Contraindications and Cautions for MediHerb

Contraindications and Cautionsfor MediHerb Botanicals

Contraindications and Cautions

3

Tablets, Capsules & Phytosynergist® Liquid Complexes.

Golden Seal 500mg

Ginkgo 2000mgAstragalus Complex

Gotu Kola Complex

Bacopa Complex

Gut Flora Complex

Bilberry 6000mg

Gymnema 4g

Boswellia Complex

Hawthorn

Broncafect®

Herbal Throat Spray Phytosynergist®

Broncafect Phytosynergist®

HiPep

Burdock Complex

Horsechestnut Complex

Capsella Complex Phytosynergist®

LivCo®

Cat’s Claw Complex

Livton® Complex

Chaste Tree

Nevaton®

ChelaCo

ProstaCo

Colax

PulmaCo

Coleus Forte

Rehmannia Complex

Cramplex

ResCo®

Cranberry Complex

ResCo Phytosynergist®DermaCo

Rhodiola & Ginseng Complex

DiaCo Phytosynergist®

Saligesic

DiGest

Silymarin

DiGest Phytosynergist®

St John’s Wort 1.8g

Dong Quai

Thyroid Complex

Echinacea Premium

Tribulus

Eleuthero

UriCo Phytosynergist®

Euphrasia Complex

Valerian Complex

Evening Primrose Oil

Vitanox®

Fe-Max Iron Tonic Phytosynergist®

Wild Yam Complex

Feverfew

Withania Complex

Ganoderma & Shiitake

Wormwood Complex

Garlic 5000mg


4

Albizia 1:2

Ashwaganda 1:1

Astragalus 1:2

Bacopa 1:2

Bilberry 1:1

Black Cohosh 1:2

Black Walnut Hulls 1:10

Bladderwrack 1:1

Bugleweed 1:2

Bupleurum 1:2

Burdock 1:2

Calendula 1:2

Californian Poppy 1:2

Cat’s Claw 1:2

Celery Seed 1:2

Chamomile High Grade 1:2

Chaste Tree 1:2

Chinese Skullcap 1:2

Cinnamon Quills 1:2

Cleavers 1:2

Coleus 1:1

Corn Silk 1:1

Cramp Bark 1:2

Damiana 1:2

Dandelion Leaves 1:1

Dandelion Root 1:2

Dong Quai 1:2

Echinacea Premium Blend 1:2

Echinacea Purpurea 1:2

Echinacea Purpurea 1:3 Glycetract

Eleuthero 1:2

Eyebright 1:2

Garlic 1:1

Ginger 1:2

Ginkgo 2:1

Globe Artichoke 1:2

Golden Seal 1:3

Gotu Kola 1:1

Gymnema 1:1

Hawthorn Berries 1:2

Horsechestnut 1:2

Horsetail 1:2

Korean Ginseng 1:2

Licorice 1:1

Licorice High Grade 1:1

Marshmallow Root 1:5 Glycetract

Milk Thistle 1:1

Milk Thistle 1:1 Glycetract

Mistletoe 1:2

Motherwort 1:2

Nettle Leaf 1:2

Nettle Root 1:2

Oats Seed 1:1

Oregon Grape 1:2

Pau d’Arco 1:2

Poke Root 1:5

Red Clover 1:2

Rehmannia 1:2

Sage 1:2

Sarsaparilla 1:2

Saw Palmetto 1:2

Schisandra 1:2

Skullcap 1:2

St John’s Wort 1:2

St John’s Wort High Grade 1:2

Tienchi Ginseng 1:2

Turmeric 1:1

Uva Ursi 1:2

Valerian 1:2

White Peony 1:2

Wild Yam 1:2

Wormwood 1:5

Yellow Dock 1:2

Liquid Extracts


5

IntroductionThis volume of contraindication and drug interaction information has been compiled by MediHerb® and Standard Process® as a resource for health care professionals who recommend MediHerb herbal products distributed by Standard Process. In this volume, MediHerb and Standard Process have brought together herb-specific information regarding cautions, potential adverse reactions and interactions with drugs. It is presented in summary form and is drawn from widely used, authoritative herbal references. The reader should recognize, however, that the information presented has not been confirmed or agreed to by MediHerb or Standard Process. For example, some information is based on in vitro data which has not been substantiated by clinical studies.

To provide basic information on contraindications and drug interactions, MediHerb and Standard Process referred to fifteen English language reference texts that are used in the United States and worldwide. This compilation of information and references is presented for the convenience of health care professionals who are encouraged to review the source literature directly. This volume should not be understood to be either complete or final. Information on herbs for health, like information on other pharmacologically active compounds, is evolutionary. Health care professionals should be alert to new information and should use reasonably available research materials to keep up-to-date. Readers are also advised that the information presented in this volume covers herbs and essential oils (and not vitamins or minerals).

How to Use this PublicationThe information is laid out in order of product name and by category starting with Tablets, Capsules and Phytosynergist® Liquid Complexes and followed by Liquid Extracts.

A general caution appears after the product name. Below this, detailed information for each ingredient (herb and essential oil) is presented.

Example:

If looking for information on Albizia Complex, go to the Tablets, Capsules and Phytosynergist® Liquid Complexes category. The general caution is indicated with the product name. Below this each of the component herbs in Albizia Complex (Chinese Skullcap, Albizia and Feverfew) are listed with the corresponding information provided from the reference texts.

For ease of use the ingredients are listed in descending order with the ingredient of highest amount first. This presentation is consistent with the catalog and product label.

Reference Text InformationAdverseEffectsofHerbalDrugs(AEHD),1,2,3 volumes1,2&3 are P.A.G.M. DeSmet’s effort as Managing Editor to draw together information gathered from available herbal pharmacovigilance sources, recognizing as well that the long history of traditional use of herbal medicines provide “a powerful tool, of course, for the identification of adverse effects.” These books were relied upon by the American Herbal Products Association in compiling the Botanical Safety Handbook, described below.

The BritishHerbalCompendium(BHC)4 is a handbook of scientific information on widely used plant drugs edited by Peter R. Bradley. Each volume is a companion to the corresponding volume of the British Herbal Pharmacopoeia. The BHC is published by the Scientific Committee of the British Herbal Medicine Association. The basic approach of the BHC is to bring together scientific information from a variety of sources to produce clear and concise summaries on important aspects of individual plant drugs.

The BotanicalSafetyHandbook(BSH)5 was published in 1997 by the American Herbal Products Association, the trade association of the herbal supplement industry in the United States. It’s authors include Association President Michael McGuffin and the President and Chief Executive Officer of the American Herbal Pharmacopoeia, Roy Upton. The preface to the BSH succinctly states its goal:

The goal of the present work is to find a rational platform for the evaluation of herb safety, neither assuming that all natural substances are inherently safe, as some popular references suggest, nor blindly accepting reports of toxicity from uncritical sources. In undertaking this task the Editors met with information that presented significant challenges. Many authors utilize unreferenced data, perpetuate historical inaccuracies or display inherent biases against the use of botanicals. Also, contemporary reviews of the toxicity of many herbs are not available. Nonetheless, the Editors are confident that the body of information presented here is largely accurate. It is our sincere hope that readers of this work will find it to be a valuable reference and will address all useful criticisms to our attention.

MediHerb’s Co-Founder, Kerry Bone, authored ClinicalApplicationsofAyurvedicandChineseHerbs(CAACH)6 in October 1996 for the reason set forth in the subtitle, as Monographs for the Western Herbal Practitioner. In his preface, Kerry Bone underscores the importance of looking to traditional sources for guidance:

As the pharmacological and clinical information on exotic plants accumulates, largely funded by the governments of India and China, western phytotherapists face an important decision. Do they ignore this useful information, or do they attempt to incorporate these plants into their daily practice? However, there is no need for any soul-searching since a traditional precedent already exists. The western system has continually adopted herbs from exotic locations. As global communication reaches new heights, and the stresses of ever-increasing industrialization create diseases common to all countries, modern phytotherapy must rise to the challenge. One aspect of meeting this challenge is the use of effective herbs, whatever their country of origin.


