Some drugs and dietary supplements don't mix. To reduce the risk of harmful drug-supplement interactions and supplement side effects, anyone who is taking any type of prescription or over-the-counter medicine should consult with a physician before taking any dietary supplement.
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IF YOU ARE USING OR PLANNING TO USE ANY OF THESE COMPOUNDS... |
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...BE AWARE THAT THEY MAY INTERACT WITH ONE OR MORE OF THESE DIETARY SUPPLEMENTS |
Alcohol |
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Beta-carotene, chamomile, gamma-butyrolactone (GBL)*, kava, valerian |
Anesthetics |
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Kava, St. John's wort**, valerian |
Anticoagulants (blood thinners) such as warfarin (Coumadin®)***; |
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Angelica root, arnica flower, anise, asafoetida, bogbean, borage seed oil, bromelain, capsicum, celery, chamomile, clove, coenzyme Q10, danshen, devil's claw, dong quai, fenugreek, feverfew, garlic, ginger, ginkgo biloba, gin seng, goldenseal, green tea (in large amounts), horse chestnut, licorice root, lovage root, meadowsweet, omega-3 fatty acids (fish oil), onion, papain, parsley, passionflower herb, poplar, quassia, red clover, rue, St. John's wort+, sweet clover, turmeric, willow bark, vitamin E |
Antidepressants |
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Ginkgo biloba, S-adenosylmethionine (SAMe), St. John's wort**, yohimbe* |
Aspirin |
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Willow bark; it is also possible that any of the drugs that interact with anticoagulants might also interact with aspirin |
Diuretics |
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Aloe, goldenseal, licorice |
Drugs that lower blood cholesterol levels (such as the "statin" drugs) |
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Red yeast rice |
Drugs that suppress the immune system, such as corticosteroids or cyclosporine |
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Echinacea, St. John's wort**, vitamin E, zinc; in addition, ginseng and melatonin may interact specifically with steroids |
Drugs to treat diabetes |
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Chromium picolinate, milk thistle |
Drugs to treat heart problems |
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Aloe, huperzine A, licorice, St. John's wort** |
Drugs to treat high blood pressure |
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Aloe, goldenseal, huperzine A, licorice, St. John's wort** |
Drugs used to treat seizure disorders (such as phenytoin, phenobarbital) |
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High-dose folic acid, ginkgo biloba, St. John's wort**, wormwood* |
Estrogen replacement therapy (or combination estrogen/progestin hormone replacement therapy) |
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Black cohosh, DHEA, saw palmetto |
Methotrexate (a drug used in the treatment of cancer and sometimes also in the treatment of other diseases, such as rheumatoid arthritis and psoriasis) |
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Echinacea, high-dose folic acid |
Monoamine oxidase inhibitors**** |
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Ephedra*, ginseng, melatonin, SAMe, St. John's wort**, yohimbe* |
Phenothiazines (a group of drugs used to treat serious mental illnesses) |
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Evening primrose oil |
Phenylpropanolamine or pseudoephedrine (found in some cold remedies, allergy remedies, and diet pills) |
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Ephedra*, yohimbe* |
Protease inhibitor and nonnucleoside reverse transcriptase inhibitor drugs used in the treatment of HIV infection |
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St. John's wort** |
Tamoxifen (a drug used in the chemoprevention of breast cancer and also in cancer treatment) |
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St. John's wort** |
Tetracycline antibiotics |
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Calcium, St. John's wort** |
Thyroid hormone (Synthroid®) |
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Calcium |
Tranquilizers or sedatives |
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Chamomile, guarana, kava, melatonin, St. John's wort**, valerian |
* The supplements marked with an asterisk can cause very serious side effects, even when taken alone. ACSH recommends that no one should use them.
** Because the extent to which St. John's wort interacts with medications is only beginning to be understood, ACSH recommends that anyone who is taking any crucially important medication should not use this herb unless the physician who prescribed the drug has specifically approved its use.
*** More food and drug interactions have been reported for Coumadin than for any other medication. Patients taking Coumadin should not start or stop taking any other medications or alternative therapies or make any substantial changes in their eating habits without consulting their physicians.
**** Because there is a potential for extremely serious interactions between monoamine oxidase inhibitors and a variety of food components, dietary supplements, and other drugs, anyone who is taking this type of medication should scrupulously follow all of the dietary and other instructions provided by the physician who prescribed the drug. |