 |
 DRUG
- NUTRIENT and DRUG- HERB INTERACTIONS
Check
your medications against this list to see
which nutrients/herbs
you need to avoid or have more of.
Consult
you doctor/dietitian/pharmacist before you
take any supplements.
 MORE
(increased intake of nutrient recommended
from food, fortified foods/drinks or supplements)
 AVOID
(nutrient/herb affects absorption of drug
and action within body)
 INCONCLUSIVE
(more evidence needed)
Other
excellent websites:
US Kroger Pharmacy/Quality
Food Centres
EBSCO publishing - evidence based health
and medical information
This
list will be continuously updated (last
update 4/9/2006)
Please
note: Individuals taking potassium-depleting
diuretics and those who are otherwise at
risk of developing potassium deficiency
(such as people with chronic diarrhea or
vomiting) may experience a fall in serum
potassium levels if they take magnesium
without taking additional potassium. This
could lead to muscle cramps or, in individuals
taking digoxin or digitalis, more serious
problems such as cardiac arrhythmias. Individuals
who have a history of potassium deficiency
and those who are at risk of developing
potassium deficiency, as well as people
taking digoxin or digitalis, should consult
a physician before taking magnesium-containing
antacids/products.
Abbreviations
used below:
HPT=
hypertension,NIDDM = diabetes, BSL = blood
sugar levels, CHOL=cholesterol,TRIG
= triglycerides
Fe
= iron, Zn=zinc, Mg=magnesium, K=potassium,
Ca=calcium, Mx= medication
> = increase <=decrease
 Actonel
(Risedronate, osteoporosis) - >anaemia,
<serum Ca/Phosphate Ca/Vit
D if intake inadequate
Antacids
Fe,
Mg, Zn - take 2 hrs before/after medication
Accupril/
Accuretic (Quinapril, HPT, ace inhibitor)
- may >anaemia K
Mg
Arginine
Licorice
St
Johns Wort Zn
Fe
Adalat/Adalat
oros (Nifepidine, HPT/angina/Ca channel
blocker) - can >weight, peppermint/licorice,
Ca+vitD
herbs
OK
Aldactone
(K sparing diuretic) - can >chol/trig
K supplements, high
K foods, Mg
>300mg/day,
diuretic
herbs - horsetail, dandelion, juniper, buchu
Amaryl
(Glimepiride, NIDDM) - Lithium,
Magnesium
and Chromium may< dose of Mx needed high
dose nicotinic acid - nicotinamide OK
oestrogens
gingko
Anginine
(Glyceryl Trinitrate, HPT) - folate
high dosevit
C
Antacid
- (Maalox, Mylanta, Gaviscon,MgOH, Ca carbonate,
Zoton) - avoid taking at mealtimes in the
elderly
because of binding to nutrients) - Chromium
Ca
Fe
Zn
Cu
Phosphorus
vit
A, D,
E,
K
B1,
B12
Folate
Mg
Ca
citrus
juice at same time as antacid. All nutrient
supplements to be taken with 2 hr gap from
antacid and high fibre/oxalate/phytate foods
to be taken separately
Arima
- (antidepressant, moclobemide) - tyramine
rich foods alcohol
Aropax
(paroxetine, SSRI) - Na
Gingko
Folate
tryptophan
St
Johns Wort SAMe
Asprin
(Astrix/Cartia/Solprin) - Fe,
Zn,
B12,
folate,
vit
C , cayene,
licorice
large
dose vit E,
large
dose fish oil blood
thinning herbs - garlic, gingko, grapeseed,
ginger, ginseng, coleus
Atacand
(candesartan, angiotensin II antagonists,
HPT) - K,
herbs
OK
Atacand
plus - can >homocysteine, >chol/trig/blood
sugars/uric Mg,
Zn,
B12,
folate,
B6,
Ca
K
vit D, herbs
OK
Avandia
(Rosiglitazone, NIDDM) -can >weight,
>diarrhoea, >anemia, >chol, herbs
OK Chromium
may
<dose of Mx needed
Avapro
(Irbesartan, angiotensin II antagonist)
- can >weight, >anaemia, K,
herbs
OK
Avapro
HCT - can >BSL, >uric, >trig,
>chol, >weight; K,
Mg,
Zn,
Ca,
vit
D, herbs
OK
Benztropine
(Cogentin, Parkinson's) - tryptophan,
niacin,
herbs
OK
Betaloc
(Metoprolol, angina, HPT, post heart attack)
- can >weight, <blood sugars,>trig,
>uric, constipation,
K,
herbs
Co
Q 10 Chromium
