✓ May be Beneficial: Side effect Eleuthero*
reduction/prevention
✓ May be Beneficial: Supportive Asian ginseng*
interaction
Depletion or interference None known Reduced drug absorption/bioavailability None known
Adverse interaction None known
fever and other allergies. In addition, some agents may be used to prevent recurrence of nasal polyps following surgical removal.
The information in this article pertains to inhaled corticosteroids in general. The interactions reported here may not apply to all the Also Indexed As terms.
Talk to your doctor or pharmacist if you are taking any of these drugs.
Summary of Interactions for Inhaled Corticosteroids
In some cases, an herb or supplement may appear in more than one category, which may seem contradictory.
For clarification, read the full article for details about the summarized interactions.
Interactions with Dietary Supplements Calcium
Most of an inhaled dose of beclomethasone is actually swallowed, which may lead to reduced absorption of cal- cium.1 Health practitioners may recommend calcium supplementation to individuals using beclomethasone inhalers.
Dehydroepiandrosterone (DHEA)
A group of women with asthma who had been taking inhaled beclomethasone were shown to have low levels of DHEA compared to women with asthma who were not taking beclomethasone.2 The authors speculated that this effect may partially explain how cortico- steroids can cause osteoporosis. However, more research is needed to confirm these suspicions and to evaluate whether supplemental DHEA is beneficial to patients taking inhaled corticosteroids.
Contains the following ingredients:
Enalapril(page 103) Hydrochlorothiazide
I N N O Z I D E
✓ May be Beneficial: Depletion or Calcium
interference Dehydroepian-
drosterone (DHEA)*
Side effect reduction/prevention None known
Supportive interaction None known
Reduced drug absorption/bioavailability None known
Adverse interaction None known
Innozide
Common names: Animal-Source Insulin: Iletin, Humalog Mix25, Humalog Mix50, Human Actarapid, Human Analog Insulin: Human- log, Human Insulin (Humulin, Novolin), Human Mixtard, Human Monotard, Human Ultratard, Hypurin, Isulatard, Lentard MC, Novolin ge, NovoRapid, Oralin, Pork Mixtard
Insulin is a natural protein made by the pancreas that helps the body use sugar. Insulin is injected by all peo- ple with type 1 (insulin-dependent) diabetes mellitus and by some people with type 2 (non-insulin-depend- ent) diabetes mellitus to help control blood sugar levels.
Any substance (dietary, supplemental, herbal, and others) that affects blood sugar levels will directly or indi- rectly affect the amount of insulin required by a person with diabetes. For example, consumption of a high-fiber diet and/or supplementation with nutrients such as chromium, biotin, vitamin E, or herbs such as Gymnema sylvestrewill often improve blood sugar control in diabet- ics. In such cases, the amount of insulin may need to be reduced in order to avoid a hypoglycemic reaction. Any- one taking insulin should consult the prescribing physi- cian before making dietary changes or taking nutrients or herbs that are designed to lower blood sugar levels.
Summary of Interactions for Insulin
In some cases, an herb or supplement may appear in more than one category, which may seem contradictory.
For clarification, read the full article for details about the summarized interactions.
Interactions with Dietary Supplements Dehydroepiandrosterone (DHEA)
Insulin has been shown to decrease the levels of DHEA and DHEA-sulfate in the blood.1 More research is
✓ May be Beneficial: Depletion or DHEA interference
✓ May be Beneficial: Supportive Biotin
interaction Chromium
Fenugreek Gymnema sylvestre*
Vitamin E Ꮬ Avoid: Adverse interaction Chromium*
Gymnema sylvestre*
Tobacco Side effect reduction/prevention None known Reduced drug absorption/bioavailability None known
I N S U L I N
needed to determine the significance of this finding.Interactions with Herbs
Fenugreek (Trigonella foenum-graecum)
In a controlled study of patients with type 1 diabetes, fenugreek (100 grams per day for ten days) was re- ported to reduce blood sugar, urinary sugar excretion, serum cholesterol, and triglycerides, with no change in insulin levels.2In a controlled study of people with type 2 diabetes, fenugreek (25 grams per day for 24 weeks) was reported to significantly reduce blood glucose lev- els.3 People using insulin should talk with their pre- scribing doctor before incorporating large amounts of fenugreek into their diet.
Gymnema sylvestre
Although no interactions have been reported, gym- nema may decrease the required daily dose of insulin.4 Therefore, people currently using insulin for the treat- ment of diabetes should discuss the use of this herb with their healthcare professional.
Interactions with Foods and Other Compound Food
Diet is an important factor in effective diabetes preven- tion and treatment. People using insulin should moni- tor their blood sugar carefully and talk with their doctor about the role of diet in diabetes control.
Alcohol
Alcohol may increase the action of insulin, leading to hypoglycemia (low blood sugar).5People using insulin should avoid alcohol.
Tobacco (Nicotiana species)
Smoking may decrease insulin activity,6 and it com- pounds the health problems associated with diabetes.
People using insulin are cautioned to avoid smoking.
Common names:Actimmune, Alferon N, Avonex, Betaferon, Be- taseron, Immukin, Immune Interferon, Infergen, Intron, Rebif, Rebif (interferon beta), Roferon-A,Viraferon (interferon alfa),Wellferon
Interferons are proteins made by the human immune system for fighting viral infections and regulating cell function. Three types of interferons are used as drugs:
interferon alpha, interferon beta, and interferon gamma.
They are used by injection to treat viral infections, hepatitis, multiple sclerosis, some cancers, and other diseases.
I N T E R F E RO N
Insulin
The information in this article pertains to interferon in general. The interactions reported here may not apply to all the Also Indexed As terms. Talk to your doctor or pharmacist if you are taking any of these drugs.
