Health risk of herbal pills interacting with other drugs

Millions of people could be risking their health by taking herbal remedies and prescription drugs at the same time, scientists warn.

Statins, warfarin and other common drugs can interact with health supplements, producing dangerous side effects or reducing the drugs’ life- saving powers, they said last night.

Herbal treatments such as St John’s wort, ginseng and chamomile are taken by an estimated one in four UK adults who buy them, without a prescription, at health food shops or online.

Statins, warfarin and other common drugs can interact with health supplements, producing dangerous side effects or reducing the drugs’ life- saving powers, they said last night. File pic

But doctors say that while they are seen as harmless health boosters, if taken alongside powerful medication the combination can be extremely dangerous. They warn of ‘life-threatening adverse drug events, prolonged hospitalisation and loss of life’.

Cancer patients have seen their drugs stop working after drinking ginseng energy drinks, transplant patients’ new kidneys have been rejected after taking chamomile, and people with HIV have seen the virus levels in their blood soar after taking ginkgo supplements.

People who take blood-thinning warfarin drugs for heart problems have been treated for major internal bleeding after using St John’s wort and other herbal medicines such as sage, goji juice or chamomile. 

And the millions of people who take cholesterol-busting statins risk severe muscle pain if they drink green tea.

Herbal treatments such as St John’s wort, ginseng and chamomile are taken by an estimated one in four UK adults who buy them, without a prescription, at health food shops or online. File pic

Herbal treatments such as St John’s wort, ginseng and chamomile are taken by an estimated one in four UK adults who buy them, without a prescription, at health food shops or online. File pic

The study’s authors, from the University of Stellenbosch in South Africa, said the dangers were grossly under-reported because people often did not realise the herbal remedies were to blame.

And they said the rise in obesity, diabetes and cancer meant the problem was going to get worse – because more people were taking medication, and seeking additional relief from supplements.

The authors, who based their findings on 49 case reports and two small studies of 15 cases each, said the middle-aged and elderly were the most at risk.

In most cases the interactions come about because the active ingredient in the herbal remedy works on the same part of the body as the drug, meaning it either cancels it out or boosts its power.

The study, published in the British Journal of Clinical Pharmacology, comes after the Medicines and Healthcare products Regulatory Agency (MHRA) warned that St John’s wort could stop the morning-after pill from working properly.

Sotiris Antoniou, of the Royal Pharmaceutical Society, said: ‘If you are taking herbal medicines, you should let your doctor or pharmacist know, so they can ensure that it is safe for you to take them with statins or warfarin and there are no interactions which could increase the risk of experiencing side effects.’

An MHRA spokesman said last night: ‘Prescription-only medicines are prescription-only for a reason – they are potent and their use should be supervised by a healthcare professional so your treatment can be monitored and any adverse reactions dealt with.

In most cases the interactions come about because the active ingredient in the herbal remedy works on the same part of the body as the drug. File pic

In most cases the interactions come about because the active ingredient in the herbal remedy works on the same part of the body as the drug. File pic

‘If you are taking medicines, and also taking herbal medicines, please read the patient information provided and if you have any further questions, speak to your healthcare professional.’

The herbal medicine market in the UK is worth £500 million. Since 2011, products have to be registered with the MHRA and granted a Traditional Herbal Registration before going on sale. 

But they do not require the same evidence as pharmaceutical drugs to determine whether they actually work.

Their labels require information about drug interactions – but experts are worried that people do not read the safety labels in the same way they do for prescription drugs, because the herbal products are not considered to be as powerful.

The NHS says: ‘Herbal medicines are those with active ingredients made from plant parts, such as leaves, roots or flowers. But being “natural” doesn’t necessarily mean they’re safe for you to take.

‘Herbal medicines… will have an effect on the body and can be potentially harmful if not used correctly.’  

WHICH HERBAL TREATMENTS INTERACT WITH OTHER DRUGS?

Warfarin:

Blood thinner taken by patients who have had heart valve replacement or have an irregular heart beat

Interacts with: St John’s wort, sage, flaxseed, goji juice, cranberry, chamomile, sheng mai-yin, red ginseng

Can result in: Internal bleeding in the brain or the chest, reduced blood clotting

Statins:

Anti-cholesterol pills taken by about 6 million people

Interacts with: Green tea

Can result in: Acute muscle pains and cramps because doubled power of statins in the blood

Cancer drug imatinib:

For chronic myeloid leukaemia

Interacts with: Ginseng

Can result in: Liver problems

Organ transplant drugs:

Immunosuppressant medication dampens the immune system after a transplant, to minimise risk of rejection

Interacts with: Chamomile, turmeric

Can result in: Cancels out the drugs, meaning the organ is rejected

HIV anti-retrovirals:

Taken by HIV-positive patients to effectively tackle the virus

Interacts with: Ginseng, ginkgo biloba

Can result in: Soaring viral load, signs of toxicity

Antidepressants:

Taken by one in ten people in Britain

Interacts with: Ginkgo biloba, celery root

Can result in: Antidepressant poisoning because it does not leave the body, worsening depression



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