Cardizem
(Diltiazem, anti-angina HPT, Ca channel
blocker) - can >weight, >BSL, >uric
DHEA
Ca
Vit
D
Capoten
(Captopril, HPT, ACE inhibitor) - <weight,
>anaemia, >uric acid K
Mg
Arginine
Licorice
St Johns Wort Zn
Fe
(supplements taken 2hrs before/after Mx)
Catapres/Clonidine
HCL (HPT) Co
enzyme Q coleus
yohimbe
Celebrex
(NSAID, Celecoxib) - >BSL, >chol,
>weight, avoid
blood thinning herbs/asprin/willowbark
arginine
feverfew
gingko
garlic
policosanol
potassium
citrate don
quai/Stohns wort vit
E
ginger/garlic/fish
oil/grape seed extract red
clover chondroitin
cayenne
folate
Cipramil
(citaloprom, SSRI, depression) - can >or
< weight, can <BSL, <serum K and
Na, Fe, tryptophan,
SAMe St Johns Wort Gingko Folate
Clopidogrel/Iscover
(Plavix, platelet aggregation inhibitor)
- can >chol, does not interact with fish
oil but not advised if you are bruising
easily; blood
thinning herbs - garlic, gingko, grapeseed,
ginger, ginseng
Colchicine
- (antigout) <weight, diarrhoea, K,
Ca,
Na,
Fe,
B12,
vit
A, b-carotene,
herbs
OK
Corticosteroids
- can >weight, >BSL, >chol Chromium
K
Zn
Ca
B6
folate
vit
C vit
D vit
A
Phosphorus
Coversyl
(Ace Inhibitor, Perindopril) - K
, Zn
herbs
OK
Coversyl
Plus (Ace Inhibitor, Perindopril) -
can >chol/uric/BSL K
, Ca,
Zn
Mg,
herbs
OK
Daonil
(Glibenclamide, NIDDM) - can >weight,
<iodine uptake by thyroid aloe
chromium
ginkgo
biotin
gymnema
vit
E
Dapatabs
(Indapamide,thiazide diuretic,HPT) can >BSL/uric/trig/chol
K,
Zn
Mg
Na,
Vit
D,
Lithium,
Ca,
herbs
OK
Diabex/Diaformin
(Metformin, NIDDM) - can <weight, <chol/trig
B12,
folate,
Ca,
large
dose niacin,
guar
gum Magnesium,
chromium, aloe, ginseng, gymnema, fenugreek,
vanadium - less Mx may be needed if take
these weaker
evidence that if take following may need
to reduce Mx - lipoic, CoQ10, arginine,
carnitine, garlic, cumin, vit E, guggul,
DHEA gingko/dong
quai St
Johns wort potassium
citrate
Diamicron
(Gliclazide,sulfonylurea)- can <Iodine
uptake by thyroid, aloe,
chromium
- can lower blood sugars gingko,
biotin,
vitE,
gymnema
Diazepam
(tranquiliser, benzodiazepine) - alcohol
grapefruit
caffeine
St
Johns Wort ashwagandha
(Withania somnifera), calendula
(Calendula officinalis), catnip
(Nepeta cataria), hops
(Humulus lupulus),
lady's
slipper (Cypripedium), lemon
balm (Melissa officinalis), passionflower
(Passiflora incarnata),
sassafras
(Sassifras officinale), skullcap
(Scutellaria lateriflora), valerian
(Valeriana officinalis), and
yerba
mansa (Anemopsis californica) kava
(Piper methysticum).
Duromine
(Phentermine, non-amphetamine, anorectic)
<weight - nil interactions
Digoxin/Lanoxin
Mg
but must be taken 2 hours after/before digoxin,
Zn,
K
if levels are low, fibre,
Ca
vit
D, Senna,
St
Johns Wort, Licorice,
Hawthorn,
Buckthorn
Ducene
(tranquiliser, benzodiazepine) - St
Johns Wort, Alcohol
Endep
(antidepressant, Amitriptyline) - B2/riboflavine,
CoQ10,
Tryptophan,
Niacin,
B
vits, SAMe,
caffeine/tea,
fibre,
alcohol,
St
John's wort, herbs
OK
Felodur
(felodipine, HPT, congestive heart failure)
- Ca,
Mg,
K,
grapefruit/oranges,
peppermint,
Quercetin,
herbs
OK
Fenac
(Diclofenac, NSAID) - Ca
Tryptophan
Lithium
Stinging
nettle willow
Fosamax
(Alendronate, Biphosphonates, bones) - Ca,
Mg - but take 2 hrs before/after Mx
Evista
(Raloxifene, Oestrogen modulator) - <chol/trig/fibrinogen
phytoestrogens
Gemfibrozil
(hypolipidaemic) - may >BSL and <blood
K CoQ10
Vit
E niacin
red
rice yeast extract
Glucophage
(Metformin, NIDDM) - can <weight,<chol/trig
B12,
folate,
Ca,
Chromium
may < dose of medication needed large
dose niacin, guar
gum, gingko,
Mg,
DHEA,
herbs
OK
Ikorel
(Nicorandil, anti-angina, K channel activator)
- ?
