Interactions with Drugs

Essiac® interactions are not well studied scientifically. Most potential interactions are based on theoretical and known reactions associated with herbal components of Essiac®: burdock root ( Arctium lappa ), sheep sorrel ( Rumex acetosella ), slippery elm bark ( Ulmus fulva ), and Turkish rhubarb ( Rheum palmatum ). However, the interactions of these individual herbs are also not well studied. Various Essiac-like products may contain different or additional ingredients, and patients are advised to carefully review product labels.

Essiac® 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. If you are using any medications, check the package insert and speak with your healthcare professional or pharmacist about possible interactions. This is based on a report of one patient in a research study taking the experimental drug DX-8951f (metabolized by CYP3A4 and CYP1A2), who experienced toxic side effects and drug clearance that was 4 to 5 times slower than in other patients. This patient was also taking "Essiac tea," although further details are not available, and it is not clear if the patient was taking Essiac® or an Essiac-like product.

Anthraquinones in rhubarb root or sheep sorrel may lead to diarrhea, dehydration, or loss of electrolytes (such as potassium), and may increase the effects of other laxative agents. Burdock has been associated with diuretic effects (increased urine flow) in one human report, and in theory may cause excess fluid loss (dehydration) or electrolyte imbalances (such as changes in blood potassium or sodium levels). These effects may be increased when burdock is taken at the same time as diuretic drugs such as chlorothiazide (Diuril®), furosemide (Lasix®), hydrochlorothiazide (HCTZ), or spironolactone (Aldactone®). The laxative and diuretic properties of herbs in Essiac® may lead to low potassium blood levels that are potentially dangerous in people taking digoxin or digitoxin.

Based on animal research and limited human study, burdock may either lower or raise blood sugar levels. Caution is advised when using medications that may also affect blood sugar. Patients taking drugs for diabetes by mouth or insulin should be monitored closely by a qualified healthcare professional. Medication adjustments may be necessary.

Based on limited human evidence that is not entirely clear, burdock may have estrogen-like properties, and may act to increase the effects of estrogenic agents including hormone replacement therapies such as Premarin® or birth control pills.

Interactions with Herbs and Dietary Supplements

Based on one human report, Essiac® 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, such as 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.

Anthraquinones in rhubarb root or sheep sorrel may lead to diarrhea, dehydration, or loss of electrolytes (such as potassium), and may increase the effects of agents with possible laxative properties, such as alder buckthorn, aloe dried leaf sap, black root, blue flag rhizome, butternut bark, dong quai, European buckthorn, eyebright, cascara bark, castor oil, chasteberry, colocynth fruit pulp, dandelion, gamboges bark, horsetail, jalap root, manna bark, plantain leaf, podophyllum root, psyllium, senna, wild cucumber fruit, and yellow dock root.

Burdock has been associated with diuretic effects (increased urine flow) in one human report, and in theory, may cause excess fluid loss (dehydration) or electrolyte imbalances (such as changes in blood potassium or sodium levels) when used with other diuretic herbs or supplements such as artichoke, celery, corn silk, couchgrass, dandelion, elder flower, horsetail, juniper berry, kava, shepherd's purse, uva ursi, and yarrow.

The laxative and diuretic properties of herbs in Essiac® may lead to low potassium blood levels that are potentially dangerous in people taking cardiac glycoside-containing herbs such as 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, rubber vine, sea-mango, senna fruit, squill, strophanthus, uzara, wallflower, wintersweet, yellow dock root, and yellow oleander.

Based on animal research and limited human study, burdock may either lower or raise blood sugar levels. Caution is advised when using herbs or supplements that can also alter blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment. Possible examples of herbs that may lower blood sugar include: Aloe vera , American ginseng, bilberry, bitter melon,fenugreek, fish oil, gymnema, horse chestnut seed extract (HCSE), marshmallow, milk thistle, Panax ginseng, rosemary, Siberian ginseng, stinging nettle, and white horehound.

Because burdock may contain estrogen-like chemicals, the effects of other agents believed to have estrogen-like properties may be altered. Possible examples include alfalfa, black cohosh, bloodroot, hops, kudzu, licorice, pomegranate, red clover, soy, thyme, white horehound, and yucca. These possible interactions are based on initial and unclear evidence.

In theory, use of rhubarb and sheep sorrel may decrease the absorption of minerals such as calcium, iron, and zinc.

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Tags: Herbal Medicine

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