Herbal, prescription meds a potent mix Herbal, prescription meds a potent mix (July 15, 2005)

By Dr. Ravin Agah

Q: Why are alternative medicines so popular these days? A: Actually, much of what we consider "alternative" has been in use in other countries and cultures for hundreds, even thousands, of years. About 70 percent of people over 50 take some form of alternative medicine.

Doctors of traditional (Western) medicine urge caution when using the alternative treatments because many of the practices have not been sufficiently studied, and several are incompatible with prescriptions. But using safe combinations of prescriptive and alternative medicines can be a wonderful approach to being healthy.

Q: Are all herbs safe to take with other medicines? A: Herbs can interact with your medications and cause serious side effects. It is always wise to tell your doctor or health practitioners what you are taking so that they can advise you of possible complications.

More than 350 studies of alternative medicines and herbs have been conducted, but only about 100 of them were well-designed tests. There is no consistent means of consumer education about dangerous combinations of herbs and prescriptive drugs.

Here are a few examples of known interaction between popular herbs and prescription and over-the-counter drugs:

* Ginseng has been a part of Chinese medicine for over 2,000 years. It is believed to increase energy, counter the effects of stress, and enhance intellectual and physical performance. But when taken with the blood-thinning drug Coumadin, it can cause bleeding episodes. Sometimes ginseng can cause insomnia or gastrointestinal upset. Ginseng can also cause an upsurge in estrogen which is not good, especially if you have breast cancer, for instance.
* Goldenseal, taken for coughs, stomach upsets, menstrual problems and even arthritis, can raise blood pressure, complicating treatment for those taking antihypertensive medications, especially beta-blockers. For patients taking medication to control diabetes or kidney disease, this herb can cause dangerous electrolyte imbalance.
* Feverfew is believed to be a natural remedy for migraine headaches, but it should never be taken with Imitrex or other migraine medications. It can result in the patient's heart rate and blood pressure rising to dangerous levels.
* Kava is an herb that has anti-anxiety, pain relieving, and muscle relaxing effects. The drink should not be taken with other substances that also act on the central nervous system, including alcohol, barbiturates, anti-depressants and antipsychotic drugs.
* St. John's Wort is a popular herb used for the treatment of mild depression. The active ingredient of St. John's Wort is hypericin, which, when combined with foods high in the amino acid tyramine (aged cheese, chicken liver, several kinds of red wine, yeast extracts, several kinds of processed meats, dried or pickled fish, legumes, soy sauce, ale and beer), can produce a rapid rise in blood pressure and severe headache.
Ravin Agah, M.D., is an internist specializing in internal medicine, immunology and infectious disease with Camino Medical Group.

E-mail a friend a link to this story.