Drug Supplement Interactions by Leo Galland M. D. DRUG- SUPPLEMENT. Omega-3 may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants (blood thinners.
Pure Alpha Lipoic Acid (ALA) Powder at BulkSupplements.com – FREE Shipping. Read Alpha Lipoic Acid (ALA) Nutritional Information and Reviews. INTERACTIONS: THE. GOOD, THE BAD AND THE UNDETERMINEDLEO. GALLAND M. D., F. A. C. P. FOUNDATION. FOR INTEGRATED MEDICINENEW YORK, NEW. YORKINTRODUCTION. In conducting a detailed analysis of the available literature during 2. Because. of the diversity of substances and interactions, the information will be. Only the results of clinical trials, controlled human. Space limitation. ANALGESIC/ANTI- INFLAMMATORYa. Aspirin and NSAIDs Three areas of potential. NSAIDs and dietary supplements have been reported. Table 1 lists six supplements that may diminish GI side effects. NSAIDs, based upon controlled experiments with healthy humans. The. protective effect of vitamin C is noteworthy because regular use of aspirin. C and suppresses gastric blood flow in humans. Potential. interactions involving platelet function are described in section 4. Numerous food. components and herbs have anti- inflammatory effects when studied in vitro. ![]() ![]() Degradation by intestinal. Of all dietary supplements, omega- 3 fatty acids. Table 2). In patients with active rheumatoid arthritis, fish. EPA) and 1. 14. 0 mg of. DHA) per day. A combination of evening. GLA and 2. 40 mg of EPA per day, may. The. effect of fish oils in reducing NSAID requirements of patients with rheumatoid. ASA Derivatives. 5- ASA derivatives are. Drugs of this class. Fish oil capsules. ![]() ASA derivatives and improve maintenance of. ASA therapy (see. Table 2). Two specific. ASA. derivatives for induction or maintenance of remission in patients with. VSL- 3, a. proprietary mixture of Lactobacillus. ![]() ![]() L. Saccharomyces boulardii. Glucocorticoids. Chromium. L to 1. 50 mg/d. L and a 5. Calcium plus. vitamin D is effective at preventing steroid- induced reduction of lumbar spine. In steroid- treated patients. SLE), DHEA, 2. 00 mg/day for 6 months, improved the. SLE- disease activity index and prevented steroid- induced bone loss, when. In. patients with Addison's disease, addition of DHEA, 5. Despite. equal content of glycyrrhizin, however, three separate formulas used in. Chinese and Japanese kampo medicine had qualitatively different. Sho- saiko- to (xiao chai hu. Asia for treatment of chronic hepatitis and now available in the. AUC by 1. 7%, through an unknown mechanism. Acetaminophen. NAPQI is usually. GSH). The amino acid N- acetylcysteine. NAC), a glutathione precursor, protects against this toxicity. Several. supplements prevent acetaminophen toxicity in laboratory animals; no human. John's. wort (Hypericum perforatum) to four patients. What makes St. Drugs that are slowly absorbed. P- gp may have their plasma levels. St. Variability of pharmacokinetic interactions with St. John's wort. preparations. Hyperforin appears to be the component of St. John's wort responsible for CYP induction. ANTIARRHYTHMIC/ANTIHYPERTENSIVEa. Digoxin. The earliest antiarrhythmic. Numerous herbs contain cardiac glycosides with structural. John's. wort may decrease plasma digoxin concentration by decreasing intestinal. Beta- blockers. Calcium channel blockers. The dihydropyridine. CYP3. A and are potentially subject. CYP3. A isozymes. This. interaction was demonstrated in human volunteers when nifedipine and felodipine. CYP3. A