|
Name
|
Possible Clinical Significance
|
Before Surgery
|
|
Alfalfa
|
May interfere with Coumadin, and steroids. May lower blood sugar levels. Possible allergic reactions. Vomiting if taken with Flagyl.
|
Reduce use or stop for
7 days
|
|
Bilberry
|
Interferes with blood clotting, may cause excessive bleeding. May lower blood sugar levels and cause diarrhea.
|
Stop 7 days before
|
|
Black Cohosh
|
May increase the effect of blood pressure medications, and interfere with blood clotting.
|
Stop 7 days before
|
|
Black Tea
|
Can interact with other prescribed drugs. May cause insomnia, increased blood sugar.
|
Reduce use or stop for 7 days
|
|
Coenzyme Q10
|
May cause dizziness, flu-like symptoms. May lower blood sugar and/or blood pressure.
|
Reduce use or stop for 7 days
|
|
Cranberry
|
Excessive use can result in increased bleeding, diarrhea, and kidney stones.
|
Reduce use or stop for 7 days
|
|
Echinacea
|
Patients with a history of liver disease should use with caution. Contraindicated in patients with autoimmune conditions. Interferes with anti-HIV medications.
|
Reduce use or stop for 7 days
|
|
Ephedra
(Ma Huang)
|
Banned by FDA. Ephedrine and pseudoephedrine-containing products are still sold. Many side effects. Discontinue use 1 week before surgery.
|
Stop 7 days before
|
|
Evening Primrose
|
GI side effects. Contraindicated for patients taking anticonvulsants.
|
Reduce use or stop for 7 days
|
|
Fish Oil
|
May cause excessive bleeding. Stop 7 days before surgery.
|
Stop 7 days before
|
|
Garlic
|
Mild reduction of blood pressure. Interferes with blood clotting.
|
Stop 7 days before
|
|
Ginger
|
Few problems with low dosages. At higher dosages may cause cardiac arrhythmias, and interfere with blood clotting.
|
Stop 7 days before
|
|
Ginkgo biloba
|
May interfere with blood clotting and interact with anticoagulants and NSAIDs (potential for increased surgical bleeding). May lower blood sugar. Discontinue 7-14 days before extensive surgery. Seeds may be toxic.
|
Stop 7 days before
|
|
Ginseng
|
May interfere with blood clotting and interfere with anticoagulants (possibly causing excessive bleeding at surgery). May decrease blood sugar. May increase blood pressure.
|
Stop 7 days before
|
|
Green Tea
|
GI upset, insomnia, irritability, possible cardiac palpitations and headaches.
|
Reduce use or stop for 7 days
|
|
Horse Chestnut
|
Possible excessive bleeding at surgery. GI upset and decreased kidney function possible.
|
Stop 7 days before
|
|
Kava (Kava-Kava)
|
Possible dizziness, depression, headaches. May prolong effects of anesthetic drugs. Interferes with blood clotting. Possibly dangerous.
|
Stop 7 days before. Probably should not be used at all.
|
|
Lavender
|
Drowsiness possible. May enhance sedative drugs like Valium. May increase bleeding problems.
|
Stop 7 days before
|
|
Licorice
|
May increase absorption of prescription drugs. Possible toxicity if used with digoxin. May lower potassium levels in patients taking diuretics. Increased bleeding risk in patients taking anticoagulant drugs.
|
Stop 7 days before
|
|
Pycnogenol
|
Possible increased bleeding risk, cardiovascular effects, and drug interactions (especially anti-hypertensive drugs). May lower blood sugar.
|
Stop 7 days before
|
|
St. John’s Wort
|
May reduce the effectiveness of many drugs including antibiotics, ibuprofen, Valium, sedatives, cardiac drugs, antidepressants, anti-HIV drugs, contraceptives, and many others. Prolongs the effect of narcotics. Stop use 7 days before surgery.
|
Stop 7 days before
|
|
Valerian
|
May increase the effect of sedative medications.
|
Reduce use or stop for 7 days
|
|
Vitamin E
|
Long-term use in high does may increase risk of death from all causes. No significant problems from short-term use, lower doses. Doses >400 IU/day may increase bleeding and delay wound healing.
|
Stop 7 days before
|
