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Herbal Remedies: Adverse Effects and Drug Interactions

美国家庭医生杂志告诫:草药能干扰西药的疗效 [原创 2006-09-03 22:03:44 ] 发表者: albert7835


王澄 美国康复科医生 纽约2006年9月

《美国家庭医生》杂志1999年3月1日发表一篇题为“草药治疗:它的副作用和对西药的干扰。”(概述)在美国,草药不被当作“药”来对待,所以美国食品和药物管理局(FDA, the U.S. Food and Drug Administration)并不对草药进行严格的科学实验。因此,草药也不准作为诊断,治疗和疾病预防的药物上市或出售。因为草药不像美国西药那样被足够纯化和效力剂量化,所以草药的一部分不良作用可能来自不纯,不是草药本身。如混杂入过敏源,植物花粉,或霉菌芽孢;也可能来自草药原料(植物株群)的不同。


双叶银杏(ginkgo biloba):自发性出血

金丝桃(St. John’s wort),又名土连翘,五心花,金丝海棠,照明莲,小狗木,水面油,金丝莲(注1):胃肠不适,过敏反应,疲劳,头晕,胡涂,口干,羞光。




双叶银杏(ginkgo biloba)干扰阿司匹林,华法林(warfarin, coumadin 美国常用抗凝药),和ticlopidine(Ticlid), clopidogrel(plavix), dipyridamole(persantine)美国常用的三个针对血小板功能的抗血液粘稠药的药效。

金丝桃(St. John’s wort)干扰抗抑郁药Antidepressants的药效。

麻黄(Ephedra)干扰咖啡因caffeine, 治鼻塞药decongestants, 兴奋剂/刺激药stimulants的药效。


胡椒(Kava)干扰镇静剂sedative, 安眠药sleeping pills, 抗精神病药antipsychotics, 和酒精alcohol的药效。





注2:Kava (Family: Piperaceae, Genus: Piper, Species: methysticum)


Herbal Remedies: Adverse Effects and Drug Interactions

West Virginia University School of Pharmacy

Morgantown, West Virginia

A growing number of Americans are using herbal products for preventive and therapeutic purposes. The manufacturers of these products are not required to submit proof of safety and efficacy to the U.S. Food and Drug Administration before marketing. For this reason, the adverse effects and drug interactions associated with herbal remedies are largely unknown. Ginkgo biloba extract, advertised as improving cognitive functioning, has been reported to cause spontaneous bleeding, and it may interact with anticoagulants and antiplatelet agents. St. John's wort, promoted as a treatment for depression, may have monoamine oxidase­inhibiting effects or may cause increased levels of serotonin, dopamine and norepinephrine. Although St. John's wort probably does not interact with foods that contain tyramine, it should not be used with prescription antidepressants. Ephedrine-containing herbal products have been associated with adverse cardiovascular events, seizures and even death. Ginseng, widely used for its purported physical and mental effects, is generally well tolerated, but it has been implicated as a cause of decreased response to warfarin. Physicians must be alert for adverse effects and drug interactions associated with herbal remedies, and they should ask all patients about the use of these products.

Increasingly, alternative therapies such as herbal products are being used in the United States. Approximately 25 percent of Americans who consult their physician about a serious health problem are employing unconventional therapy, but only 70 percent of these patients inform their physician of such use.1

Herbal products are not tested with the scientific rigor required of conventional drugs, and they are not subject to the approval process of the U.S. Food and Drug Administration (FDA). Herbal products therefore cannot be marketed for the diagnosis, treatment, cure or prevention of disease. Nonetheless, the Dietary Supplement Health and Education Act of 1994 allows these products to be labeled with statements explaining their purported effect on the structure or function of the human body (e.g., alleviation of fatigue) or their role in promoting general well-being (e.g., enhancement of mood or mentation).2 Analysis of some of the putative effects of herbal products shows that they sometimes closely resemble claims of clinical efficacy for various diseases or conditions.







作者:admin@医学,生命科学    2011-01-14 05:14