Interaction of Drugs and Nutraceuticals

Presented by:

Saloni Shroff FN-Semester 1Roll no.: 04 Nutrigenomics

What are Nutraceuticals??

Any substance , i.e., a food or a part of food that provides medical or health benefits including the prevention or treatment of diseases.

Examples: Basil leaves, Aloevera, Turmeric, Amla, Drumstick leaves and many more.

Drug Interaction A drug interaction is a

situation in which a substance (usually another drug) affects the activity of a drug when both are administered together.

Interactions may also exist between drugs and foods (drug-food interactions), as well as drugs and medicinal plants or herbs (drug- plant interactions).

Such interactions may intensify or reduce the effectiveness of a drug or cause a serious side effect.

Some possible medicinal herb – drug interactions…

GARLIC:

(Allicin)

Hypotensive propertyHypocholesterolemic effect

Acts as an anti-inflammatory agentAnti-bacterial as well as anti fungal property

•Garlic taken with anticoagulants may increase the risk of bleeding.

Anticoagulants (such

as warfarin)

•Garlic may intensify the effects of these drugs, causing an excessive decrease in blood sugar levels (hypoglycaemia).

Hypoglycaemic drugs (such as insulin

 and glipizide)

•Garlic decreases blood levels of protease inhibitors, making them less effective.

Protease inhibitors (such as

indinavir or saquinavir), which are used

to treat HIV infection

GINGER:

Ginger is commonly used to treat Various types of stomach problems – acts as Carminative agent,Including-

motion sickness upset stomach diarrhea nausea (anti-emetic) loss of appetite

Other uses include pain relief from arthritis, menstrual pain,upper respiratory tract infections- cough and bronchitis.

• Ginger taken with anticoagulants may increase the risk of bleeding.

Anticoagulants (such

as warfarin)

• Ginger might decrease blood sugar. Taking ginger along with diabetes medications might cause your blood sugar to go too low.

Antidiabetic drugs- insulin,

metformin (Glucophage)

• Ginger might reduce blood pressure in a way that is similar to some medications for blood pressure. Taking ginger along with these might cause your blood pressure to drop too low or cause an irregular heartbeat.

Medications for high blood pressure

(Calcium channel blockers- nifedipine ,

verapamil )

GREEN TEA:

(Polyphenol)

Improve mental alertness and thinking. Bone loss (osteoporosis) Solid tumor cancers. Green tea is also used to treat –

Crohn’s disease Parkinson’s disease Cardio vascular diseases Diabetes Low blood pressure Chronic fatigue syndrome (CFS) Dental cavities (caries) Kidney stones Skin damage

•Green tea may cause warfarin to be less effective.

Anti coagulants

(such as warfarin)

•Taking green tea along with stimulant drugs might cause serious problems including increased heart rate and high blood pressure.

Stimulant drugs (such as

amphetamines, Ephedrine, Cocaine)

•Green tea might interact with Bortezomib (Velcade) and decrease its effectiveness for treating certain types of cancer.

Bortezomib (Velcade) is

used in certain types of cancers

GINGKO BILOBA:

The leaf extract of this plant is possibly effective for-

Alzheimer’s disease and other forms of dementia. Improving thinking problems caused by old age as well as in

young people. Painful response to cold especially in the fingers and toes

(Raynaud’s syndrome). Leg pain when walking due to poor blood flow (peripheral

vascular disease). Vertigo and dizziness. Premenstrual syndrome (PMS). Improving color vision in people with diabetes.

•Ginkgo taken with anticoagulants or with aspirin or other NSAIDs may increase the risk of bleeding.

Anticoagulants (such as

warfarin), aspirin, Ibuprofen and other

NSAIDs

•Ginkgo may reduce the effectiveness of anticonvulsants in preventing seizures.

Anticonvulsants (such as phenytoin)

•Ginkgo may intensify the effects of these drugs and increase the risk of side effects, such as headache, tremors, and manic episodes.

Monoamine oxidase inhibitors (MAOIs, a type of antidepressant)

•Ginkgo might increase or decrease insulin and blood sugar in people with type 2 diabetes. Taking ginkgo along with diabetes medications might decrease how well your medication works.

Medications for diabetes (Antidiabetic

drugs- Amaryl, Glucotrol)

LICORICE:

Licorice is used for various digestive system complaints including stomach ulcers, heartburn, colic, and ongoing inflammation of the lining of the stomach (chronic gastritis).

Some people use licorice for sore throat, bronchitis, cough, and infections caused by bacteria or viruses.

Licorice is also used in an herbal form called Shakuyaku-kanzo-to to increase fertility in women with a hormonal disorder called polycystic ovary syndrome.

In combination with other herbs, licorice is also used to treat prostate cancer and the skin disorder known as eczema.

•Licorice may increase salt and water retention and increase blood pressure, making antihypertensive less effective.

Antihypertensives

•Licorice may increase the risk of an abnormal heart rhythm, making antiarrhythmic therapy less effective.

Antiarrhythmics

•Because licorice increases urine formation, it can result in low levels of potassium, which is excreted in urine. When licorice is taken with digoxin, the low potassium levels increase the risk of digoxin toxicity.

