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Drug interactions with Natural Health Products: A Discussion Paper (November 2001)

8.0 References

1. Natural Health Products Directorate. Natural Health Products Proposed Regulatory Framework. Working Draft as of September 21, 2001. In.; 2001.

2. Health Canada. Canadian Adverse Drug Reaction Monitoring Program Reporting Form; 1998.

3. Ramsay C, Walker M, Alexander J. "Alternative medicine in Canada: Use and public attitudes". Public Policy Sources Number 21. Vancouver: The Fraser Institute; 1999.

4. Blumenthal M, Brusse WR, Goldberg A, Gruenwald J, Hall T, Riggins CW, et al., editors. The Complete German Comission E Monographs. Austin, Texas: American Botanical Council; 1998.

5. Peirce A. The American Pharmacists Association. Practical Guide to Natural Medicines: The Stonesong Press Inc; 1999.

6. Newall CA, Anderson LA, Phillipson JD. Herbal Medicines. A Guide For Health Care Professionals. London: The Pharmaceutical Press; 1996.

7. Boon H, Smith M. The Botanical Pharmacy. Kingston, ON: Quarry Press; 1999.

8. Chandler F, editor. Herbs. Everyday Reference for Health Professionals. Ottawa: Canadian Pharmaceutical Association and the Canadian Medical Association; 2000.

9. Boon H, Smith M. "Herbals: Adverse reactions and interactions." Pharmacy Practice 2000;16(6):41-44.

10. Cupp MJ. "Herbal remedies: Adverse effects and drug interactions." American Family Physician 1999;59(5):1239-1244.

11. Fugh-Berman A. "Herb-drug interactions." Lancet 2000;355:134-38.

12. Lambrecht JE, Hamilton W, Rabinovich A. "A review of herb-drug interactions: Documented and theoretical." US Pharmacist 2000;25(8):42-53.

13. Miller LG. Herbal medicinals. "Selected clinical considerations focusing on known or potential drug-herb interactions." Archives of Internal Medicine 1998;158:2200-2211.

14. Ernst E. "Possible interactions between synthetic and herbal medicinal products. Part 1: A systematic review of the indirect evidence." Perfusion 2000;13:4-15.

15. Braun L. "Herb-drug interaction guide." Australian Family Physician 2001;30(2):151.

16. Braun L. "Herb-drug interactions." Australian Family Physician 2001;30(6):581-582.

17. Braun L. "Herb-drug interaction guide." Australian Family Physician 2000;29(12):1155-1156.

18. Barone GW, Gurley BJ, Ketel BL, Abul-Ezz SR. "Herbal supplements: A potential for drug interactions in transplant recipients." Transplantation 2001;71(2):239-241.

19. Stenton SB, Bungard TJ, Ackman ML. "Interactions between warfarin and herbal products, minerals , and vitamins: A pharmacist's guide." Canadian Journal of Hospital Pharmacy 2001;54(3):184-90.

20. D'Arcy P. "Adverse reactions and interactions with herbal medicines. Part 2 - drug interactions." Adverse Drug Reactions and Toxicological Review 1993;12(3):147-162.

21. Fugh-Berman A, Ernst E. "Herb-drug interactions: Review and assessment of report reliability." British Journal of Clinical Pharmacology 2001;52:587-595.

22. Adams P. "Drug interactions that matter. (1) Mechanisms and management." The Pharmaceutical Journal 1998;261:618-621.

23. Lee R. "Potentiation of warfarin by Dong quai." Pharmacotherapy 1999;19(7):870-876.

24. Heck AM, deWitt BA, Lukes AL. "Potential interactions between alternative therapies and warfarin." American Journal of Health-System Pharmacy 2000;57(13):1221-30.

25. Mancano MA. "Drug Interactions with warfarin: Part 5." Pharmacy Times 2000;66(September):8,10.

26. Vaes lPJ, Chyka PA. "Interactions of warfarin with garlic, ginger, ginkgo or ginseng: Nature of the evidence." Annals of Pharmacotherapy 2000;34:1478-82.

27. Gowen J, Roller L. "Herbal medicines and interactions. Counseling casebook." Australian Journal of Pharmacy 2000;81:1146-1150.

28. Vuksan V, Sievenpiper JL, Koo VYY, Francis T, Beljan-Zdravkovic U, Xu Z, et al. "American ginseng (Panax quinquefolium L) reduces postprandial glycemia in nondiabetic subjects and subjects with Type 2 diabetes mellitus." Archives of Internal Medicine 2000;160:1009-1013.