6

The EuropeanScientificCooperationofPhytotherapy(ESCOP) first published monographs on the medicinal uses of plant drugs in March 1996 in loose-leaf form as a series of fascicules. In 2003 the ESCOP monographs were completely revised and expanded and made available as a book.7 ESCOP is the European umbrella organization of national associations of phytotherapy. Members include the trade associations from the major European Union countries. The ESCOP Scientific Committee prepares the monograph as follows:

In preparing drafts, [the] ESCOP Scientific Committee has the advantage that it can incorporate the views, knowledge and experience, not only of different nationalities, but also of individuals from different scientific and professional backgrounds, such as medical doctors, practicing phytotherapists, pharmacognosists, pharmacologists and regulatory affairs specialists. The Committee, operating as two subcommittees, assesses information from published scientific literature on each plant drug with the assistance of leading researchers on specific plants, who are invited to meetings of the Committee for discussion and critical evaluation of the literature.

One of the strengths of EssentialOilSafety:AGuideforHealthCareProfessionals(EOS)8 is the presentation of concise profiles of essential oils. This includes safety information for the oral use of essential oils – an area of traditional practice often ignored. The book provides information from a number of scientific sources, including toxicological reports, in a transparent and reliable way. The function of the book, as described by the authors, is to reassure users of essential oils by showing that many supposed dangers do not in fact exist and also to “to hoist some red flags” where appropriate.

The TherapeuticGuidetoHerbalMedicine(TGHM),9 the Complete German Commission E Monographs, was published in 1998 by the American Botanical Council, a non-profit organization dedicated to providing scientific information about botanicals. This volume translates the Commission E monographs, the only substantial governmental review of herbal products. These monographs were published in the 1980s and early 1990s. The Commission has since disbanded. Accordingly, some of the work of the Commission is no longer generally accepted as current. Nonetheless, the Commission’s work has substantial value to health care professionals. The compiler of the translations, Mark Blumenthal, is founder and Executive Director of the American Botanical Council and is widely respected as an herbal expert. In his foreword to this volume, Varro E. Tyler, Ph.D., Sc.D., Dean and Distinguished Professor of Pharmacognosy Emeritus, Purdue University stated:

. . . in 1978, the Bundesgesundheitsamt (Federal Health Agency), now called the Federal Institute for Drugs and Medical Devices, established an expert committee on herbal remedies, composed principally of members proposed by associations of the health professions, to evaluate the safety and efficacy of phytomedicines. This so-called “Commission E” included physicians, pharmacists, pharmacologists, toxicologists, representatives of the pharmaceutical industry, and lay persons. Its assessment is independent of the Federal Health Agency, which handles only the organizational details.

Unlike the United States Food and Drug Administration which evaluates drugs only in a passive manner based on data supplied by the manufacturer, Commission E actively checks so-called bibliographic data independently. Such data include information obtained from clinical trials, field studies, collections of single cases, scientific literature including facts published in the standard reference works, and expertise of medical associations. If controlled clinical data are lacking, safety and efficacy can still be determined on the basis of information in the literature, the presence of supplemental data supporting clinical results, and significant experimental studies supporting traditional use.

By 1993, about 300 such monographs had been prepared. Approximately two-thirds of them are positive assessments covering herbs that have been found to be safe and effective; the remainder are negative (unapproved), usually because use of the drug presents an unsatisfactory risk-benefit ratio. Although critical scientists and clinicians might quibble with a few of the findings in some of the monographs – I do so myself – it is necessary to remember that, taken as a whole, they represent the most accurate information available in the entire world on the safety and efficacy of herbs and phytomedicines. As such, they are worthy of careful study by anyone interested in any type of drug therapy. Ignorance of the Commission E monographs is ignorance of a substantial segment of modern medicine.

HerbalMedicine(HM)10 is another book by Mark Blumenthal and his colleagues. It presents herbal information that expands on the German Commission E monographs. Published in 2000, this volume is one of the few up-to-date publications available in the field. Each herbal monograph is extensively annotated and referenced. Dr. Varro Tyler’s foreword to his volume articulated why this expanded text provides value to the field.

Although the pioneering judgments rendered by the Commission E on the safety and efficacy of over 380 herbs remain generally the best available, there is, of course, always room for improvement. The medicinal potential of herbs has become the focus of more and more scientific and clinical studies in the field in recent years. New information has provided additional insights and, in some cases, modified previous judgments. That is only to be expected in such a dynamic field.

Therefore, Mark Blumenthal, Alicia Goldberg, and Josef Brinckmann have performed a substantial service to all those interested in herbal medicine by expanding the content in the Commission E herb monographs of the most widely used herbs in America to include updated, detailed information on their botany, history, composition, safety, efficacy, and therapeutic use. And for those who lamented its initial absence, an extensive list of published references is provided, each of which is appropriately keyed to a specific statement in the monograph. This listing is followed by a compilation of additional literature resources for those who want still more background information on a particular botanical.

In short, these expanded versions of selected original Commission E monographs would seem to fulfill all of the desires of those who felt that the original version did not meet their expectations, or that its large size and price did not allow for its widest distribution and use. I am quite certain that this volume will meet and even exceed those expectations and wishes. It is destined to occupy a prominent position on the shelf of useful herbal literature for the foreseeable future.


7

PrinciplesandPracticeofPhytotherapy(PPP)11 was coauthored by Simon Mills, Director, Centre for Complementary Health Studies, University of Exeter, UK, and Secretary of the Board of Directors of ESCOP together with MediHerb’s Kerry Bone. Simon Mills also serves as Chairman of the British Herbal Medicine Association. In his foreword, the highly respected American herbal scientist James A. Duke describes the Mills and Bone volume as follows:

These authors, representing respectively the traditions of Great Britain and Australia, have 40 years of clinical practice of herbal medicine between them. They are also both solid scientists; able to apply rigorous scrutiny to the many claims made for their medicines. Every traditional claim offered forth in their book is countered by an exhaustive pharmacological and phytochemical analysis. And excitingly new, the authors have comprehensively covered, and covered well: herbal pharmacodynamics (effect of an active phytochemical at target site(s)) and pharmacokinetics, explaining what actually happens to the phytochemicals in the body when humans consume herbal medicines, and how much of a phytochemical can be concentrated at the site. It is most exciting to read what the authors have to say in this important and understudied area of herbal medicine. These pharmacokinetic observations alone would make the book worthwhile.

Pharmacist Melanie Johns Cupp of West Virginia University is the editor of ToxicologyandClinicalPharmacologyofHerbalProducts(TCPHP).12 In this volume, the authors seek to provide “medical examiners, toxicologists, and health care providers with an objective review of the available information on the pharmacology and toxicology of commonly used herbs.” They present data from case reports and include information of value to pathologists. Human, animal and in vitro data are also presented along with information on pharmacology, therapeutics, and adverse effects. According to the author of the foreword, Steven B. Karch, M.D., they have done an “excellent job in combining the scientific literature for reliable, peer-reviewed information about the most widely used herbal products.”

The WorldHealthOrganization‘sMonographsonSelectedMedicinalPlants(WHO) were first published in 1999 to promote international harmonization in the quality control and use of herbal medicines and in the development of national formularies. Twenty-eight monographs were published in volume 1, with another series published in 2001.13,14 The second part of each monograph describes the clinical applications of the plant material, including detailed pharmacological information, contraindications, adverse effects and dosage.

One of the most recent additions to the scholarship of herbal therapy is AClinicalGuidetoBlendingLiquidHerbs(CGBLH)15 written by MediHerb’s Kerry Bone and published in 2003 focuses solely on liquid herbal preparations and features monographs of 125 popular herbs. The monographs are written in an easy-to-read and summarized format presenting safety and clinical information relevant to the health care professional. Additional pharmacological and clinical information is provided for further study. In addition to the monographs, a chapter is devoted to explaining the principles of formulating liquid herbal mixtures for the individual patient, with examples for key conditions presented. Simon Mills notes in the foreword that “[Kerry] combines many years of herbal research and a personal commitment to producing the highest-quality herbal remedies with an equal experience in the consulting room with real patients. With this combination of skills, he has produced the most important guide to herbal prescription so far.”

MediHerb and Standard Process encourage health care professionals to obtain these and other publications which describe the uses and cautions associated with the use of herbs for health. As herbs grow in popularity, more sources of information will appear. Health care professionals have an obligation to keep up-to-date on the growing literature of herbs for health in order to serve the needs of their patients.