Digoxin

•Licorice may intensify the effects of most diuretics, causing increased, rapid loss of potassium. •Licorice may interfere with the effectiveness of potassium-sparing diuretics, such as spironolactone, making these diuretics less effective.

Diuretics or water pills (such as

Thalitone, Diuril)

•Licorice may intensify the effects of these drugs and increase the risk of side effects, such as headache, tremors, and manic episodes.

MAOIs (Monoamines Oxidase inhibitors)

KAVA:(kava-lactones)

Native to the South Pacific. The root is usedfor medicine.

Kava is used to calm anxiety, stress, restlessness, and treat insomnia. It is also used for attention deficit-hyperactivity disorder (ADHD), epilepsy, psychosis, depression, migraines and other headaches, chronic fatigue syndrome (CFS), common cold and other respiratory tract infections, tuberculosis, muscle pain, and cancer prevention.

Some people use kava for urinary tract infections (UTIs), pain and swelling of the uterus, menstrual discomfort. Reduces anxiety and hot flashes in women with menopause.

Kava is applied to the skin for skin diseases including leprosy, to promote wound healing, and as a painkiller.

It is also used as a mouthwash for toothaches.

•Kava may intensify or prolong the effects of sedatives.

Sedatives (such as barbiturates

and benzodiazepines)

CHAMOMILE:

(An extract or tea)

Used on the skin to reduce swelling andfight bacteria and as a tea or dietarysupplement for stomach cramps.

To treat irritation from chest colds, slowhealing wounds, abscesses, guminflammation, and skin conditions suchas eczema, chickenpox and diaper rash.

•Chamomile taken with anticoagulants may increase the risk of bleeding.

Anticoagulants (drugs that prevent blood clots,

such as warfarin

•Chamomile may intensify or prolong the effects of sedatives.

Sedatives (such as barbiturates and benzodiazepines)

•Chamomile may reduce iron absorption.Iron

The pollen found in chamomile preparations may cause allergic reactions. If one

is allergic to ragweed pollen, chamomile use must

be prohibited.

Feverfew is used for fever, irregular menstrual periods, arthritis, psoriasis, allergies, asthma, dizziness, and nausea and vomiting.

Some people use feverfew for infertility. It is also used for anaemia, cancer, common cold, earache, liver disease, prevention of miscarriage, muscular tension, bone disorders, swollen feet, diarrhoea, upset stomach and intestinal gas.

Feverfew is sometimes applied directly to the gums for toothaches or to the skin to kill germs.

FEVERFEW:

•Feverfew taken with anticoagulants may increase the risk of bleeding.

Anticoagulants (such as warfarin)

•Feverfew may reduce iron absorption.Iron

•Feverfew may increase heart rate and blood pressure when it is taken with drugs used to manage migraine headaches.

Drugs used to manage migraine

headaches (such as ergotamine)

•NSAIDs reduce the effectiveness of feverfew in preventing and managing migraine headaches.

Non steroidal anti-inflammatory

drugs (NSAIDs)

MILK THISTLE:

Milk thistle seed might protect liver cells from toxic chemicals and drugs.

It also seems to have antioxidant and anti-inflammatory effects. Milk thistle plant extract might enhance the effects of estrogen.

Diabetes. A compound in milk thistle called silymarin appears to decrease blood sugar in people with type 2 diabetes.

Gallbladder problems, liver disease (cirrhosis, hepatitis and other liver conditions), swelling of the lungs (pleurisy), malaria, menstrual problems.

•Milk thistle may intensify the effects of these drugs, causing an excessive decrease in blood sugar levels.

Drugs that decrease blood sugar levels (hypoglycaemic

drugs)

•Milk thistle decreases blood levels of protease inhibitors, making them less effective.

Protease inhibitors (such as

indinavir or saquinavir), which are used to treat HIV infection

REFERENCES .. http://altmedicine.about.com/od/ephedra/a/ephedr

a.htm http://www.webmd.com/vitamins-supplements/ing

redientmono-933-feverfew.aspx?activeingredientid=933&activeingredientname=feverfew

http://www.merckmanuals.com/home/special_subjects/medicinal_herbs_and_nutraceuticals/overview_of_medicinal_herbs_and_nutraceuticals.html

http://www.biologicnr.com/research-info/nutrient-drug-interactions-data-base/

http://www.webmd.com/sleep-disorders/guide/chamomile-topic-overview

http://www.webmd.com/vitamins-supplements/ingredientmono-981-echinacea.aspx?activeingredientid=981&activeingredientname=echinacea

http://www.nlm.nih.gov/medlineplus/druginfo/natural/300.html

http://www.nlm.nih.gov/medlineplus/druginfo/natural/961.html

http://www.nlm.nih.gov/medlineplus/druginfo/natural/1000.html

http://www.webmd.com/vitamins-supplements/ingredientmono-943-goldenseal.aspx?activeingredientid=943&activeingredientname=goldenseal

http://www.rxlist.com/milk_thistle/supplements.htm

http://www.nlm.nih.gov/medlineplus/druginfo/natural/971.html

http://www.webmd.com/vitamins-supplements/ingredientmono-870-valerian.aspx?activeingredientid=870&activeingredientname=valerian