2010年3月2日 星期二

常見健康食品副作用

一般民眾最容易忽略的就是健康食品的副作用,衛生署有這類的網站,可以供大家參考。

底下引用四則資訊供大家參考

大蒜可能之副作用:

過敏反應(接觸性皮膚炎、血管性水腫、過敏性休克、蕁麻疹)、腸胃道副作用(小腸 阻塞、上腹痛、食道痛、吐血、血便)、抑制血小板功能(抗凝血功能)、引發姿勢性低血壓,眩暈(類似梅尼爾氏症)。

大蒜可能之交互作用:

併用藥物

交互作用

大蒜

Ritonavir

短時間併用可能增加Ritonavir血中濃度,引起腸胃道 副作用。

Saquinavir

併用可能降低Saquinavir血中濃度。

Warfarin

延長血液凝集時間和延長INR(International normalized ratio)。可能增加手術後出血機率及自發性脊髓硬腦膜上血腫。

Chorpropamide

可能增加口服降血糖藥的作用。

Acetaminophen

動物實驗認為可減少Acetaminophen所造成之肝毒 性。

文獻來源:

1.German K. Garlic and the risk of TURP bleeding. Br J Urol 1995;75:518.

2.Perez-Pimiento AJ. Anaphylactic reaction to young garlic. Allergy 1999;54:626-9.

3.Borrelli F. Garlic(Allium sativum L.):adverse effects and drug interactions in humans. Mol Nutr Food Res 2007;51:1386-97.

4.Sussman E. Garlic supplements can impede HIV medication. Aids 2002;16:N5.

5.Piscitelli SC. The effect of garlic supplements on the pharmacokinetics of saquinavir. Clin Infect Dis 2002;34:234-8.

6.Vaes LP. Interactions of warfarin with garlic, ginger, ginkgo, or ginseng:nature of the evidence. Ann Pharmacother 2000;34:1478-82.

7.Zhang XH. Gender may affect the action of garlic oil on plasma cholesterol and glucose levels of normal subjects. J Nutr 2001;131:1471-8.

8.Lin MC. Protective effect of diallyl sulfone against acetaminophen-induced hepatotoxicity in mice. J Biochem Toxicol 1996;11:11-20.


銀杏可能之副作用:

常見之副作用如腹瀉、暈眩、頭痛、噁心。

嚴重不良反應:過敏、不正常出血、昏暈。

銀杏可能之交互作用:

併用藥物

交互作用

銀杏

Omeprazole

降低Omeprazole血中濃度1

Trazodone

造成過度鎮定效果而增加昏迷危險2

Risperidone

延緩Risperidone代謝,增加其副作用3

非類固醇抗發炎藥物

增加出血風險4

Cilostazol(Pletal)

增加出血風險5

Thiazides

反而造成血壓上升6 (機轉不明)

BuspironeFluoxetine

使患者發生輕躁症(hypomanic episode)。可能增加血清素症候群(serotonin syndrome)風險,如高血壓、高體溫、意識狀態改 變、肌躍症7

Valproate sodium

可能使癲癇復發8

Nicardipine

可能降低降血壓藥物作用9

Insulin

可能降低胰島素作用10

eoprostenol

可能增加出血風險11

文獻來源:

1. Yin OQ. Pharmacogenetics and herb-drug interactions: experience with Ginkgo biloba and omeprazole. Pharmacogenetics 2004;14:841-50.

2. Galluzzi S. Coma in a patient with Alzheimer’s disease taking low dose trazodone and ginkgo biloba. J Neurol Neurosurg Psychiatry 2000;68:679–683.

3. Lin YY. Association between priapism and concurrent use of risperidone and ginkgo biloba. Mayo Clin Proc.2007;82(10):1289-1290.

4. Meisel C. Fatal intracerebral mass bleeding associated with ginkgo biloba and ibuprofen. Atherosclerosis 2003;167:367.

5. Aruna D. Pharmacodynamic interaction studies of Ginkgo biloba with cilostazol and clopidogrel in healthy human subjects. Br J Clin Pharamacol 2007;63:333-8.

6. Shaw D. Traditional remedies and food supplements. A 5-year toxicological study(1991-1995). Drug Safety 1997;17:342-56.

7. Spinella M. Hypomania induced by herbal and pharmaceutical psychotropic medicines following mild traumatic brain injury. Brain Inj 2002;16:359-67.

