Lupus Site - a guide for lupus patients and their families

Many herbs can interfere with prescription drugs, or can be dangerous if taken in large quantities. Always check with your doctor before taking any herbal remedy or dietary supplement.

Bromelain (Pineapple enzyme) - May increase the effect of blood-thinning drugs (e.g. Warfarin, Heparin).

Cat's Claw - May increase the risk of bleeding if taken with blood-thinning drugs (e.g. Warfarin, Heparin).

Cayenne Pepper - Reports of possible interaction with MAO inhibitors and antihypertensive therapy (used to lower blood pressure). In large quantities, may cause damage to liver and kidneys.

Chamomile - Contains coumarin, but chamomile's effects on the body's anticoagulation system have not been studied. If used with anticoagulants such as warfarin, close monitoring by a doctor is advised.

Devil's Claw - May interfere with antacids, cardiac or diabetic medications. Use with caution is taking NSAIDs, which can irritate the stomach, as it can stimulate stomach acids.

DHEA - May cause liver damage if taking azathioprine or methotrexate. Can increase insulin resistance or sensitivity in diabetics.

Dong Quai - May interact with blood-thinning medications (e.g. Warfarin, Heparin). May increase sun sensitivity.

Echinacea - May be toxic to the liver if used for more than eight weeks. Should not be used with drugs that can cause liver problems, such as anabolic steroids, amiodarone, methotrexate and ketoconazole. Should not be given with immunosuppressants such as corticosteroids and cyclosporine because it can stimulate the immune system.

Evening primrose oil and borage (GLA) - Should not be used with anticonvulsants because they may lower the seizure threshold. Not recommended for patients diagnosed with schizophrenia. May increase the effects of anticoagulants and NSAIDs.

Feverfew - Effect on migraine headaches may be compromised by non-steroidal anti-inflammatory drugs, such as aspirin and ibuprofen. May increase blood-thinning effect of Warfarin or other anticoagulants, including NSAIDs. Not to be used if pregnant, as it may cause miscarriage.

Fish Oil (Omega-3 fatty acids) - May increase the blood-thinning effects of anticoagulants and NSAIDs.

Garlic - Should not be used with warfarin or other anticoagulents, because it affects clotting. May also interact with hypoglycemic medications, and anti-inflammatory drugs.

Ginger - Should not be used with warfarin because it affects clotting. Do not use if you have gallstones. Large quantities may interfere with cardiac, antidiabetic or anticoagulant (Warfarin, Heparin) therapy.

Gingko - Can inhibit clotting so should not be used with aspirin or other non-steroidal anti-inflammatory drugs or with anticoagulants such as warfarin or heparin. Also should not be used in conjunction with anticonvulsant drugs used by epileptics, such as carbamazepine, phenytoin and phenobarbital, or with tricyclic antidepressants.

Ginseng - Should not be used with warfarin, heparin, aspirin and other non-steroidal anti-inflammatory drugs because it can inhibit clotting. Also may cause headache, tremulousness and manic episodes in patients treated with phenelzine sulfate. Should not be used with estrogens or corticosteroids because it may add to those drugs' side effects. May also interfere with the heart drug digoxin or with digoxin monitoring. Should not be used by diabetics because it can affect blood glucose levels.

Goldenseal - Should be avoided by people with high blood pressure. May interfere with anticoagulant therapy (Heparin).

Karela - Should not be used by patients with diabetes because it can affect blood glucose levels.

Kava - Should not be used with the tranquilliser alprazolam because it may result in coma. Do not take with sleeping medications or tranquilisers.

Kelp - May interfere with thyroid replacement therapies.

Liquorice - Can offset the effect of the diuretic drug spironolactone. May also interfere with heart drug digoxin or with digoxin monitoring. Potassium loss due to other drugs, e.g., thiazide diuretics, can be increased.

Melatonin - Appears to boost the immune system, so should be avoided by people with autoimmune diseases including lupus.

St. John's Wort - Can produce skin reactions to light so fair-skinned users may wish to take care and anyone taking other drugs that cause light sensitivity, such as piroxicam or tetracycline, may want to avoid this herb. The active ingredient in St. John's Wort is uncertain, so it should not be used with two common types of psychiatric drugs called monoamine oxidase inhibitors and selective serotonin reuptake inhibitors. Tannic acid in the herb may inhibit absorption of iron. Can block the effects of drugs, including oral contraceptives, tricyclic antidepressants, cyclosporin, several heart drugs and warfarin.

Stinging Nettle - May increase the effects of tranquilisers and sedative drugs. May decrease the effect of certain cardiac and diabetic drugs.

Valerian - Should not be used with barbiturates, such as thiopental and pentobarbital -can cause excessive sedation. Do not use if taking tranquilisers or sleep medications, as it increases the effect.

White willow bark - Aspirin is made from the drug salaicin, which is contained in White Willow Bark .Do not take with aspirin or other NSAIDs, as it increases their effects. May increase the effects of anticoagulant drugs (e.g. Warfarin, Heparin).