Urinary excretion of p-hydroxylated
methamphetamine metabolites in man. II. Effect of alcohol intake on
methamphetamine metabolism. Pharmacol Biochem Behav 1988;29:733–40.
10 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996.
10 Blumenthal, M (Ed.): The Complete German Commission E
Monographs: Therapeutic Guide to Herbal Medicines. American Botanical
Council. Austin, TX. 1998.
10 Facts and Comparisons, The Review of Natural Products,
Clinisphere 2.0, Wolters Kluwer Company, 2000
11 Jori A, Bianchetti A, Prestini PE, Garattini S: Effects of
eucalyptol on the metabolism of other drugs in rats and in man, Eur. J.
pharmacol, 9:362-6, 1970
11 Brinker, F Herb Contraindications and Drug Interactions,
Eclectic Medical Publications, 1998
12 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996.
13 9. Scanlon J. Treatment of hyperkinetic child with
dextroamphetamine and ephedrine. Pediatrics 1970;46:975–6.
14 10. Sifton DW, ed. Physicians Desk Reference. Montvale,
NJ: Medical Economics Company, Inc., 2000, 2953–4.
Adriamycin
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied
Health
• nutrient affected by drug: Vitamin B2
(Riboflavin) Doxorubicin can interfere with the normal metabolism and
function of vitamin B2 and increase it urinary excretion. Doxorubicin
has been shown to form a 1:1 stoichiometric complex with riboflavin, as
well as to compete for binding to tissue proteins.1
• Research with rats has demonstrated
riboflavin deficiency due to doxorubicin, even when dietary sources of
riboflavin have been sufficient. Studies by Pinto et al has
demonstrated that the increased levels in aldosterone associated with
doxorubicin are the result of the drug's inhibition of flavin coenzyme
biosynthesis. They concluded that their findings with rat studies
suggest that flavins play a decisive role in regulating the levels of
aldosterone and raise the possibility that the doxorubicin-induced
increase in serum aldosterone may be part of the pathogenetic
mechanisms of cardiovascular toxicity and overall muscular weakness.
Research looking at adverse effects, especially doxorubicin-induced
mortality, has indicated that supplementation with riboflavin may
reduce adverse side effects and enhance survival rates.2
• Antioxidant action reduces cardiac
toxicity. However, as a strong antioxiidant and as an effective
promoter of glutathione activity, vitamin C could potentially inhibit
the therapeutic mechanism of doxorubicin which relies upon the
cytotoxic effect of free radical formation.3
• Animal studies, using mice and guinea
pigs, indicated that vitamin C significantly increased life expectancy
by reducing the cardiotoxicity of doxorubicin; this positive effect was
gained without interfering with the drug's anticancer effects. However,
the relationship between these findings based on animal studies and
human clinical cardiac toxicity is uncertain. Supplementation of
vitamin C at doses of one or more grams per day is prescribed by some
practitioners as nutritional support for patients taking doxorubicin,
even though the practice lacks conclusive data based on human studies4
• Initial research by Prasad et al
suggested that supplementation with vitamin E might reduce cardiac and
skin toxicity due to doxorubicin. Research studies with animals have
found that vitamin E's potent antioxidant activity can protect against
Adriamycin-induced cardiotoxicity; hence reducing the risk of heart
failure which is a serious side effect associated with doxorubicin.5
• No conclusive evidence has come forth
confirming the cardioprotective effect of vitamin E in human trials.
Nevertheless, some evidence suggests that supplementation with vitamin
E may allow use of higher doses of doxorubicin without correspondingly
increasing toxicity.6
• Anecdotal reports indicate that very
high doses of vitamin E (1600 IU) may reduce the amount of alopecia
(hair loss) resulting from use of doxorubicin. (Wood LA. N Engl J Med
1985;312:1060 ) As of yet, no research on humans has duplicated the
protective effect against hair loss found in one study with rabbits
nutritional support: Supplementation of vitamin E at doses of 800 IU or
more is prescribed by some practitioners as nutritional support for
patients taking doxorubicin, even though no decisive evidence has
emerged showing that the vitamin reduces drug toxicity or protects
against hair loss.7
• In vitro evidence suggests that
vitamin E enhances the growth inhibitory effect of doxorubicin, at
least in a test tube.8
• Research has found that N-acetyl
cysteine (NAC) exerts a protective effect from the cardiotoxicity of
doxorubicin, at least in animals; no research with human has yet
confirmed these results. The prescription of oral NAC for individuals
receiving doxorubicin therapy is not a common practice among
nutritionally-oriented physicians.9
• Coenzyme Q10 reduces free radical
formation induced by doxorubicin. Studies with both animals and humans
have found that pretreating with coenzyme Q10, at levels of 100 mg per
day, reduces cardiac toxicity caused by doxorubicin. Coenzyme Q10
reduces free radical formation induced by doxorubicin.10
• Individuals taking doxorubicin
(Adriamycin) may benefit from supplementation with coenzyme Q10 at some
point in their treatment protocol. However, such supplementation should
only be started after consultation with and under the close supervision
of the prescribing physician and/or a nutritionally trained healthcare
professional. Nutrients with antioxidant potential should generally be
avoided during the course of treatment with doxorubicin as there is
concern that the effectiveness of the medication might be diminished
since it relies upon free radical formation for its cytotoxic effect.
