Page 132 - 2018 SP Product Guide

how the risk of interaction is assessed, with worked examples from the chart: go to www.mediherb.com and view the Herb-Drug
For more information on the process used to assess the herb-drug interaction research (and why some research is not included),
considered low risk and a caution is recommended: the patient should be monitored, through the normal process of repeat
In the case of gliclazide, because the trial found little effect on a clinically-relevant outcome, the potential interaction is
A recommended action is suggested on a risk assessment of the information in the Basis of Concern. In these examples:
Recommended Action Monitor at high doses (> 100 mg/day anthocyanins, low level of risk). Monitor (low level of risk). Contraindicated unless under close supervision. Monitor (low level of risk). Contraindicated. Contraindicated. Monitor (low level of risk). Monitor (very low level of risk). Monitor (low level of risk).
It is recommended that St John’s wort is contraindicated in patients taking cancer chemotherapeutic drugs.

Potential Herb-Drug Interactions for Commonly Used Herbs*

Interaction Chart under ‘Resources’. Antiplatelet activity observed in healthy volunteers (173 mg/day of bilberry anthocyanins). 1 Case report of Uncontrolled trial (600 mg/day of bilberry anthocyanins + 30 mg/day of vitamin C for 2 months then reduced maintenance dose) of 9 patients taking anticoagulant drugs – treatment reduced retinal hemorrhages without Case report (patient reported to consume “large amounts of bilberry fruits every day fo

consultations. Health care professionals please note: when a patient presents using any of the drugs listed below and there is a potential interaction with the herb you intend to dispense, it is important that you or your patient discuss the potential interaction with their prescribing physician before you dispense the herb to the patient. Theoretical concern based on deliberations of German Commission E. Case report, in a patient with cirrhosis bein

postoperative bleeding (bilberry extract undefined). 2
wort resulted in decreased levels of cancer chemotherapeutic drugs. (Italicized words represent the information in
volunteers administration of St John’s wort resulted in increased clearance of the hypoglycemic drug gliclazide, and
information in the Potential Interaction column. For example, clinical studies found that administration of St John’s
The chart is read from left to right. The information in the Basis of Concern column provides the evidence for the
Basis of Concern Herb Alone Herb or Constituent and Drug impairing coagulation. 3 Case report. 5 Theoretical concern, no cases reported. thyroxine. 7 Case report.
so may reduce the drug’s efficacy, however, glucose and insulin response to glucose loading were unchanged.
More details may be provided in the Basis of Concern column. For example, in a clinical study with healthy

Potential Interaction Potentiation of bleeding. Black Cohosh Actaea racemosa (Cimicifuga racemosa) May potentiate increase in liver enzymes, specifically ALT. May decrease effectiveness of drug due to natural iodine content. 6 May add to effect of drug. May interfere with administration of diagnostic procedures using radioactive isotopes. 8 Should not be administered concurrently with preparations containing thyroid hormone.

How to Read the Chart the Herb-Drug Interaction chart below.) Drug Bilberry Vaccinium myrtillus Warfarin Statin drugs eg atorvastatin Bladderwrack Fucus vesiculosus Hyperthyroid medication eg carbimazole Thyroid replacement therapies eg thyroxine Bugleweed Lycopus virginicus, Lycopus europaeus Radioactive iodine Thyroid hormones Cat’s Claw Uncaria tomentosa HIV protease inhibitors ACE inhibitor Theophylline

Health Care Professional Resources • MediHerb Product Catalog 2018 131
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