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Table 3. Common Herbal Treatments Used by People With Cancer and Possible Food/Drug Interactions
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Herbal
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Possible Food/Drug Interactions
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MAOIs = monoamine oxidase inhibitors.
|
| Black cohosh |
May further reduce lipids or blood pressure when combined with prescription medications; may increase antiproliferative effect obtained with tamoxifen. |
| Chamomile |
May increase bleeding when used with anticoagulants; may increase sedative effect of benzodiazepines. |
| Dong quai |
May increase effects of warfarin. |
| Echinacea |
May interfere with immunosuppressive therapy. |
| Garlic |
May increase bleeding time with aspirin, dipyridamole, and warfarin; may increase effects and adverse effects of hyperglycemic agents. |
| Ginkgo biloba |
May increase bleeding time with aspirin, dipyridamole, and warfarin; may increase blood pressure when used with thiazide diuretics. |
| Ginseng |
May adversely affect platelet adhesiveness/blood coagulation; may increase hypoglycemia with insulin; may interfere with antipsychotic drugs; may cause hypertension when used long-term with caffeine. |
| Kava kava |
May increase central nervous system depression when used with alcohol and sedatives; may cause hepatotoxicity.[12,13] |
| St. John's wort |
May cause serotonin syndrome when used with antidepressants and drugs using p450 microsomal enzyme for metabolism.[14] Interacts with procarbazine. |
| Ma huang (ephedra) |
Increases toxicity with beta-blockers, MAOIs, caffeine, and St. John’s wort. |
| Yohimbe |
Decreases effect of antidepressants, antihypertensives, hyperglycemic agents, MAOIs, and St. John’s wort. |
References
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Center for Food Safety and Applied Nutrition.: Consumer Advisory: Kava-Containing Dietary Supplements May Be Associated with Severe Liver Injury. Washington, DC: U.S. Food and Drug Administration, CFSAN, 2002. Available online. Last accessed May 7, 2009.
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Taylor CL: Letter to Health Care Professionals: FDA Issues Consumer Advisory That Kava Products May Be Associated with Severe Liver Injury. Washington, DC: U.S. Food and Drug Administration, Center for Food Safety and Applied Nutrition, 2002. Available online. Last accessed May 7, 2009.
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Piscitelli SC, Burstein AH, Chaitt D, et al.: Indinavir concentrations and St John's wort. Lancet 355 (9203): 547-8, 2000.
[PUBMED Abstract]
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