Herbal supplements and drug interactions

Many common herbal supplements interact with common heart medicines. This list covers only some interactions. Be sure to talk to your health care provider before you take any herbal supplements if you take prescription medicines.

Coenzyme Q-10

If you take coenzyme Q-10, it can lower:

• How well warfarin works
• Your blood pressure, if you also take a drug to treat high blood pressure

Danshen

Danshen can interact strongly with some heart medicines, such as:

• Blood thinners. Danshen may raise your risk of bleeding. This can happen if you also take warfarin or other blood thinners, such as clopidogrel (Plavix) or aspirin, with danshen.
• Blood pressure medicine. Danshen may make your blood pressure too low if you take danshen with a drug used to lower blood pressure. An example of a blood pressure drug is the calcium channel blocker diltiazem (Cardizem).
• Digoxin (Lanoxin). If you take danshen, it may add to the effects of digoxin. Digoxin is used to treat many heart conditions. It also might raise the risk of irregular heartbeat, also called arrhythmia.

Evening primrose

Evening primrose may raise your risk of bleeding if you also take a blood thinner, such as:

• Aspirin
• Clopidogrel
• Warfarin

Garlic

Garlic may raise your risk of bleeding if you also take a blood thinner, such as:

• Aspirin
• Clopidogrel
• Warfarin

Ginkgo biloba

Ginkgo biloba may raise your risk of bleeding if you also take a blood thinner, such as:

• Aspirin
• Clopidogrel
• Warfarin

Ginseng

If you take ginseng with warfarin, it may lessen how well warfarin works.

Hawthorn

Hawthorn might interact with:

• Beta blockers, such as atenolol (Tenormin), nadolol (Corgard) or propranolol (Inderal LA, Innopran XL)
• Calcium channel blockers, such as diltiazem, nifedipine (Procardia) and verapamil (Calan SR, Verelan)
• Nitrates, such as nitroglycerin (Nitrostat, Nitro-Dur, others) and isosorbide (Isordil, Bidil)
• Digoxin

Licorice

The herb licorice may lower warfarin levels and can add to digoxin's effects.

Saw palmetto

Saw palmetto might make your risk of bleeding higher if you also take a blood thinner, such as:

• Aspirin
• Clopidogrel
• Warfarin

St. John's wort

It's not suggested to take St. John's wort if you take blood thinners. It also may keep some medicines from working as well as they should, such as:

• Calcium channel blockers
• Digoxin
• Warfarin
• Statins, such as atorvastatin (Lipitor), lovastatin (Altoprev) and rosuvastatin (Crestor)
• Anti-rejection medicine, also called immunosuppressant medicine, such as cyclosporine (Gengraf, Neoral, Sandimmune)