Should use of coenzyme Q10 be
agreed upon a dosage in the range of 50-100 mg three times daily would
be in the range many nutritionally oriented healthcare professionals
would use.11
• One of the vital roles of ascorbic
acid (vitamin C) is to act as an antioxidant to protect cellular
components from free radical damage. Ascorbic acid has been shown to
scavenge free radicals directly in the aqueous phases of cells and the
circulatory system. Ascorbic acid has also been proven to protect
membrane and other hydrophobic compartments from such damage by
regenerating the antioxidant form of vitamin E. In addition, reduced
coenzyme Q, also a resident of hydrophobic compartments, interacts with
vitamin E to regenerate its antioxidant form. The mechanism of vitamin
C antioxidant function, the myriad of pathologies resulting from its
clinical deficiency, and the many health benefits it provides, are
reviewed12
• nutrient affecting drug toxicity:
N-acetyl Cysteine (NAC), a precursor to Glutathione. Antioxidant action
reduces cardiac toxicity of doxorubicin13
• There are no Herbal considerations at
this time14
References
1 Pinto J, et al. Cancer 1986 Oct
15;58(8 Suppl):1911-1914
2 Ogura R, et al. J Nutr Sci Vitaminol (Tokyo). 1991
Oct;37(5):473-477; Raiczyk GB, et al. Proc Soc Exp Biol Med 1988
Sep;188(4):495-499; Pinto JT, et al. Endocrinology 1990
Sep;127(3):1495-1501
3 Labriola D, Livingston R. Oncology (Huntingt). 1999
Jul;13(7):1003-1008.
4 Fujita, K, et al. Cancer Res 1982;42:309-316; Shimpo K, et
al. Am J Clin Nutr 1991 Dec;54(6 Suppl):1298S-1301S; Ellison, NM,
Londer H. 1981
5 Prasad KN, et al. Proc Soc Exp Biol Med 1980
Jun;164(2):158-163; Ellison NM. Cancer Bull 1985;37(3):112-113; Am
Heart J 1986;lll:95; Myers C, et al. Cancer Treat Rep 1976;60:961-962;
Sonneveld P. Cancer 1978;62:1033-1036
6 Ellison, NM, Londer H. 1981; Weiji NI, et al. Cancer
Treatment Rev 1997,23:209-210
7 Weiji NI, et al. Cancer Treatment Rev 1997;23:209-240.
8 Ripoll EAP, et al. J Urol 1986;136:529-531
8 Ellison, NM. Relationship between vitamin E and cancer -
facts, not fancy. Cancer Bull 1985;37(3):112-113
8 Ellison, NM, Londer H. Vitamin E and C and their
relatiuonship to cancer. In: Newell GR, Ellison NM, eds. Nutrition and
Cancer: Etiology and Treatment. New York: Raven Press, 1981.
9 Schmitt-Graff A, et al. Pathol Res Pract. 1986
May;181(2):168-74; Martinez E, Domingo P. Lancet 1991;338:249; Doroshow
JH, et al. J Clin Invest 1981;68:1053-1064; Meyers C, et al. Semin
Oncol 1983;10:53-55
10 Gaby, AR.1987; Judy WV, et al. 1984,231-241; Ogura R, et
al. J Appl Biochem 1979,1:325;
10 Folkers K. 1985; Gaby, AR. 1987; Anonymous. Nutr Rev
1988;46:1367; Beyer RE. Biochem Cell Biol 1992 70(6):390-403
10 Shinozawa S, et al. Biol Pharm Bull. 1993
Nov;16(11):1114-1117; Shinozawa S, et al. Acta Med Okayama. 1991
Jun;45(3):195-199; Shinozawa S, et al. Acta Med Okayama.
10 Acta Med Okayama. 1991 Jun;45(3):195-199; Shinozawa S, et
al. Acta Med Okayama. 1987 Feb;41(1):11-17; Shinozawa S, et al. Acta
Med Okayama. 1984 Feb;38(1):57-63; Labriola D, Livingston R. Oncology
(Huntingt). 1999 Jul;13(7):1003-1008
11 Anonymous. Vitamin E and cell injury. Nutr Rev
1988;46:1367.
11 Doroshow JH, Locker GY, Ifrim I, Myers CE. Prevention of
doxorubicin cardiac toxicity in the mouse by N-acetylcysteine. J Clin
Invest 1981 Oct;68(4):1053-1064
11 Beyer RE. An analysis of the role of coenzyme Q in free
radical generation, and as an antioxidant. Biochem Cell Biol 1992
70(6):390-403
11 Doroshow JH, Locker GY, Ifrim I, Myers CE. Prevention of
doxorubicin cardiac toxicity in the mouse by N-acetylcysteine. J Clin
Invest 1981 Oct;68(4):1053-1064.
11 Ellison, NM. Relationship between vitamin E and cancer -
facts, not fancy. Cancer Bull 1985;37(3):112-113.
11 Ellison, NM, Londer H. Vitamin E and C and their
relatiuonship to cancer. In: Newell GR, Ellison NM, eds. Nutrition and
Cancer: Etiology and Treatment. New York: Raven Press, 1981.
11 Folkers K. Basic chemical research on coenzyme Q10 and
integrated clinical research on therapy of diseases. In: Lenaz G, ed.
Coenzyme Q. John Wiley and Sons, 1985.
11 Fujita K, Shinpo K, Yamada K, Sato T, Niimi H, Shamoto M,
Nagatsu T, Takeuchi T, Umezawa H. Reduction of Adriamycin toxicity by
ascorbate in mice and guinea pigs. Cancer Res 1982 Jan;42(1):309-316.
11 Judy, WV, Hall, JH, Dugan, W, et al. Coenzyme Q10
reduction of Adriamycin cardiotoxicity. In Biomedical and Clinical
Aspects of Coenzyme Q, vol.4, ed. Folkers, K, Yamamura, Y. Amsterdam:
Elsevier/North Holland Biomedical Press, 1984,231-241.
11 Labriola D, Livingston R. Possible interactions between
dietary antioxidants and chemotherapy. Oncology (Huntingt). 1999
Jul;13(7):1003-1008; discussion 1008, 1011-1012.
11 Martinez, E, Domingo, P. N-acetylcysteine as
chemoprotectant in cancer chemotherapy. Lancet 1991 Jul
27;338(8761):249. (Letter)
11 Myers C, Bonow R, Palmeri S, Jenkins J, Corden B, Locker
G, Doroshow J, Epstein S. A randomized controlled trial assessing the
prevention of doxorubicin cardiomyopathy by N-acetylcysteine. Semin
Oncol 1983 Mar;10(1 Suppl 1):53-55.
