FRIDAY, May 14 (HealthDay News) -- Many popular over-the-counter herbal and nonherbal supplements interact negatively with warfarin, leading to an increased risk of health complications in patients taking both, according to a study presented this week at Heart Rhythm 2010, the Heart Rhythm Society's 31st Annual Scientific Sessions, held from May 12 to 15 in Denver.
Jennifer L. Strohecker, of the Intermountain Medical Center in Salt Lake City, and colleagues used 2008 sales data to identify the top 20 herbal and top 20 nonherbal supplements taken by Americans; used the Natural Medicines Comprehensive Database, AltMedDex (Micromedex) and Natural Standard databases to review their potential to interact with warfarin; and also searched databases for relevant case reports and clinical trials.
Overall, the researchers found that 14 (35 percent) of the supplements were associated with a clinically significant change in the International Normalized Ratio, including nine which potentiated the risk of bleeding and five which decreased the effectiveness of warfarin. They note that supplements including cranberry, garlic, ginkgo, and saw palmetto have been linked to bleeding events, and that other supplements have been linked to either an increase (e.g., glucosamine/chondroitin, essential fatty acids, multi-herb products, and evening primrose oil) or decrease (e.g., coenzyme Q10, soy, melatonin, ginseng, St. Johns' wort) in prothrombin time requiring adjustments in warfarin dose or vitamin K intake.
"It's important for patients to disclose as much information as possible about how they are treating themselves to ensure they receive the highest quality of care possible," Strohecker said in a statement.
Several authors disclosed relationships with Boston Scientific/EP Technologies; one with Cook Medical Inc.
Abstract No. AB02-5
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