Page 134 - 2018 SP Product Guide

Recommended Action Monitor (very low level of risk). Monitor at doses equivalent to ≥ 3 g/day fresh garlic (low level of risk). Stop taking at least one week before surgery. Monitor (medium level of risk). Monitor (low level of risk). Monitor at doses equivalent to < 4 g/day dried ginger (low level of risk). Monitor at doses equivalent to < 4 g/day dried ginger (very low risk). Contraindicated unless under close supervision at doses equivalent to > 4 g/day

Basis of Concern Reports of worsening epilepsy in schizophrenics. No causal association demonstrated and no effect observed in later trials. 48 Concern may be overstated, as antiplatelet/anticoagulant drugs are often coadministered eg aspirin and warfarin. Herb Alone Case reports of increased bleeding tendency with high garlic intake. In three of the four cases the bleeding occurred after surgery. 49-52 Anecdotal: garlic taken shortly before testing interferes

Potential Interaction May decrease effectiveness of drug. Aspirin: May increase bleeding time. Clopidogrel: May potentiate effect of drug. Warfarin: May potentiate effect of drug. Large doses could increase bleeding tendency. Decreases drug level. May decrease effectiveness of drug. Phenprocoumon: May increase effectiveness of drug. Warfarin: Increased risk of spontaneous bleeding. May produce a synergistic antiplatelet effect.

Evening Primrose Oil Oenothera biennis Garlic Allium sativum (See also Hypoglycemic herbs) Antiplatelet and anticoagulant Ginger Zingiber officinale Antiplatelet and anticoagulant

Drug Phenothiazines drugs HIV protease inhibitors Antacids drugs Nifedipine

Herb-Drug Interaction Chart • MediHerb Product Catalog 2018 133
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