DHEA : Interactions

by MedlinePlus

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Interactions with Drugs

Based on laboratory and animal studies, DHEA may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be increased in the blood, and may cause increased effects or potentially serious adverse reactions. Central nervous system agents, including carbamazepine and phenytoin, induce the P450 enzymes that metabolize DHEA and DHEA-S and therefore can decrease circulating concentrations of these hormones. If you are using any medications, check the package insert and speak with your healthcare professional or pharmacist about possible interactions.

Based on human data, DHEA may increase blood sugar levels. Caution is advised when using medications that may also lower blood sugar such as metformin (Glucophage®). In postmenopausal women, DHEA (1600mg daily, orally for 28 days) has been shown to cause insulin resistance. A qualified healthcare professional should closely monitor patients taking drugs for diabetes by mouth or insulin. Medication adjustments may be necessary.

In theory, DHEA may increase the risk of blood clotting. Patients who take anticoagulants (blood thinners) or antiplatelet drugs (such as aspirin) to prevent blood clots should discuss the use of DHEA with a healthcare professional. Examples of blood thinning drugs include warfarin (Coumadin®), heparin, and clopidogrel (Plavix®). The risk of blood clots is also increased by smoking or by taking other hormones (such as oral contraceptives or hormone replacement therapy), and these should not be combined with DHEA unless under medical supervision.

DHEA may alter heart rates or rhythm, and should be used cautiously with heart medications or drugs that may also affect heart rhythm.

Although it is not widely studied, there are some reports that drugs such as amlodipine, nicardipine and other calcium channel blockers like diltiazem (Cardizem®) and alprazolam (Xanax®) may increase DHEA levels in the body, which could lead to increased side effects when taken with DHEA supplements. In theory, increased hormone levels may occur if DHEA is used with estrogen or androgen hormonal therapies. DHEA may interact with psychiatric drugs such as clozapine (Clozaril®).

DHEA may interact with GABA-receptor drugs used for seizures or pain. Based on animal research, DHEA may decrease the effectiveness of methadone. DHEA may add to the effects of clofibrate. Based on laboratory research, DHEA may contribute to tamoxifen resistance in breast cancer.

Depletion: Drugs that reduce the normal levels of DHEA produced by the body include dopamine, insulin, corticosteroids such as dexamethasone, drugs used to treat endometriosis such as danazol, opiate painkillers, and estrogen-containing drugs. Metopirone and benfluorex may increase blood DHEA levels.

Interactions with Herbs and Dietary Supplements

Based on laboratory and animal studies, DHEA may interfere with the way the body processes certain herbs or supplements using the liver's "cytochrome P450" enzyme system. As a result, the levels of other herbs or supplements to be too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system. Examples of herbs and supplements that may also affect the P450 system include bloodroot, cat's claw, chamomile, chaparral, chasteberry, damiana, Echinacea angustifolia , goldenseal, grapefruit juice, licorice, oregano, red clover, St. John's wort, wild cherry, and yucca. If you are using any medications, check the package insert and speak with your healthcare professional or pharmacist about possible interactions.

DHEA may raise blood sugar levels or cause insulin resistance, and may add to the effects of herbs/supplements that may also increase blood sugar levels, such as arginine, cocoa, ephedra (when combined with caffeine), or melatonin. DHEA may work against the effects of herbs/supplements that may decrease blood sugar levels, such as Aloe vera , American ginseng, bilberry, bitter melon, burdock,fenugreek, fish oil, gymnema, horse chestnut seed extract (HCSE), maitake mushroom, marshmallow, milk thistle, Panax ginseng, rosemary, shark cartilage, Siberian ginseng, stinging nettle and white horehound. Serum glucose levels should be monitored closely by a qualified health care professional while using DHEA. Dosing adjustments may be necessary.

In theory, DHEA may increase the risk of blood clotting, and may add to the effects of herbs/supplements that may also increase the risk of clotting, such as coenzyme Q10 or Panax ginseng . DHEA may work against the effects of herbs/supplements that may "thin" the blood and reduce the risk of clotting, such as Ginkgo biloba, garlic, saw palmetto, alfalfa, American ginseng, angelica, anise, Arnica montana , asafetida, aspen bark, bilberry, birch, black cohosh, bladderwrack, bogbean, boldo, borage seed oil, bromelain, capsicum, cat's claw, celery, chamomile, chaparral, clove, coleus, cordyceps, danshen, devil's claw, dong quai, EPA (eicosapentaenoic acid, found in fish oils), evening primrose oil, fenugreek, feverfew, fish oil, flaxseed/flax powder (not a concern with flaxseed oil), ginger, grapefruit juice, grapeseed, green tea, guggul, gymnestra, horse chestnut, horseradish, licorice root, lovage root, male fern, meadowsweet, nordihydroguairetic acid (NDGA), omega-3 fatty acids, onion, papain, panax ginseng, parsley, passionflower, poplar, prickly Ash, propolis, quassia, red clover, reishi, Siberian ginseng, sweet clover, rue, sweet birch, sweet clover, turmeric , vitamin E, white willow, wild carrot, wild lettuce, willow, wintergreen, or yucca.

It is not known what effects occur when DHEA is used with herbs that are believed to have hormonal effects in the body. Examples of agents with possible estrogen-like (phytoestrogenic) effects in the body include alfalfa, black cohosh, bloodroot, burdock, hops, kudzu, licorice, pomegranate, red clover, soy, thyme, white horehound, and yucca. Agents with possible progestin-like (phytoprogestational) effects in the body include chasteberry, bloodroot, oregano, damiana, and yucca.

DHEA may alter heart rates or rhythms. Caution is advised in patients taking herbs/supplements that may alter heart function or that include cardiac glycosides. Examples include adonis, balloon cotton, black hellebore root/melampode, black Indian hemp, bushman's poison, cactus grandifloris, convallaria, eyebright, figwort, foxglove/digitalis, frangipani, hedge mustard, hemp root/Canadian hemp root, king's crown, lily-of-the-valley, motherwort, oleander leaf, pheasant's eye plant, plantain leaf, pleurisy root; psyllium husks, redheaded cotton-bush, rhubarb root, rubber vine, sea-mango, senna fruit, squill, strophanthus, uzara, wallflower, wintersweet, yellow dock root, yellow oleander should use caution. Notably, bufalin/Chan Suis is a Chinese herbal formula that has been reported as toxic or fatal when taken with other agents that may alter conduction properties of the heart.

Chromium picolinate may increase blood DHEA levels. Carnitine and DHEA may have additive effects. Based on animal research, DHEA may increase melatonin secretion and prevent breakdown of vitamin E in the body.

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