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Can My Herbal Supplements Harm Me? By Dwayne Haskell

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Unknown to most people is the fact that everyday foods and Herbal supplements can and do interact with I popular became

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interested while talking to my Pharmacist that my son couldn't take decongestant cold medications with his heart medication. Well, I knew about interactions between two drugs, but when the Pharmacist told me he couldn't have grapefruit juice, I was stunned. Seems that grapefruit juice increases the blood concentrations of the drug. Basically that means that it greatly

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grapefruit juice increases the blood concentrations of the drug. Basically that means that it greatly enhances the effects of the drug which could result in an overdose of the medication. This is everyday grapefruit juice! It got me wondering about other everyday foods and Herbs we take. Below are a few foods and Herbs that have an effect on your medications. Finance This list is a basic guide, and is by no means the meant to replace your Doctor or Pharmacist. Consult with them about any prescriptions you are taking and the foods and Herbs that will interact with them. Although I have taken this information from a handout from a local Hospital, Use this information at your own risk. Again, I am not a Doctor or Pharmacist, and I have had NO medical training, so please consult with yours for more information. Insurance People usually ask if Herbal supplements change the way their prescription drugs work. The answer is YES! Some medications should never be taken with Herbal supplements. Some can cause unwanted side effects or cause the medication to stop working to their full effect. Another misconception about supplements is that they are completely safe because they are natural. Yes, they may be from plants, but they are not natural to your body. Herbal supplements are not tested or inspected like prescription drugs are tested, so the supplements vary in quality and strength from pill to pill and bottle to bottle. Just like supplements, foods can change the way your body responds to medications. One example is grapefruits and grapefruit juice. Many people aren't aware that grapefruit juice can increase the drug levels of certain medications. An increase in the levels will also increase the side effects of the drug. T hing s t o R e me mb e r 1. Herbal supplements and foods can change the way your medications work. 2. Tell your caregiver what Herbal supplements you take and what foods you eat often. 3. Ask your Doctor or Pharmacist what Herbal supplements or foods will interact with your medications. 4. Always talk with your Doctor or Pharmacist FIRST before taking any Herbal supplements. Loan Music Travel Movies Maps Cars Hotels Furniture Games

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DISCLAIMER: The following charts are not all inclusive and do not contain every interaction of drugs with foods and herbs. It serves as a guide only. Consult with your Doctor, Pharmacist or a registered dietician if you have any questions. Analg e sics ( Pain R e lie ve rs) Aspirin Celecoxib (Celebrex) Ibuprofen (Advil, Motrin) Naproxen Fo o d : Avoid alchohol. Avoid large amounts of orange juice and vitamin C. He rb s:Avoid Black Cohosh, Dong Quai, Evening Primrose, Feverfew, Flaxseed Oil, and Ginko as it increases the risk of bleeding. Narcotics Codeine (Tylenol #2, 3, 4) Morphine (MS Contin) Oxycodone (Oxycontin/Percocet) Fo o d s:Avoid alchohol. He rb s:Do not take with Kava or Valerian as it may make you feel drowsy. Ant ib io t ics Ciproflaxacin (cipro) Levofloxacin (Levaquin) Fo o d : Take 2 Hrs before or 6 Hrs after antacids, dairy products amd multi- vitamins that contain calcium, iron, z inc, or magnesium. Avoid large amounts of caffeine.See Chart 3 below. He rb s:

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Methronidaz ole Fo o d s:Avoid alchohol during and 3 days after taking this medication to avoid nausea and vomiting. He rb s: Penicillin Fo o d s:Citrus fruits/juices and carbonated beverages will decrease desired effect. He rb s: Tetracycline Fo o d s:Take 2 Hrs before or 6 Hrs after antacids, dairy products amd multi- vitamins that contain calcium, iron, z inc, or magnesium. He rb s:Dong Quai or St. John's Wort increase the risk of sunburn. Trimethoprim/Sulfamethoxaz ole (Bactrim, Septra) Fo o d s:May cause rash if taken with alchohol. He rb s:Dong Quai or St. John's Wort increase the risk of sunburn. Ant ico ag ulant s ( B lo o d T hinne rs) Warfarin (Coumadin) Fo o d : Avoid alchohol. Avoid foods high in Vitamin K: beef liver, oils and green leafy vegetables (broccoli, brussel sprouts, cabbage, collards, spinach). He rb s: Avoid Black Cohosh, Dong Quai, Evening Primrose, Feverfew, Flaxseed Oil and Ginko as they increase the risk of bleeding. Do not take St. John's Wort as it may decrease the desired effect. C ho le st e ro l Lo we ring Ag e nt s Atorvastatin (Lipitor) Pravastatin (Pravachol) PDFmyURL.com

