Interactions

Interactions with Drugs

Chocolate may affect blood sugar levels. Caution is advised when using medications that may also affect blood sugar. People taking insulin or drugs for diabetes by mouth should be monitored closely by a qualified healthcare professional, including a pharmacist. Medication adjustments may be necessary.

Chocolate may increase the risk of bleeding when taken with drugs that increase the risk of bleeding. Some examples include aspirin, anticoagulants ("blood thinners") such as warfarin (Coumadin®) or heparin, anti-platelet drugs such as clopidogrel (Plavix®), and non-steroidal anti-inflammatory drugs such as ibuprofen (Motrin®, Advil®) or naproxen (Naprosyn®, Aleve®).

Chocolate may affect blood pressure. Caution is advised in people taking drugs that affect blood pressure.

Chocolate may also interact with activated charcoal, agents for bone loss, agents for teeth, agents that affect blood vessel width, agents that affect mental function, agents that affect the heart (including heart rhythm), agents that affect the immune system, agents that affect the nervous system, agents that affect the stomach and intestines, agents that damage the liver, angiotensin-converting enzyme (ACE), antianxiety agents, anticancer agents, aspirin, antidepressants (selective serotonin reuptake inhibitors, SSRIs), anti-inflammatory agents, calcium salts, cannabinoids (present in marijuana), cholesterol-lowering agents, fertility agents, gamma-aminobutyric acid (GABA), iron salts, painkillers, salbutamol, and sunscreens.

Interactions with Herbs and Dietary Supplements

Chocolate may affect blood sugar levels. Caution is advised when using herbs or supplements that may also affect blood sugar. Blood glucose levels may require monitoring, and doses may need adjustment.

Chocolate may increase the risk of bleeding when taken with herbs and supplements that are believed to increase the risk of bleeding. Multiple cases of bleeding have been reported with the use of Ginkgo biloba, and fewer cases with garlic and saw palmetto. Numerous other agents may theoretically increase the risk of bleeding, although this has not been proven in most cases.

Chocolate may affect high blood pressure. Caution is advised in people taking herbs or supplements that affect blood pressure.

Chocolate may also interact with activated charcoal, anticancer herbs and supplements, antidepressants (selective serotonin reuptake inhibitors, SSRIs), anti-inflammatory herbs and supplements, antioxidants, caffeine, calcium, cannabinoids, cholesterol-lowering herbs and supplements, copper, fertility herbs and supplements, gamma-aminobutyric acid (GABA), ginseng, grapefruit, herbs and supplements for bone loss, herbs and supplements for teeth, herbs and supplements that affect blood vessel width, herbs and supplements that effect mental function, herbs and supplements that affect the heart (including heart rhythm), herbs and supplements that affect the immune system, herbs and supplements that affect the nervous system, herbs and supplements for the stomach and intestines, herbs and supplements that damage the liver, iron, painkillers, plant sterols, probiotics, stimulants, sunscreens, and vitamins.

This evidence-based monograph was prepared by The Natural Standard Research Collaboration

www.naturalstandard.com