HE ALTH & HE ALIN G
Risky herb & drug combinations
Many people believe that all ‘natural’ herbs and foods are safe with the concurrent use of medication. However herbs and foods may interact with medications, resulting in serious adverse reactions.
by Bec Farah Y
ou may have heard on the radio that vitamin E is a cardio- protective, or seen a television
ad highlighting the immune boosting properties of echinacea root, and then headed to your local pharmacy or health food store to purchase these glorious supplements. But would you have first asked yourself a couple questions, such as: “What medications am I currently taking?” “Do I take these on an empty stomach, or with a meal?” Many people believe that all ‘natural’
herbs and foods are safe with the concurrent use of medication. This is incorrect. Herbs and foods may interact with medication, resulting in serious adverse reactions. Conversely, while certain medications interact adversely with herbs and supplements, there are some herb/drug combinations that can produce therapeutic benefits.
FOODS AND BEVERAGES Some foods and beverages, even healthy ones, can reduce the therapeutic efficacy of your medication if ingested concurrently. The presence of food in the
digestive tract may delay or decrease the absorption of medications. The absorption of the common antibiotic azithromycin, for example, is decreased when administered with food, reducing its bioavailability by 43%. It is therefore often recommended to take certain medications on an empty stomach or one to two hours after eating.
26 MARCH 2017
In contrast, some medications are easier to tolerate when taken with food. Non- steroidal anti-inflammatories (NSAIDs), oestrogen, and cholesterol medications are examples of drugs that should be administered with food to reduce gut irritation and possible nausea.
FIBRE Dietary fibre can affect medication absorption. Soluble fibres such as pectin have been shown to slow down the absorption of acetaminophen, a common painkiller. Insoluble fibres, including bran, have a similar effect on digoxin, a major heart medication.
GRAPEFRUIT JUICE Compounds found in grapefruit have been shown to inhibit cytochrome P450, an enzyme in the liver, leading to increased blood levels of medications and toxicity. Adverse reactions such as
light-headedness, headaches, and facial flushing are common, and raised blood pressure and heart rates can also result. Grapefruit and its juice are therefore recommended to avoid completely when taking some medications.
SOY Soy milk, tofu, tempeh and soy- containing products raise concerns as consumption has been associated with reduced absorption of thyroid medication.
TYRAMINE The amino acid tyramine – found in aged cheeses, red wines, cured meats, and some fermented foods, regulates blood pressure. Monoamine oxides (MAO) inhibitors, commonly prescribed for depression, are known to interact with foods containing tyramine, leading to severe hypertensive emergency. Therefore, the above foods high in tyramine should be avoided altogether with medication administration.
CAFFEINE Coffee, black tea, and even chocolate can have a stimulatory impact when taken with certain medications. Patients taking anti-arrhythmic drugs may experience an irregular heartbeat while consuming caffeine. Caffeine can increase anxiety and reduce drug effectiveness of benzodiazepines; reversing the need to sleep. It has been reported that caffeine has raised
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