|
|
Coleus* | |
|
Tannin-containing herbs* such as green tea, black tea, uva ursi, black walnut, red raspberry, oak, and witch hazel | |
|
Caffeine Ephedra | |
|
Vitamin C | |
| Depletion or interference |
None known |
| Side effect reduction/prevention |
None known |
An asterisk (*) next to an item in the summary indicates that the interaction is supported only by weak, fragmentary, and/or contradictory scientific evidence.
Ephedra
Ephedra is the plant from which ephedrine was originally isolated. Until 2004,
ephedra—also called ma huang—was used in many herbal products, including
supplements promoted for weight loss. To prevent
potentially serious interactions, people taking ephedrine or pseudoephedrine should avoid
using ephedra-containing drug products and should read product labels carefully for ma huang
or ephedra content. Native North American ephedra, sometimes called Mormon tea, contains no
ephedrine.
Coleus
A test tube study demonstrated that the bronchodilating effects of salbutamol, a drug with
similar actions in the lung to ephedrine, were significantly increased by the addition of
forskolin, the active component of the herb Coleus forskohlii.1 The
results of this preliminary research suggest that the combination of forskolin and
beta-agonists (like ephedrine) might provide an alternative to raising the doses of the
beta-agonist drugs as they lose effectiveness. Until more is known, coleus should not be
combined with ephedrine without the supervision of a doctor.
Tannin-containing herbs
Tannins are a group of unrelated chemicals that give plants an astringent taste. Herbs
containing high amounts of tannins may interfere with the absorption of ephedrine or
pseudoephedrine taken by mouth.2 Herbs containing high levels of tannins include green tea, black tea, uva
ursi (Arctostaphylos uva-ursi), black walnut (Juglans nigra),red raspberry (Rubus idaeus),oak (Quercus spp.), and witch
hazel (Hamamelis virginiana).
Food
Foods that acidify the urine may increase the elimination of ephedrine from the body,
potentially reducing the action of the drug.3 Urine-acidifying foods include eggs,
peanuts, meat, chicken, vitamin C (greater than 5 grams
per day), wheat-containing foods, and others.
Foods that alkalinise the urine may slow the elimination of ephedrine from the body, potentially increasing the actions and side effects of the drug.4 Urine-alkalinising foods include dairy products, nuts, vegetables (except corn and lentils), most fruits, and others.
Caffeine
Caffeine, which is found in coffee, tea, chocolate,
guaraná (Paullinia cupana), and some nonprescription and supplement
products, can amplify the side effects of ephedrine and pseudoephedrine. People should avoid
combination products containing ephedrine/pseudoephedrine/ephedra and caffeine.
1. Yousif MH, Thulesius O. Forskolin reverses tachyphylaxis to the bronchodilator effects of salbutamol: an in-vitro study on isolated guinea-pig trachea. J Pharm Pharmacol 1999;51:181–6.
2. Brinker F. Interactions of pharmaceutical and botanical medicines. J Naturopathic Med 1997;7(2):14–20.
3. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 105.
4. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 105–6.
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