Dangerous herb and drug interactions 4/11
(This article is adapted from ConsumerReportsHealth.org.)
Several different herbal supplements that are widely sold can harm the heart directly. For example, Yohimbe, which is sold and used as a treatment for impotence, has been linked to heart attacks and dangerous increases in heart rate.
Some other supplements threaten the heart by interacting with heart medicines, according to an article in the Feb. 9, 2010, issue of the "Journal of the American College of Cardiology."
Even if supplements are taken for non-cardiac reasons, they can also interact with certain heart medication. Echinacea, for example, which might be taken for a cold, can make statins more potent, possibly increasing the risk of side effects, and St. John's wort, often taken for depression, can make statins less effective.
The table below lists some common examples of dangerous herb and heart-drug interactions. Consumer Reports health experts recommend that you talk with a doctor before taking any supplement, not just those listed below, especially if you take any medication regularly.
| Twelve supplements you should avoid |
Herv
(also known as)
|
Heart-related drug |
Potential dangerous interaction |
| Alfalfa |
Warfarin (Coumadin), to prevent blood clots |
Bleeding |
| Aloe vera |
Digoxin (Lanoxin), to treat heart failure due to an abnormal heart beat |
Increased potency, possibly making side effects such as nausea, vomiting, and dangerously slow heart beat more likely |
| Danshen |
Aspirin, clopidogrel (Plavix), or warfarin (Coumadin)
Digoxin (Lanoxin) |
Bleeding
Increased potency, possibly making side effects such as nausea, vomiting, and dangerously slow heart beat more likely |
| Echinacea |
Amiodarone (Cordarone), for abnormal heart rhythms
Fibrates, niacin, and statins to lower LDL (bad) cholesterol or triglyceride levels |
Dangerous change in EKG
Liver damage |
| Garlic |
Aspirin, clopidogrel (Plavix), heparin, or warfarin (Coumadin) |
Bleeding |
| Ginkgo biloba |
Aspirin, warfarin (Coumadin) |
Bleeding |
| Ginseng |
Digoxin (Lanoxin)
Warfarin (Coumadin) |
Interferes with blood tests for digoxin
Decreased effectiveness of warfarin |
| Hawthorn |
Calcium-channel blockers such as diltiazem (Cardizem) and nifedipine (Procardia), and nitrates, such as isosorbide (Isordil)
Digoxin (Lanoxin) |
Increased potency, possibly making side effects more likely
Increased potency, possibly making side effects such as nausea, vomiting, and dangerously slow heart beat more likely |
| Licorice |
Spironolactone (Aldactone), used for high blood pressure and heart failure |
Low potassium levels |
| Saw palmetto |
Aspirin, clopidogrel (Plavix), or warfarin (Coumadin) |
Bleeding |
| Soy milk |
Warfarin (Coumadin) |
Decreased effectiveness of warfarin |
| St. John's wort |
Amiodarone (Cordarone), simvastatin (Zocor), and warfarin (Coumadin)
Clopidogrel (Plavix)
Digoxin (Lanoxin) |
Decreased effectiveness of amiodarone, simvastatin, and warfarin
Bleeding
Decreased blood levels of digoxin |
| Yohimbe |
ACE inhibitors, such as captopril (Capoten) and lisinopril (Prinivil, Zestril), for high blood pressure and heart failure
Beta-blockers, such as atenolol (Tenormin) and metoprolol (Lopressor, Toprol) |
Decreased effectiveness of ACE inhibitors and beta-blockers
Increased heart rate with beta- blockers |
Many of the listed drugs are also available as generics.
Source: Adapted from the Journal of the American College of Cardiology, Feb. 9, 2010.
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Related links
What's behind our dietary supplements coverage? 1/11
Dangerous "natural" supplements 9/10
The National Institutes of Health's Office of Dietary Supplements
The FDA, for alerts, advisories, and other actions
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