Indocid
(indomethacin, NSAID) - can >blood sugars,
>K, Fe+Indocid
=stomach irritation/bleeding - take with
food, Ca,
Folate,
vit
C, K/Na,
Lithium,
salicylates/white
willow, herbs
OK
Isoptin/SR
(Verapamil,Ca channel blocker,antiarrhythmic,angina,HPT)
carnitine
Ca+vit
D grapefruit
herbs
OK
Kaluril
(K sparing diuretic, amiloride) - can >chol/BSL
, K,
Mg,
thiamin,
herbs
OK
Karvea
(Irbesartan,HPT, angiotensin II antagonist)
- can >weight, K,
herbs
OK
Karvezide
(HPT) can >homocysteine,>BSL/uric/TRIG/Chol
Mg,
K,
Zn,
Ca,
vitD,
herbs
Klacid
(Clarithromycin, antibiotic for peptic
ulcer) - vit
K, Fe,
B1,
B12,
probiotic,
saccharomyces,
herbs
Largactil
(Chlorpromazine/benzodiazepine, antianxiety)
- can >weight, >chol, Mg
supplements but to be taken with 2hr gap,
vit
B2, B12,
evening
primrose oil, St
Johns Wort alcohol,
herbs
OK
Lasix
(loop diuretic, HPT, heart failure)-
can >homocysteine, >BSL/uric/chol/trig,
Mg,
K,
Zn,
Ca,
thiamin,
folate,
dandelion
horsetail, licorice,
juniper,
buckthorn
Levlen
ED (oral contraceptive) folic
Mg
B1,
B2, B3, B6, B12 vit
C Zn
St
Johns wort
Lexapro
(antidepressant, SSRI, escitalopram) - >BSL,
>chol, <serum Na tryptophan
st
johns wort
Lithium
(lithicarb, manic depression); inositol,
omega
3, folate,
Cu
tryptophan,
Iodine,
constant
Na intake (avoid low/highNa), psyllium,
xanthines
(cocoa,coffee,tea,caffeine, carbonated drinks
alcohol,
copper
Lipidil
(fenofibrate, <chol/trig) - folate
vit
B12 vit
B6 vit
C vit
E Herbs
OK sun
exposure
Lipitor
(atorvastatin, HMGCO reductase inhibitors)
- vit
A, Co
Q10, niacin
Mg
antacids/MgOH,
grapefruit,
herbsOK
Lipex
(simvastatin) - vit
A, Co
Q10, fish
oil niacin
vit
E herbs
OK
Losec
(proton pump inhibitor, Omeprazole) - Folate
Fe
Zn
B12
thiamin
selenium
cranberry,
St
Johns Wort
Madopar
(antiparkinson, levodopa) - >5mg
B6 supplement or B6 rich food (wheat bran,
soy flour, walnuts,
vegemite, potato crisps, peanuts, banana,
chicken/beef, eggs, oats, brown rice) can
<drug effect Fe
supplement - chelates levodopa if taken
at same time amino
acid or protein supplement high
protein intake -
keep high protein foods to evening meal
- restrict high biological protein intake
to 0.5g/kg/day to stabilise drug
effects folate
vit
C policosanol
tryptophan
Methotrexate
- aspirin,
Ca,
B12,
folate
in arthritis (folate deficiency can increase
methotrexate toxicity - should not take
folate if methotrexate is being used to
treat cancer), b-carotene,
ginger,
glutamine,
vit
A, milk
thistle, Zn,
melatonin
antioxidant/multivitamins
(vit E,C,lipoic acid) medicinal
mushroom coriolus versicolor for cancer
Metoprolol
(b-blocker, angina, heart attacks, HPT)
- can >weight, >uric/trig, K
Micardis
(Telmisartan,Angiotensin II antagonist,
HPT) - can >chol, K,
herbs
OK
Micardis
Plus - can >BSL, >uric, >chol/trig,
>homocysteine, K,
Ca,
vit
D, Mg,
Zn
Minidiab
- (Glipizide, NIDDM) can <iodine uptake
by thyroid, >weight gain, high
dose vit B3, fenugreek,
gingko,
gymnema,
Mg
low
dose Chromium may <dose of Medication
needed
Mobic
- (NSAID, Meloxicam) - can >anaemia,
lithium,
salicylates/white
willow
Nardil
- Phenelzine/Monoamine Oxidase Inhibitors
- B6
(pyridoxine), aspartame,
ginseng,
St
Johns wort, Tyramine
Modecate
- fluphenazine/phenothiazines - Co
Q10, milk
thistle, vitamin
E, B6,
gingko,
phenylalanine,
Johns
wort herbs
Monoplus
- Mg,
K,
Zn,
Ca
- supplements with these minerals to be
taken with 2hr gap,
herbs
Monopril
- (fosinopril,ace inhibitor,HPT,heart failure,heart
attack) -K,
Fe,
Zn
Ca/Mg
supp taken 2hr gap
Arginine
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