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Don't combine grapefruit with some meds

Suzy's safety checklist on how to use herbal medicine and drugs

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Posted: Saturday, February 27, 2010 12:00 am

Dear Pharmacist: I take eight different medications and six supplements each day. I worry constantly that they will interact. Please tell your readers what some of the most common interactions are?

— K.S. Decatur, Ill.

A: Clip this article, or forward it to someone you care for, because it just might save a life. I'm going to give you a "safety checklist" of common drug-herb interactions, and there is a huge section devoted to this in my book, "Drug Muggers."

Alcohol: The world's most famous liquid muscle relaxant, alcohol slows the heart rate down. If you combine it with sleeping pills or narcotic pain-relievers, it can stop the heart! It's also dangerous to combine it with beta blockers (blood pressure meds).

Grapefruit: A delicious fruit that when juiced, provides powerful anti-cancer flavonoids and antioxidants. Like a few other fruits, it can block a biochemical pathway in the liver that causes the levels of medications to rise (rather than getting broken down and cleared out of the body). Some drugs that interact with grapefruit include oxycodone (Percocet), estrogen-containing hormones, most statin cholesterol drugs, sildenafil (Viagra), diazepam and some antihistamines. The interaction may occur even if you wait several hours after your medication.

Ginkgo biloba: Famed for it's ability to sharpen memory by increasing blood flow to the brain. If you are taking a blood thinner, like warfarin, aspirin or Plavix, then you may experience enhanced blood-thinning effects which may lead to easy bruising and internal bleeding.

Pomegranate or grapefruit juice: Chock full of antioxidants and heart-healthy nutrients, but it might spike the level of sex pills (Cialis, Levitra or Viagra) causing headache, indigestion, flushing, heart palpitations or visual disturbances.

Stinging nettle: It helps men with prostate problems and women with overactive bladder. Thing is, it has this lovely benefit of slightly lowering blood sugar. If you take stinging nettle while also taking diabetic medication, your blood sugar may drop too low so monitor carefully or avoid the herb.

Iron or zinc supplements: Wonderful to help improve immunity and rev up thyroid production, but these can block the actions of many popular antibiotics including Cipro and Levaquin.

St. John's wort: Fantastic for boosting mood and reducing pain. It can increase levels of other drugs, causing them to spike so high that you get dangerous side effects. This doesn't mix well with digoxin, omeprazole (Prilosec), MAO anti-depressants, oral contraceptives, alprazolam (Xanax), and drugs used for HIV/AIDS.

Ginseng, ma huang or bitter orange, caffeine: Found in many diet pills, these stimulate the body so avoid if you take breathing medications such as inhalers (bronchodialators) or theophylline.

Arginine: Very popular natural amino acid that helps erectile dysfunction and improves blood flow to the heart. It's wonderful that arginine also reduces blood pressure, but if you take this with nitroglycerin or isosorbide drugs, it can result in dangerously low blood pressure.

This information is not intended treat, cure or diagnose your condition. Suzy Cohen is the author of "The 24-Hour Pharmacist." For more information, visit www.dearpharmacist.com.

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