In particular The Essential Guide to Herbal Safety by Kerry Bone and Simon Mills should be consulted. This accurate and comprehensive book presents an extensive discussion of the principles of herbal safety and major issues relating to this important area. Leading international experts contribute to the book providing a wealth of information on issues such as quality, interactions, adverse reactions, toxicity, allergy, contact sensitivity and idiosyncratic reactions. The Essential Guide to Herbal Safety was the recipient of the American Botanical Council (ABC) James A. Duke Botanical Literature Award 2006, which honors the singular outstanding contribution by a book to the knowledge and understanding of medicinal and aromatic plants.

NOTE:Theinformationcompiledinthisvolumeisonlyascurrentasthereferencessetforthabove.ForthemostcurrentscientificinformationregardinganyoftheherbsusedinMediHerbproducts,thefollowingonlinedatabasesareupdatedonaregularbasisandcanbesearchedbyherbname:

http://ods.od.nih.gov/health.aspxNationalInstitutesofHealthOfficeofDietarySupplementsInternationalBibliographicInformationonDietarySupplements(IBIDS)database.http://www.ncbi.nlm.nih.gov/sites/entrezNationalLibraryofMedicineMedlinedatabase.http://www.herbmed.orgAlternativeMedicineFoundation.http://www.mediherb.comMediHerbPtyLtd.

REFERENCES1 de Smet PAGM, Keller K, Hansel R et al (eds). Adverse Effects of Herbal Drugs, Volume 1. Springer-Verlag, Berlin, 1992.2 de Smet PAGM, Keller K, Hansel R et al (eds). Adverse Effects of Herbal Drugs, Volume 2. Springer-Verlag, Berlin, 1993.3 de Smet PAGM, Keller K, Hansel R et al (eds). Adverse Effects of Herbal Drugs, Volume 3. Springer-Verlag, Berlin, 1997.4 British Herbal Medicine Association. British Herbal Compendium, Volume 1. BHMA, Bournemouth, 1992.5 McGuffin M, Hobbs C, Upton R et al (eds). American Herbal Products Association’s Botanical Safety Handbook. CRC Press, Boca Raton, 1997.6 Bone K. Clinical Applications of Ayurvedic and Chinese Herbs. Phytotherapy Press, Warwick, 1996.7 ESCOP Monographs: The Scientific Foundation for Herbal Medicinal Products, 2nd Edition. ESCOP, European Scientific Cooperative on Phytotherapy, Exeter, 2003.8 Tisserand R, Balacs T. Essential Oil Safety: A Guide for Health Care Professionals. Churchill Livingstone, Edinburgh, 1995.9 Blumenthal M et al (eds). The Complete German Commission E Monographs: Therapeutic Guide to Herbal Medicines. American Botanical Council, Austin, 1998.10 Blumenthal M et al (eds). Herbal Medicine: Expanded Commission E Monographs. American Botanical Council, Austin, 2000.11 Mills S, Bone K. Principles and Practice of Phytotherapy: Modern Herbal Medicine. Churchill Livingstone, Edinburgh, 2000.12 Cupp MJ (ed). Toxicology and Clinical Pharmacology of Herbal Products. Humana Press, Totowa, NJ, 2000.13 World Health Organization. WHO Monographs on Selected Medicinal Plants, Volume 1. WHO, Geneva, 1999.14 World Health Organization. WHO Monographs on Selected Medicinal Plants, Volume 2. WHO, Geneva, 2001.15 Bone K. A Clinical Guide to Blending Liquid Herbs: Herbal Formulations for the Individual Patient. Churchill Livingstone, St. Louis, 2003.

Note: TheinformationpresentedhereinhasnotbeenconfirmedoragreedtobyMediHerborStandardProcess.Someinformationisbasedonin vitrodataandcasereportsthathavenotbeensubstantiatedbyclinicalstudies.Thiscompilationofinformationandreferencesispresentedfortheconvenienceofpractitionerswhoareencouragedtoreviewthesourceliterature.

Sources: �AEHD1�=AdverseEffectsofHerbalDrugsVol.1,AEHD2�=AdverseEffectsofHerbalDrugsVol.2,AEHD3�=AdverseEffectsofHerbalDrugsVol.3,BHC�=BritishHerbalCompendium,BSH�=BotanicalSafetyHandbook,CAACH�=ClinicalApplicationsofAyurvedicandChineseHerbs,CGBLH�=ClinicalGuidetoBlendingLiquidHerbs,EOS�=EssentialOilSafety:AGuideforHealthCareProfessionals,ESCOPM�=EuropeanScientificCooperativeonPhytotherapyMonographs,HM�=HerbalMedicine,PPP�=PrinciplesandPracticeofPhytotherapy,TGHM�=TherapeuticGuidetoHerbalMedicines,TCPHP�=ToxicologyandClinicalPharmacologyofHerbalProducts,WHO1�=WorldHealthOrganizationMonographsonSelectedMedicinalPlants,Volume1,WHO2�=WorldHealthOrganizationMonographsonSelectedMedicinalPlants,Volume2

The�herb�classification�found�in�the�Botanical�Safety�Handbook�are�defined:

Class�1�= Herbsthatcanbesafelyconsumedwhenusedappropriately.

Class�2�= Herbsforwhichthefollowinguserestrictionsapply:(2a)forexternaluseonly;(2b)nottobeusedduringpregnancy;(2c)nottobeusedwhilenursing;(2d)otherspecificuserestrictionsasnoted.

Class�3�= Herbsforwhichsignificantdataexisttorecommendthefollowinglabeling:“Tobeusedonlyunderthesupervisionofanexpertqualifiedintheappropriateuseofthissubstance.”Labelingmustincludeproperuseinformation:dosage,contraindications,potentialadverseeffectsanddruginteractions,andanyotherrelevantinformationrelatedtothesafeuseofthissubstance.

Class�4�= Herbsforwhichinsufficientdataareavailableforclassification.


8

Tablets, Capsules & Phytosynergist® Liquid Complexes

ProductandIngredientName Class Contraindications,CautionsandPotentialAdverseReactions InteractionswithDrugs

Albizia�ComplexContraindicated in individuals with a known hypersensitivity to Feverfew, parthenolide or other members of the daisy family. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

Chinese�SkullcapScutellaria baicalensisroot

1 Traditionallycontraindicatedincoldconditions.(CGBLH,83)Gastricdiscomfortoccursrarely.(AEHD2,291)

Noneknown.(CGBLH,83)

AlbiziaAlbizia lebbekbark

Noinformation. Noneknown.(CAACH,94)Sincetheherbcontainssaponins,itmaybeagastrointestinalirritant.Itmayalsobecontraindicatedoratleastinappropriateintopicalapplicationtoopenwounds,patientswithceliacdisease,andsomeupperdigestiveirritations.(PPP,46,170)

Noneknown.(CAACH,95;CGBLH,59)

FeverfewTanacetum partheniumleaf&stem

2b Contraindication:pregnancy.Occasionalmouthulcerationandgastricdisturbanceshavebeenreported,buttheincidenceislow.Contactallergyisknownbutrare.Nomajoradverseeffectswithlong-termusehavebeenrecorded.(BHC,97)Contraindicatedinthosewithknownhypersensitivitytoeitherfeverfew,parthenolideorothermembersoftheCompositaefamily.(PPP,391;WHO2,324;CGBLH,219)

Noneknown.(ESCOPM,493;PPP,391;CGBLH,219)In vitrostudiessuggestthatfeverfewmayinhibitplateletaggregation(TCPHP,102),however,resultsfromclinicaltrialssuggestthatnormalclottingmechanismsremainintact.(PPP,387)

Andrographis�ComplexContraindicated in pregnancy and lactation. Contraindicated in known allergy to plants of the daisy family.

EchinaceaEchinacea angustifoliaroot

1 CommissionEcautionedthatEchinacea pallidarootandE. angustifoliaherbandrootshouldnotbeusedinsystemicdiseasessuchastuberculosis,leukosis,collagenosis,multiplesclerosis,AIDS,HIVinfections,andotherautoimmunediseases(basedontheoreticalconsiderationsandnotonanyreportsofadversefindings).Otherauthoritativesourcesdonotsupporttheserestrictions.(HM,94;TGHM,121,328;PPP,359-360)Allergicreactions,mainlycontactdermatitis,mayoccurrarelyinsusceptiblepatientsfromEchinaceaaerialparts.ThelikelihoodofEchinacearootpreparationscausingallergyisverylow.(CGBLH,185)

Noneknown.(HM,95;PPP,360)Cautionisadvisedfortransplantpatientstakingimmunosuppressivedrugs,short-termtherapyonlyissuggested.(PPP,360;CGBLH,185)

Refer to the MediHerb Herb-Drug Interactions chart.