Rosuvastatin (Crestor) Simvastatin (Z ocor) Fo o d : Avoid alchohol. Do not take with grapefruit juice. He rb s: St. John's Wort may decrease desired effect. D iab e t e s Me d icat io ns Glipiz ide (Glucotrol, Glucotrol XL) Glyburide (Glynase, Micronase) Metformin (Glucophage) Fo o d : Avoid alchohol. He rb s: Do not take with Ephedra as it may increase blood sugar and decrease desired effect. Ere ct ile D ysf unct io n Sildenafil (Viagra) Tadalafil (Cialis) Vardenafil (Levitra) Fo o d : Do not take with grapefruit juice. He rb s: Do not take with Yohimbe as it may increase side effects. G ast ro int e st inal Ag e nt s ( St o mach Me d s) Prochlorperaz ine (Compaz ine) Fo o d : Do not take with alchohol. He rb s: Do not take with Dong Quai, Kava, St. John's Wort or Valerian as they may make you drowsey. Cimetidine (Tagamet) Fo o d s: Avoid alchohol. Take 1 hour before or 2 hours after antacids. Limit caffeine intake; see Chart 3. PDFmyURL.com

He rb s: St John's Wort may decrease desired effect. Lansoproz ole (Prevacid) Omepraz ole (Prilosec) Pantopraz ole (Protonix) Rabepraz ole (Aciphex) Fo o d s: Avoid alchohol as it may cause upset stomach. He rb s: St. John's Wort may decrease desired effect. He art and B lo o d Pre ssure Me d icat io ns *Note: The following herbs may cause an INCREASE in blood pressure and decrease desired effect of any blood pressure medications: Black Cohosh, Dong Quai, Ephedra, Hawthorn, Quassia, Vervain and Yohimbe. Angiotensin Converting Enz yme (ACE) InhibitorsCaptopril (Capoten) Linisopril (Prinivil, Z estril) Fo o d : Avoid salt substitutes that contain potassium and potassium rich foods; see Chart 1. He rb s: See *Note above Beta BlockersAtenolol (Tenormin) Metoprolol (Lopressor, Toprol Z L) Propranolol (Inderal) Fo o d s: Avoid alchohol. He rb s: See *Note above. Calcium Channel BlockersDiltiaz em (Cardiz em, Tiaz ac) PDFmyURL.com

Verapamil (Calan, Verelan) Fo o d s: Do not take with grapefruit juice. A low sodium diet may be recommended. He rb s: See *Note above. Digoxin (Lanoxin) Fo o d s: Avoid antacids. Limit caffeine intake; see Chart 3 below. He rb s: Avoid Ma Huang and St. John's Wort as they may decrease desired effect. NitratesIsosorbide (isordil, Imdur) Nitroglycerin Patch (Nitrol) Fo o d s: Avoid alchohol. He rb s: See *Note above. D iure t ics ( Wat e r Pills) Furosemide (Lasix) Hydrochlorothiaz ide Fo o d : INCLUDE potassium rich foods in diet; see Chart 1 below. He rb s: See *Note above under Heart and Blood Pressure Medications. Ho rmo ne R e p lace me nt T he rap y Estrogen (Premarin, Premphase, Prempro) Fo o d : Avoid alchohol. He rb s: St John's Wort may decrease desired effect. Do not take Black Cohosh Dong Quai, Red Clover or Saw Palmetto because of the possible side effects. Mo o d D iso rd e rs PDFmyURL.com

Aripipraz ole (Abilify) Cloz apine (Cloz aril) Olanz apine (Z yprexa) Risperidone (Risperdal) Fo o d : Avoid alchohol. Do not take grapefruit juice. Limit caffeine intake; see Chart 3. He rb s: Do not take with Kava, St. John's Wor or Valerian as they may make you feel drowsy. Benz odiaz epinesAlpraz olam (Z anax) Clonaz epam (Klonopin) Diaz epam (Valium) Loraz epam (Ativan) Fo o d s: Avoid alchohol. Do not take grapefruit juice. Limit caffeine intake; see Chart 3 below. He rb s: Do not take with Kava, St. John's Wor or Valerian as they may make you feel drowsy. Lithium (Eskalith, Lithobid) Fo o d : Avoid alchohol. Limit caffeine intake; see Chart 3 below. He rb s: Avoid Green Tea. Monoamine Oxidase Inhibitors (MAOI's)Phenelz ine (Nardil) Tranylcypromine (Parnate) Fo o d s: Avoid alchohol. Avoid tyramine- rich foods see Chart 2 below. He rb s: Do not take with Ephedra, Kava, Ginko, St. John's Wort or Yohimbe as they may increase effect and cause a serious increase in blood pressure. Selective Seratonin Reuptake Inhibitors (SSRI's)PDFmyURL.com

