🌿 Folk Prescriptions

In recent years, reports on adverse effects of herbal medicines from abroad have increased. Besides documented cases of kidney damage from herbs like Guangfangji, Guanmutong, and Aristolochia, foreign pharmacologists have also investigated potential adverse interactions between common herbal plants (including TCM herbs) and synthetic drugs. Results show that interactions between synthetic drugs and herbs can enhance or reduce the efficacy or toxicity of one or both drugs.
Properly Equipping Your Home Medicine Cabinet (Image)
Below are some adverse interactions between herbs and certain Western drugs, based on authoritative medical literature (1994–1999) retrieved by Dr. Adeline of the University of Washington:
▲ Ginkgo biloba, garlic, angelica, and salvia miltiorrhiza used with warfarin (anticoagulant) may increase bleeding tendency.
▲ Ginkgo biloba used with acetaminophen or ergotamine may cause bilateral epidural hematoma (reported even with ginkgo alone).
▲ Ginkgo biloba used with thiazide diuretics may cause hypertension.
▲ Ginkgo biloba used with aspirin may lead to anterior chamber hemorrhage, as ginkgo lactones are potent PAF inhibitors.
▲ St. John’s wort (Hypericum perforatum) used with serotonin reuptake inhibitors (e.g., trazodone, sertraline, nefazodone) may cause mild serotonin syndrome.
▲ St. John’s wort used with theophylline, cyclosporine, digoxin, or phenprocoumon may reduce their bioavailability.
▲ St. John’s wort used with paroxetine (an antidepressant) may cause drowsiness and incoherence.
▲ St. John’s wort used with oral contraceptives (e.g., ethinylestradiol, desogestrel) may cause genital ulceration and bleeding.
▲ St. John’s wort used with HIV protease inhibitor indinavir may drastically reduce indinavir concentration, rendering it ineffective and potentially promoting HIV resistance.
▲ Ginseng used with antidepressants (e.g., phenelzine) may cause headache, tremors, and mania.
▲ Areca nut used with antipsychotics (e.g., flupentixol, cyproheptadine, fluphenazine) may exacerbate extrapyramidal symptoms.
▲ Areca nut used with prednisolone or salbutamol may fail to fully control asthma, as arecoline induces bronchoconstriction in a dose-dependent manner.
▲ Herbs containing anthraquinones (e.g., Cassia acutifolia, Rhamnus purshiana) and soluble fiber (e.g., Plantago ovata) may reduce absorption of certain synthetic drugs, such as metformin, glipizide, and penicillin derivatives.
Medication Knowledge: What Does "Extended-Release Capsule" Mean? How to Read Drug Labels
Dr. Adeline believes that adverse interactions between herbs and synthetic drugs extend far beyond these examples. As awareness and research grow, more discoveries will emerge. She emphasizes that clinicians should inquire about patients’ herbal usage and inform them of verified facts. For instance, patients with coagulopathies, those awaiting surgery, or those on anticoagulant therapy should avoid ginkgo, salvia miltiorrhiza, angelica, papaya, and garlic, as these herbs may render anticoagulants ineffective and cause bleeding.