Some of the medicinal herbs, their nutraceutical properties and possible drug interaction between them.

1. Interaction of Drugs
and Nutraceuticals
Presented by:
Saloni Shroff FN-Semester 1
Roll no.: 04 Nutrigenomics

2. What are Nutraceuticals??

3. Any substance , i.e., a
food or a part of food that
provides medical or health
benefits including the
prevention or treatment
of diseases.
Examples: Basil leaves,
Aloevera, Turmeric, Amla,
Drumstick leaves and
many more.

4. Drug Interaction
A drug interaction is a
situation in which a
substance (usually
another drug) affects
the activity of a drug
when both are
administered together.
Interactions may also
exist between drugs
and foods (drug-food
interactions), as well
as drugs and medicinal
plants or herbs (drug-plant
interactions).

5. Such interactions
may intensify or
reduce the
effectiveness of a
drug or cause a
serious side effect.

6. Some possible medicinal
herb – drug interactions…

7. GARLIC:
(Allicin)
Hypotensive property
 Hypocholesterolemic effect
 Acts as an anti-inflammatory agent
Anti-bacterial as well as anti fungal property

8. • Garlic taken with anticoagulants
may increase the risk of
bleeding.
Anticoagulants (such as
warfarin)
• Garlic may intensify the effects of
these drugs, causing an
excessive decrease in blood
sugar levels (hypoglycaemia).
Hypoglycaemic drugs
(such as insulin
and glipizide)
• Garlic decreases blood levels of
protease inhibitors, making them
less effective.
Protease inhibitors (such
as
indinavir or saquinavir),
which are used to treat
HIV infection

9. GINGER:
Ginger is commonly used to treat
Various types of stomach problems –
acts as Carminative agent,
Including-
 motion sickness
 upset stomach
 diarrhea
 nausea (anti-emetic)
 loss of appetite
Other uses include pain relief from arthritis, menstrual pain,
upper respiratory tract infections- cough and bronchitis.

10. • Ginger taken with anticoagulants may
increase the risk of bleeding.
Anticoagulants
(such as warfarin)
• Ginger might decrease blood sugar.
Taking ginger along with diabetes
medications might cause your blood
sugar to go too low.
Antidiabetic drugs-insulin,
metformin
(Glucophage)
• Ginger might reduce blood pressure in a
way that is similar to some medications for
blood pressure. Taking ginger along with
these might cause your blood pressure to
drop too low or cause an irregular
heartbeat.
Medications for high
blood pressure
(Calcium channel
blockers- nifedipine
, verapamil )

11. GREEN TEA:
(Polyphenol)
 Improve mental alertness and thinking.
 Bone loss (osteoporosis)
 Solid tumor cancers.
 Green tea is also used to treat –
 Crohn’s disease
 Parkinson’s disease
Cardio vascular diseases
Diabetes
Low blood pressure
 Chronic fatigue syndrome (CFS)
Dental cavities (caries)
Kidney stones
 Skin damage

12. • Green tea may cause warfarin
to be less effective.
Anti coagulants
(such as warfarin)
• Taking green tea along with
stimulant drugs might cause serious
problems including increased heart
rate and high blood pressure.
Stimulant drugs
(such as
amphetamines,
Ephedrine,
Cocaine)
• Green tea might interact with
Bortezomib (Velcade) and decrease
its effectiveness for treating certain
types of cancer.
Bortezomib
(Velcade) is used
in certain types of
cancers

13. GINGKO BILOBA:
The leaf extract of this plant is possibly
effective for-
 Alzheimer’s disease and other forms of dementia.
 Improving thinking problems caused by old age as well as
in young people.
 Painful response to cold especially in the fingers and toes
(Raynaud’s syndrome).
 Leg pain when walking due to poor blood flow (peripheral
vascular disease).
 Vertigo and dizziness.
 Premenstrual syndrome (PMS).
 Improving color vision in people with diabetes.

14. • Ginkgo taken with anticoagulants
or with aspirin or other NSAIDs
may increase the risk of bleeding.
Anticoagulants
(such as
warfarin), aspirin,
Ibuprofen and
other NSAIDs
• Ginkgo may reduce the
effectiveness of anticonvulsants in
preventing seizures.
Anticonvulsants
(such as
phenytoin)
• Ginkgo may intensify the effects of
these drugs and increase the risk
of side effects, such as headache,
tremors, and manic episodes.
Monoamine
oxidase inhibitors
(MAOIs, a type of
antidepressant)

15. • Ginkgo might increase or decrease
insulin and blood sugar in people
with type 2 diabetes. Taking ginkgo
along with diabetes medications
might decrease how well your
medication works.
Medications
for diabetes
(Antidiabetic
drugs- Amaryl,
Glucotrol)

16. LICORICE:
 Licorice is used for various digestive system complaints including
stomach ulcers, heartburn, colic, and ongoing inflammation of the
lining of the stomach (chronic gastritis).
 Some people use licorice for sore throat, bronchitis, cough, and
infections caused by bacteria or viruses.
 Licorice is also used in an herbal form called Shakuyaku-kanzo-to
to increase fertility in women with a hormonal disorder called
polycystic ovary syndrome.
 In combination with other herbs, licorice is also used to treat
prostate cancer and the skin disorder known as eczema.

