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Complimentary and Alternative Medicine

Complimentary and Alternative Medicine. Useless Weeds?. Critical Considerations. Quality of products Look for Standardize herbal products Buy single-herb products Select products that have been tested Choose brands that adhere to GMP’s * USP Verification Mark.

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Complimentary and Alternative Medicine

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  1. Complimentary and Alternative Medicine Useless Weeds?

  2. Critical Considerations • Quality of products Look for Standardize herbal products Buy single-herb products Select products that have been tested Choose brands that adhere to GMP’s *USP Verification Mark

  3. Are you a Candidate? • Generally,Herbal products should not be recommended for the following: Those with chronic conditions Pregnant and lactating women Individuals taking other medications People having surgery within two weeks Children

  4. St. John’s Wort • Mild to moderate depression • Dosage: 300mg TID(standardized to 3% hypericin) • Adverse rxns: photosensitivity, itching, headache, bloating • Interactions: MAOI’s, SSRI’s and other Antidepressant drugs, Indinavir, Digoxin, Theophylline,Cyclosporin

  5. Echinacea • Stimulation of immune system • Dosage:various • Adverse rxns: cross-sensitivity in patients allergic to flowers (pollen) in the daisy family or sunflower seeds • Interactions: should not be administered with immunosuppressants

  6. Ginkgo Biloba • Vascular insufficiency resulting in short term memory loss, vertigo, headache, tinnitus, and erectile dysfunction • Dosage:Memory or circulation; 120 mg/day in 2-3 divided doses • Adverse Rxns: breast tenderness in women, muscle spasms, cramps, bleeding, mild digestive problems • Interactions: Aspirin, Ticlid, Plavix, Dypyridamole, and Coumadin-may augment the anticoagulant effect

  7. Ginseng • Increase energy and reduces stress • Dosage: 100 – 300 mg/day • Adverse reactions: may raise BP and estrogen levels • Interactions: warfarin, Nardil, and digoxin

  8. Ginger • Prevent nausea related to motion sickness, seasickness, and anesthesia • Dosage: Dried ginger 2-4 grams daily • Adverse rxns:GI discomfort with high doses ( > 6 grams) if taken on empty stomach • Interactions: Aspirin, Ticlid, Dypyridamole, and Coumadin-may augment the anticoagulant effect inhibits platelet aggregation – monitor bleeding times

  9. Garlic • Lower serum cholesterol • Dosage:10 mg of alliin or a total of allicin potential of 4,000 mcg/day, or 1 clove (4 grams) of fresh garlic/day • Adverse rxns: Generally nontoxic but may cause GI irritation; odor may pervade breath and skin • Interactions: May potentiate antihypertensives; high doses may alter blood sugar levels and blood clotting

  10. Saw Palmetto • Symptoms of BPH (benign prostatic hyperplasia)relieves difficult urine flow and emptying a irritable bladder • Dosage:160 mg bid of standardized fat-soluble saw palmetto extract containing 85-95% fatty acids and sterols • Adverse Rxns: uncommon but includes headache, mild abdominal pain, nausea, dizziness • Interactions: None reported

  11. Black Cohosh • Dysmenorrhea and Menopausal Symptoms • Dosage:40mg daily up to six months • Adverse rxns: Hypotension,and stomach upset these are rare • Interactions: may potentiate antihypertensives; may interfere with hormonal medications

  12. Milk Thistle • Loss of appetite, and liver and Gallbladder disorders • Dosage:200 mg-400mg daily standardized to provide at least 70% silymarin • Adverse Rxns: Possible loose stools as result of increased bile flow typically none with proper use • Interactions: possibly, medications metabolized in the CYP3A4 pathway

  13. Cayenne • Pain disorders such as shingles, muscle spasms, neuropathy, and joint pain • Dosage: 0.025% - 0.075% capsaicinpreparation qid • Adverse rxns: local burning avoid additional heat application with topical use • Interactions: ACE inhibitors and theopylline

  14. Kava Kava • Anxiety,and insomnia • Dosage:Anxiolytic: 45-70 mg kavalactons tid; Sedative: 180-210 mg/day kavalactons 1 hour before bedtime • Adverse Rxns: GI discomfort • Interactions: avoid alcohol, muscle relaxants, sedatives, antianxiety agents, antidepressants, antipsycotics- may have an additive effect

  15. Valerian • Sedative to treat insomnia, nervousness and anxiety • Dosage:150 – 300 mg of valerian extract 30 – 45 minutes before bedtime for sleep; 150 mg qid for anxiety • Adverse Rxns: morning drowsiness; with long-term use headache, uneasiness,and cardiac disturbances these are rare • Interactions: Additive effect with other CNS depressants

  16. Feverfew • Prophylactic for migraine headache • Dosage:125 mg dry powdered leaf (parthenolide) capsules • Adverse rxns: edginess, Stomach upset, and skin rashes from herbal contact • Interactions: Aspirin, Ticlid, Dypyridamole, and Coumadin-may augment the anticoagulant effect

  17. Peppermint • Headache • Dosage:Tea 1-2 teaspoonfuls dried leaves in 1 cup water; or Enteric-coated capsules: 1 – 2 tid for IBS • Adverse Rxns: Skin rash, heartburn, or muscle tremor contact dermatitis • Interactions: None known

  18. Soy • Prevention:Menopausal symptoms, cancer, coronary heart disease ,and osteoporosis • Source:Whole foods providing the equivalent of 50-120 mg of isoflavones/day • Adverse Rxns: None consistently reported • Interactions: May interfere with absorption of supplemental thyroid hormones, therefore stagger doses at least 2 hours apart

  19. Ephedra • Weight loss • Dosage: typically,1 bid • Adverse Rxns: increases BP, which can lead to stroke, heart disease, and seizures • Interactions: caffeine, decongestants, and other stimulants

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