inhibitor. Although. garlic extracts may induce CYP3. A (and were shown to reduce bioavailability of. In. vitro, pycnogenol stimulates endothelial nitric oxide synthesis, an effect that. ACE inhibitors. ACE inhibitors. Co- administration of iron (and. ACE inhibitors may significantly reduce drug. ACE inhibitors. decrease potassium excretion, so that administration of potassium to patients. ACE inhibitors may cause severe hyperkalemia. The addition of. NAC 6. ANTIBIOTICa. Tetracyclines, quinolones. Studies in rats have. Metronidazole. None of the suspected. Vitamin C (2. 50 mg bid). E (2. 00 IU bid), impaired the effectiveness of metronidazole in the. H. Nitrofurantoin. Deglycyrrhizinated licorice (DGL). DGL with nitrofurantoin improved. Trimethoprim. Concomitant use of trimethoprim with potassium salts may. Antibiotic- associated diarrhea (AAD). The majority of. positive studies have been done with Lactobacillus. GG and S. ANTITHROMBOTICa. Aspirin and other inhibitors of platelet. Many of. these, however, do not manifest antiplatelet effects when taken orally by human. Others, like resveratrol, only inhibit the. Dietary. supplements that inhibit human platelet function after oral administration are. Table 4. These might act in an additive fashion with antiplatelet. Vitamin E. (alpha- tocopherol) is an exception. Vitamin E and. aspirin have synergistic antiplatelet effects. Aspirin inhibits platelet. The interaction may be adverse or beneficial, depending upon the. A. prospective long- term study, however, found no increase in bleeding episodes or. Warfarin. Although many. Table 5) and some . Coenzyme Q1. 0 is structurally. K and has been reported to interfere with response to. Although. two case reports suggest a decreased warfarin effect in patients taking ginseng. Variations. in the ginseng preparations used may account for the differences. ANTILIPEMICMost HMG co. A reductase inhibitors (statins) are substrates for P- gp. CYP3. A, making them candidates for pharmacokinetic interactions with herbs. Izzo). Red yeast rice. K, which is identical with lovastatin, and yields similar. Further. analysis found that the antioxidant cocktail prevented the increase in. HDL2- C produced by simvastatin- niacin . The. adverse effect of vitamins E and C on anti- lipemic therapy may be specific to. HDL- C. Statin- induced. Q1. 0 depletion may impair mitochondrial function, raising the serum. ANTINEOPLASTICBecause most. Natural substances. St. Although studies in vivo are lacking, in. P- gp . The use of herbal. During the course of a clinical trial, self- administration. Zinc supplementation induces. Many commonly used. Although high dose pyridoxine (3. Some of these substances are. A detailed. discussion of the controversy concerning co- administration of antioxidants with. The controversy. itself is based upon a misunderstanding of the concept of . Almost all antioxidants exist in at. The notion that antioxidants protect cancer cells from the effects. The. presumed mechanism for both effects is pseudoaldosteronism, produced by a. Severe hypermagnesemia has occurred. Herbs with diuretic. Abuse of Cascara segrada has been. HYPOGLYCEMIC. In a. A review of. clinical research on the hypoglycemic effect of natural products concluded that. Coccinia indica and American ginseng. None of these agents appears adequate as stand alone. IMMUNE MODULATION. The increase. in cyclosporine trough concentration by grapefruit juice is well- known and has. Cyclosporine in. its turn inhibits