8. Granger AS. Ginkgo biloba precipitating epileptic seizures. Age and Ageing 2001;30:523-5.

9. Shinozuka K. Feeding of Ginkgo biloba extract(GBE) enhances gene expression of hepatic cytochrome P-450 and attenuates the hypotensive effect of nicardipine in rats. Life Sci 2002;70:2783-92.

10. Kudolo GB. The effect of 3-month ingestion of Ginkgo biloba extract on pancreatic beta-cell function in response to glucose loading in normal glucose tolerant individuals. J Clin Pharamacol. 2000 Jun;40(6):647-54.

11.Drug interaction checker. http://www.drugs.com/drug_interactions.php


人參可能之副作用:

失眠、腹瀉、陰道出血、乳房疼痛(mastalgia)9,也可能與Steven-Johnson Syndrome1有關。

使用人參之禁忌:高血壓、急性氣喘發作、急性感染期、流鼻血和月經期間。

人參可能之交互作用:

併用藥物

交互作用

人參

降血糖藥物

人參有降血糖功能,與降血糖藥物或胰島素併用可能增加低血糖發生率3,4

Warfarin

可能降低Warfarin效用5

酒精

延緩胃的排空時間,降低酒精血漿中濃度,可能降低酒精效用6

Phenelzine

可能使患者頭痛、失眠之副作用加重7

流行性感冒疫苗(anti-influenza polyvalent vaccine)

併用人參者,自然殺手細胞活性明顯增加,可能可增加免疫力8

Nifedipine

可能增加Nifedipine血中濃度,而增加Nifedipine副作用。

精神興奮劑(麻黃)

人参具神經興奮作用,須小心使用。

雌激素(estrogen)

可能引起雌激素過多。

免疫抑制劑

人参具促進免疫的作用,可能降低免疫抑制劑之功效。

文獻來源:

1.Dega H. Ginseng as a cause for Steven-Johnson syndrome? Lancet 1996;347:1344.

2.Kiefer D. Panax ginseng. Am Fam Physician 2003;68:1539-42.

3.Sotaniemei EA. Ginseng therapy in non-insulin-dependent diabetic patients. Diabetes Care 1995;18:1373-5.

4.Vuksan V. American ginseng improves glycemia in individuals with normal glucose tolerance:effect of dose and time escalation. J Am Coll Nutr 2000;19:738-44.

5.Kuo SC. Antiplatelet components in Panax ginseng. Planta Med 1990;56:164-7.

6.Koo MW. Effects of ginseng on ethanol induced sedation in mice. Life Sci 1999;64:153-60.

7.Jones BD. Interaction of ginseng with phenelzine. J Clin Psychopharmacol 1987;7:201-2.

8.Scaglione F. Efficacy and safety of the standardised Ginseng extract G115 for potentiating vaccination against the influenza syndrome and protection against the common cold. Drugs Exp Clin Res 1996;22:65-72.

9.Palmer BV. Gin seng and mastalgia. Br Med J 1978;1:1284.

10.Shin HR. The cancer-preventive potential of Panax ginseng: a review of human and experimental evidence. Cancer Causes Control 2000;11:565-76.


紅麴可能之副作用:

過敏反應1、橫紋肌溶解症2

紅麴可能之交互作用:

併用藥物

交互作用

紅麴

Ritonavir

RitonavirCYP 3A4強力抑制劑,可能會增加發生橫紋肌溶解症的風險。

Cyclosporine

CyclosporineCYP 3A4抑制劑,可 能增加橫紋肌溶解發生的可能。

鈣離子阻斷劑(diltiazemverapamil)

diltiazemverapamil會抑制CYP 3A4, 增加血中Monacolin K的濃度,可能會發生橫紋肌溶解症的副作用。

抗黴菌藥(ItraconazoleFluconazole)

ItraconazoleFluconazole CYP 3A4強 力抑制劑,可能會增加發生橫紋肌溶解症的風險。

1.Hipler UC. Case report. Monascus purpureus--a new fungus of allergologic relevance. Mycoses. 2002 Feb;45(1-2):58-60.

2.Smith DJ. Chinese redrice-induced myopathy.South Med J.2003 Dec;96(12):1265-7.

3.Prasad GV. Rhabdomyolysis due to red yeast rice (Monascus purpureus) in a renal transplant recipient. Transplantation. 2002;74:1200-1.