17. • Licorice may increase salt and water
retention and increase blood pressure,
making antihypertensive less effective.
Antihypertensives
• Licorice may increase the risk of an
abnormal heart rhythm, making
antiarrhythmic therapy less effective.
Antiarrhythmics
• Because licorice increases urine formation,
it can result in low levels of potassium,
which is excreted in urine. When licorice is
taken with digoxin, the low potassium levels
increase the risk of digoxin toxicity.
Digoxin

18. • Licorice may intensify the effects of most
diuretics, causing increased, rapid loss of
potassium.
• Licorice may interfere with the effectiveness
of potassium-sparing diuretics, such
as spironolactone, making these diuretics
less effective.
Diuretics or
water pills
(such as
Thalitone,
Diuril)
• Licorice may intensify the effects of these
drugs and increase the risk of side effects,
such as headache, tremors, and manic
episodes.
MAOIs
(Monoamines
Oxidase
inhibitors)

19. KAVA:
(kava-lactones)
Native to the South Pacific. The root is used
for medicine.
 Kava is used to calm anxiety, stress, restlessness, and treat
insomnia. It is also used for attention deficit-hyperactivity
disorder (ADHD), epilepsy, psychosis, depression, migraines and
other headaches, chronic fatigue syndrome (CFS), common cold
and other respiratory tract infections, tuberculosis, muscle pain,
and cancer prevention.
 Some people use kava for urinary tract infections (UTIs), pain
and swelling of the uterus, menstrual discomfort. Reduces
anxiety and hot flashes in women with menopause.
 Kava is applied to the skin for skin diseases including leprosy, to
promote wound healing, and as a painkiller.
 It is also used as a mouthwash for toothaches.

20. • Kava may intensify or
prolong the effects of
sedatives.
Sedatives (such
as barbiturates
and
benzodiazepines)

21. CHAMOMILE:
(An extract or tea)
Used on the skin to reduce swelling and
fight bacteria and as a tea or dietary
supplement for stomach cramps.
To treat irritation from chest colds, slow
healing wounds, abscesses, gum
inflammation, and skin conditions such
as eczema, chickenpox and diaper rash.

22. • Chamomile taken with
anticoagulants may increase the
risk of bleeding.
Anticoagulants (drugs
that prevent blood clots,
such as warfarin
• Chamomile may intensify or
prolong the effects of sedatives.
Sedatives (such as
barbiturates and
benzodiazepines)
• Chamomile may reduce iron
absorption.
Iron
The pollen found in chamomile preparations may cause allergic
reactions. If one is allergic to ragweed pollen, chamomile use must be
prohibited.

23.  Feverfew is used for fever,
irregular menstrual
periods, arthritis,
psoriasis, allergies, asthma, di
zziness, and nausea and
vomiting.
 Some people use feverfew for
infertility. It is also used for
anaemia, cancer, common
cold, earache, liver disease,
prevention of miscarriage,
muscular tension, bone
disorders, swollen
feet, diarrhoea, upset
stomach and intestinal gas.
 Feverfew is sometimes applied
directly to the gums
for toothaches or to the skin to
kill germs.
FEVERFEW:

24. • Feverfew taken with anticoagulants may
increase the risk of bleeding.
Anticoagulants
(such as warfarin)
Iron • Feverfew may reduce iron absorption.
• Feverfew may increase heart rate and blood
pressure when it is taken with drugs used to
manage migraine headaches.
Drugs used to
manage migraine
headaches (such as
ergotamine)
• NSAIDs reduce the effectiveness of feverfew
in preventing and managing migraine
headaches.
Non steroidal anti-inflammatory
drugs
(NSAIDs)

25. MILK THISTLE:
 Milk thistle seed might protect liver cells from toxic
chemicals and drugs.
 It also seems to have antioxidant and anti-inflammatory
effects. Milk thistle plant extract might
enhance the effects of estrogen.
 Diabetes. A compound in milk thistle called silymarin
appears to decrease blood sugar in people with type 2
diabetes.
 Gallbladder problems, liver disease (cirrhosis, hepatitis and
other liver conditions), swelling of the lungs (pleurisy),
malaria, menstrual problems.

26. • Milk thistle may intensify the effects
of these drugs, causing an excessive
decrease in blood sugar levels.
Drugs that decrease
blood sugar levels
(hypoglycaemic drugs)
• Milk thistle decreases blood levels of
protease inhibitors, making them
less effective.
Protease inhibitors (such
as
indinavir or saquinavir),
which are used to treat
HIV infection

27. REFERENCES ..
http://altmedicine.about.com/od/ephedra/a/ephedra.htm
http://www.webmd.com/vitamins-supplements/ingredientmono-933-
feverfew.aspx?activeingredientid=933&activeingredientname=feverfew
http://www.merckmanuals.com/home/special_subjects/medicinal_herbs_
and_nutraceuticals/overview_of_medicinal_herbs_and_nutraceuticals.htm
l
http://www.biologicnr.com/research-info/nutrient-drug-interactions-data-base/
http://www.webmd.com/sleep-disorders/guide/chamomile-topic-overview
http://www.webmd.com/vitamins-supplements/ingredientmono-981-
echinacea.aspx?activeingredientid=981&activeingredientname=echinacea
http://www.nlm.nih.gov/medlineplus/druginfo/natural/300.html
http://www.nlm.nih.gov/medlineplus/druginfo/natural/961.html
http://www.nlm.nih.gov/medlineplus/druginfo/natural/1000.html
http://www.webmd.com/vitamins-supplements/ingredientmono-943-
goldenseal.aspx?activeingredientid=943&activeingredientname=goldense
al
http://www.rxlist.com/milk_thistle/supplements.htm
http://www.nlm.nih.gov/medlineplus/druginfo/natural/971.html
http://www.webmd.com/vitamins-supplements/ingredientmono-870-
valerian.aspx?activeingredientid=870&activeingredientname=valerian