metabolism of statins, increasing blood levels and the. Rhabdomylosis, a manifestation of statin toxicity. K. At 5 mg/day, folic. The polyherbal. medicine sho- saiko- to, used in Japan. C, is now available in the United States. Allergic. pneumonitis, an uncommon side effect of both sho- saiko- to and interferon alpha. Until more. information is available, it seems prudent to advise patients receiving. NAC not only potentiates the cardioprotective. Folate is. involved in regeneration of tetrahydrobiopterin. CONCLUSION. Extreme. The literature on. CYP or P- gp induction/inhibition or to additive. Many of these are not substantiated when tested in. A number of small clinical trials demonstrate. Familiarity with these will allow physicians to direct their patients. Prescribed in this fashion, it may be possible to apply precision to the. OMEGA- 3 FATTY ACID ENHANCEMENT. OF CLINICAL RESPONSE TO MEDICATION IN CONTROLLED CLINICAL TRIALSDRUG/CLASS. DRUGS WITH SIGNIFICANT. REDUCTION IN PLASMA LEVELS WHEN CO- ADMINISTERED WITH ST. DIETARY SUPPLEMENTS THAT. INHIBIT PLATELET FUNCTION AFTER ORAL ADMINISTRATION TO HUMANSSUPPLEMENT. DIETARY SUPPLEMENTS WITH. DOCUMENTED INTERACTIONS WITH WARFARINSUPPLEMENT. DIETARY SUPPLEMENTS THAT. MAY PREVENT TOXICITY OF ANTINEOPLASTIC CHEMOTHERAPY: CLINICAL TRIALSSUPPLEMENT. Drug- Nutrient Workshop. New York. Applied. Nutrition, Inc., 2. Br J Rheumatol. 1. Ann Rheum Dis. 1. Folate, colitis, dysplasia. Nutr Rev. 1. 98. 9 Oct; 4. Am J Gastroenterol 2. N Engl J. Med 1. 99. A case- control study. Gastroenterology. Med Sci. Monit. 2. Nov; 1. 0(1. 1): PI1. Eur J Gastroenterol. Hepatol. 2. 00. 3 Jun; 1. May; 5. 1(5): 5. 89- 9. Cochrane Database Syst Rev. CD0. 00. 95. 2. Calcif Tissue Int. Lupus. 1. 99. 9; 8: 1. Vollenhoven et al, Treatment. J Rheumatol. 1. 99. Arthritis. Rheum. J Clin. Endocrinol. Metab. 2. 00. 0; 8. Nippon. Naibunpi. Gakkai. Zasshi 1. Postgrad Med 2. 00. Drug Saf 2. 00. 1; 2. John's. wort- -a case report. Pharmacopsychiatry 2. Br J Clin. Pharmacol. Proc Natl. Acad. Sci. U S A. 2. 00. 0; 9. Biol. Psychiatry. An evidence- based stsrematic. Natural Standard Research. Collaboration. Expert Opin. Drug. Saf. 2. 00. Am J Clin Path. 2. Mc. Rae, Elevated serrum. Siberian ginseng. CMAJ 1. 99. 6; 1. Am J Hos. Pharm 1. Ann. Ital Med Int. Br J Clin. Pharmacol. N- 3 Fatty acids for the prevention of atrial fibrillation after coronary artery bypass surgery: a. J Am Coll. Cardiol. Cardiovasc Drugs Ther. Mol Cell Biochem. J Cardiovasc. Pharmacol. A randomized, controlled trial. Ann Intern Med. 1. Clin. Pharmacol. Ther. Am J Therapeutics 2. J Cardiovasc. Pharmacol. Br J Clin. Pharmacol. Arch Intern med 1. J Pharm Sci. J Pharm. Pharmacol. 1. 99. Arzneimittelforschung. Helicobacter 2. 00. JAMA 1. 99. 4; 2. Clin. Infect Dis 2. Indian J Physiol. Pharmacol. 1. 98. Arzneimittelforschung. Probiotics in the. JPediatr. Meta- analysis of probiotics for the prevention of antibiotic associated. Clostridium difficile disease. Am. J Gastroenterol. J Assoc Physicians India. Lipids. 1. 99. 3; 2. Fundam. Clin. Pharmacol. Blood Cells Mol Dis. Ann Med 1. 99. 8; 3. Am. J Clin. Nutr. Suppl): 1. 38. 1S- 1. S. Blood Coagul. Fibrinolysis. Pharmacol Res. Lancet. A randomized, double- blind. Ugeskr. Laeger. 2. Am J Cardiol. 1. 99. Ann Pharmacother. Blood Coagul. Fibrinolysis. Am J Health Syst. Pharm 1. 99. 7; 5. Br J Clin. Pharmacol. Transplantation 2. An analysis of nine proprietary Chinese. J Altern Complement Med.
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