Drug Name
Echinacea
Used for
Boost immune system
Side Effects
Hepatotoxicity: use for
only 10-14 days no
more than 8 weeks
Renal impairment
(BUN, Creatinine, UOP)
D/D Interaction
Other drugs or
conditions that also
affect liver function like acetaminophen,
cirrhosis, hepatitis
Monitor ALT/AST
Garlic
Lower cholesterol
Lower Triglycerides
Act as anticoagulant
Good compliment to
cardiovascular health
Increased risk of
hypoglycemia with
insulin and diabetic
agents
Don’t take with other
anticoagulants
(bleeding risk), garlic,
ginger, gingko
Ginseng
Increase Stamina
Boosts cognitive
functioning
Stimulates sympathetic
nervous system:
increased BP, HR
Digoxin Toxicity
Decreases
effectiveness of
anticoagulants
Lower Triglycerides and
increase HDL
Elderberry
Decrease length and
severity of viral illness
(colds and influenza)
Safe, very few side
effects
Caffeine can increase
adverse effects
No concerning drugdrug interactions
May also prevent
Antiinflammatory/Antioxident
St. John’s Wort
Used as antidepressant
Photosensitivity
Decreased effect of
Warfarin (clot/ low
PT/INR)
Don’t use with other
antidepressants
Kava Kava
Use to calm
Liver failure reported,
changes serotonin,
melatonin levels in the
brain, visual, mild GI
disturbances
Don’t use with other
CNS depressants, if
taken with Alprazolam
make cause coma
Bleeding
Anticoagulants and
antiplatelets- increase
bleeding risk.
Digoxin toxicity
Ginkgo Biloba
Licorice
Improve memory and
Cognitive functioning
People take it for PUD but
it can actually cause
Ephedra (ma haung)
ulcers in high doses.
Used as an appetite
suppressant
Significant
cardiovascular effects
(MI, dysrhythmias,
sudden cardiac death)
Increases risk of
toxicity:
Theophylline
Digoxin
Caffeine increases risk
of adverse event
1. Herbals are not regulated by the FDA drug approval process. Dietary Supplement Health and
Education Act (DSHEA)
a) Do not require testing before marketing
b) Efficacy does not have to be demonstrated
c) Do not have to prove safety
d) No regulation about accuracy of label
2. There are many reasons that patients turn to Herbals; healthcare providers must directly ask about
herbal medications. Patients often do not reveal they are taking them.
3. Nurses and healthcare providers should educate patients AND be aware of peer reviewed data bases
(IBIDS/CARDS) where they can find reliable literature about herbals.
4. The Dietary Supplement Verification Program (DSVP) and ConsumerLab: Quality Product Seal provide
voluntary oversight for herbals.
5. Know the medications that must be discontinued before surgery (Not the timing). Know in general
terms that herbals can cause cardiovascular problems (dysrhythmias), increased sedation, bleeding (or
clotting), electrolyte disturbances, glucose imbalances, and immunosuppression (poor healing).