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Herbal Remedies: Adverse Effects and Drug Interactions, American Academy of Family Physicians:"A growing number of Americans are using herbal products for preventive and therapeutic purposes. The manufacturers of these products are not required to submit proof of safety and efficacy to the U.S. Food and Drug Administration before marketing. For this reason, the adverse effects and drug interactions associated with herbal remedies are largely unknown. Ginkgo biloba extract, advertised as improving cognitive functioning, has been reported to cause spontaneous bleeding, and it may interact with anticoagulants and antiplatelet agents. St. John's wort, promoted as a treatment for depression, may have monoamine oxidase­inhibiting effects or may cause increased levels of serotonin, dopamine and norepinephrine."
American Academy of Family Physicians
P.O. Box 11210 Shawnee Mission, KS 66207-1210
http://www.aafp.org/afp/990301ap/1239.html

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What is a drug-drug interaction? Be MedWise.com:"Drug-drug interactions occur when a drug interacts, or interferes, with another drug. This can alter the way one or both of the drugs act in the body, or cause unexpected side effects. The drugs involved can be prescription medications, over-the-counter medicines and even vitamins and herbal products. Are all drug-drug interactions the same? Not all drug-drug interactions are equal. Sometimes when two drugs interact, the overall effect of one or both of the drugs may be greater than desired. For example, both aspirin and blood-thinners like warfarin Coumadin - used to protect against heart attack - help to prevent blood clots from forming. Using these medications together, however, may cause excessive bleeding."
National Council on Patient Information and Education
4915 Saint Elmo Ave., Suite 505 Bethesda, MD 20814-6082
Phone: (301) 656-8565 Fax: (301) 656-4464
e-mail: ncpie@ncpie.info
http://www.bemedwise.org/quiz_facts/facts.htm

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Center for Drug Safety (for fee service):"We have all come to believe that the drugs we take are safe. The truth is drugs of all types can cause drug interaction problems including over-the-counter drugs, vitamins, herbs and other alternative medicines. Checking for drug interactions is critical to your good health. The Center for Drug Safety provides you all the drug information you'll need to ensure your prescription drugs and other drugs do not result in adverse drug events or adverse drug reactions. For your convenience we have assembled a short list of terms related to drug information and drug interaction. While many of these terms are similar, we can assure you, this is the right place for all your drug interaction needs."
The Center for Drug Safety
1908 Cemetery Road - Holiday Florida 34691
727-945-7970 Fax: 727-945-7975
http://www.centerfordrugsafety.org

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Interactions Between Herbal Medicines and Prescription Drugs, James Meschino, DC, MS, Chiroweb:"In recent years, the general public has embraced the practice of taking dietary supplements to help optimize health, slow the aging process or address specific health concerns. In addition to the use of vitamin and mineral supplements, the population has also acknowledged the potential health-promoting benefits of various herbal remedies. Quoting from U.S. statistics, the percentage of the population using herbal products grew from 2.5% in 1990 to 12.5% in 1997.1 This made herbal product use second only to relaxation techniques among various complementary therapies. In 1997, annual out-of-pocket expenditures for herbal medicinal products in the United States were estimated at $5.1 billion."
Dynamic Chiropractic
PO Box 4109 Huntington Beach, CA 92605-4109 (714) 230-3150
http://www.chiroweb.com/archives/21/16/13.html

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Drug Interactions, Council on Family Health:"Drug interactions may make your drug less effective, cause unexpected side effects or increase the action of a particular drug. Some drug interactions can even be harmful to you. Reading the label every time you use a nonprescription or prescription drug and taking the time to learn about drug interactions may be critical to your health. You can reduce the risk of potentially harmful drug interactions and side effects with a little bit of knowledge and common sense."
Council on Family Health
1155 Connecticut Avenue, N.W., Suite 400
Washington, D.C. 20036
Phone: (202) 429-6600
http://www.pueblo.gsa.gov/cic_text/health/drug-interactions/druginte3.htm

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Drugdigest.org (free service):"Check potential interactions* between two or more drugs (complete instructions below):"
http://www.drugdigest.org/DD/Interaction/ChooseDrugs

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Drug Interactions Guide, Drugs.com:"This Guide helps you to find out if drugs interact with each other or interact with food. Checking Drug Interactions between two or more drugs With the Drug Interactions Guide you can create your own personalized list of medicines, and then check the list for possible drug-drug and drug-food interactions."
http://www.drugs.com/xq/cfm/pageID_1150/int_0/qx/index.htm

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Drug Interaction Checker, Drugstore.com:"Drug interactions can result in unwanted side effects or prevent a medicine from doing its job. Find out if your medicines interact with each other. First, create a list of the products you use. Include: • Prescription medicines • Nonprescription medicines • Herbs, vitamins, and supplements. We'll also check for interactions with alcohol, food, and tobacco."
http://www.drugstore.com/pharmacy/drugchecker/

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Grapefruit Juice-Drug Interactions Home Page:"Take a look through these frequently asked questions about Grapefruit Juice Drug Interactions first. If you can't find the answer to your question, send an email to me at delbe@powernetdesign.com."
http://www.powernetdesign.com/grapefruit/

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Safety Check by Drug Name Index, Safety Check by Herbal Remedy Index / Nutritional Supplement Index, Healthwell.com:
HIV Drug Interactions:"The therapeutic area of HIV, and in particular HIV drug interactions, is a rapidly changing field. We endeavour to keep abreast of the latest developments in the area and offer up-to-date details on hot topics of interest and recent publications. All items that appear in these sections are also archived for future reference. You can also find a section outlining recent updates to www.hiv-druginteractions.org."
http://www.hiv-druginteractions.org/