Holy�BasilOcimum tenuiflorumleaf

Noinformation. Contraindicatedduringpregnancyandlactation.(WHO2,212)

Noinformation.

AndrographisAndrographis paniculataherb

2b Contraindication:pregnancy,(BSH,9;CAACH,100;CGBLH,65)lactation;knownallergytoplantsoftheAcanthaceaefamily.(WHO2,20)Highdosesmaycausegastricdiscomfort,lossofappetiteandvomiting,butgenerallytherearefewsideeffectsanditisnon-toxic.(CAACH,99)Twocasesofurticariahavebeenreported.(WHO2,21;CGBLH,65)

Noneknown.(PPP,266;CGBLH,65)

Holy�BasilOcimum tenuiflorumleafessentialoil

Noinformation. Noinformation. Noinformation.









9



Astragalus�ComplexContraindicated in known allergy to plants of the daisy family. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional. Discontinue during an acute infection or fever.

Astragalus�Astragalus membranaceusroot

1 Contraindications:notadvisableinacuteinfections.(PPP,277;CAACH,19;CGBLH,77)

Noneknown.(PPP,277;WHO1,56;BSH,17;CGBLH,77)

EchinaceaEchinacea purpurearoot

1 CommissionEcautionedthatEchinacea pallidarootshouldnotbeusedinsystemicdiseasessuchastuberculosis,leukosis,collagenosis,multiplesclerosis,AIDS,HIVinfections,andotherautoimmunediseases(basedontheoreticalconsiderationsandnotonanyreportsofadversefindings).Otherauthoritativesourcesdonotsupporttheserestrictions.(TGHM,121;PPP,359-360)ShouldnotbeadministeredtopatientswithknownallergytoanyplantofAsteraceae(Compositae).(ESCOPM,137)Allergicreactions,mainlycontactdermatitis,mayoccurrarelyinsusceptiblepatientsfromEchinaceaaerialparts.ThelikelihoodofEchinacearootpreparationscausingallergyisverylow.(CGBLH,185)

Noneknown.(ESCOPM,137;PPP,360)Cautionisadvisedfortransplantpatientstakingimmunosuppressivedrugs,short-termtherapyonlyissuggested.(PPP,360;CGBLH,185)


EleutheroEleutherococcus senticosusroot

1 Contraindicatedinacutephaseofinfections,(PPP,142,539)pregnancy,lactationandincasesofknownallergytoplantsoftheAraliaceaefamily.(WHO2,91)CommissionEnotedacontraindicationforhypertension.(HM,107;PPP,539;TGHM,125)TwoclinicalstudiesrecommendthatEleutherococcusnotbeadministeredtopatientswithhighbloodpressure(HM,107;TGHM,62;BSH,45),althoughacausalrelationshiptotheuseofEleutherococcuscouldnotbeestablished.(ESCOPM,142)Cautionisadvisedincardiovasculardisorders.(CGBLH,195)Insomnia,palpitations,tachycardiaandhypertensionhavebeenrarelyobservedinassociationwithclinicalstudies.(BSH,45;CGBLH,195)

Noneknown.(HM,108;TGHM,125;PPP,539;ESCOPM,143)Reportsthattheherbmayincreaseserumdigoxinlevels,butnotconclusive(PPP,539)andtheidentityoftheplantmaterialasEleutherococcuswasnotestablished.(WHO2,91)










10



Bacopa�ComplexContraindicated in pregnancy. Contraindicated during lactation unless otherwise directed by a qualified health care professional. Discontinue during an acute infection or fever.

SchisandraSchisandra chinensisfruit

1 Contraindicatedinpregnancy,excepttoassistchildbirth;intheearlystagesofcoughorrashandinexcessheatpatterns.(CGBLH,405)Maybecontraindicatedinlivercarcinoma.(PPP,192)Raresideeffectsofappetitesuppression,stomachupset,andurticariaarereported.(BSH,104)



BacopaBacopa monnieriherb

Noinformation. Containingsaponins,thisherbisapotentialgastrointestinalirritant.(PPP,46;CGBLH,80)

Noneknown.(CAACH,101-102;CGBLH,80)





RosemaryRosmarinus officinalisleafessentialoil

Noinformation. Adversereactionsarenotnotedforthedailydosageof10–20drops.(TGHM,48,197)Basedonthecineolecontentoftheessentialoil,cautionmaybewarrantedinwomenwishingtoconceive.(CGBLH,389)Atanoraldailydoseof0.5mLorabove:shouldnotbetakeninpregnancy;usewithcautioninepilepsyandfever.(EOS,113-114,165)

Noinformation.

Bilberry�6000mgNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

BilberryVaccinium myrtillusfruit

1 Veryhighdosesshouldbeusedcautiouslyinpatientswithhemorrhagicdisordersandinthosetakingwarfarinorantiplateletdrugs.(PPP,301)Mildsideeffectsaffectingthegastrointestinal,cutaneousandnervoussystemsobservedinasmallpercentageofpatients.(CGBLH,93)

Noneknown.(HM,18;TGHM,88;ESCOPM,346)Possibleinteractionwithwarfarinandantiplateletdrugsinveryhighdoses.(PPP,301)










11



Boswellia�ComplexNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

BoswelliaBoswellia serratagumoleoresin

1 Noinformation. Noinformation.

Celery�SeedApium graveolensfruit

2b,2d Apium graveolenscancauserareallergicreactions,evenendinginanaphylacticshock('celery-carrot-mugwort'allergicreaction).(TGHM,320;BHC,57)Cancontainphototoxicfuranocoumarins.(TGHM,320)TheBHCrecommendsthatceleryiscontraindicatedinkidneydisordersandpregnancy,(BHC,57)althoughnoevidencehasbeenfoundforthecontraindicationinpregnancy.(CGBLH,134)Asadiuretic,inappropriateandpossiblycontraindicatedinrenalfailureanddiabetes.(PPP,222;BSH,11)



GingerZingiber officinalerhizome

2b,2d Contraindicatedwithgallstones;consultaphysicianfirst.(HM,156;BSH,125;TGHM,136)Mayincreasethechanceofbleeding.(PPP,401)Adailydoseof2gofdriedgingershouldnotbeexceededinpregnancy.Usewithcautionincasesofpepticulceration,gastroesophagealreflux,orothergastricdiseases.Atdosesapproachingorgreaterthanthemaximumrecommendeddose,anincreaseingastricsecretoryactivityleadingtoheartburnispossible.(CGBLH,227)Overdosemayleadtoablood-thinningeffectandanincreaseingastricsecretoryactivityleadingtoheartburn.(PPP,401;ESCOPM,548)Topicalapplicationmaycausecontactdermatitisinsensitivepatients.(PPP,401)

Noneknown.(HM,156;TGHM,136)Mayincreasetheabsorptionofpharmaceuticaldrugs.(PPP,401)Cautionindicatedfordailydosesof(dried)gingerinexcessof4gwithpatientstakingblood-thinningdrugssuchaswarfarin,oraspirinorwhohaveincreasedriskofhemorrhage.(PPP,401;TCPHP,129;CAACH,106;CGBLH,227)Mayenhanceabsorptionofsulphaguanidine.(ESCOPM,548)


TurmericCurcuma longarhizome

2b,2d Contraindicatedinobstructionofbilepassages;incaseofgallstones,useonlyafterconsultingwithaphysician.(TGHM,222;HM,382;WHO1,121;PPP,578;ESCOPM,107)Theherbshouldnotbeadministeredtopatientswhosufferfromstomachulcersorhyperacidity.(BSH,39;HM,382)Occasionalcasesofallergicdermatitisreported.(WHO1,121;PPP,578)Careshouldbeexercisedwithwomenwishingtoconceiveandpatientscomplainingofhairloss.(CGBLH,436)Patientsapplyingtopicaldosesshouldbecautionedagainstexcessiveexposuretosunlight.(PPP,578)

Noneknown.(HM,382;TGHM,222;ESCOPM,108)Highdoses(>15g/day)shouldnotbegiventopatientstakingantiplateletoranticoagulantdrugs.(PPP,578;CGBLH,436)










12



Broncafect®Contraindicated in high blood pressure, edema (water retention), congestive heart failure, low blood potassium, pregnancy and lactation. Contraindicated in known allergy to plants of the daisy family.

