Patients sometimes do not discuss supplements
they take

When you ask patients what drugs or supplements they are taking, some patients may not know that they should mention herbs and vitamins.

It is important that you ask your patients to tell you about every drug they take, including any daily vitamins. Patients often do not realize that many of these supplements contain active ingredients that can have strong effects in the body.

Taking a combination of supplements, using these products together with medicine, or substituting them in place of prescribed medicines can lead to harmful, even life-threatening results. Also, some supplements can have unwanted effects before, during, and after surgery.

Here are some medications that tend to have a negative interaction when taken with over-the-counter herbs and supplements:

• Blood pressure medications
• Blood thinners (anticoagulants, anti-platelet agents, nonsteroidal anti-inflammatory drugs such as aspirin, ibuprofen, or naproxen)
• Diabetes medications
• Drugs that affect the liver
• Heart medications
• Monoamine oxidase inhibitors (MAOIs)

Some herbal and dietary supplements are believed to interact with certain drugs. Below are a few common examples:

• Calcium and heart medicine (e.g., Digoxin), thiazide diuretics (Thiazide), and aluminum- and magnesium-containing antacids
• Magnesium and thiazide and loop diuretics (e.g., Lasix, etc.), some cancer drugs (e.g., Cisplatin, etc.), and magnesium-containing antacids
• Vitamin K and a blood thinner (e.g., Coumadin)
• St. John’s Wort and selective serotonin reuptake inhibitor (SSRI) drugs (i.e., anti-depressant drugs)
• St. John’s Wort and birth control pills