Should I check with my doctor or healthcare provider before using a supplement?

• Some supplements may interact with prescription and over-the-counter medicines.
  Taking a combination of supplements or using these products together with medications (whether prescription or OTC drugs) could under certain circumstances produce adverse effects, some of which could be life-threatening. Be alert to advisories about these products, whether taken alone or in combination. For example: Coumadin (a prescription medicine), ginkgo biloba (an herbal supplement), aspirin (an OTC drug) and vitamin E (a vitamin supplement) can each thin the blood, and taking any of these products together can increase the potential for internal bleeding. Combining St. John's Wort with certain HIV drugs significantly reduces their effectiveness. St. John's Wort may also reduce the effectiveness of prescription drugs for heart disease, depression, seizures, certain cancers or oral contraceptives.

• Some supplements can have unwanted effects during surgery:
  It is important to fully inform your doctor about the vitamins, minerals, herbals or any other supplements you are taking, especially before elective surgery. You may be asked to stop taking these products at least 2-3 weeks ahead of the procedure to avoid potentially dangerous supplement/drug interactions -- such as changes in heart rate, blood pressure and increased bleeding - that could adversely affect the outcome of your surgery.

• Adverse effects from the use of dietary supplements should be reported to MedWatch:
  You, your health care provider, or anyone may report a serious adverse event or illness directly to FDA if you believe it is related to the use of any dietary supplement product, by calling FDA at 1-800-FDA-1088, by fax at 1-800-FDA-0178 or reporting on-line at: http://www.fda.gov/medwatch/how.htm. FDA would like to know whenever you think a product caused you a serious problem, even if you are not sure that the product was the cause, and even if you do not visit a doctor or clinic. In addition to communicating with FDA on-line or by phone, you may use the MedWatch form available from the FDA Web site.