Citalopram (Celexa) Escitalopram (Lexapro) Fluoxetine (Proz ac) Paroxetine (Paxil) Fo o d : Avoid alchohol. He rb s: Do not take with Ephedra, Kava, Melatonin, Valerian or Yohimbe as they may make you drowsy. Do not take with St. John's Wort as it may increase effect of drug and risk of side effects. Tricyclic Antidepressants (TCA's)Amitriptyline (Elavil) Desipramine (Norpramin) Nortriptyline (Pamelor) Fo o d s: Avoid alchohol. Do not take with grapefruit juice. He rb s: Do not take with Kava, St. John's Wort or Valerian as they may make you feel drowsy. O ral C o nt race p t ive s ( B irt h C o nt ro l) Estradiol Cypionate Ethinyl Estradiol Mestranol Fo o d : Avoid smoking. He rb s: Do not take with Chaste Tree Berry, Red Clover, Saw Palmetto or St. John's Wort as they may decrease desired effect. O st e o p o ro sis Alendronate (Fosomax) Risendronate (Actonel)

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Fo o d : Take only with plain water. Do not take anything else within 30 minutes of taking these drugs as they may decrease desired effect. He rb s: Se iz ure Me d icat io ns Carbamaz epine (Carbatrol, NOT Tegretol) Divalproex (Depakote) Oxcarbaz epine (trileptal) phenytoin (Dilantin) Fo o d : Avoid alchohol. Do not take with grapefruit juice. He rb s: Evening Primrose increases risk for seiz ures. Do not take with Kava or Valerian as they may make you feel drowsy. St. John's Wort may decrease desired effect. T hyro id Me d icat io ns Levothyroxine (Levoxyl, Synthroid, Unithroid) Thyroid (Armour Thyroid) Fo o d : Limit intake of Brussel Sprouts, cabbage, kale, greens, rutabaga, soybeans and turnips. He rb s: Do not take with Lemon Balm. Misce llane o us AntihistaminesChlorpheniramine (Chlor- Trimeton) Diphenhydramine (Benadryl) Fo o d : Do not take with alchohol. He rb s: Do not take with Kava or Valerian as it may make you feel drowsy. Cyclosporine (Neoral, Sandimmune) PDFmyURL.com

Fo o d s: Do not take with grapefruit juice. He rb s: Do not take with Echinacea or St. John's Wort as they may decrease desired effect. Prednisone Methylprednisolone Fo o d : Avoid alchohol. Calcium supplements may be recommended to prevent Osteoporosis.Limit caffeine intake; see Chart 3 below. He rb s: Avoid Echinacea or St. John's Wort as they may decrease desired effect. Theopylline (theo- Dur) Fo o d s: Avoid alchohol.Limit caffeine intake; see Chart 3 below. He rb s: Do not take with Ephedra or Green Tea as it may increase effect of drug. Fo o d s: He rb s: C hart # 1 High potassium rich foods include the following: Apricots, Artichokes, Asparagus, Avacado, Banana, Broccoli, Brussel Sprouts, Carrots, Celery, Chocolate, Dates, Dried Beans, Dried Fruit, Figs, Greens, Honeydew, Milk, Orange Juice, Potato, Pumpkin, Prune Juice, Raisins, Rhubarb, Spinach, Squash, Tomato, V- 8 Juice C hart # 2 High tyramine-content foods include the following: Aged Cheese*, Aged Meat,Anchovies, Avacados, Bananas, Beer, Broad Beans, Caffeine Chicken Liver, Chocolate, Cola Drinks, Canned Figs, Mushrooms, Raisins, Sausages, Sour Cream PDFmyURL.com

Soy Sauce, Wine (Chianti, Sherry), Yeast, Yogurt *Camembert, Chedder, Gruyer, processed American and Stilton C hart # 3 High caffeine-content foods include the following: Chocolate (milk and dark, Coffee (brewed, cappuccino, expresso) Caffeinated water (Java, Kank, Aqua Blast), Ice Cream (coffee, chocolate) Soft Drinks (Mountain Dew, Coca Cola, Pepsi, Root Beer, Sunkist Orange Soda) Teas (green Tea, Ginseng, Snapple Iced Tea, Lipton)

Dwayne Haskell owns and operates Hidden Hills Nursery. He also enjoys teaching others how to grow their own landscape plants from rooted cuttings. After building his own misting system for his nursery, he realiz ed he could design and build a system for home gardeners who are interested in starting their own plants from cuttings. He offers complete misting kits, individual components, and advice at Mistkits.com kava klo no p in Inf o rmat io n

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Are you currently taking Herbal Supplements? Many folks are not aware of the potential interactions between prescribed medications, Herbal supplements and common foods. Read on to see how the Herbs and foods we commonly take can affect the medications you are taking.

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