Caution with Herbal Remedies

 

Herbal Remedy

Common Use

Possible Side Effect

Pre Operative Concern

Recommendations

ARNICA

Reduce swelling and bruising.

Inhibits blood clotting.

May increase risk of bleeding or potentiate the effects of Warfarin therapy.

 

Discontinue at least 24 hours before surgery.

ECHINACEA

Boosts immunity.

Impairs wound healing & suppresses immunity if used long term.

Allergic reaction, impairs immune suppressive drugs, can cause immune suppression when taken long-term could impair wound healing.

 

Discontinue as far in advance as possible.

GARLIC

Lowers cholesterol and BP.

Inhibits platelet aggregation & increases fibrinolysis.

Risk of bleeding, especially when combined with other drugs that inhibit clotting.

 

 

Discontinue at least 7 days before surgery.

GINGER

Reduces nausea, vomiting and vertigo.

Inhibits blood clotting.

Risk of bleeding, especially when combined with other drugs that inhibit clotting.

 

 

Discontinue at least 7 days before surgery.

GINKO BIOBA

Improves circulation memory and alertness.

Inhibits platelet aggregation.

Risk of bleeding, especially when combined with other drugs that inhibit clotting.

 

 

Discontinue at least 36 hours before surgery.

GINSENG

Increases concentration and stamina.

Lowers blood glucose. Inhibits platelet aggregation.

Lowers blood sugar levels. Increase risk of bleeding. Interferes with warfarin.

 

 

Discontinue at least 7 days before surgery.

ST JOHNS WORT

Reduces anxiety, helps depression and sleep problems.

Inhibits re-uptake of neuro-transmitters [similar to prozac].

Alters metabolisms of other drugs such as cyclosporin, warfarin, steroids, protease inhibitors. May interfere with many other drugs.

 

Discontinue at least 5 days before surgery.

FEVERFEW

Treats migraine, arthritis and allergies.

Inhibits blooding clotting.

May increase bleeding, especially in-patients already taking anticoagulants.

 

Discontinue at least 36 hours before surgery.

EPHDRA

Suppress appetite.

Increase heart rate, increases blood pressure.

Risk of heart attack, arrhythmias, stroke, interaction with other drugs, kidney stones.

 

Discontinue at least 24 hours before surgery.

KAVA

Reduces anxiety.

Sedates decreases anxiety.

May increase sedative effects of anaesthesia. Risks of addiction, tolerance and withdrawal unknown.

 

Discontinue at least 24 hours before surgery.

VALERIAN

Reduces anxiety and sedates.

Sedates.

Could increase effects of sedatives. Long term use could increase the amount of anaesthesia needed. Withdrawal symptoms resemble Valium addiction.

 

If possible, taper dose weeks before surgery. If not, continue use until surgery. Treat withdrawal symptoms with benzodiazepines.

“Complementary Medicines – Are they” Dr Paul Smedley. Oral & Maxillofacial Surgeon. 2002-07-27

This chart based upon:- JAMA .2001.Vol 286.no 2./IntelHealth News Service. July 11.2001./ASA publication

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