LicoriceGlycyrrhiza glabraroot

2b,2c,2d Itisrecommendedthatpatientswithcardiovascularorrenaldiseaseuselicoriceonlyundercareofhealthcareprofessional.(TCPHP,232;PPP,474)Patientspronetopotassiumdeficiencyarealsoadvisednottouselicorice.(TCPHP,232;TGHM,161)Treatmentnottoexceedsixweeks.(TCPHP,232;BSH,58;TGHM,162)Contraindications:hypertension,cholestaticliverdisorders,inflammatoryliverdisorders,livercirrhosis,hypertonia,hypokalemia,severeobesityandseverekidneyinsufficiency(HM,236;BSH,58;BHC,146;TGHM,161;WHO1,190;AEHD3,72;ESCOPM,298)pregnancyandlactation(ESCOPM,298).Inthecaseofpregnancydosesupto3gperdayarelikelytobesafe.(PPP,474)Alsocontraindicatedifthereisedemaorcongestiveheartfailure.(PPP,474)Cautionisadvisedwithelderlypatients.(CGBLH,312)Ingestionofanexcessiveamountcanleadtoseverehypertension,cardiacarrhythmias,cardiomyopathy,cardiacarrest,pseudoaldosteronism,myopathy,pulmonaryandgeneralizededema.(AEHD3,73;BSH,58;BHC,146;AEHD3,72;CGBLH,313)

Shouldnotbetakenconcurrentlywithcorticosteroidtreatment.(WHO1,190;AEHD3,77)MaydecreaseplasmaclearanceandincreasetheAUCofprednisolone.Licoricemaypotentiatetheactivityofprednisoloneandothercorticosteroiddrugs.(ESCOPM,298;CGBLH,313)Concurrentuseoffurosemidemaypotentiatedevelopmentofacuterenalfailure.(AEHD3,77)Potassiumlossduetootherdrugs,e.g.thiazidediuretics,canbeincreased.Withpotassiumloss,sensitivitytodigitalisglycosidesincreases.(HM,237;TGHM,161;WHO1,190)Excessiveuseoflicoricemayinteractwithantiarrhythmicdrugsorwithdrugswhichinducereversiontosinusrhythm(e.g.quinidine).(ESCOPM,298)Shouldnotbeadministeredinconjunctionwithspironolactoneoramiloride.(WHO1,190)Insulinmaybesynergisticwithglycyrrhizinincausingelectrolytedisturbancesandsuppressionofreninandaldosterone.(AEHD3,77)Thereisaslightchancethatlicoricemaycounteractthecontraceptivepill,onthebasisoftheconstituentglycyrrhizin.(CGBLH,312)


Pleurisy�RootAsclepias tuberosaroot

2b,2d Canadianregulationsdonotallowtheherbasanon-medicinalingredientfororaluseproducts.(BSH,17)Howevernoadverseeffectshavebeendocumentedforrecommendeddosages.(CGBLH,374)






White�HorehoundMarrubium vulgareherb

2b Largedosescanbelaxative.(BSH,74) Noneknown.(TGHM,148;HM,199;CGBLH,456)

Continues on next page









13







ThymeThymus vulgarisleafessentialoil

Noinformation. Noneknownforanoraldailydoseof0.5mLorabove.(EOS,113-114,176)Substantialdosesshouldbeavoidedinpregnancy.(BSH,116)

Noinformation.

Broncafect�Phytosynergist®Contraindicated in high blood pressure, edema (water retention), congestive heart failure, low blood potassium, pregnancy and lactation. Contraindicated in known allergy to plants of the daisy family.














14







Pleurisy�RootAsclepias tuberosaroot

2b,2d Canadianregulationsdonotallowtheherbasanon-medicinalingredientfororaluseproducts.(BSH,17)Howevernoadverseeffectshavebeendocumentedforrecommendeddosages.(CGBLH,374)


ThymeThymus vulgarisleaf

1 Patientssensitivetobirchpollenorcelerymayhavecross-sensitivityorpossibleadversereactiontothisherb.Contactdermatitishasbeenreported.(WHO1,264)Classificationsandconcernsforthisherbarebasedupontherapeuticuseanddosageandmaynotberelevanttoitsconsumptionasaspice.(BSH,116)

Noneknown.(HM,377;TGHM,219;WHO1,264;CGBLH,431)





White�HorehoundMarrubium vulgareherb

2b Largedosescanbelaxative.(BSH,74) Noneknown.(TGHM,148;HM,199;CGBLH,456)









15



Burdock�ComplexContraindicated in pregnancy and lactation.

BurdockArctium lapparoot

1 Noneknown.(BHC,46;TGHM,318) Noneknown.(CGBLH,118)

Sheep�SorrelRumex acetosellaherb

2d Individualswithahistoryofkidneystonesshouldusetheherbcautiously.(BSH,100)

Noinformation.

Slippery�ElmUlmus rubrastembark

1 Noneknown.(BHC,204)Mucilagesuchasslipperyelmisinappropriatelyprescribedincongestivebronchialandcatarrhalconditions.(PPP,169)Sincetheyhavebeenknowntocauseesophagealobstruction,mucilagesshouldbetakenwithplentyofwaterandlargedosesshouldnotbeprescribedintabletform.(PPP,26)

Noneknown.(BHC,204)

RhubarbRheum palmatumroot

2b,2c,2d Contraindicatedinintestinalobstruction,acuteintestinalinflammatione.g.Crohn'sdisease,ulcerativecolitis,appendicitis,abdominalpainofunknownorigin,(TGHM,195)pregnancy,lactationandchildrenunder10yearsofage.(ESCOPM,420)Insingleincidents,cramp-likediscomfortsofthegastrointestinaltractcanoccur.Thisrequiresadosagereduction.Withchronicuseorabusearangeofsideeffectsarepossibleduetodisturbanceofwaterandelectrolytebalance,especiallypotassiumdeficiencywhichcanleadtodisordersofheartfunctionandmuscularweakness.Pigmentimplantationintotheintestinalmucosa(pseudomelanosiscoli)canoccurbutitisharmlessandusuallyreversesupondiscontinuationoftheherb.(TGHM,195)Laxativescontaininganthraquinoneglycosidessuchasrhubarbarealsocontraindicatedinpatientswithboweldisease,diarrheaandconstipationassociatedwithbowelimpermeability.(PPP,173)Theyshouldnotbeusedforperiodsofmorethan2weekswithoutmedicaladvice.(ESCOPM,420)Abdominalspasmandpainmayoccurinthosewithirritablecolon.Anon-clinicallyrelevantdiscolorationofurinemayalsooccur.(ESCOPM,420)Althoughitisoftenrecommendedthatindividualswithahistoryofkidneystonesshouldusetheherbcautiously,onthebasisofitcontainingoxalate,(BSH,97)thissideeffecthasnotbeenestablished.

Withlong-termuseorabuse,duetolossofpotassium,anincreaseineffectivenessofcardiacglycosidesandaneffectonantiarrhythmicdrugsispossible.Potassiumdeficiencycanbeincreasedbysimultaneousapplicationofthiazidediuretics,corticosteroidsorlicoriceroot.(TGHM,196)









16



Capsella�Complex�Phytosynergist®Contraindicated in pregnancy. Contraindicated during lactation unless otherwise directed by a qualified health care professional.