11 Myers, C, McQuire, W, Young, R. Adriamycin amelioration of
toxicity by alpha-tocopherol. Cancer Treat Rep 1976 Jul;60(7):961-962.
11 Ogura R, Ueta H, Hino Y, Hidaka T, Sugiyama M. Riboflavin
deficiency caused by treatment with adriamycin. J Nutr Sci Vitaminol
(Tokyo). 1991 Oct;37(5):473-477
11 Ogura R, Toyama H, Shimada T, Murakami M. The role of ubiquinone (Coenzyme
Q10) in preventing Adriamycin-induced mitochondrial disorders in rat
heart. J Appl Biochem 1979,1:325.
11 Okamoto K, Ogura R. Effects of vitamins on lipid
peroxidation and suppression of DNA synthesis induced by adriamycin in
Ehrlich cells. J Nutr Sci Vitaminol (Tokyo) 1985 Apr;31(2):129-137.
11 Pinto JT, Delman BN, Dutta P, Nisselbaum J.
Adriamycin-induced increase in serum aldosterone levels: effects in
riboflavin-sufficient and riboflavin-deficient rats. Endocrinology 1990
Sep;127(3):1495-1501.
11 Pinto J, Raiczyk GB, Huang YP, Rivlin RS. New approaches
to the possible prevention of side effects of chemotherapy by
nutrition. Cancer 1986 Oct 15;58(8 Suppl):1911-1914.
11 Prasad KN, Edwards-Prasad J, Ramanujam S, Sakamoto A.
Vitamin E increases the growth inhibitory and differentiating effects
of tumor therapeutic agents on neuroblastoma and glioma cells in
culture. Proc Soc Exp Biol Med 1980 Jun;164(2):158-163.
11 Ripoll, EAP, Rama, BN, Webber, MM. Vitamin E enhances the
chemotherapeutic effects of Adriamycin on human prostatic carcinoma
cells in vitro. J Urol 1986 Aug;136(2):529-531.
11 Raiczyk GB, Rivlin RS, Pinto J. Enhancement of
adriamycin-induced mortality during riboflavin administration and
riboflavin deficiency in rats. Proc Soc Exp Biol Med 1988
Sep;188(4):495-499.
11 Shinozawa S, Kawasaki H, Gomita Y. [Effect of biological
membrane stabilizing drugs (coenzyme Q10, dextran sulfate and reduced
glutathione) on adriamycin (doxorubicin)-induced toxicity and
microsomal lipid peroxidation in mice]. Gan To Kagaku Ryoho. 1996
Jan;23(1):93-98. [Article in Japanese]
11 Shinozawa S, Gomita Y, Araki Y. Protective effects of
various drugs on adriamycin (doxorubicin)-induced toxicity and
microsomal lipid peroxidation in mice and rats. Biol Pharm Bull. 1993
Nov;16(11):1114-1117.
11 Shinozawa S, Gomita Y, Araki Y. Tissue concentration of
doxorubicin (adriamycin) in mouse pretreated with alpha-tocopherol or
coenzyme Q10. Acta Med Okayama. 1991 Jun;45(3):195-199.
11 Shinozawa S, Gomita Y, Araki Y. Protection against
adriamycin (doxorubicin)-induced toxicity in mice by several clinically
used drugs. Acta Med Okayama. 1987 Feb;41(1):11-17.
11 Shinozawa S, Etowo K, Araki Y, Oda T. Effect of coenzyme Q10 on the
survival time and lipid peroxidation of adriamycin (doxorubicin)
treated mice. Acta Med Okayama. 1984 Feb;38(1):57-63.
11 Schmitt-Graff A, Scheulen ME. Prevention of adriamycin
cardiotoxicity by niacin, isocitrate or N-acetyl-cysteine in mice. A
morphological study. Pathol Res Pract. 1986 May;181(2):168-74.
11 Shimpo K, Nagatsu T, Yamada K, Sato T, Niimi H, Shamoto M,
Takeuchi T, Umezawa H, Fujita K. Ascorbic acid and adriamycin toxicity.
Am J Clin Nutr 1991 Dec;54(6 Suppl):1298S-1301S
11 Sonneveld, P. Effect of alpha-tocopherol on the
cardiotoxicity of Adriamycin in the rat. Cancer 1978
Jul;62(7):1033-1036.
11 Weiji NI, Cleton, F.T, Osanto S. Free radicals and
antioxidants in chemotherapy-induced toxicity. Cancer Treatment Rev
1997 Jul;23(4):209-240. (Review)
11 Wood, LA. Possible prevention of Adriamycin-induced
alopecia by tocopherol. N Engl J Med 1985;312:1060. (Letter)
12 J Bioenerg Biomembr. 1994 Aug;26(4):349-58
12 Department of Biology, University of Michigan, Ann Arbor
48109
12 PMID: 7844109 [PubMed - indexed for MEDLINE
13 Schmitt-Graff A, et al. Pathol Res Pract. 1986
May;181(2):168-74; Martinez E, Domingo P. Lancet 1991;338:249; Doroshow
JH, et al. J Clin Invest 1981;68:1053-1064; Meyers C, et al. Semin
Oncol 1983;10:53-55
Agenerase
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied
Health
• Agenerase Capsules - Each Agenerase
pill contains 109 IU of vitamin E per capsule. This means that if
you're taking Agenerase, you're also taking 1,744 IU of vitamin E per
day. Because vitamin E can thin the blood, you should not take any
other vitamin E supplements in addition to Agenerase. People taking
blood-thinning drugs should talk to their doctor about the amount of
vitamin E in Agenerase to make sure it isn't dangerous to your health.
