Heart meds and herbs don't mix

Alphabet T Taking herbal remedies alongside prescribed medicines for heart conditions can make for a high-risk concoction
Heart healthHeart health

If it’s natural it must be good for you, right? Not always, and especially not if you are already taking prescription drugs for heart disease. In fact the mix could be life-threatening, according to a review article published in the Journal of the American College of Cardiology.

Gingko biloba, St. John’s wort and garlic are among the herbal supplements mentioned that can put you at risk if you take them while you are on heart medication. And the risk is likely to be even higher if you have other health conditions for which you are taking prescription drugs.

"Many people have a false sense of security about these herbal products because they are seen as 'natural,'" said Arshad Jahangir, MD, cardiologist at Mayo Clinic in Arizona and senior author of the study. "But 'natural' doesn't always mean they are safe. Every compound we consume has some effect on the body, which is, in essence, why people are taking these products to begin with," he added.

Taking herbal supplements that may affect you badly is a risk in itself – it’s always a good idea to ask your GP or pharmacist for advice before you add them to your daily diet. It’s vital to remember that herbs can interact with the drugs you take for your heart condition. They may make the drugs less effective, or could boost their potency, with serious results, such as an increased risk of cardiac arrhythmias.

"We can see the effect of some of these herb-drug interactions — some of which can be life-threatening — on tests for blood clotting, liver enzymes and, with some medications, on electrocardiogram," Dr Jahangir said.

"These herbs have been used for centuries — well before today's cardiovascular medications — and while they may have beneficial effects these need to be studied scientifically to better define their usefulness and, more importantly, identify their potential for harm when taken with medications that have proven benefit for patients with cardiovascular diseases," said Dr Jahangir. "Patients, physicians, pharmacists and other healthcare providers need to know about the potential harm these herbs can have."

With around 235 million prescriptions issued for the treatment of cardiovascular disease in England in 2006, this is potentially an enormous problem – another good reason for being careful about what you take. "This review highlights the problem of increasing numbers of people taking herbal medicines assuming that natural or herbal implies that they are safe," said Cathy Ross, Cardiac Nurse at the British Heart Foundation.

"Many commonly used herbal or natural preparations including St John’s Wort and Ginkgo will interact with medicines commonly prescribed to treat heart and circulatory disease and should be avoided. Everyone should discuss with their doctor all other remedies that they are taking or wish to take."

Even something as everyday as grapefruit and grapefruit juice, (and herbal preparations made from grapefruit), can react with certain statins. In fact people taking statins are generally advised to avoid grapefruit altogether.

If you would like to find out more about the safety and regulation of herbal remedies, go to the Medicines and Healthcare products Regulatory Agency (MHRA) at www.mhra.gov.uk

Useful website

The British Heart Foundation www.bhf.org.uk

First published February 12, 2010


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