Dong�QuaiAngelica polymorpha(Angelica sinensis)root

2b Contraindicatedinbleedingorveryheavymenstruation,firsttrimesterofpregnancy,tendencytospontaneousabortion,acuteviralinfectionssuchascoldsorinfluenza.(CAACH,5-6;BSH,11;PPP,352;CGBLH,182)Alsocontraindicatedindiarrheacausedbyweakdigestionandinhemorrhagicdisease.(PPP,352)Headachemayoccurinsensitiveindividuals.(WHO2,32)Cardiovascularsideeffectsincludeexcessivebleeding.(TCPHP,290)Acaseofgynecomastiainamalehasbeenreported.(CGBLH,182)Dongquaihastwofuranocoumarins(psoralenandbergapten),whicharephotoreactiveandhavethepotentialtocauseseverephotodermatitis.Thesefuranocoumarinsarealsophotocarcinogenic.However,theriskofphototoxicityinhumansfromingestionofdongquaihasnotbeencharacterized.(TCPHP,290-291)

Basedonanimalstudies,cautionisadvisedforpatientsreceivingchronictreatmentwithanticoagulantdrugssuchasCoumadin(warfarin).(PPP,352)


False�UnicornChamaelirium luteumroot

2b Excessivedosesmayproducenauseaandvomiting.(BHC,125)Canadianregulationsdonotallowthisherbasanon-medicinalingredientfororaluseproducts.(BSH,27)Verylargedosesaresaidtocausenauseaandvomiting.(CGBLH,204)

Noneknown.(BHC,125;CGBLH,204)

Shepherd’s�PurseCapsella bursa-pastorisherb

2b,2d Largedosesmaycauseheartpalpitations;individualswithhistoryofkidneystonesshouldusecautiously.(BSH,23;HM,351)

Noneknown.(TGHM,208;HM,352;CGBLH,413)

Refer to the MediHerb Herb-Drug Interactions chart (under Polyphenolic- or Flavonoid-containing herbs).

White�PeonyPaeonia lactifloraroot

1 Consultwithaphysicianwhenpatienthasbreastcancercondition.(PPP,244)Theherbreducestestosteroneproductionfromovariesbutnotfromadrenalglands.(CAACH,31)

Noneknown.(CGBLH,458)ShouldnotbecombinedwithFritillaria verticillata,Cuscuta japonicaandRheum officinale.(WHO1,199)Cautionshouldbeexercisedwhenusedwithestrogenicdrugsoranticoagulantdrugs.(PPP,244;CGBLH,458)









17



Cat's�Claw�ComplexContraindicated in pregnancy and lactation. Contraindicated in patients taking anticoagulant drugs. Contraindicated in known allergy to plants of the daisy family.

Cat’s�ClawUncaria tomentosainnerstembark

4 Contraindicatedinpatientsundergoingskingraftsandorgantransplants;hemophiliacsprescribedfreshbloodplasma;simultaneousadministrationofcertainvaccines,hormonetherapies,thymusextracts,andinsulinandchildrenunderthreeyearsofage.(BSH,119)Usewithcautioninpregnancyandlactation.Diarrheaandindigestionhavebeenreportedinseveralpatients.(CGBLH,131)


Pau�d’ArcoTabebuia avellanedaeinnerstembark

1 Contraindicatedwithanticoagulants.(PPP,504)Adverseeffectsarenotexpectedwhenconsumedwiththerecommendeddosage.(PPP,500)Cautionisadvisedinpregnancy.(CGBLH,366)

Patientsonanticoagulanttherapyshouldnotbeprescribedpaud’arcoduetothewarfarin-likeactionofnaphthoquinonesathighdoses.(PPP,504)






Chaste�TreeNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

Chaste�TreeVitex agnus-castusfruit

2b,2d Contraindicatedinconjunctionwithprogesteronedrugs,thecontraceptivepill,orHRT.(PPP,332;BSH,123;ESCOPM,9)TheherbmayaggravatepurespasmodicdysmenorrheanotassociatedwithPMS.(PPP,332)Rareoccurrencesofitching,urticariaandheadachehavebeenreported.(PPP,333;BSH,123;HM,63;TGHM,108;ESCOPM,9;CGBLH,142)Shouldbeusedcautiouslyduringpregnancyandonlyintheearlystagesfortreatinginsufficientcorpuslutealfunction.(CGBLH,142)

Mayinteractantagonisticallywithdopaminereceptorantagonists,progesteronedrugs,contraceptivepillorHRT.(PPP,332;HM,63;TGHM,108;CGBLH,142)









18



ChelaCoContraindicated in known allergy to Garlic. Contraindicated in lactation. Not to be used during pregnancy unless otherwise directed by a qualified health care professional. In anemia and cases where iron supplementation is required, do not take simultaneously with meals or iron supplements.

HawthornCrataegus monogynaherbfloweringtops

1 Occasionalsideeffectsincludegastrointestinaldisorders,palpitation,headache,dizziness,circulatorydisturbances,sleeplessnessandinneragitation.(CGBLH,270)Aphysicianmustbeconsultedincaseswheresymptomscontinueunchangedforlongerthansixweeksorwhenfluidaccumulatesinthelegs.Medicaldiagnosisisabsolutelynecessarywhenpainsoccurintheregionoftheheart,spreadingouttothearms,upperabdomenortheareaaroundtheneck,orincasesofrespiratorydistress(shortnessofbreath).(TGHM,143;ESCOPM,99;WHO2,77)In1997,itwasnotedthatinCanada,theherbcarriesnewdrugstatusandisnotapproved,asself-treatmentofcardiovascularconditionsisdeemedinappropriate.(TCPHP,257)

Hawthornpreparationsmayhaveapotentiatingeffectwhichmaynecessitateasmallerdosageofdigitalis,(PPP,446;BSH,37)thoughthisactionhasnotbeenconfirmed.(HM,186)Hawthornpreparationsmayactinsynergywithbeta-blockersandotherhypotensivedrugs.Modificationofdrugdosagemayberequired.(PPP,446;CGBLH,270;TCPHP,257)

Refer to the MediHerb Herb-Drug Interactions chart (under Hawthorn and Tannin- or OPC-containing herbs).

Milk�ThistleSilybum marianumfruit

1 ContraindicatedincasesofknownallergytoplantsoftheAsteraceae(Compositae)family.(WHO2,310)Sideeffect:amildlaxativeeffectandmildgastrointestinalcomplaintshavebeenobservedinoccasionalinstancesfromthestandardizedpreparation.(HM,260;TGHM,170;WHO2,310;CGBLH,326)

Noneknown.(PPP,560;HM,261;TGHM,170)

Refer to the MediHerb Herb-Drug Interactions chart (under Milk Thistle and Polyphenolic- or Flavonoid-containing herbs).

GarlicAllium sativumbulb

2c Contraindicationwithgastrointestinaldisturbance;inrareinstances,theremaybechangestothefloraoftheintestine,orallergicreactions.(TGHM,134;HM,145;BSH,6;BHC,106)Freshgarlic,extractsoroilmayalsocauseheartburn,nausea,vomiting,anddiarrheaiftakenonanemptystomach.(WHO1,26)Garlicintakeshouldbediscontinued10daysbeforesurgery.(PPP,200)Mayincreasetheriskofpostoperativebleeding.(WHO1,25;ESCOPM,15;AEHD3,229)Contactallergyisnoted.(AEHD1,74;WHO1,26)Hematologicconcernbaseduponin vitrodataandcasereportsforgarlicandgarlicoil.[Editor’snote:theresultsofcasereportsareconflicting.](TCPHP,110,111,301)

Noneknown.(TGHM,134)Garlic’santiplateleteffectmightbedangerousinpatientstakingwarfarinorantiplateletagentssuchasaspirin,ticlopidine,clopidogrel,ordipyridamole.(TCPHP,118;HM,115;WHO1,25)Aninteractionhasbeenobservedintwopatientstakingwarfarin.(ESCOPM,15)










19



ColaxContraindicated in closure of the gallbladder and in known allergy to plants of the daisy family. Use only with professional supervision in gallstones. This product contains Rhamnus purshiana (Cascara). Read and follow directions carefully. Do not use if you have or develop diarrhea, loose stools, or abdominal pain because Cascara may worsen these conditions and be harmful to your health. Consult your health care professional if you have frequent diarrhea or if you are pregnant, nursing, taking medication, or have a medical condition.

