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Nutrition in Cancer Care (PDQ®)
Patient VersionHealth Professional VersionEn españolLast Modified: 08/11/2009
Table 3. Common Herbal Treatments Used by People With Cancer and Possible Food/Drug Interactions

Herbal  Possible Food/Drug Interactions 
MAOIs = monoamine oxidase inhibitors.
Black cohosh May further reduce lipids or blood pressure when combined with prescription medications; may increase antiproliferative effect obtained with tamoxifen.
Chamomile May increase bleeding when used with anticoagulants; may increase sedative effect of benzodiazepines.
Dong quai May increase effects of warfarin.
Echinacea May interfere with immunosuppressive therapy.
Garlic May increase bleeding time with aspirin, dipyridamole, and warfarin; may increase effects and adverse effects of hyperglycemic agents.
Ginkgo biloba May increase bleeding time with aspirin, dipyridamole, and warfarin; may increase blood pressure when used with thiazide diuretics.
Ginseng May adversely affect platelet adhesiveness/blood coagulation; may increase hypoglycemia with insulin; may interfere with antipsychotic drugs; may cause hypertension when used long-term with caffeine.
Kava kava May increase central nervous system depression when used with alcohol and sedatives; may cause hepatotoxicity.[12]
St. John's wort May cause serotonin syndrome when used with antidepressants and drugs using p450 microsomal enzyme for metabolism.[13] Interacts with procarbazine.
Ma huang (ephedra) Increases toxicity with beta-blockers, MAOIs, caffeine, and St. John’s wort.
Yohimbe Decreases effect of antidepressants, antihypertensives, hyperglycemic agents, MAOIs, and St. John’s wort.

References

  1. U.S. Food and Drug Administration.: Consumer Advisory: Kava-Containing Dietary Supplements May Be Associated with Severe Liver Injury. Washington, DC: U.S. Food and Drug Administration, 2002. Available online. Last accessed August 11, 2009. 

  2. Piscitelli SC, Burstein AH, Chaitt D, et al.: Indinavir concentrations and St John's wort. Lancet 355 (9203): 547-8, 2000.  [PUBMED Abstract]


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