Summary of Interactions for Interferon
In some cases, an herb or supplement may appear in more than one category, which may seem contradictory.
For clarification, read the full article for details about the summarized interactions.
Interactions with Dietary Supplements N-acetyl cysteine (NAC)
One preliminary trial found that adding 600 mg NAC three times per day to interferon therapy for people with chronic hepatitis C led to improvement in their conditions not seen with interferon alone.1 However, other preliminary2, 3 and double-blind trials4, 5 have failed to confirm the efficacy of this approach. At the present time, sufficient evidence is lacking to support the use of this drug-nutrient combination in persons with hepatitis.
Thymus peptides
Peptides or short proteins derived from the immune organ known as the thymus gland have been investi- gated in combination with interferon therapy for peo- ple with hepatitis B and C. One study found that adding thymus humoral factor-gamma 2 to interferon therapy prevented decreases in white blood cell counts sometimes seen with interferon alone, and also seemed to improve the efficacy of interferon against hepatitis B.6Thymus humoral factor-gamma 2 must be admin- istered by injection, requiring consultation with a doc- tor. It is not known whether orally administered thymus extracts would be useful in combination with interferon.
✓ May be Beneficial: Side effect Thymus
reduction/prevention peptides*
✓ May be Beneficial: Supportive Licorice*
interaction N-acetyl
cysteine (NAC)*
Thymus peptides*
Ꮬ Avoid: Reduced drug absorption/ Thymus
bioavailability peptides*
Ꮬ Avoid: Adverse interaction Bupleurum Depletion or interference None known
Interactions with Herbs Bupleurum (Bupleurum chinense)
Bupleurum is the major constituent of a Japanese Kampo (herbal) medicine formula called sho-saiko-to.
This formula has been used alone or with interferon to treat hepatitis. Eighty or more cases of drug-induced pneumonitis (inflammation of the lungs) have been as- sociated with the use of sho-saiko-to alone or with in- terferon.7, 8, 9, 10 Until more is known, sho-saiko-to should not be combined with interferon.
Licorice (Glycyrrhiza glabra)
Injections of the licorice compound glycyrrhizin are commonly used to treat hepatitis in Japan. The combi- nation of glycyrrhizin and interferon may be more effec- tive than interferon alone.11, 12Injectable glycyrrhizin is available from some physicians. So far, human studies have not used orally administered licorice extracts in conjunction with interferon.
Common names:Ipecacuanha Emetic Mixture
Ipecac syrup is a drug used to induce vomiting in the treatment of drug overdoses and in certain poisonings.
In addition, people with eating disorders, such as bu- limia and anorexia nervosa, occasionally abuse ipecac to avoid weight gain. In emergency situations, a local poi- son control center should be contacted before ipecac is given.
Summary of Interactions for Ipecac
In some cases, an herb or supplement may appear in more than one category, which may seem contradictory.
For clarification, read the full article for details about the summarized interactions.
✓ May be Beneficial: Side effect Potassium reduction/prevention
Ꮬ Avoid: Reduced drug absorption/ Activated
bioavailability charcoal
Carbonated beverages Milk Depletion or interference None known
Supportive interaction None known
Adverse interaction None known
I P E C A C
Ipecac
Interactions with Dietary Supplements Potassium
In order to lose weight, some individuals who are overly zealous, as well as those with eating disorders, occasion- ally induce vomiting with ipecac. However, chronic abuse of ipecac can result in low blood levels of potas- sium,1which might result in an irregular heart rhythm.
Though avoidance of this behavior is the best form of prevention, individuals who abuse ipecac should sup- plement with potassium or high-potassium foods to prevent potassium deficiency.
Interactions with Foods and Other Compounds Milk and carbonated beverages
Some references have suggested that taking ipecac along with milk or carbonated beverages might reduce the ef- fectiveness of the drug.2 However, controlled studies have shown that drinking neither milk3nor carbonated beverages4inhibits the action of ipecac. Consequently, ipecac can be given with or without milk or carbonated beverages.
Activated charcoal
In the treatment of certain poisonings, activated char- coal is used to reduce the amount of poison absorbed into the body. Some references have suggested that peo- ple avoid giving ipecac and activated charcoal together.5 However, controlled studies have shown that activated charcoal may not completely block the effects of ipecac,6 and that the combination is effective when activated charcoal is given ten minutes after ipecac treatment.7 Until more information is available, individuals should probably wait to give activated charcoal until after the ipecac-induced vomiting stops.
Common names:Alti-Ipratropium, Apo-Ipravent, Atrovent, Iprat- ropium Steri-Neb, Novo-Ipramide, Nu-Ipratropium, PMS-Ipratropium, Respontin, Rinatec
Combination drug:Combivent
Ipratropium bromide is a drug used by oral inhalation to keep breathing passages open in chronic obstructive pulmonary diseases, including chronic bronchitis and emphysema. Ipratropium bromide for oral inhalation is available alone and in a combination product. It is also available as a nasal spray to relieve runny nose associ- ated with allergies and common colds.
I P R AT RO P I U M B RO M I D E
Summary of Interactions for Ipratropium Bromide
In some cases, an herb or supplement may appear in more than one category, which may seem contradictory.
For clarification, read the full article for details about the summarized interactions.
Interactions with Foods and Other Compounds Food
Atrovent and Combivent for oral inhalation contain soy lecithin. Rarely, people very sensitive to soy have re- acted to these drugs,1and life-threatening anaphylactic reaction is possible, though extremely rare. Ipratropium bromide nasal spray and solution for inhalation contain no soy lecithin.
Common names:Aprovel, Avapro Combination drug:CoAprovel