Table 1 Key safety criteria adapted from monographs developed by the National Center for Complementary and Integrative Health (NCCIH)
Herbal product | Precautions | Interactions | Side effects |
|---|---|---|---|
St John’s Wort | Increased sensitivity to sunlight | Antidepressants Birth control pills Cyclosporin, which prevents the body from rejecting transplanted organs Digoxin, a heart medication Some HIV drugs including indinavir Some cancer medications including irinotecan Warfarin, an anticoagulant Taking ST John’s Wort with certain antidepressants or other drugs that affect serotonin may lead to increased serotonin-related side effects which may be potentially serious | Anxiety Dry mouth Dizziness GI symptoms Fatigue Headache Sexual dysfunction |
Ginkgo | If you are older, have a known bleeding risk, or are pregnant you should be cautious about gingko possibly increasing your risk of bleeding | Anticoagulants | Headache Stomach upset Allergic skin reactions |
Ginseng (Asian) | Some evidence suggests that ginseng might affect blood sugar and blood pressure. If you have diabetes or high blood pressure consult your healthcare provider before using Asian ginseng Pregnancy and breastfeeding? | warfarin | Headaches Sleep problems Digestive problems |
Garlic | Taking garlic may increase the risk of bleeding. If you take an anticoagulant such as warfarin or if you need surgery tell your healthcare provider if you’re taking or planning to take garlic dietary supplements | Warfarin Saquinavir (HIV) | Breath and body odour Heartburn Upset stomach Some people have allergic reactions to garlic |
Echinacea | Some people have allergic reactions which might be rare People with atopy may be more likely to have an allergic reaction when taking Echinacea | Â | Digestive tract symptoms such as nausea or stomach pain |