Literature DB >> 17785609

Potential interactions between complementary/alternative products and conventional medicines in a Medicare population.

Gary W Elmer1, William E Lafferty, Patrick T Tyree, Bonnie K Lind.   

Abstract

BACKGROUND: Despite the high prevalence of complementary and alternative medicine (CAM) product use among the elderly, little is known about the extent of concurrent CAM-conventional medicine use and the potential for adverse reactions.
OBJECTIVE: To determine the prevalence of CAM product use concurrent with conventional medications, prescription and nonprescription, in a Medicare population and assess the risk for adverse interactions.
METHODS: Retrospective analysis was performed on Cardiovascular Health Study interview data from 1994, 1995, 1997, and 1999. The prevalence of concurrent combinations of CAM products and conventional drugs was tabulated. The adverse interaction risks were categorized as unknown, theoretical, and significant.
RESULTS: Of 5052 participants, the median age was 75, 60.2% were female, 16.6% were African American, and 83.4% were white. The percent using CAM products during the 4 time periods was 6.3%, 6.7%, 12.8%, and 15.1%. The percent using both CAM products and conventional drugs was 6.0%, 6.2%, 11.7%, and 14.4%. Of these, 294 (5.8%) individuals took combinations considered to have a significant risk for an adverse interaction. Combinations with risk were observed on 393 separate interviews. Most (379) involved a risk of bleeding due to use of ginkgo, garlic, or ginseng together with aspirin, warfarin, ticlopidine, or pentoxifylline. An additional 786 observations of combinations were considered to have some, albeit theoretical or uncertain, risk for an adverse interaction.
CONCLUSIONS: Concurrent use of CAM products and conventional medicines in a Medicare population was found to be common. Research to define the risks of combining ginkgo and garlic supplements with aspirin should be of high priority.

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Year:  2007        PMID: 17785609      PMCID: PMC2864004          DOI: 10.1345/aph.1K221

Source DB:  PubMed          Journal:  Ann Pharmacother        ISSN: 1060-0280            Impact factor:   3.154


  25 in total

1.  Subarachnoid haemorrhage associated with Ginkgo biloba.

Authors:  S Vale
Journal:  Lancet       Date:  1998-07-04       Impact factor: 79.321

2.  Association of Ginkgo biloba with intracerebral hemorrhage.

Authors:  M K Matthews
Journal:  Neurology       Date:  1998-06       Impact factor: 9.910

3.  Probable interaction between warfarin and ginseng.

Authors:  K Janetzky; A P Morreale
Journal:  Am J Health Syst Pharm       Date:  1997-03-15       Impact factor: 2.637

4.  Spontaneous hyphema associated with ingestion of Ginkgo biloba extract.

Authors:  M Rosenblatt; J Mindel
Journal:  N Engl J Med       Date:  1997-04-10       Impact factor: 91.245

5.  Garlic and the risk of TURP bleeding.

Authors:  K German; U Kumar; H N Blackford
Journal:  Br J Urol       Date:  1995-10

6.  Garlic as a possible risk for postoperative bleeding.

Authors:  B E Burnham
Journal:  Plast Reconstr Surg       Date:  1995-01       Impact factor: 4.730

7.  Incidence of cardiovascular disease in older Americans: the cardiovascular health study.

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8.  Assessing the use of medications in the elderly: methods and initial experience in the Cardiovascular Health Study. The Cardiovascular Health Study Collaborative Research Group.

Authors:  B M Psaty; M Lee; P J Savage; G H Rutan; P S German; M Lyles
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9.  Spontaneous spinal epidural hematoma with associated platelet dysfunction from excessive garlic ingestion: a case report.

Authors:  K D Rose; P D Croissant; C F Parliament; M B Levin
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10.  Effect of garlic (Allium sativum) on blood lipids, blood sugar, fibrinogen and fibrinolytic activity in patients with coronary artery disease.

Authors:  A Bordia; S K Verma; K C Srivastava
Journal:  Prostaglandins Leukot Essent Fatty Acids       Date:  1998-04       Impact factor: 4.006

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Review 3.  Drug and dietary interactions of warfarin and novel oral anticoagulants: an update.

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6.  Evaluation of the effect of lime fruit juice on the anticoagulant effect of warfarin.

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7.  Attitudes of older adults regarding disclosure of complementary therapy use to physicians.

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8.  Use of prescription and over-the-counter medications and dietary supplements among older adults in the United States.

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9.  Accidental intakes of remedies from complementary and alternative medicine in children--analysis of data from the Swiss Toxicological Information Centre.

Authors:  Tycho Jan Zuzak; Christine Rauber-Lüthy; Ana Paula Simões-Wüst
Journal:  Eur J Pediatr       Date:  2009-10-13       Impact factor: 3.183

10.  Attitude of Medical Students and Doctors towards Complementary, Alternative and Integrative Medicine: A Single-Center, Questionnaire-Based Study.

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