29. LaValle JB, Krinsky DL, Hawkins EB, Pelton R, Ashbrook Willis N. Natural Therapeutics Pocket Guide. Ohio: Lexi-Comp; 2000-2001.

30. Gordon JB. "SSRIs and St. John's Wort: Possible toxicity?" [letter]. American Family Physician 1998;57(5):950,953.

31. Brinker F. Herb Contraindications and Drug Interactions. Second ed. Sandy, OR: Eclectic Medical Publications; 1998.

32. Schmiedlin-Ren P, Edwards D, Ftizsimmons M, He K, Lown K, Woster P, et al. "Mechanisms of enhanced oral availability of CYP3A4 substrates by grapefruit constituents." Drug Metabolism and Disposition 1997;25(11):1228-1233.

33. Kane G, Lipsky J. Drug-grapefruit juice interactions. Mayo Clinical Proceeding 2000;75:933-942.

34. Piscitelli SC, Burstein AH, Chaitt D, Alfaro RM, Falloon J. "Indinavir concentrations and St John's wort" [letter]. Lancet 2000;355(9203):547-8.

35. Roby CA, Anderson GD, Kantor E, Dryer DA, Burstein AH. "St. John's wort: Effect on CYP3A4 activity." Clinical Pharmacology and Therapeutics 2000;67:451-7.

36. Wharry S. "Health Canada sounds warning over St. John's wort." Canadian Medical Association Journal 2000;162:1723.

37. Ernst E. "Second thoughts about the safety of St. John's wort." Lancet 1999;355:134-38.

38. Durr D, Steiger B, Kullak-Ublick GA, Rentsch KM, Steinert HC, Meier PJ, et al. "St.
John's wort induces intestinal P-glycoprotein/MDRI and intestinal and hepatic CYP3A4." Clinical Pharmacology and Therapeutics 2000;68:598-604.

39. Moore LB, Goodwin B, Jones SA, Wisely GB, Serabjit-Singh CJ, Willson TM, et al. "St. John's wort induces hepatic drug metabolism through activation of the pregnane X receptor." Proceedings of the National Academy of Sciences 2000;97(13):7500-7502.

40. Wang Z, Gorski C, Hamman M, Huang S, Lesko L, SD H. "The effects of St. John's wort (Hypericum perforatum) on human cytochrome P450 activity." Clinical Pharmacology and Therapeutics 2001;70:317-26.

41. Budzinski JW, Foster BC, Vandenhoek S, Arnason JT. "An in vitro evaluation of human cytochrome p450 3A4 inhibition by selected commercial herbal extracts and tinctures." Phytomedicine 2000;7(4):273-82.

42. Ishihara K, Kushida H, Yuzurihara M, Wakui Y, Yanagisawa T, Kamei H, et al. "Interaction of drugs and Chinese herbs: Pharmacokinetic changes of tolbutamide and diazepam caused by extract of Angelica dahurica." Journal of Pharmacy and Pharmacology 2000;52:1023-1029.

43. Foster BC, Foster MS, Vandenhoek S, Krantis A, Budzinski JW, Arnason JT, et al. "An in vitro evaluation of human cytochrome p450 3A4 and p-glycoprotein inhibition by garlic." Journal of Pharm Pharmaceutic Sci 2001;4(2):176-184.

44. Meyer K, Schwartz J, Crater D, Keyes B. "Zingiber officinale (ginger) used to prevent 8-Mop associated nausea." Dermatology Nursing 1995;7(4):242-4.

45. Schoepp G. "Q: Is coenzyme Q10 (ubiquinone) effective for the treatment of heart failure?" Pharmacy Practice 1997;13(3):31-2.

46. Mortensen SA, Leth A, Agner E, Rohde M. "Dose-related decrease of serum coenzyme Q10 during treatment with HMG-CoA reductase inhibitors." Molecular Aspects of Medicine 1997;18(Suppl):S137-44.

47. Palasciano G, Portincasa P, Palmieri V, Ciani D, Vendemiale G, Altomare E. "The effect of silymarin on plasma levels of malon-dialdehyde in patients receiving long-term treatment with psychotropic drugs." Current Therapeutic Research 1994;55:537-545.

48. Werbach M. Nutritional Influences on Illness. Second ed. Tarzana: Third Line Press; 1993.

49. Shaw D, Leon C, Kolev S, Murray V. "Traditional remedies and food supplements. A 5-year toxicological study (1991-1995)." Drug Safety 1997;17(5):342-356.

50. Barnes J, Mills S, Abbot N, Willoughby M, Ernst E. "Different standards for reporting ADRs to herbal remedies and conventional OTC medicines: Face-to-face interviews with 515 users of herbal remedies." British Journal of Clinical Pharmacology 1998;45:496-500.

