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Herbal Supplements May Cause Dangerous Drug Interactions in Orthopaedic Surgery Patients
Date:10/10/2011

products pose no risk," said Dr. Rispler.

Many of the most popular herbal supplements used today can have serious side effects when combined with prescription medicines. For example:

  • Feverfew (used for migraine prevention), ginger, cranberry, St. John's Wort and ginseng can interact with the anti-clotting drug warfarin;
  • Feverfew, ginger, and gingko can interact with aspirin;
  • Garlic can interfere with anti-clotting medications and the immunosuppressant drug cyclosporine (prevents transplant rejection);
  • Valerian (used as a sedative) can intensify anesthetics; and
  • St. John's Wort can interact with immunosuppressive drugs and potentially lead to transplant rejection.

Herbal products marketed for osteoarthritis also can pose serious risks when combined with prescription medications. For example:

  • Glucosamine, chondroitin and flavocoxid can affect clotting agents;
  • Black cohosh can interact with the cancer drug tamoxifen; and
  • Cat's claw can interact with clotting agents, blood pressure medications and cyclosporine.

Most surgery-related side effects can be avoided by stopping the CAM product at least one to two weeks prior to surgery and during the postoperative period while prescription medications such as blood thinners or antibiotics are being used. The problem arises when physicians do not know that a patient is using a CAM product, Dr. Rispler said.

"One of the main reasons that patients do not disclose the use of a CAM product is that they may not believe it is important information to convey to the physician because they feel they are safe to use and all-natural," he said. "Patients may also decide not to report CAM product use if they are worried their physician may be prejudiced against the supplement's use, or believe their physician will not have an understanding of the
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SOURCE American Academy of Orthopaedic Surgeons
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