Microsoft powerpoint - herb-drug interaction 2006

Herb-Drug Interactions
„ Herbs with higher risk of adverse reactions John K. Chen, Ph.D., Pharm., O.M.D., L.Ac.
Evergreen Herbs and Medical Supplies, LLC 17431 East Gale Ave. City of Industry, CA 91748 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 „ Difficulty/Impossible to predict interactions „ Gadually increase the dose of the herbs; Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 „ Rapid onset of enzyme inhibition (takes Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 „ Prevent ototoxicity and nephrotoxicity due to „ Guang Fang Ji (Radix Aristolochiae „ Compound injection with Huang Qi (Radix Astragali) and Lu Han Cao (Herba Pyrolae) „ Guan Mu Tong (Caulis Aristolochiae „ May prevent ototoxicity and nephrotoxicity „ Ma Dou Ling (Fructus Aristolochiae) „ Qing Mu Xiang (Radix Aristolochiae) Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 847 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 „ Bactrim (sulfamethoxazole and trimethoprim) „ Augmentin (amoxilicillin & clauvulanate p.) „ Vicodin (hydrocodon & acetaminophen) „ Tylenol #3 (codeine & acetaminophen) „ cocktail approach to treating HIV & cancer.
Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 Eighteen Incompatibles (Shi Ba Fan) Rx Glycyrrhizae (Gan Cao) is
Rhizoma et Radix Veratri (Li Lu) is
Radix Euphorbiae Kansui (Gan Sui), Radix Euphorbiae seu Knoxiae (Da Ji) Wu Ling Zhi (Excrementum Trogopteri seu Rz Aconiti (Wu Tou) is incompatible with
Bulbus Fritillariae Cirrhosae (Chuan Radix Salviae Miltiorrhizae (Dan Shen) Bulbus Fritillariae Thunbergii (Zhe Bei Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 19-24 Nineteen Counteractions (Shi Jiu Wei) „ Sulfur (Liu Huang) & Mirabilitum (Mang Xiao) „ Mercury (Shui Yin) & Arsenolite (Pi Shuang) „ Rhizoma Euphorbiae E. (Lang Du) & Lithargyrum (Mi Tuo Seng) „ Semen Crotonis (Ba Dou) & Semen Pharbitidis (Qian Niu Zi) „ Flos Caryphylli (Ding Xiang) & Radix Curcumae (Yu Jin) „ Nitrum (Ya Xiao) & Rhizoma Sparganii (Shan Ling) „ Cornu Rhinoceri (Xi Jiao) & Rz. Aconiti Kusnezoffii (Cao Wu) „ Cornu Rhinoceri (Xi Jiao) & Rhizoma Aconiti (Chuan Wu) „ Radix Ginseng (Ren Shen) & Rhizoma Trogopterorum (Wu Ling „ Cortex Cinnamomi (Rou Gui) & Hallositum Rubrum (Chi Shi Zhi) Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 19-24 „ Dan Shen (Radix Salviae Miltiorrhizae) „ Blocks the re-cycling process of vitamin K „ Dang Gui (Radicis Angelicae Sinensis) „ Slow onset of action, long duration of action „ Chuan Xiong (Rhizoma Ligustici Chuanxiong) „ Caution w/ anticoagulant or antiplatelet drugs Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 „ Salviae Miltiorrhizae (Dan Shen) with „ Potential interaction with any other anti- „ Increase in AUC (area under the curve) „ Potential interaction with OTC drugs, dietary „ Potential adverse reaction with acupuncture „ Potential interactions with Chinese herbs Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 636 „ Zhi Mu (Radix Anemarrhenae) and „ Xuan Shen (Radix Scrophulariae) and „ Che Qian Zi (Semen Plantaginis) „ Huang Qi (Radix Astragali) and „ Use with caution with antidiabetic drugs Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 „ Sedatives: Herbs that calm shen (spirit)
often potentiates the sedative effect of „ [Note: Many categories of drugs induce sedation, such as antihistamines, narcotic analgesics, barbiturates, benzodiazepines and others.] Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 25-30 „ General effect: Ma Huang contains
„ Stimulant effect:
„ Ma Huang should not be combined with cardiovascular system. Combining Ma ephedrine, pseudoephedrine, theophylline, Huang with cardiac glycosides may lead to (MAOI), or substances with similar properties.
Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 36 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 36 „ Beta blockers: The effect of beta blockers
„ Acetaminophen: Niu Bang Gen (Radix
may be reduced when combined with Ma Arctii) has marked hepatoprotective effects. Huang because of increased levels of Niu Bang Gen suppressed the elevated SGOT and SGPT levels induced by carbon tetrachloride or acetaminophen in a dose-dependent manner. It also alleviated the „ [Note: Examples of beta blockers include atenolol (Tenormin), metoprolol (Lopressor/Toprol), sotalol (Betapace), propranolol (Inderal), and labetalol (Normodyne/Trandate).] Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 36 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 70 „ Acetaminophen:
„ Tolbutamide: It was demonstrated in one
study that the formula Xiao Chai Hu Tang „ The mechanism of this hepatoprotective action is based on the antioxidative effect of bioavailability of tolbutamide after oral Niu Bang Gen on hepatocytes, hence eliminating the deleterious effects of toxic „ Xiao Chai Hu Tang was found to accelerate metabolites from carbon tetrachloride or the initial absorption rate, reduce the area under the plasma concentration-time curve, and decrease the overall bioavailability of tolbutamide.18 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 70 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 84 „ Interferon: It has been reported that increased
„ Antibiotics: Concurrent use of baicalin, a
risk of acute pneumonitis may be associated with flavone isolated from Huang Qin, was found use of interferon, Xiao Chai Hu Tang, or both in to have synergistic antibiotic effect with beta-lactam antibiotics, such as ampicillin, „ Among patients with chronic hepatitis or liver amoxicillin, methicillin and cefotaxime. cirrhosis, the frequency of drug-induced „ The addition of baicalin restored the effectiveness of these drugs against beta- „ 0.5% in those given only interferon-alpha lactam-resistant Staphylococcus aureus and „ 0.7% in those given only Xiao Chai Hu Tang methicillin-resistant Staphylococcus aureus(MRSA).15 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 84 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 137 Guan Ye Lian Qiao (Herba Hypericum) „ SSRI’s: Since St. John’s Wort and SSRI
„ Da Qing Ye (Folium Isatidis), Ban Lan Gen (Radix Isatidis) and Qing Dai (Indigo Naturalis) „ Sulfonylureas: tolbutamide (Orinase), glipizide drug may lead to “serotonin syndrome” with (Glucotrol), and glyburide (DiaBeta/Micronase) „ Sulfonamides: sulfadiazine, sulfisoxazole, sulfamethoxazole, trimethoprim/sulfamethoxazole (Bactrim/Septra), and erythromycin/sulfisoxazole (Pediazole).] „ [Note: Examples of SSRI’s include fluoxetine (Prozac), paroxetine (Paxil), sertraline (Zoloft), citalopram (Celexa), and fluvoxamine (Luvox).] Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 176 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 208-211 Fu Zi (Radix Aconiti Lateralis Praeparata) Chuan Wu (Radix Aconiti Preparata) „ Antiarrhythmics: Patients who have a past
„ Antiarrhythmics: Patients who have a past
history of cardiovascular disorders or are history of cardiovascular disorders or are taking antiarrhythmic medications should taking antiarrhythmic medications should take Fu Zi with extreme caution.13 take Chuan Wu with extreme caution.10 „ [Note: Examples of antiarrhythmics include quinidine, „ [Note: Examples of antiarrhythmics include quinidine, procainamide (Pronestyl), disopyramide (Norpace), procainamide (Pronestyl), disopyramide (Norpace), flecainide (Tambocor), propafenone (Rythmol), and flecainide (Tambocor), propafenone (Rythmol), and Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 438 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 442 Cao Wu (Radix Aconiti Kusnezoffii) „ Antiarrhythmics: Patients who have a past
history of cardiovascular disorders or are taking antiarrhythmic medications should take Cao Wu with extreme caution.5: „ [Note: Examples of antiarrhythmics include quinidine, procainamide (Pronestyl), disopyramide (Norpace), flecainide (Tambocor), propafenone (Rythmol), and amiodarone (Cordarone).] Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 445 Copyright 2004. Chen and Chen. Chinese Medical Herbology and Pharmacology. Page: 438 „ Educate and general public on the effect of Herb-Drug Interactions
„ Increase education and training among „ Regulation of herbs as “traditional medicine” John K. Chen, Ph.D., Pharm., O.M.D., L.Ac.
Evergreen Herbs and Medical Supplies, LLC 17431 East Gale Ave. City of Industry, CA 91748

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