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Medicine - Herb/Food Interactions, holistic-online.com:"Herbs and Foods May Lead to Complications If You Take Them with Drugs. Many people have the mistaken notion that, being natural, all herbs and foods are safe. This is not so. Very often, herbs and foods may interact with medications you normally take that result in serious side reactions. It is always a good practice to tell your doctor or health practitioners what you are taking so that they can advise you of possible complications, if there is any. You should also keep an eye for unusual symptoms. Very often, this may foretell the symptoms of a drug interaction. Experts suggest that natural does not mean it is completely safe. Everything you put in your mouth has the potential to interact with something else. The medication that is taken by mouth travels through the digestive system in much the same way as food and herbs taken orally do. So, when a drug is mixed with food or another herb, each can alter the way the body metabolizes the other. Some drugs interfere with the body's ability to absorb nutrients. Similarly, some herbs and foods can lessen or increase the impact of a drug."
http://www.holistic-online.com/Herbal-Med/hol_herb_med_reac.htm

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Herbal Medicine and the Kidney Patient - What are the Risks?:"The kidney transplant patient is also at risk from improper or ill-advised herbal medicine use. For example, the herb echinacea is promoted as an immune system stimulant. There is good (albeit limited) evidence showing that it actually does stimulate the immune system. Therefore, it should not be used by anyone with an autoimmune disease (such as lupus, Type I diabetes, or rheumatoid arthritis), or anyone on immunosuppresants - including transplant patients. Herbs affecting blood pressure, such as ephedra, should also be avoided by kidney transplant patients. Lastly, it has recently been found that the popular herb used for treating mild depression, St. John’s Wort, can interact with the transplant drug, cyclosporine, decreasing its effectiveness. This is just one example of a harmful herb - prescription drug interaction."
iKidney.com c/o Watson Pharma, Inc.
311 Bonnie Circle Corona, Ca 92880 USA
info@ikidney.com
http://www.ikidney.com/iKidney/Lifestyles/NutritionalTips/Hemodialysis/HerbalMedicineandtheKidneyPatient_WhataretheRisks.htm

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Herb and drug interactions: 'Natural' products not always safe, Mayoclinic.com:"You may think herbal supplements are safe because they're labeled "natural." But many herbal supplements contain active ingredients that can harm you if taken with certain prescription or over-the-counter (OTC) drugs. In addition, some medical situations increase your risk of adverse effects if you take herbal products. Talk to your doctor before taking any herbal products if you're pregnant or breast-feeding or if you have."
http://www.mayoclinic.com/invoke.cfm?id=SA00039

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Drug Interactions, Medicinenet.com:"Whenever two or more drugs are taken concurrently, there is a chance that there will be an interaction among the drugs. The interaction may increase or decrease the effectiveness and/or the side effects of the drugs. It also may result in a new side effect, that is, a side effect not seen with the use of any one drug alone. The likelihood of drug interactions increases as the number of drugs being taken by a patient increases. Therefore, people who take several medications are at the greatest risk for interactions. Drug interactions contribute to the cost of healthcare because of the medical care costs that are required to treat them. Interactions can also lead to pain and suffering that could be avoided. This month's topic discusses the issue of drug interactions and several ways to avoid them."
http://www.medicinenet.com/script/main/art.asp?li=MNI&articlekey=19912

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Project Inform's Drug Interactions ( HIV/AIDS Treatment Information ):"With the number of drugs available to treat HIV and prevent or treat opportunistic infections (OIs), the potential for drug interactions becomes an increasing concern. Developing a health management plan and deciding which therapies to include in that plan seems a daunting task. Not only does each particular therapy have potential side effects, but each therapy might augment or diminish the benefit of other drugs. Many people are taking a variety of therapies simultaneously, ranging from experimental and approved antivirals to complimentary approaches and over-the-counter medications. Drug interactions are not always considered when developing a treatment strategy, but may play a major role in the success of any plan for managing HIV disease."
http://www.projinf.org/fs/drugin.html

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Drug Interaction, Psychiatrysource.com:"Patients are often taking several prescribed medications, over the counter medications, herbal supplements, or vitamins. Interactions between these products may reduce the effectiveness of a prescription, result in additive pharmacodynamic effects, or hazardous interactions. Create a custom interactions report by selecting prescription medications over the counter medications herbal supplements vitamins relevant for your patient's situation. Choose to screen the combination to alert you of interactions with foods, caffeine, alcohol, or grapefruit juice. This database is based on medications, herbal supplements, and vitamins available in the United States. This is not medical advice a prescription should only be changed upon advice from a physician."
http://www.psychiatrysource.com/psychsource/DesktopDefault.html?tabid=45&tabindex=7

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Food & Drug Interactions, U. S. Food and Drug Administration National Consumers League, 1998:"Medicines can treat and cure many health problems. However, they must be taken properly to ensure that they are safe and effective. Many medicines have powerful ingredients that interact with the human body in different ways, and diet and lifestyle can sometimes have a significant impact on a drug's ability to work in the body. Certain foods, beverages, alcohol, caffeine, and even cigarettes can interact with medicines. This may make them less effective or may cause dangerous side effects or other problems. When you take medicine, be sure to follow your doctor's instructions carefully to obtain the maximum benefit with the least risk. Changes in a medicine's effect due to an interaction with food, alcohol or caffeine can be significant; however, there are many individual factors that influence the potential for such variations, like dose, age, weight, sex, and overall health."
http://vm.cfsan.fda.gov/~lrd/fdinter.html

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