drug-herb nutrient interactions_dr.dorothia dayley

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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