If you are taking a blood-thinning medication or you have low vitamin
K, your doctor will decide if the amount of vitamin E in Agenerase
interferes with your treatment.1
• Agenerase may increase the amount of
fat in your body or you may notice changes in the location of your body
fat. Tell your doctor if you experience any changes like these.2
• Agenerase can be taken with or
without food. However, a high fat meal may decrease the absorption of
this medication.3
• Do not use St. John’s wort with this
medication.4
• Do not take this medication with
HMG-CoA reductase inhibitors, which would include the herb Red Yeast
Rice.5
• Due to the amount of vitamin E in
this medication, there may thinning of the blood. The following herbs
may contribute to blood thinning and should not be used while taking
this medication: Angelica, Anise, Arnica, Asafoetida, Bogbean,
Capsicum, Celery, Chamomile, Danshen, Fenugreek, Feverfew, Garlic,
Ginger, Ginkgo, Ginseng (Panax), Gotu kola, Horse chestnut, Licorice,
Meadowsweet, Papain, Prickly ash, Poplar, Quassia, Red clover, Rue, and
Willow.6
References
1 Reference: GlaxoSmithKline studies
on Agenerase. October 2002.
2 Reference: GlaxoSmithKline studies on Agenerase. October
2002.
3 Reference: GlaxoSmithKline studies on Agenerase. October
2002.
4 Reference: GlaxoSmithKline studies on Agenerase. October
2002.
5 Reference: GlaxoSmithKline studies on Agenerase. October
2002.
6 Gadkari, et al. Effect of ingestion of raw garlic on serum
cholesterol levels, clotting time and fibrinolytic activity in normal
subjects. J Postgrad Med 1991;37:128-31.
6 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996.
6 Janetsky, K et al. Probably interaction between warfarin
and ginseng. Am J Health-Syst Pharm 1997;54:692-93.
6 Kleijnen J, Knipschild P. Ginkgo biloba. Lancet
1992;340:1136-39.
6 PDR for Herbal Medicines, 2nd edition, Medical Economics
Company, 2000
Akineton
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied
Health
• Avoid alcohol with this medication.1
• Take with food for stomach upset.2
• Take plenty of fluids with this
medication, unless otherwise directed by a physician.3
• The following herbs have sedative
qualities and could intensify the effects of this medication: calamus,
calendula, chamomile, California poppy, catnip, couch grass,
elecampane, ginseng Siberian, goldenseal, gotu kola, hops, Jamaican
dogwood, kava, lemon balm, sage, St. John's wort, sassafras, scullcap,
shepherd's purse, stinging nettle, valerian, withania root, and yerba
mansa.4
• Anticholinergic side effects and
adverse reactions may increase if chinese club moss, henbane and thorn
apple are used with anticholinergic drugs.5
References
1 Facts and Comparisons, Clinisphere
2.0, Wolters Kluwer Company, 2000
2 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer
Company, 2000
3 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer
Company, 2000
4 PDR for Herbal Medicines, 2nd edition, Medical Economics
Company, 2000
4 The Review of Natural Products, Clinisphere 2.0, Wolters
Kluwer Company, 2000
4 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996.
5 Blumenthal, M (Ed.): The Complete German Commission E
Monographs: Therapeutic Guide to Herbal Medicines. American Botanical
Council. Austin, TX. 1998.
5 PDR for Herbal Medicines, 2nd edition, Medical Economics
Company, 2000
5 The Review of Natural Products, Clinisphere 2.0, Wolters
Kluwer Company, 2000
Albuterol
Sulfate
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied
Health
• This drug may induce hyperglycemia.
It is important to limit sugar intake and strictly monitor blood
glucose levels, particularly if you are diabetic.1
• The use of caffeine should be limited
when using this medication.2
• Albuterol may interact with these
herbs to increase cardiovascular side effects. They include Blue
Cohosh, Goldenseal, Hawthorn, and Motherwort3
• Albuterol may interact with Licorice,
Ginseng and Ephedra (Ma Huang) to overstimulate the cardiovascular
system.4
References
1 Smith AP, Banks J, Cheong, B,
Gunawardena: Mechanisms of abnormal glucose metabolism during the
treatment of acute severe asthma. Quart J Med. 1992; NS82:71-80.
1 Pronsky, Z Food Medication Interactions, 11th edition, 1999
2 Pronsky, Z Food Medication Interactions, 11th edition, 1999
2 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer
Company, 2000
3 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996.
3 Facts and Comparisons, The Review of Natural Products,
Clinisphere 2.0, Wolters Kluwer Company, 2000
3 PDR for Herbal Medicines, 2nd edition, Medical Economics
Company, 2000
4 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996.
4 PDR for Herbal Medicines, 2nd edition, Medical Economics
Company, 2000
Alesse
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied
Health
• Extended use of Allese-28 may cause
deficiencies in folic acid, iron, magnesium, zinc, and vitamins B2, B6,
B12, and C. Supplementation may be recommended with long term use of
the medication.1
• Allese-28 may cause levels of vitamin
A ,K, iron and copper to increase. Discuss dietary considerations in
relation to these increases with your physician or pharmacist.2
• Caffeine intake should be limited.
Hormonal contraceptive agents may increase the effect of caffeine.3
• Herbs that may affect Allese-28
include Blue cohosh, Licorice, Red Sage, Skullcap.4
• The following herbs may be hormonally
active and could disturb the action of Allese-28: Agnus Castus, Black
Cohosh, Ginseng, Motherwort, Pleurisy Root, Red Clover, Saw
Palmetto,and Vervain5
References
1 Van Nostrand Reinhold: Oral
contraceptives and nutrient interactions, 1988:38.
1 Lindenbaum J, Whitehead N, Reyner F. Oral contraceptive
hormones, folate metabolism,
and the cervical epithelium. Am J Clin Nutr 1975;28:346-53.
1 Frassinelli-Gunderson EP, Margen S, Brown JR. Iron stores
in users of oral contraceptive agents. Am J Clin Nutr 1985;41(4):703.
1 Adams PW, Wynn V, Rose DP, et al. Effect of pyridoxine
hydrochloride (vitamin B6) upon depression associated with oral
contraception. Lancet 1973;I:897-904.
1 Wynn V. Vitamins and oral contraceptive use. Lancet
1975;1:561-64.
1 Holt GA. Food & Drug Interaction. Chicago: Precept
Press, 1998, 197-98.
