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Herbs And Drugs Interact In Dangerous Ways

Posting Date: 07/31/2000

When the former Prime Minister of the tiny island of Fiji was finally released by rebels after two months of captivity, he sat down with his enemies and drank a cup of kava. This traditional Fijian ceremony signified forgiveness.

For centuries, kava has played an important role in many South Pacific societies. They use it in their most important rituals.

But cultures can collide. One man from the island of Tonga was arrested in San Mateo, California, for driving while impaired after a six-hour kava ceremony at his church. He was weaving between lanes although he hadn't consumed any alcohol.

In North America kava has become a popular anti-stress herb that is used by millions to relax or go to sleep. But some people may not appreciate its pharmacological power or the possibility of dangerous interactions.

In one case, a person intending to switch to kava from the anti-anxiety drug Xanax wound up in a coma-like condition and had to be hospitalized. He made the mistake of combining his prescription pill with the herb.

Scientists are beginning to learn much more about herb-drug interactions. But labels on herbal products rarely reflect up-to-date research.

A recent report in the Proceedings of the National Academy of Sciences demonstrates that a component of St. John's wort, hyperforin, has a profound effect on the liver enzymes that process many medicines. It kicks these enzymes into high gear so that the drugs leave the body more quickly and may not be as effective as anticipated.

There are cases in which St. John's wort seems to have lowered levels of the asthma drug theophylline, the immune-suppressant cyclosporine, the heart medicine digoxin and drugs used to treat HIV and AIDS.

Experts anticipate that many other medicines may also be affected, including birth control pills, blood pressure drugs such as Plendil, Sular or Cozaar, the antiseizure medicine Tegretol and the anticancer compound tamoxifen.