Question: I know that most cries of “herbs are dangerous!” are unfounded. But can herbs react with drugs? Are those reactions dangerous?
Dr. Wright: Herb-drug interactions can be dangerous, depending on the herb, the drug, and the combination of the two. A few years ago, regular Nutrition & Healing columnist Kerry Bone outlined some basic guidelines for using herbs in conjunction with other medications.
Those guidelines are as follows:
1. If you are taking any drug and wish to take herbs as well, it’s best to seek the advice of a professional trained in herbal therapy.
2. The following drugs have a narrow therapeutic window (meaning that they can become dangerously toxic or dangerously ineffective with only relatively small changes in their blood concentrations): digoxin, Coumadin, antirejection drugs, many anti-HIV drugs, phenytoin, and phenobarbital. Never take any herbal supplement with these drugs except under professional guidance.
3. If your heart, liver, or kidney function is impaired, if you are elderly, pregnant, if you have received an organ transplant, or if you have a genetic disorder that deranges normal biochemical functions, do not take herbal supplements with drugs except under professional guidance.
4. Never take drugs and herbal supplements at the same time of day. Always separate them by at least an hour, preferably more.
5. If you have any type of serious disease and are being treated with chemical drugs, do not take any herbal supplement except under professional guidance.
6. Stop all herbal supplements about one week prior to surgery.
7. Research any herbal supplement you wish to take to see if there are known (not speculative) herb-drug interactions. Much is known, for example, about St. John’s wort, but there is still some speculation. Learn to differentiate between the two.
8. If you believe that an herbal supplement you are taking is causing an interaction, stop taking it and seek professional advice.
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