1 Werbach MR. Foundations of Nutritional Medicine. Tarzana,
CA: Third Line Press, 1997, 210-11 [review].
1 Kornberg A, Segal R, Theitler J, et al: Folic acid deficiency,
megaloblastic anemia and peripheral polyneuropathy due to oral
contraceptives, Isr J Med Sci, 1989, 25 (3): 142-5.
1 Harper JM, Levine AJ, Rosenthal DL, et al: Erythrocyte folate levels, oral
contraceptive use and abnormal cervical cytology, Acta Cytol, 1994, 38
(3): 324-30.
1 Blum M, Kitai E, Ariel Y, Et Al: Oral Contraceptive Lowers
Serum Magnesium, Harefuah, 1991, 121 (10):363-4.
1 Seelig Ms, Interrelationship Of Magnesium And Estrogen In
Cardiovascular And Bone Disorders, Eclampsia, Migraine, And
Premenstrual Syndrome, J Am Coll Nutr, 1993, 12(4):442-58.
1 Webb JL, Nutritional effects of oral contraceptive use, a
review, J Reprod Med, 1980, 25 (4): 150-6.
1 Prasad AS, Lei KY, Moghissi KS, et al: Effect of oral
contraceptives on nutrients III - Vitamins B6, B12, and folic acid, Am
J Obstet Gynecol, 1976, 125(8):1063-9.
1 Bhagavan HN, Brin M: Drug-Vitamin B6 Interaction, Curr
Concepts Nutr, 1983, 12:1-12.
1 Kishi H, Kishi T, Williams RH, et al: Deficiency of vitamin
B6 in women taking contraceptive formulations, Res Commun Chem Pathol
Pharmacol, 1997, 17(2):283-93.
1 Rivers JM: Oral contraceptives and ascorbic acid, Am J Clin
Nutr, 1975, 28(5):550-4.
1 Weininger J, King JC: Effect of oral contraceptive agents
on ascorbic acid metabolism in the rhesus monkey, Am J Clin Nutr, 1982,
35(6):1408-16.
1 Muneyvirci-Delale O, Nacharaju VL, Altura BM, et al: Sex
steroid hormones modulate serum ionized magnesium and calcium levels
throughout the menstrual cycle in women, Gertil Steril, 1998,
69(5):958-62.
2 Werbach MR. Foundations of Nutritional Medicine. Tarzana,
CA: Third Line Press, 1997, 210-11 [review].
2 Wynn V. Vitamins and oral contraceptive use. Lancet
1975;1:561-64.
2 Horwitt MK, Harvey CC, Dahm CH Jr. Relationship between
levels of blood lipids, vitamins C, A, and E, serum copper compounds,
and urinary excretions of tryptophan metabolites in women taking oral
contraceptive therapy. Am J Clin Nutr. 1975 Apr;28(4):403-12.
2 Smith JL, Goldsmith GA, Lawrence JD. Effects of oral
contraceptive steroids on vitamin and lipid levels in serum. Am J Clin
Nutr. 1975 Apr;28(4):371-6.
2 Webb JL. Nutritional effects of oral contraceptive use: a
review. J Reprod Med. 1980 Oct;25(4):150-6. Review.
3 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer
Company, 2000
4 Zava, DT: Estrogen and progestin bioactivity of foods,
herbs and spices. Proc. Soc. Exp. Biol. Med. 1998, 217:369-378.
4 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996.
5 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996.
5 PDR for Herbal Medicines, 2nd edition, Medical Economics
Company, 2000
Aleve
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied
Health
• Folate and vitamin C
supplementation may be helpful with long term use of the medication.1
• Vitamin E intake with NSAIDs may
increase risk of bleeding.2
• Chondroitin sulfate has some
anti-platelet properties; consult a pharmacist prior to using NSAID's
and chondroitin together due to the increased potential for bleeding.3
• Take with food to avoid stomach upset.4
• Ulcers induced by NSAIDs may be
minimized by Licorice.5
• Due to their blood-thinning
properties, taking angelica, anise, arnica, asafoetida, bogbean, boldo,
danshen, fenugreek, feverfew, garlic, ginger, ginkgo, ginseng (Panax),
horse chestnut, meadowsweet, prickly ash, passionflower, poplar,
quassia, red clover, turmeric, and willow with NSAIDs may increase
adverse reactions and side effects.6
• Avoid feverfew with NSAID's, the
herbs' effect may theoretically be reduced.7
References
1 Baggott JE, Morgan SL, Ha T, et al.
Inhibition of folate-dependent enzymes by non-steroidal anti-inflammatory drugs.
Biochem J 282: 197-202, 1992.
1 Lawrence VA, Loewenstein JE, and Eichner ER. Aspirin and folate binding: in
vivo and in vitro studies of serum binding and urinary excretion of
endogenous folate. J Lab Clin Med 103: 944-948, 1984.
1 Molloy TP and Wilson CW. Protein-binding of ascorbic acid.
Interaction with acetylsalicylic acid. Int J Vitam Nutr Res 50:
387-392, 1980.
1 Das N and Nebioglu S. Vitamin C-aspirin interactions in
laboratory animals. J Clin Pharm Ther 17: 343-346, 1992.
2 Liede KE, Haukka JK, Saxen LM, et al. Increased tendency
toward gingival bleeding caused by joint effect of alpha-tocopherol
supplementation and acetylsalicylic acid. Ann Med 30: 542-546, 1998.
2 Steiner M. Vitamin E, a modifier of platelet function:
rationale and use in cardiovascular and cerebrovascular disease. Nutr
Rev. 1999 Oct;57(10):306-9.
3 Griffith, Winter H MD Vitamins, herbs, minerals and
supplements- the complete guide. Revised edition. Fisher books, 1998.
3 McKevoy GK, ed. AHFS Drug Information. Bethesda, MD:
American Society of Health-System Pharmacists, 2000.
