Dr. Philip Hansten from the University of Washington School of Pharmacy has spent more than 30 years chronicling and documenting drug interactions.

In an article in Pharmacy Times, he and Dr. John Horn focus on the risks for people with diabetes or taking blood thinners.

In patients taking warfarin (Coumadin): CAMs associated with an increased risk of bleeding?

• Cayenne
• Willow bark
• St. John’s wort
• Ginger
• Coenzyme Q10
• Chitosan

Increased risk of drug-CAM interactions in diabetes

• Nopal (prickly pear cactus) combined with oral hypoglycemic agents metformin (Glucophage) or glyburide (Diabeta)

The risk when using blood sugar test strips containing the enzyme glucose dehydrogenase pyrroloquinolinequinone (GDH-PQQ) such as the Free- Style and Accu-Chek systems:

• Galactose: Usually combined with glucose in dairy products.
• Xylose: Sometimes used to reduce the risk of gastrointestinal tract cancers and lower blood cholesterol.

The bottom line?
Most support for these interactions comes from reports of individual patient experiences. Few detailed studies are available.

People using these combinations should consult their healthcare provider for guidance.

An online registry has been established to collect reports of altered warfarin response due to CAM therapy.

1/4/08 21:32 JR