Asteraceae: Drug Interactions, Contraindications, And Precautions

Patient survey data from Canada, the U.S., and Australia show that one in five patients use prescription drugs concurrently with CAM. The inherent polypharmaceutical nature of complementary and alternative medicine increases the risk of adverse events if these complementary and alternative medicine either have pharmacological activity or interfere with drug metabolism. Since confirmed interactions are sporadic and based largely on case reports, advice to avoid certain drug-CAM combinations is based on known pharmacological and in vitro properties. Known Hypersensitivity to Asteraceae Cross-reactive sesquiterpene lactones are present in many, if not all, Asteraceae. Patients with known CAD from one plant may develop similar type IV reactions following contact with others. Affected patients are often advised to avoid contact with all Asteraceae, yet this advice is based on limited knowledge of cross-reactivity between relatively few members of this large family. Some authorities recommend avoiding Asteraceae-derived complementary and alternative medicine if, for example, the patient is known to have IgE-mediated inhalant allergy to ragweed. While a reasonable approach, this ignores a number of important facts: (1) Read more […]

Vulvovaginal Candidiasis

Vulvovaginal candidiasis (VVC), commonly referred to as yeast infection, is the second most common cause of vaginitis in the United States. Approximately 75% of all women will experience an episode of VVC in their lifetime, with recurrent vulvovaginal candidiasis occurring in 5% of women. It is most commonly caused by the fungus Candida albicans; however, other Candida species, such as C. tropicalis and C. glabrata are becoming increasingly common, possibly because of increased use of OTC anti-fungals, and they are also typically more resistant to antifungal treatments. OTC antifungal treatments are among the top 10 selling OTC medications in the United States with an estimated $250 in annual sales. Establishing Candida as a cause of vaginitis can be difficult, because 50% of all women have Candida organisms as part of their normal vaginal flora. Candida is not considered a sexually transmitted disease, and conventional medical practice does not include treatment of male partners unless uncircumcised or presenting with inflammation of the glans penis. recurrent vulvovaginal candidiasis is defined as four or more episodes annually. Recurrence may be a result of associated factors, intestinal microorganism reservoir, Read more […]

Herb-Drug Interactions: Cola

Cola acuminata Schott & Endl. or Cola nitida Schott & Endl. (Sterculiaceae) Synonym(s) and related species Guru nut, Kola. Garcinia kola Heckel, Sterculia acuminata Beauv. Pharmacopoeias Cola (British Ph 2009, European Ph, 6th ed., 2008 and Supplements 6.1, 6.2, 6.3 and 6.4). Constituents Cola seed contains xanthine derivatives, mainly caffeine (1.5 to 3%) to which it may be standardised, with traces of theobromine and theophylline. Other constituents include flavonoids from the flavanol group (such as catechin and epicatechin), amines, an anthocyanin pigment (kola red) and betaine. Use and indications The main use of cola seed is as a stimulant for depression, tiredness and poor appetite, and as a diuretic. Both uses can be attributed to the caffeine content. Cola is also used as flavouring agent in the manufacture of soft drinks. Pharmacokinetics For the pharmacokinetics of caffeine, see caffeine. For information on the pharmacokinetics of individual flavonoids present in cola, see under flavonoids. Interactions overview Cola contains significant amounts of caffeine, therefore the interactions of caffeine, should be applied to cola, unless the product is specified as decaffeinated. By Read more […]