4 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer
Company, 2000
4 Pronsky, Z Food Medication Interactions, 11th edition, 1999
5 Brinker, F Herb Contraindications and Drug Interactions,
Eclectic Medical Publications, 1998
5 Rees WDW, Rhodes J, Wright JE, et al. Effect of
deglycyrrhizinated liquorice on gastric mucosal damage by aspirin.
Scand J Gastroenterol 14: 605-607, 1979.
6 Rosenblatt M and Mindel J. Spontaneous hyphema associated
with ingestion of Ginkgo biloba extract. N Engl J Med 336(15): 1108,
1997.
6 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996.
6 PDR for Herbal Medicines, 2nd edition, Medical Economics
Company, 2000
6 The Review of Natural Products, Facts and Comparisons,
Clinisphere 2.0, Wolters Kluwer Company, 2000
7 Miller LG. Herbal medicinals: selected clinical
considerations focusing on known or potential drug-herb interactions.
Arch Int Med 1998;158(20):2200-11.
7 The Review of Natural Products, Facts and Comparisons,
Clinisphere 2.0, Wolters Kluwer Company, 2000
Allegra
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied
Health
• These types of agents may increase
thirst, drink plenty of fluids, unless otherwise directed.1
• Avoid or limit alcohol use with these
agents.2
• Avoid calamus, calendula, California
poppy, catnip, couch grass, elecampane, gotu kola, hops, Jamaican
dogwood, kava, lemon balm, sage, St. John's wort, sassafras, shepherd's
purse, stinging nettle, valerian, wild carrot, wild lettuce, withania
root, and yerba mansa while taking Allegra due to possible increased
sedative effects.3
References
1 Facts and Comparisons, Clinisphere
2.0, Wolters Kluwer Company, 2000
2 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996:21,45,63,282.
2 Brinker, F Herb Contraindications and Drug Interactions,
Eclectic Medical Publications, 1998
3 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996.
3 Brinker, F Herb Contraindications and Drug Interactions,
Eclectic Medical Publications, 1998
3 PDR for Herbal Medicines, 2nd edition, Medical Economics
Company, 2000
Allopurinol
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied
Health
• Consume adequate fluids, unless
otherwise directed to keep urine alkaline.1
• Allopurinol may contribute to iron
depletion, and iron supplementation may be beneficial.2
• Take with food or milk to reduce
stomach upset.3
• Avoid large doses of vitamin C, this
may contribute to an increased risk of kidney stones with allopurinol.4
• Allopurinol may theoretically
increase the length of action of anticoagulant herbs, based on its
known interaction with warfarin. These herbs include : Angelica, anise,
arnica, asafoetida, bogbean, boldo, danshen, fenugreek, feverfew,
garlic, ginger, ginkgo, ginseng (Panax), horse chestnut, licorice,
meadowsweet, prickly ash, passionflower, poplar, quassia, red clover,
turmeric, and willow.5
References
1 Pronsky, Z Food Medication
Interactions, 11th edition, 1999
1 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer
Company, 2000
2 Park GD, Berlinger WG, Spector R, Kitt TM, Tsalikian E:
Sustained reductions in oxypurinol renal clearance during a restricted
diet, Clinical Pharmacol Ther, 1987; 41:616-621.
2 Lin YW, Okazaki S, Hamahata K, Watanabe K, Usami I,
Yoshibayashi M, Akiyama Y, Kubota M. Acute pure red cell aplasia
associated with allopurinol therapy. Am J Hematol. 1999
Jul;61(3):209-11.
3 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer
Company, 2000
3 Pronsky, Z Food Medication Interactions, 11th edition, 1999
4 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer
Company, 2000
4 Pronsky, Z Food Medication Interactions, 11th edition, 1999
5 Brinker, Francis: Herb Contraindications and Drug
Interactions, Eclectic Medical Publications, 1998
5 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996.
Alora
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied
Health
• Studies have shown that grapefruit
juice significantly increases estradiol levels in the blood. Do not
drink grapefruit juice or eat grapefruit while taking this medication.1
• It may also be possible that
supplements containing quercetin also increase the levels of estradiol
in the blood. Talk to your pharmacist if you are taking any supplements
that contain this nutrient.2
• This drug may increase risk of folic acid deficiency,
which could affect reproductive and cardiovascular health.
Supplementation is considered beneficial.3
• Vitamin C may result in increased
estrogen effects.4
• The following herbs may affect
hormone levels: Agnus Castus (Vitex), Alfalfa, Bayberry, Black Cohosh,
Dong Quai, Ginseng, Horseradish, Licorice Root, Pleurisy Root, Red
Clover, Red Sage, Saw Palmetto, Tobacco, Vervain, and Wild Yam. Consult
your pharmacist for more information.5
References
1 Schubert W, Cullberg G, Edgar B,
Hedner T. Inhibition of 17 beta-estradiol metabolism by grapefruit
juice in ovariectomized women. Maturitas 1994;20:155-63.
1 Schubert W, Eriksson U, Edgar B, et al. Flavonoids in
grapefruit juice inhibit the in vitro hepatic metabolism of 17
beta-estradiol. Eur J Drug Metab Pharmacokinet 1995;3:219-24.
1 Weber A, Jager R, Borner A, et al. Can grapefruit juice
influence ethinylestradiol bioavailability? Contraception 1996;53:41-7.
2 Kuiper GG, Lemmen JG, Carlsson B, et al. Interaction of
estrogenic chemicals and phytoestrogens with estrogen receptor beta.
Endocrinology 1998;139:4252-63.
3 Kornberg A, Segal R, Theitler J, et al: Folic acid deficiency,
megaloblastic anemia and peripheral polyneuropathy due to oral
contraceptives, Isr J Med Sci, 1989, 25 (3): 142-5.
3 Harper JM, Levine AJ, Rosenthal DL, et al: Erythrocyte folate levels, oral
contraceptive use and abnormal cervical cytology, Acta Cytol, 1994, 38
(3): 324-30.
4 Blum M, Kitai E, Ariel Y, Et Al: Oral Contraceptive Lowers
Serum Magnesium, Harefuah, 1991, 121 (10):363-4.