51. Boon H, Brown JB, Gavin A, Kennard MA, Stewart M. "Breast cancer survivors' perceptions of complementary/alternative medicine (CAM): Making the decision to use or not to use." Qualitative Health Care 1999;9(5):639-653.

52. Montbriand MJ. "Freedom of choice: An issue concerning alternate therapies chosen by patients with cancer." Oncology Nursing Forum 1993;20:1195-2101.

53. McNeill JR. "Interactions between herbal and conventional medicines." The Canadian Journal of CME 1999;December:97-113.

54. Drew AK, Myers SP. "Safety issues in herbal medicine: Implications for health professions." Medical Journal of Australia (MJA) 1997;166:538-541.

55. Eisenberg DM, Davis RB, Ettner SL, et al. "Trends in alternative medicine use in the United States, 1990-1997: Results of a follow-up national survey." Journal of the American Medical Association 1998;280(18):1569-1575.

56. Boon H, Stewart M, Kennard MA, Gray R, Sawka C, Brown JB, et al. "The use of complementary/alternative medicine by breast cancer survivors in Ontario: Prevalence and perceptions." Journal of Clinical Oncology 2000;18(13):2515-2521.

57. Verhoef MJ, Sutherland R, Brkich L. "Use of alternative medicine by patients attending a gastroenterology clinic." Canadian Medical Association Journal 1990;142(2):121-125.

58. Verhoef MJ, Hagen N, Pelletier G, Forsyth P. "Alternative therapy use in neurologic disease. Use in brain tumour patients." Neurology 1999;52(1):617-622.

59. Frank C, Godwin M, Verma S, Kelly A, Birenbaum A, Seguin R. "Natural health product use in a day hospital population." Geriatrics Today: Journal of the Canadian Geriatric Society 2001;May:64-67.

60. Baugniet J, Boon H, Ostbye T. "Complementary/alternative medicine: Comparing the view of medical students with students in other health care professions." Family Medicine 2000;32(3):178-84.

61. Chang ZG, Kennedy DT, Holdford DA, Small RE. "Pharmacists' knowledge and attitudes toward herbal medicine." The Annals of Pharmacotherapy 2000;34:710-715.

62. Walter G, Rey J, Harding A. "Psychiatrists' experience and views regarding St. John's wort and 'alternative' treatments." Australian and New Zealand Journal of Psychiatry 2000;34:992-996.

63. Vickers A, Zollman C. "ABC of complementary medicine: Homoeopathy. "British Medical Journal 1999;319(7217):1115-8.

64. Zollman C, Vickers A. "ABC of complementary medicine: Complementary medicine and the doctor." British Medical Journal 1999;319(7224):1558-61.

65. Zollman C, Vickers A. "ABC of complementary medicine: Complementary medicine and the patient." British Medical Journal 1999;319(7223):1486-9.

66. Vickers A, Zollman C. ABC of complementary medicine. Hypnosis and relaxation therapies. British Medical Journal 1999;319(7221):1346-9.

67. Vickers A, Zollman C. "ABC of complementary medicine: Unconventional approaches to nutritional medicine." British Medical Journal 1999;319(7222):1419-22.

68. Vickers A, Zollman C. "ABC of complementary medicine: Massage therapies." British Medical Journal 1999;319(7219):1254-7.

69. Vickers A, Zollman C. "ABC of complementary medicine: The manipulative therapies - osteopathy and chiropractic." British Medical Journal 1999;319(7218):1176-9.

70. Vickers A, Zollman C. "ABC of complementary medicine: Herbal medicine." British Medical Journal 1999;319(7216):1050-3.

71. Vickers A, Zollman C. "ABC of complementary medicine: Acupuncture." British Medical Journal 1999;319(7215):973-6.

72. Zollman C, Vickers A. "ABC of complementary medicine: Complementary medicine in conventional practice." British Medical Journal 1999;319(7214):901-4.

73. Zollman C, Vickers A. "ABC of complementary medicine: Users and practitioners of complementary medicine." British Medical Journal 1999;319(7213):836-8.

74. Zollman C, Vickers A. "What is complementary medicine?" British Medical Journal 1999;319(7211):693-6.

75. Eisenberg DM, Kessler RC, Van Rompay MI, Kaptchuk TJ, Wilkey SA, Appel S, et al. "Perceptions about complementary therapies relative to conventional therapies among adults who use both: Results from a national survey." Annals of Internal Medicine 2001;135(5):344-51.

