Hops: Interactions. Practice Points. FAQ

Adverse Reactions

Drowsiness is theoretically possible at excessive doses. Contact with the herb or oil has resulted in reports of systemic urticaria, allergic dermatitis, respiratory allergy and anaphylaxis.

Significant Interactions

Interactions reported here are theoretical and have yet to be tested clinically for significance.

PHARMACEUTICAL SEDATIVES

Additive effects are theoretically possible — observe the patient (this interaction may be beneficial).

DRUGS METABOLISED CHIEFLY WITH CYP2B OR CYP3A

Altered drug effect — CYP induction and inhibition has been demonstrated. However, it is unknown if these effects are clinically significant — observe the patient for signs of altered drug effectiveness.

ANTI-OESTROGENIC DRUGS

Hops may alter the efficacy of these medicines; use with caution in patients taking anti-oestrogenic drugs.

Contraindications and Precautions

According to one source, hops should be used with caution in depression. Due to the herb’s oestrogenic activity, disruption to the menstrual cycle is considered possible. Use is contraindicated in patients with oestrogen-dependent tumours.

Pregnancy Use

Caution in pregnancy because of possible hormonal effects.

Practice Points / Patient Counselling

• Hops is often used as a mild sedative in combination with other herbs such as valerian and passionflower.

• Several randomised trials have found that the combination of hops and valerian improve sleep quality, without next-day drowsiness; however, further investigation is required to determine the role of hops in achieving this effect.

• Although generally taken orally, it has also been successfully used as a bath additive and in aromatherapy pillows to induce sleep.

• It is traditionally used to treat anxiety, restlessness, pain, neuralgia and indigestion.

• It should not be used in patients with oestrogen-dependent tumours, and should be used with caution in pregnancy.

Answers to Patients’ Frequently Asked Questions

What will this herb do for me?

Hops may be a useful treatment for anxiety and restlessness, and when combined with other sedative herbs, such as valerian or passionflower, improves sleep quality without inducing next-day hangover effects.

When will it start to work?

Several doses may be required; however, effects are generally seen within 2 weeks.

Are there any safety issues?

Constituents in the herb appear to have some oestrogenic activity, therefore people with oestrogen-dependent tumours should avoid its use.