5 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996.
5 Brinker, F Herb Contraindications and Drug Interactions,
Eclectic Medical Publications, 1998
Alprazolam
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied
Health
• Alcohol can increase both the
sedative and the intoxifying effects of Alprazolam. Use of alcohol
should be avoided.1
• Melatonin levels may be diminished
with long term use of benzodiazepines like alprazolam. Consult a
pharmacist or physician regarding the need for melatonin
supplementation and the benefits of using melatonin to withdraw the use
of benzodiazepines.2
• Tobacco may increase the rate of
elimination of Alprazolam and thereby decrease its effects. Avoid using
both together.3
• The following herbs have sedative
qualities and could intensify the effects of Alprazolam: calamus,
calendula, chamomile, California poppy, catnip, couch grass,
elecampane, ginseng Siberian, goldenseal, gotu kola, hops, Jamaican
dogwood, kava, lemon balm, sage, St. John's wort, sassafras, scullcap,
shepherd's purse, stinging nettle, valerian, withania root, and yerba
mansa.4
References
1 Pronsky, ZM: Food-Medication
Interactions, 11th edition, 1999
1 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer
Company, 2000
2 Kabuto M, Namura I, Saitoh Y. Nocturnal enhancement of
plasma melatonin could be suppressed by benzodiazepines in humans.
Endocrinol Jpn. 1986 Jun;33(3):405-14.
2 McIntyre IM, Norman TR, Burrows GD, Armstrong SM.
Alterations to plasma melatonin and cortisol after evening alprazolam
administration in humans. Chronobiol Int. 1993 Jun;10(3):205-13.
2 Garfinkel D, Zisapel N, Wainstein J, et al. Facilitation of
benzodiazepine discontinuation by melatonin: a new clinical approach.
Arch Intern Med 159: 2456-2460, 1999.
3 Brinker, F Herb Contraindications and Drug Interactions,
Eclectic Medical Publications, 1998
4 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996.
4 Almeida JC. Coma from the health food store: Interaction
between kava and alprazolam. Ann Intern Med 1996;125:940-41.
4 Brinker F. Herb contraindications and drug interactions,
2nd ed. Sandy, OR: Eclectic Medical Publications, 1998
4 Speroni E, et al. Sedative effects of crude extract of
Passiflora incarnata after oral administration. Phytother Res 10:
S92-94, 1996.
4 PDR for Herbal Medicine, 2nd edition, Medical Economics
Company, 2000
4 The Review of Natural Products, Clinisphere 2.0, Wolters
Kluwer Company, 2000
Altace
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied
Health
• Avoid consuming excessive potassium
in foods and supplements when taking Altace. Be careful with salt
substitutes which contain potassium. Ask your physician or pharmacist
about the importance of electrolyte balance.1
• Avoid or limit alcohol use.2
• ACE inhibitors like Altace may
contribute to a deficiency in zinc. Ask your pharmacist regarding the
need for supplementation.3
• Avoid using antacids or supplements
containing iron or magnesium within two hours of the medication.4
• Some herbs possess cardiac properties
that may intensify the action of Altace, resulting in an excessive
lowering of blood pressure or other cardiac side effects. Such herbs
include: black hellebore, calamus, cereus, cola, coltsfoot, devil's
claw, European mistletoe, fenugreek, fumitory, digitalis leaf, hedge
mustard, figwort, lily of the valley roots, motherwort, pleurisy root,
squill bulb leaf scales, white horehound, mate, scotch broom flower,
shepherd's purse, and wild carrot5
• These herbs possess diuretic
properties which may intensify the effects of altace: Alfalfa,
Angelica, Astragalus, Basil, Bean Pod, Buckthorn, Burdock, Butcher’s
Broom, Buchu, Celery, Cleavers, Cornflower, Dandelion, Elecampane,
Elder, Goat's Rue, Hempnettle, Horsetail, Indian-Hemp, Juniper,
Marigold, Meadowsweet, Parsley, Rauwolfia, Sarsaparilla, Sweet clover,
Turmeric, and Vervain.6
References
1 Burnakis TG & Mioduch HJ:
Combined therapy with captopril and potassium supplementation. A
potential for hyperkalemia. Arch Intern Med 1984; 144:2371-2372.
1 Good CB, McDermott L, McCloskey B. Diet and serum potassium
in patients on ACE inhibitors. JAMA 1995;274:538.
1 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer
Company, 2000
1 Pronsky, Z Food Medication Interactions, 11th edition, 1999
2 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer
Company, 2000
2 Pronsky, Z Food Medication Interactions, 11th edition, 1999
3 Golik A, Zaidenstein R, Dishi V, et al: Effects of
captopril and enalapril on zinc metabolism in hypertensive patients, J
Am Coll Nutr, 1998, 17(1):75-8.
3 Golik A, Modai D, Averbukh Z, et al: Zinc metabolism in
patients treated with captopril versus enalapril, Metabolism, 1990,
39(7): 665-7.
4 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer
Company, 2000
4 Campbell NR and Hasinoff BB. Iron supplements: A common
cause of drug interactions. Br J Clin Pharmacol 31: 251-255, 1991.
5 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996.
5 Brinker, F Herb Contraindications and Drug Interactions,
Eclectic Medical Publications, 1998
5 Blumenthal M, et al. ed. The Complete German Commission E
Monographs: Therapeutic Guide to Herbal Medicines. Trans. S. Klein.
Boston, MA: American Botanical Council, 1998.
5 PDR for Herbal Medicines. 2nd ed. Montvale, NJ: Medical
Economics Company, Inc., 2000.
6 PDR for Herbal Medicines, 2nd edition, Medical Economics
Company, 2000
6 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996.
Amaryl
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied
Health
• There is some evidence that
metformin, a sulfonylurea class drug may cause vitamin B12 deficiency.
