Feverfew
Avoid taking with:
- Aspirin
- Ticlopidine (Ticlid) — blood-thinning medication
- Clopidogrel (Plavix) — blood-thinning medication
- Dipyridamole (Persantine) — blood-thinning medication
- Warfarin (Coumadin) — blood-thinning medication
These medications can reduce blood clot formation. Feverfew may increase this effect, causing spontaneous and excessive bleeding.
Garlic
Avoid taking with:
- Aspirin
- Ticlopidine (Ticlid) — blood-thinning medication
- Clopidogrel (Plavix) — blood-thinning medication
- Dipyridamole (Persantine) — blood-thinning medication
- Warfarin (Coumadin) — blood-thinning medication
- Cyclosporine (Neoral, Sandimmune) — an immunosuppressant
- Saquinavir (Fortovase, Invirase) — an HIV protease inhibitor
Combined with garlic, anticoagulant medications may cause spontaneous and excessive bleeding. Garlic may decrease the effectiveness of immunosuppressants and HIV protease inhibitors.
Garlic may cause lower levels of blood sugar, which may decrease your need for insulin if you have diabetes. If you take insulin and garlic together, monitor your blood sugar carefully and report any changes to your doctor.
Ginger
Avoid taking with:
- Aspirin
- Ticlopidine (Ticlid) — blood-thinning medication
- Clopidogrel (Plavix) — blood-thinning medication
- Dipyridamole (Persantine) — blood-thinning medication
- Warfarin (Coumadin) — blood-thinning medication
- H2 blockers and proton pump inhibitors — acid-blocking medication
Ginger may increase the effect of anticoagulants, which may cause excessive bleeding. It may also increase the production of stomach acid, which could counteract the effects of antacid medications.
Ginger may lower your blood pressure or blood sugar levels, which may reduce your need for blood-pressure-lowering medications or insulin if you have diabetes. Monitor your blood pressure or blood sugar levels if you take these medications and report any changes to your doctor.
Ginkgo
Avoid taking with:
- Aspirin
- Ticlopidine (Ticlid) — blood-thinning medication
- Clopidogrel (Plavix) — blood-thinning medication
- Dipyridamole (Persantine) — blood-thinning medication
- Warfarin (Coumadin) — blood-thinning medication
- Antidepressants
- Antipsychotic medications
- Insulin
Ginkgo may increase the anticoagulant effect of these drugs and has the potential to cause spontaneous and excessive bleeding when used in conjunction with these medications. It can also increase the amount of antidepressant medication in your blood. When combined with antipsychotic medications, ginkgo may cause seizures. Ginkgo also affects insulin levels, so if you're taking the two together, monitor your glucose levels carefully.
Ginseng
Avoid taking with:
- Warfarin (Coumadin) — blood-thinning medication
- Phenelzine (Nardil) — an antidepressant
- Digoxin (Lanoxicaps, Lanoxin) — heart medication
- Insulin and oral antidiabetic medications
Used with warfarin, ginseng can increase your risk of bleeding problems. Ginseng with phenelzine may cause headache, trembling and manic behavior. Ginseng may interfere with digoxin's pharmacologic action or the ability to monitor digoxin's activity.
Ginseng can reduce blood sugar levels in people with type 2 diabetes (formerly called adult-onset or noninsulin-dependent diabetes). Without careful glucose monitoring, the use of ginseng with insulin or oral antidiabetic medications may cause dangerously low blood sugar levels.
Ipriflavone
Avoid taking with:
- Warfarin (Coumadin) — blood-thinning medication
- Antipsychotics
- Tacrine (Cognex) — an Alzheimer's disease medication
- Theophylline (Elixophyllin, Uniphyl) and zafirlukast (Accolate) — asthma medications
- Caffeine
- Tamoxifen (Nolvadex) — a cancer treatment and prevention medication
- Cyclobenzaprine (Flexeril) — a muscle relaxant
- Celecoxib (Celebrex) — pain-relieving arthritis medication
- Nonsteroidal anti-inflammatory medications — pain-relieving medication
Ipriflavone affects the way these drugs are metabolized, usually increasing the levels of the medications in the blood and the effects of the drugs.
Kava
Avoid taking with:
- Sedatives
- Sleeping pills
- Antipsychotics
- Alcohol
- Drugs used to treat anxiety or Parkinson's disease
Combined with these drugs, kava can produce deep sedation and, in some cases, even coma. In late 2001, following reports from Europe of liver problems in several people who used kava, the Food and Drug Administration started investigating the safety of this herb. Until more is known, don't start taking kava or products that contain kava. If you already do so, contact your doctor for advice and ask if you need liver function tests to check for unexpected liver problems. Don't take kava if you have a history of liver problems, if you're depressed, or if you take antidepressants or prescription sedatives.
Melatonin
Avoid taking with:
- Nifedipine (Adalat, Procardia) — used to lower blood pressure and treat heart disease
- Fluvoxamine (Luvox) — an antidepressant
Melatonin may reduce nifedipine's ability to lower blood pressure, which could lead to an increased heart rate and blood pressure level if these drugs are taken together. Fluvoxamine slows the metabolism of melatonin, which may result in excessive sleepiness.
St. John's wort
Avoid taking with any prescription medications. In particular, avoid taking St. John's wort and:
- Antidepressants
- HIV protease inhibitors — used to treat HIV/AIDS
- Non-nucleoside reverse transcriptase inhibitors — used to treat HIV/AIDS
- Digoxin (Lanoxicaps, Lanoxin) — heart medication
- Theophylline (Elixophyllin, Uniphyl) — an asthma medication
- Cyclosporine (Neoral, Sandimmune) — an immunosuppressant
- Chemotherapy
- Oral contraceptives
- Nifedipine (Adalat, Procardia) and diltiazem (Cardizem, Dilacor) — blood pressure and heart disease medications
- Warfarin (Coumadin) — blood-thinning medication
- Alcohol
- Tamoxifen (Nolvadex) — a cancer treatment and prevention medication
St. John's wort has been shown to affect your body's metabolism of all of these drugs. Many other drugs are likely to be affected, too. Until more is known about St. John's wort's ability to alter the metabolism of pharmaceutical medications, it's probably best not to combine such medications with St. John's wort.
Also, the combination of St. John's wort with some antidepressants, such as selective serotonin reuptake inhibitors, may cause an excess of serotonin (serotonin syndrome). Typical symptoms include headache, stomach upset and restlessness.
St. John's wort may reduce the effectiveness of some oral contraceptives. Use another form of birth control while taking St. John's wort.