ØAvoid herbs containing digoxinlike substances (Digitalis lanata –yellow foxglove; Eleutherococcus senticosus –Siberian ginseng etc.)

ØAvoid use with Licorice (can cause hypokalemia)

ØAvoid use with Kyushin (crossreacts with digoxin assay)

ØHawthorn can potentiate digoxin action (synergistic effects)

ØAvoid herbal medicinals containing thujones that lower seizure threshold

Ø(Wormwood – Appetite Stimulant)

ØEvening Primrose Oil contains gamolenic acid (GLA) that lowers seizure threshold.

ØAvoid Shankapulshpi, an Ayurvedic preparation, which diminishes anti-epileptic effect.

ØAvoid Primrose Oil.

ØSeveral herbal medicinals interact with Warfarin:

ØGinseng, Arnica, Celery, Chamomile, Dan-Shen, Dong-Quai, Feverfew, Garlic, Ginger, Ginkgo.

ØAvoid use of Kava- Kava.

ØPyrone, the active component of kava, has been found to have weak effects on aminobutyric acid and benzodiazepine receptors in vitro.

Ø1994 German study group verified synergism between pyrones and other active sedatives with aminobutyric acid.

Cyclosporine

ØImmunostimulating herbs will offset or minimize the immunosuppressive effects.

ØExamples: (Astralagus, Echinacea, Licorice root, Alfalfa sprouts,Zinc Lozenges)

ØAvoid herbal medicinals with diuretic effect (ex.:Artichoke, Goldenseal, Selery seeds, Dandelion).

ØAquaretic herbs (water but no sodium excretion) can diminish effect of diuretic drug (hydrochlorothiazide) if sodium is retained.

ØHorseradish, used as antiseptic with circulatory and digestive stimulating effect, can depress thyroid function.

ØKelp diets, contain 0.7mg of iodine per tablet, may result in hyperthyroidism taken in conjunction with thyroid replacement.

Nonsteroidal Anti-inflammatory Drugs

ØAvoid use with herbal medicinals that are known to have adverse GI effects.

ØExamples: Gossypol (inhibits lactate dehydrogenase X found in sperm and male gonadal cells, exerting contraceptive activity), Coffee arabica, Cola acuminata,Uva-Ursi)

ØLicorice may offset effects.Antispasmotic and anti-inflammatory herb for use in gastritis and peptic ulcer disease.

ØThe hemisuccinate derivative of glycyrrhetainic acid, a component of licorice, is carbenoxolone, which is used allopathically for duodenal and gastric ulcers.Licorice renders the patient unable to convert 11-deoxycortisol or deoxycorticosterone into the active glucocorticoids, cortisol, and corticosterone, respectively.This acquired 11-beta-hydroxylase deficiency results in sodium retention, hypertension, and hypokalemia.