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。 |
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) | |
Buspirone、Fluoxetine | 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 | Ritonavir為CYP |
Cyclosporine | Cyclosporine為CYP | |
鈣離子阻斷劑(diltiazem、verapamil) | diltiazem、verapamil會抑制CYP | |
抗黴菌藥(Itraconazole、Fluconazole) | Itraconazole、Fluconazole 為CYP |
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.