Commonly Used Herbal Supplements and Potential Problems
Herbal Supplement
Aloe


Gel
Latex
Black Cohosh
Echinacea
Feverfew
Garlic
Ginger Root
Ginkgo Biloba
Problems / Concerns
 None with aloe gel applied topically.
 Aloe latex, when ingested, can
cause severe diarrhea resulting in
fluid & electrolyte imbalance.
 Although rare, has been associated
with liver toxicity.
 Can potentiate the effects of
antihypertensive medication
 Can potentiate the effects of insulin
and oral hypoglycemics
May potentiate the effects of
estrogens
 Short-term use stimulates immune
function; avoid using if autoimmune
diseases.
Long-term use suppresses immune
function; avoid if immunocompromised.
 Suppresses platelet aggregation;
increases the risk of bleeding in
patients on ASA, warfarin or heparin
 May cause GI upset; avoid with
infectious or inflammatory
gastrointestinal disorders.
 Suppresses platelet aggregation;
increases the risk of bleeding in
patients on ASA, warfarin or heparin
 Increases insulin levels, potentiating
the effects of drugs used to treat
diabetes
 Large doses can cause CNS
depression & cardiac dysrhythmias
 Suppresses platelet aggregation;
increases the risk of bleeding in
patients on ASA, warfarin or heparin


Suppresses coagulation; increases
the risk of bleeding in patients on
ASA, warfarin or heparin
May promote seizures; avoid taking
with drugs that can lower the seizure
threshold (antidepressants,
Goldenseal
Kava
Ma Huang (Ephedra)
St. John’s Wort
antipsychotics, antihistamines,
decongestants, cholinesterase
inhibitors & systemic
glucocorticoids).
 High doses can cause nausea,
vomiting & diarrhea.
Toxic doses can hypertension, seizures,
and death from respiratory failure.
 Can cause hepatitis, cirrhosis & liver
failure; avoid in persons with liver
disease.
 When taken in high doses, effects
are similar to alcohol including CNS
depression, impaired vision and loss
of coordination.
 Prolonged use can cause dry, scaly
skin and yellowing of the skin, hair &
nails, dryness.
Can intensify the effects of drugs with
CNS depressant effects (alcohol,
barbiturates, opioids &
benzodiazepines).
 Cardiovascular stimulation resulting
in tachycardia, hypertension,
palpitations and anginal pain
 CNS stimulation resulting in
agitation, insomnia, euphoria &
psychosis
 Potentiates the effects of CNS
stimulants, beta1 and beta2 agonists,
ergotamine & nasal decongestants.
 If used concurrently with MAO
inhibitors, can cause a hypertensive
crisis
 May cause dry mouth, dizziness,
constipation & confusion
 Photosensitivity reactions are
possible; wear protective clothing &
sunscreen on exposed skin
 Speeds up drug metabolism of
anticoagulants, antiretrovirals,
immunosuppressants & theophylline
resulting in a decreased
effectiveness of these drugs.
 Speeds up drug excretion of digoxin,
calcium channel blockers, steroids,

Saw Palmetto



Valerian

protease inhibitors & some
anticancer drugs
Can cause potentially fatal serotonin
syndrome if used concurrently with
SSRIs, amphetamines, MAO
inhibitors & some tricyclic
antidepressants.
High doses may cause diarrhea
May decrease levels of prostatespecific antigen (PSA), resulting in
false negatives
Concurrent use with finasteride is
not recommended because of the
potential for additive effects.
May cause daytime drowsiness,
dizziness, & depression resulting in
unsafe ambulation and diminished
self-care functions
Lehne, R.A. (2007) Pharmacology for Nursing Care (6th edition). St. Louis, MO:
Saunders Elsevier.