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Ginseng, Cardiac Drugs Don't Mix: Herb Interactions You Should Know
Environmental Nutrition, Jan, 1999 by Catherine Golub
Medication Indications for Use
Generic name (Brand names)
Cardiac medications
digitoxin (Crystodigin, Digitoxin) Help regulate heart rate.
digoxin (Digoxin, Lanoxin) Treat congestive heart
failure.
propranolol HCI (Inderal) Helps regulate heart rate.
Lowers blood pressure.
Diuretics
chlorthalidone (Hygroton) Lower blood pressure,
furosemide (Lasix) while causing potassium
hydrochlorothiazide depletion. Treat excessive
(HydroDIURIL, Microzide) fluid retention.
metolazone (Zaroxolyn)
spironolactone (Aldactone) Lowers blood pressure,
but holds on to potassium.
Calcium channel blockers
amlodipine (Norvasc) Dilate blood vessels.
diltaizem (Cardizem, Dilacor XR, Lower blood pressure.
Tiamate)
felodipine (Plendil)
isradipine (Dynacric)
nicardipine (Cardene)
nifedipine (Adalat, Procardia)
nisoldipine (Sular)
verapamil HCI (Calan, Isoptin)
Other blood pressure medications
bisoprolol fumarate (Zebeta) Control high blood
clonidine (Catapres) pressure.
doxazosin mesylate (Cardura)
guanfacine HCI (Tenex)
hydralazine HCI (Apresoline)
labetalol HCI (Normodyne,
Trandate)
metoprolol tartrate (Lopressor,
Toprol XL)
nadolol (Corgard)
prazosin HCI (Minipress)
terazosin HCI (Hytrin)
valsartan (Diovan)
Psychotherapeutic medications
amitriptyline HCI (Elavil) Treats depression.
chlordiazepoxide (Librium) Treats anxiety,
chlorpromazine HCI (Thorazine) Treats psychosis,
clomipramine HCI (Anafranil) Treats obsessive-compulsive
disorder.
lithium carbonate (Eskafith, Treats manic depression,
Lithobid, Lithonate, Lithotabs)
phenelzine sulfate (Nardil), a Treats depression,
monoamine oxidase
inhibitor--known as MAOI.
Diabetes medications
acarbose (Precose) Lower blood glucose.
chlorpropamide (Diabinese)
effects.
glipizide (Glucotrol)
metformin HCI (Glucophage)
Miscellaneous medications
aspirin (Bufferin) Nonsteroidal anti-inflammatory
pain reliever,
astemizole (Hismanal) Antihistamines used to treat
hydroxyzine (Atarax, Vistaril) allergies. Also treat anxiety
loratadine (Claritin) and nausea.
bisacodyl (Dulcolax) Stimulant laxative.
caffeine (Caffedrine, Methylxanthine-containing
NoDoz, Vivarin) stimulant,
phenobarbital (Phenobarbital) Treats convulsions, sedative.
tetracycline HCI (Achromycin-V, Antibiotic used to treat
Sumycin, Tetracycline) infection.
theophylline (Theo-Dur) Treats asthma.
warfarin sodium (Coumadin) Anticoagulant (inhibits blood
clotting),
Medication Selected Herb Interactions
Generic name (Brand names) Common name (Latin name)
Cardiac medications
digitoxin (Crystodigin, Digitoxin) The following enhance the
digoxin (Digoxin, Lanoxin) drugs' effects, risking
digitalis toxicity--irregular
heartbeat--as occurs
in poisoning from foxglove
(Digitalis purpurea):
* senna (Cassia senna)
* Siberian ginseng
(Eleutherococcus senticosis)
Diuretic herbs may exacerbate
potassium depletion and cause
digitalis toxicity:
* dandelion (Taraxcum
officinale)
* hydrangea (Hydrangea
aborescens)
* parsley (Camm petroselenium)
* St. John's wort (Hypericum
perforatum)
* uva ursi or bearberry
(Arctostaphlyos uva-ursi)
May aggravate drugs' side
effect of swollen and tender
breasts:
* ginseng (Panax ginseng)
* rauwolfia (Rauwolfia
serpentina)
propranolol HCI (Inderal) Natural licorice (Glycyrrhiza
glabra) may increase heart
rate and raise blood pressure,
countering drug's effects.
American mistletoe
(Phorandendron) (leaves used
in teas) may raise blood
pressure, countering drug's
effects.
European mislleloe (Viscus
album) may lower blood
pressure, enhancing drug's
effects.
Diuretics
chlorthalidone (Hygroton) Stimulant laxatives can
furosemide (Lasix) exacerbate drugs'
hydrochlorothiazide potassium-depleting effect,
(HydroDIURIL, Microzide) contributing to confusion,
metolazone (Zaroxolyn) weakness and irregular
heartbeat:
* aloe (Aloe barbadensis)
* cascara sagrada (Rhamnus
pershianus)
* senna (Senna alexandrine)
Diuretic herbs may exacerbate
drugs' effects on potassium
depletion;
* dandelion (Taraxcum
officinale)
* hydrangea (Hydrangea
aborescens)
* parsley (Camm
petroselenium)
* St. John's wort (Hypericum
perforatum)
* uva ursi or bearberry
(Arctostaphlyos uva-ursi)
May counteract drugs' effects:
* natural licorice
(Glycyrrhiza glabra)
* yohimbe (Pausinystalia
yohimbe)
spironolactone (Aldactone) * yohimbe (Pausinystalia
yohimbe) may counteract
drug's effects.
