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Table 1 Key safety issuesa

From: Buyer beware? Does the information provided with herbal products available over the counter enable safe use?

St John's wort

Ginkgo

Asian ginseng

Garlic

Echinacea

Precautions

    

Sensitivity to sunlight

Increased bleeding risk

People with diabetes should use extra caution, especially if using medicines to lower blood sugar or taking other herbs ... also thought to lower blood sugar.

Can thin the blood

Allergy to related plants in daisy family

 

Bleeding disorders

 

Use with caution if planning to have surgery or dental work.

People with asthma or atopy may be more likely to have an allergic reaction.

 

Scheduled surgery or dental procedures

 

Use with caution if you have a bleeding disorder.

 

Interactions

    

Antidepressants

Anticoagulant drugs

 

Interferes with effectiveness of saquinavir, a drug used to treat HIV

 

Oral contraceptives

    

Digoxin

    

Indinavir and possibly other HIV medications

    

Irinotecan and possibly other anticancer drugs

    

Seizure control drugs

    

Warfarin and related anticoagulants

    

Cyclosporine

    

Side effects

    

Anxiety

Headache

Headache

Breath and body odour

Allergic reactions including rashes

Dry mouth

Nausea

Sleep problems

Heartburn

Increased asthma

Dizziness

Gastrointestinal upset

Gastrointestinal problems

Upset stomach

Anaphylaxis

Gastrointestinal symptoms

Diarrhoea

Allergic reactions

Allergic reactions

Gastrointestinal side effects

Fatigue

Dizziness

Breast tenderness

  

Headache

Allergic skin reactions

Menstrual irregularities

  

Sexual dysfunction

More severe allergic reactions occasionally reported

High blood pressure

  
  1. aAs identified in the NCCAM Herbs at a Glance monographs [13].