76. Kessler RC, Davis RB, Foster DF, Van Rompay MI, Walters EE, Wilkey SA, et al. "Long-term trends in the use of complementary and alternative medical therapies in the United States." Annals of Internal Medicine 2001;135(4):262-8.

77. Eisenberg DM, Kaptchuk TJ, Laine C, Davidoff F. "Complementary and alternative medicine - An Annals series." Annals of Internal Medicine 2001;135(3):208.

78. Kaptchuk TJ, Eisenberg DM. Varieties of healing. 2: A taxonomy of unconventional healing practices. Annals of Internal Medicine 2001;135(3):196-204.

79. Kaptchuk TJ, Eisenberg DM. "Varieties of healing. 1: Medical pluralism in the United States." Annals of Internal Medicine 2001;135(3):189-95.

80. Verhoef M, Best A, Boon H. "The role of complementary medicine in medical education: Opinions of medical educators." Annals of the College of Physicians and Surgeons of Canada 2001 (Submitted).

81. Boon H. "Herbal medicine: The role of the nutrition educator." ONE Bulletin 2001;20(2):3-6.

82. Smith M, Boon H. "Counseling cancer patients about herbal medicine." Patient Education and Counseling 1999;38:109-120.

83. Borins M. "What to tell your patients about herbs." Hospital Medicine 1999;August:27-29.

84. Eisenberg D. "Advising patients who seek alternative medical therapies." Annals of Internal Medicine 1997;127(1):61-69.

85. Cadwell V. "Natural remedies: The hazards of unasked questions." Emergency Medical Services (EMS) 2000;November:30.

86. Volpe JC. Natural Health Products: A New Vision. Ottawa: Report of the Standing Committee on Health; November, 1998.

87. Gillis MC, editor. Compendium of Pharmaceuticals and Specialties. 33rd ed. Ottawa: Canadian Pharmaceutical Association; 1998.

88. Guidelines for Reporting Adverse Reactions to Marketed Drugs. Ottawa: Minister of Public Works and Government Services Canada; 1996. Report No.: Cat no H49-106/1996E.

89. US Food and Drug Administration. Next link will take you to another Web site http://www.fda.gov/medwatch/what.htm In November 1, 2001.

90. Barnes J. Personal Communication. In.; 2001.

91. Mann R. "Monitoring the Safety of Medicines." Clinical Research Manual. London: Euromed Communications Ltd; 1998.

92. Canadian Pharmacists Association (presented by Dr. Jeff Poston and Noelle-Dominique Willems). "Herbal and homeopathic products: Ensuring safe choices for Canadians." A Report Presented to the Standing Committee on Health; 1998 February 5.

93. American Society of Anesthesiologists (ASA). "Anesthesiologists warn herbal users: Tell doctor before surgery what you're taking." Inpharma 1999;3(1181 (April)):21.

94. Henney JE. "Risk of drug interactions with St. John's wort." Journal of the American Medical Association 2000;283(13):1679.

95. Ruschitzka F, Meier PJ, Turina M, Luscher TF, Noll G. "Acute heart transplant rejection due to Saint John's wort" [letter]. Lancet 2000;355(9203):548-9.

96. Johne A, Brockmoller J, Bauer S, Maurer A, Langheinrich M, Roots I. "Pharmacokinetic interaction of digoxin with an herbal extract from St John's wort (Hypericum perforatum)". Clinical Pharmacology & Therapeutics 1999;66(4):338-45.

97. Health Canada Advisory. Potentially harmful drug interaction with St. John's wort and prescription drugs; 2000 April 7. Report No.: 2000-36.

98. Nebel A, Schneider BJ, Baker RK, Kroll DJ. "Potential metabolic interaction between St. John's wort and theophylline" [letter]. Annals of Pharmacotherapy 1999;33(4):502.

99. Janetzky K, Morreall AP. "Probable interactions between warfarin and ginseng." American Journal of Health-System Pharmacy 1997;54(March 15):692-93.

100. Staba EJ, Staba JE. Ginseng. In: Chandler RF, editor. Herbs. Everyday Reference for Health Professionals. Nepean, ON: CPhA/CMA; 2000. p. 130-135.

101. Gebhart F. "Beware of dangerous herbal interactions, expert warns." Drug Topics 1997;October:87.

102. Jones B, Runikis A. "Interaction of ginseng with phenelzine." Journal of Clinical Psychopharmacology 1987;7(3):201-2.

103. Zoeller J. "Time-tested herbs provide 'gentle relief'". American Druggist 1997;April:40.

104. McRae S. "Elevated serum digoxin levels in a patient taking digoxin and Siberian ginseng" [see comments]. Canadian Medical Association Journal 1996;155(3):293-5.