Calcium channel blockers
amlodipine (Norvasc) May counteract drugs' effects:
diltaizem (Cardizem, Dilacor XR, * natural licorice
Tiamate) (Glycyrrhiza glabra)
felodipine (Plendil) * yohimbe (Pausinystalia
isradipine (Dynacric) yohimbe)
nicardipine (Cardene)
nifedipine (Adalat, Procardia) American mistletoe
nisoldipine (Sular) (Phorandendron) (leaves used
verapamil HCI (Calan, Isoptin) in teas) may raise blood
pressure, countering
drugs' effects.
European mistletoe (Viscus
album) may lower blood
pressure, enhancing drugs'
effects.
May aggravate drugs' side
effect of swollen and tender
breasts:
* ginseng (Panax ginseng)
* rauwolfia (Rauwolfia
serpentina)
Other blood pressure medications
bisoprolol fumarate (Zebeta) May counteract drugs' effects:
clonidine (Catapres) * natural licorice
doxazosin mesylate (Cardura) (Glycyrrhiza glabra)
guanfacine HCI (Tenex) * yohimbe (Pausinystalia
hydralazine HCI (Apresoline) yohimbe)
labetalol HCI (Normodyne,
Trandate) American mistletoe
metoprolol tartrate (Lopressor, (Phorandendron) (leaves used
Toprol XL) in teas) may raise blood
nadolol (Corgard) pressure, countering
prazosin HCI (Minipress) drugs' effects.
terazosin HCI (Hytrin)
valsartan (Diovan) European mistletoe (Viscus
album) may lower blood
pressure, enhancing drugs'
effects.
Psychotherapeutic medications
amitriptyline HCI (Elavil) ginseng (Panax ginseng) may
counteract the drug's effects.
kava (Piper methysticum) can
exacerbate drug's effects on
the central nervous system,
causing drowsiness and slowed
breathing.
ma huang (Ephedra) can enhance
drug's toxic effects.
psyllium (Plantago) can
decrease drug's effects.
yohimbe (Pausinystalia
yohimbe) drug can increase
toxicity of herb (if taken at
same time).
chlordiazepoxide (Librium) same as above
chlorpromazine HCI (Thorazine) same as above
clomipramine HCI (Anafranil) same as above
lithium carbonate (Eskafith, same as above
Lithobid, Lithonate, Lithotabs)
phenelzine sulfate (Nardil), a same as above
monoamine oxidase St. John's wort (Hypericum
inhibitor--known as MAOI. perforatum) is a weak MAOI,
and may exacerbate drug's
effects.
Diabetes medications
acarbose (Precose) bitter melon or karela
chlorpropamide (Diabinese) (Morordica charantia) can
glipizide (Glucotrol) lower blood sugar,
metformin HCI (Glucophage) exacerbating drugs' effects.
Miscellaneous medications
aspirin (Bufferin) garlic (Allium sativum)
contains allicin, an
anticoagulant. Five to 20
cloves of raw garlic is as
potent as aspirin and could
exacerbate its effects.
wintergreen (Gaultheria
procumbens) contains
salicylates, the active
compound in aspirin,
and could cause toxicity.
astemizole (Hismanal) May have sedative action,
hydroxyzine (Atarax, Vistaril) exacerbating drowsiness and
loratadine (Clafftin) fatigue side effects of drug:
* hops (Humulus lupulus)
* kava (Piper methysticum)
* passion flower (Passiflora
incamata)
* scopolia (Scopolia
camiolica)
* valerian (Valeriana
officinalis)
bisacodyl (Dulcolax) Stimulant laxatives can
exacerbate potassium loss and
contribute to confusion,
weakness or irregular
heartbeat:
* aloe (Aloe barbadensis)
* cascara sagrada (Rhamnus
pershianus)
* senna (Senna alexandrina)
anthraquinone-containing herbs
can exacerbate laxative
effect:
* aloe (Aloe barbadensis)
* cascara sagrada (Rhamnus
pershianus)
* senna (Senna alexandrina)
* yellow dock (Rumex crispus)
caffeine (Caffedrine, guarana (Paullinia cupana) is
NoDoz, Vivarin) very high in caffeine.
ma huang (Ephedra) can
exacerbate toxic effects of
caffeine.
phenobarbital (Phenobarbital) Herbs that exacerbate liver
toxicity (and are not even safe
to use alone):
* chaparral (Larrea
tridentata)
* coltsfoot (Tussilago
farfara)
* comfrey (Symphytum
officinale)
tetracycline HCI (Achromycin-V, St. John's wort may exacerbate
Sumycin, Tetracycline) drugs' side effect of increased
sensitivity to the sun.
theophylline (Theo-Dur) ma huang (Ephedra) can
exacerbate rapid heart rate,
anxiety and high blood
pressure.
warfarin sodium (Coumadin) Herbs with anticoagulant
effects that may exacerbate
drugs' effects, possibly
triggering postoperative
bleeding or a bleeding stroke
in susceptible people:
* chamomile (Matricaria
recutita)
* feverfew (Tanacetum
parthenium)
* garlic (Allium sativum)
* ginseng (Panax ginseng)
* ginger (Zingiber
officinale)
* ginkgo (Ginkgo biloba)
* seaweed (Fucus and other
species)
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