CascaraRhamnus purshianastembark

2b,2d Contraindicatedinintestinalobstruction,acuteintestinalinflammatione.g.Crohn'sdisease,ulcerativecolitis,appendicitis;abdominalpainofunknownorigin,colic,hemorrhoids,nephritis(TGHM,104;HM,49;WHO2,264)pregnancy,lactation,(BHC,52)childrenunder10yearsofageandpatientswithseveredehydrationstateswithwaterandelectrolytedepletion.(ESCOPM,414)Freshorinadequatelypreparedcascarabarkshouldnotbeusedbecauseseverevomitingandintestinalspasmcanresult.(CGBLH,127)Insingleincidents,cramp-likediscomfortsofthegastrointestinaltractcanoccur.Thisrequiresadosagereduction.Withchronicuseorabusearangeofsideeffectsarepossibleduetodisturbanceofwaterandelectrolytebalance,especiallypotassiumdeficiencywhichcanleadtodisordersofheartfunctionandmuscularweakness.Pigmentimplantationintotheintestinalmucosa(pseudomelanosiscoli)canoccurbutitisharmlessandusuallyreversesupondiscontinuationoftheherb.(TGHM,105;HM,49)Laxativescontaininganthraquinoneglycosidessuchascascaraarealsocontraindicatedinpatientswithboweldisease,diarrheaandconstipationassociatedwithbowelimpermeability.(PPP,173)Theyshouldnotbeusedforperiodsofmorethan2weekswithoutmedicaladvice.(ESCOPM,414;WHO2,264)Abdominalspasmandpainmayoccurinthosewithirritablecolon.Anon-clinicallyrelevantdiscolorationofurinemayalsooccur.(ESCOPM,414)

Increasedintestinaltransittimemayresultinreducedabsorptionoforallyadministereddrugs.(WHO2,264)Withlong-termuseorabuse,duetolossofpotassium,anincreaseineffectivenessofcardiacglycosidesandaneffectonantiarrhythmicdrugsispossible.Potassiumdeficiencycanbeincreasedbysimultaneousapplicationofthiazidediuretics,corticosteroidsorlicoriceroot.(TGHM,105;HM,49)


Dandelion�RootTaraxacum officinaleroot

Noinformation. Contraindicatedoratleastinappropriateinthefollowing:(1)obstructedbileducts,(2)unconjugatedhyperbilirubinemia,(3)acuteorseverehepatocellulardisease,(4)septiccholecystitis(wherethereisriskofperitonitis),(5)intestinalspasmorileus,(6)livercancerand(7)gallbladderempyema.(PPP,187;BHC,73,76;ESCOPM,503;BSH,114)Incaseofgallstones,firstconsultaphysician.(HM,80,81)Maycausesuperacidicstomachproblems.(BSH,114)

Noneknown.(TGHM,119;HM,80,81;ESCOPM,503;CGBLH,173)

Yellow�DockRumex crispusroot

2d Usewithcautioninpregnancy.(CGBLH,474)Contraindicatedoratleastinappropriateinconstipationassociatedwithbowelirritability,boweldisease,diarrhea.(PPP,173)Individualswithahistoryofkidneystonesshouldusecautiously.(BSH,100)












20



Dill�SeedAnethum graveolensseed

1 Maybecontraindicatedorinappropriateingastroesophagealreflux.(Thisappliestoleafandessentialoil.)(PPP,29,171)

Noneknown.(TGHM,121)

ChamomileMatricaria recutitaflower

1 ContraindicatedinknownallergytochamomileorothermembersoftheCompositaefamily.(CGBLH,137)Maycauserarecontactallergy.(BHC,155)Allergicconcernbaseduponcasereports.(TCPHP,301)Highlyconcentratedhotteaisnotedasemetic.(BSH,74)GermanStandardLicenserequiresthefollowinglabel:“Theinfusionshouldnotbeusedneartheeyes.”(BSH,74)Thepollencontainedintheseinfusionsappearstoberesponsiblefortheallergicreaction.(CGBLH,138)

Noneknown.(TGHM,107;HM,60;BHC,155)Avoidconcomitantadministrationofchamomileduringironintake.Inanemiaandcasesforwhichironsupplementationisrequired,chamomileshouldnotbetakensimultaneouslywithmealsorironsupplements.(CGBLH,137-138)


Coleus�ForteContraindicated in hypotension. Contraindicated in gastric or duodenal ulcers unless otherwise directed by a qualified health care professional. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional. Do not use this product while taking any prescription drug(s) without the advice of your prescribing physician.

ColeusColeus forskohliiroot

Noinformation. Contraindicatedinhypotension.(CAACH,106)Usecautiouslyinpepticulcer.(CGBLH,156)

Forskolinhastheabilitytopotentiatemanydrugs.Usecautiouslyinpatientstakingprescribedmedication,especiallyhypotensiveandantiplateletdrugs.(CAACH,106;CGBLH,156)










21



CramplexNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

CorydalisCorydalis ambiguatuber

Noinformation. Contraindication:pregnancy.(CAACH,28)Cautionisadvisedinprescribingforchildren,andpatientswithneurologicaldisease,depression,psychosis,liverandkidneydiseaseorthosewithahistoryofallergicoranaphylacticreactions.(PPP,232)Herbalsedativessuchascorydalisarealsocontraindicatedinpatientswithdepressionandinsomniamarkedbyincreasingrestlessnessduringtheearlyhoursofthemorning.(PPP,233)

Cautionisadvisedinpatientsconcurrentlyconsumingpowerfulanalgesics.(PPP,232)

Raspberry�LeafRubus idaeusleaf

1 Usecautiouslyinpatientswithhighlyinflamed,ulceratedordamagedgastrointestinaltissue.(PPP,37)Noadverseeffectsexpectedinpregnancyorlactation,butconfiningusetothesecondandthirdtrimestersismoreappropriate.(CGBLH,381)

Tannin-containingherbsmayreducetheabsorptionofpharmacologicalsubstancese.g.metalions(ironsupplements)andthiamine.Avoidconcurrentconsumption.(PPP,37,103)

Refer to the MediHerb Herb-Drug Interactions chart (under Tannin- or OPC-containing herbs).

Wild�YamDioscorea villosaroot&rhizome

1 Largedosesproduceemesis.(BSH,42)Oralusemaycauseirritationofthegastricmucousmembranesandreflux.(CGBLH,464)Alsoclassifiedascholereticandcholagogue,theherbiseithercontraindicatedoratleastinappropriateinthefollowing:(1)obstructedbileducts,(2)unconjugatedhyperbilirubinemia,(3)acuteorseverehepatocellulardisease,(4)septiccholecystitis(wherethereisriskofperitonitis),(5)intestinalspasmorileus,and(6)livercancer.(PPP,187)

Noneknown.(CGBLH,464)Consultphysicianwhenpatientisbeingtreatedwithestrogen-promotingdrugs.(PPP,46,245)Theherbiscontraindicatedoratleastinappropriatewhenthereisalreadyprescriptionofstronganti-inflammatorymedication.(PPP,149)

Cramp�BarkViburnum opulusstembark

Noinformation. Nauseaandvomitingmayoccurwithlargedoses.(CGBLH,100)Canadianregulationsdonotallowcrampbarkasanon-medicinalingredientfororaluseproducts.(BSH,122)














22



Cranberry�ComplexContraindicated in kidney disease. Contraindicated in pregnancy and lactation.

CrataevaCrataeva nurvalastembark

Noinformation. Noneknown.(CGBLH,168) Noneknown.(CGBLH,168)

Uva�UrsiArctostaphylos uva-ursileaf

2b,2d Largedosesmaycausenauseaandvomiting.(HM,391;BHC,212)Mayalsocausecrampingandconstipation,duetohightannincontent.Notsuitableforlong-termuse.(PPP,284;ESCOPM,536;CGBLH,444)Contraindications:kidneydisorders,renalfailure,whichmaybetheoretical,andpregnancy.(BHC,212;PPP,223,284;BSH,13;ESCOPM,536-537)

Shouldnotbegivenwithtreatmentsthatwillleadtotheproductionofacidicurine(leadingtoareductionofantibacterialeffect).Thehightannincontentcouldinterferewiththeabsorptionofsomenutrients.(CGBLH,444)


CranberryVaccinium macrocarponfruit

Noinformation. Ingestionoflargeamountsofcranberryjuice(morethan3litersperday)mayresultindiarrheaandothergastrointestinalsymptoms.(TCPHP,158)

Noinformation.