Amaryl may also have similar effects, monitor blood levels periodically
with long term use of this medication.1
• High doses of niacin may increase
blood glucose levels, and excessive use of this nutrient should be
avoided in diabetes.2
• Alcohol use should be limited as it
can interfere with diabetes management.3
• Vitamin E may play a beneficial role
in protecting against diabetic complications. However, because it can
lower blood sugar levels do not supplement large doses of the vitamin
without consulting a pharmacist.4
• Potatoes can interfere with blood
sugar levels and Amaryl dosage may require adjustment.5
• The following herbs may lower blood
sugar levels: Alfalfa, Aloe vera, Bilberry, Bitter melon, Burdock,
Celery, Cornsilk, Eucalyptus, Fenugreek, Garlic, Ginger, Panax Ginseng,
Juniper, Marshmallow, Myrrh, Nettle, Onions, Sage and Tansy.6
• Licorice is contraindicated in
diabetes.7
References
1 Adams JF, Clark JS, Ireland JT, et
al: Malabsorption of vitamin B12 and intrinsic
factor secretion during biguanide therapy, Diabetologia, 1983,
24(1):16-8.
1 Berger W, Incidence of severe side effects during therapy
with sulfonylureas and biguanides, Horm Metab Res Suppl, 1985, 15:111-5.
1 Rieder HP, Berger W, and Fridrich R: Vitamin status in
diabetic neuropathy, Z Ernahrungswiss, 1980, 19 (1):1-13.
1 Carpentier JL, Bury J, Luyckx A, et al: Vitamin B12 and folic acid serum
levels in diabetics under various therapeutic regimens, Diabete Metab,
1976, 2(4):187-90.
2 McKevoy GK, ed. AHFS Drug Information. Bethesda, MD:
American Society of Health-System Pharmacists, 1998.
2 Schwartz ML. Severe reversible hyperglycemia as a
consequence of niacin therapy. Arch Intern Med. 1993 Sep
13;153(17):2050-2.
2 Roe DA. Drug and nutrient interactions in the elderly
diabetic. Drug Nutr Interact. 1988;5(4):195-203. Review.
3 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer
Company, 2000
3 Pronsky, Z Food Medication Interactions, 11th edition, 1999
4 Paolisso G, D'Amore A, Giugliano D, et al. Pharmacologic
doses of vitamin E improve insulin action in healthy subjects and
non-insulin-dependent diabetic patients. Am J Clin Nutr 57:650-656, 1993
4 Ceriello A, Giugliano D, Quatraro A, Donzella C, Dipalo G,
Lefebvre PJ. Vitamin E reduction of protein glycosylation in diabetes.
New prospect for prevention of diabetic complications? Diabetes Care.
1991 Jan;14(1):68-72.
4 Tutuncu NB, Bayraktar M, Varli K. Reversal of defective
nerve conduction with vitamin E supplementation in type 2 diabetes: a
preliminary study. Diabetes Care. 1998 Nov;21(11):1915-8.
5 Gannon MC, et al. Diabetes Care 1993;16:874.
5 The Review of Natural Products, Facts and Comparisons,
Clinisphere 2.0, Wolters Kluwer Company, 2000
6 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996.
6 Brinker F. Herb contraindications and drug interactions,
2nd ed. Eclectic Medical Publications, 1998.
6 Welihinda J, et al. Effect of Momordica charantia on the
glucose tolerance in maturity onset diabetes. J Ethnopharmacol 17:
277-282, 1986.
7 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996.
7 Brinker, F Herb Contraindications and Drug Interactions,
Eclectic Medical Publications, 1998
Ambien
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied
Health
• Do not drink alcohol with this
medication. Alcohol could intensify the effects of Ambien.1
• Many herbs have sedative qualities
and could intensify the effects of Ambien. They include: calamus,
calendula, chamomile, California poppy, catnip, couch grass,
elecampane, ginseng Siberian, goldenseal, gotu kola, hops, Jamaican
dogwood, kava, lemon balm, sage, St. John's wort, sassafras, scullcap,
shepherd's purse, stinging nettle, valerian, withania root, and yerba
mansa.2
References
1 Facts and Comparisons, Clinisphere
2.0, Wolters Kluwer Company, 2000
1 Pronsky, Z Food Medication Interactions, 11th edition, 1999
2 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines A
Guide for Health-care Professionals. London: The Pharmaceutical Press,
1996.
2 Brinker, F Herb Contraindications and Drug Interactions,
Eclectic Medical Publications, 1998
2 PDR for Herbal Medicines, 2nd edition, Medical Economics
Company, 2000
2 The Review of Natural Products, Clinisphere 2.0, Wolters
Kluwer Company, 2000
Amikacin
side effects, nutrient depletions, herbal interactions and health notes:
Data provided by Applied
Health
• reports: Animal studies and case
reports indicate that renal tubular damage due to aminoglycosides, such
as gentamicin, can lead to hypokalemia combined with hypocalcemia,
hypomagnesemia and alkalosis. adverse effects: The toxicities of
aminoglycosides include toxicity to the kidneys and ears (vestibular
and auditory) and, rarely, neuromuscular blockade and hypersensitivity
reactions. These adverse reactions are more common when aminoglycosides
are given in combination with vancomycin. Nephrotoxicity results from
renal cortical accumulation resulting in tubular cell degeneration and
sloughing. Ototoxicity is usually irreversible. The prescribing
physician should closely monitor (draw aminoglycoside and vancomycin
serum levels) patients for these potential side effects.1
• research: Akbar et al have noted that
this phenomenon may be especially common among children with cystic
fibrosis who have a history of repeated use of aminoglycosides2
• nutritional support: Individuals
using aminoglycosides, especially on a repeated or chronic basis,
should consult with their prescribing physician and/or a nutritionally
oriented healthcare professional about nutritional support to restore
normal levels of these important minerals. Patients undergoing extended
treatment with aminoglycosides may need to have their doctor regularly
monitor their kidney function along with magnesium and potassium
status. Serum creatinine, BUN and creatinine clearance should be
measured prior to initiating therapy and should be monitored throughout
treatment. In this regard, many nutritionally-or