BuchuBarosma betulinaleafessentialoil

Noinformation. Constituentsintheessentialoilcancauseirritation.(TGHM,317)Atanoraldailydoseof0.5mLorabove:usewithcaution;shouldnotbetakeninpregnancyandchildrenupto2yearsofage.(EOS,113-114,124)

Noinformation.









23



DermaCoContraindicated in pregnancy and lactation.

Oregon�GrapeBerberis aquifolium(Mahonia aquifolium)root&rhizome

2b Canadianregulationsrequirebilinguallabelwarningagainstuseinpregnancyandisanunacceptablenon-medicinalingredientinoraluseproducts.(BSH,73)Contraindicatedinpregnancy,andjaundicedneonates.(CGBLH,80)Thisherbisclassifiedasacholereticandcholagogue.Itiseithercontraindicatedoratleastinappropriateinthefollowing:(1)obstructedbileducts,(2)unconjugatedhyperbilirubinemia,(3)acuteorseverehepatocellulardisease,(4)septiccholecystitis(wherethereisriskofperitonitis),(5)intestinalspasmorileus,and(6)livercancer.(PPP,187)Asanalterative,thisherbmaybeprovocativetoskindisease,andcareneedstobetakentoreducetheprospectsofexacerbations.(PPP,254)

Berberine,analkaloidconstituentofthisherb,maypotentiateotherdrugswhichdisplacetheproteinbindingofbilirubin.(PPP,295)

SarsaparillaSmilax ornataroot&rhizome

1 Risks:takingtheherbmayleadtogastricirritationandtemporarykidneyimpairment(diuresis).Theabsorptionofsimultaneouslyadministeredsubstancesmaybeincreased.Theeliminationofothersubstances(e.g.,hypnotics)isaccelerated.Thiscancauseanuncontrolledconditionofincreasedordecreasedactionofherbstakensimultaneously.(TGHM,372)Theseconcernsaretheoretical,andnotestablishedbyanimalstudiesorcasereports.(CGBLH,397)

CommissionEadvisesofpotentialdruginteractionswithhypnotics,digitalisglycosides,andbismuth.However,nootherreferencesubstantiatestheseconcerns.(BSH,108)Suchconcernswouldbealleviatedbynottakingsarsaparillasimultaneouslywithdrugmedication.(CGBLH,397)

CleaversGalium aparineherb

1 Thisherbmaybeprovocativetoskindisease,andcareneedstobetakentoreducetheprospectsformajorexacerbations.(PPP,254)
















24



DiaCo�Phytosynergist®Contraindicated in high blood pressure, edema (water retention), congestive heart failure, low blood potassium, pregnancy and lactation. Contraindicated in known allergy to plants of the daisy family.





Elder�FlowerSambucus nigraflower

1 Diureticmechanismindicatespotassiumloss,apotassiumsupplementmaybeindicated.(PPP,221)

Noneknown.(HM,104;TGHM,124;CGBLH,191)

Lime�FlowerTilia cordataflower

1 RegulatedintheU.S.asanallowableflavoringagentinalcoholicbeveragesonly.(BSH,116)Allergicreactionoccursrarely.(AEHD2,304;CGBLH,318)

Noneknown.(HM,241;TGHM,342)Avoidconcomitantadministrationoflimeflowerduringironintake.Inanemiaandcasesforwhichironsupplementationisrequired,limeflowershouldnotbetakensimultaneouslywithmealsorironsupplements.(CGBLH,318)


YarrowAchillea millefoliumherb

2b Yarrowisanantispasmodicandmaybecontraindicatedorinappropriateingastricandentericpoisoningincidents.(PPP,172)Mayincreasemenstrualbloodflow,notbyuterinecontraction,butbyregulatingthebloodvesselsintheuterus.(BSH,171)Contraindication:knownhypersensitivitytoYarroworotherCompositae.(BHC,228;HM421;TGHM,233)Someauthoritiesadviseimmediatecessationoftreatmentintheeventof“itchingandinflammatorychangesintheskin”forpersonspronetoallergiestoAsteraceae(Compositae).(BSH,3)Thujone-containingvarietiesshouldbeavoidedduringpregnancyandlactation.(CGBLH,471)















25















26



DiGestContraindicated in gastric or duodenal ulcers unless otherwise directed by a qualified health care professional. Contraindicated in closure of the gallbladder. Use only with professional supervision in gallstones. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.




TangerineCitrus reticulatafruitpeel










GentianGentiana lutearoot

2d Contraindicatedingastricandduodenalulcers,hyperacidityandwhengastricirritationandinflammationarepresent.(BHC,110;BSH,56;TGHM,135;HM,150;ESCOPM,174;CGBLH,224)Contraindicatedoratleastinappropriateinconditionsclassedas‘cold-dry’inearlymedicine,involvingreadyshiveringwithdrycoughandnotablysomekidneydiseases.(PPP,173)Headachesmayoccasionallyoccurinpersonssensitivetobittersubstances.(TGHM,135;BSH,56;ESCOPM,175)Dosesatthehigherendoftherecommendedrangeinliquidformmaycausenauseainsomepeople.(CGBLH,224)Maynotbewell-toleratedbypersonswithhighbloodpressure.(BSH,56)

Noneknown.(HM,151;TGHM,135;ESCOPM,175;CGBLH,224)

TangerineCitrus reticulatafruitpeelessentialoil


ChamomileMatricaria recutitafloweressentialoil










27



DiGest�Phytosynergist®Contraindicated in known allergy to plants of the daisy family. Contraindicated in gastric or duodenal ulcers unless otherwise directed by a qualified health care professional. Contraindicated in closure of the gallbladder. Use only with professional supervision in gallstones. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.












Milk�ThistleSilybum marianumseed




GentianGentiana lutearoot

2d Contraindicatedingastricandduodenalulcers,hyperacidityandwhengastricirritationandinflammationarepresent.(BHC,110;BSH,56;TGHM,135;HM,150;ESCOPM,174;CGBLH,224)Contraindicatedoratleastinappropriateinconditionsclassedas‘cold-dry’inearlymedicine,involvingreadyshiveringwithdrycoughandnotablysomekidneydiseases.(PPP,173)Headachesmayoccasionallyoccurinpersonssensitivetobittersubstances.(TGHM,135;BSH,56;ESCOPM,175)Dosesatthehigherendoftherecommendedrangeinliquidformmaycausenauseainsomepeople.(CGBLH,224)Maynotbewell-toleratedbypersonswithhighbloodpressure.(BSH,56)










28



Dong�QuaiDo not use in severe menorrhagia. Contraindicated in the first trimester of pregnancy, especially in higher doses. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

Dong�QuaiAngelica polymorpha(Angelica sinensis)root




Echinacea�Premium�Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional. Contraindicated in known allergy to plants of the daisy family.

















29



EleutheroNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional. Discontinue during an acute infection or fever.





Euphrasia�ComplexContraindicated in pregnancy and lactation. Contraindicated in known allergy to Golden Rod.

EyebrightEuphrasia officinalisherb

1 Nocontraindicationsnoted.(PPP,376;CGBLH,203) Noneknown.(TGHM,330;PPP,376;CGBLH,202)

Golden�RodSolidago virgaureaherb

2d Inchronickidneydisorders,aphysicianshouldbeconsulted.(BSH,108)Irrigationtherapy(copiousfluidintake)iscontraindicatedincaseofedemaduetoimpairedheartandkidneyfunction.(HM,180;TGHM,139)Contraindicatedinknownallergytogoldenrod.AllergicreactionsmayoccurinsusceptiblepatientssensitizedtoplantsfromtheCompositaefamily.(CGBLH,246)

Noneknown.(HM,180;ESOPM,1996,1;TGHM,139;CGBLH,246)





Golden�SealHydrastis canadensisroot&rhizome

2b Contraindicatedinhypertensiveconditions,pregnancyandjaundicedneonates(PPP,294;CGBLH,250)Freshplantmaycauseirritationtothemucosa.(BSH,62)Canadianregulationsdonotallowgoldensealasanon-medicinalingredientfororaluseproducts.(BSH,62)

Berberine,analkaloidconstituentofthisherb,mayreinforcetheeffectsofotherdrugswhichdisplacetheproteinbindingofbilirubin.(PPP,295)

CayenneCapsicum annuumfruit

1 Whenadministeredinlowdosescautionisadvisedinpatientswithhyperacidity,reflux,inflammatoryboweldisordersandchronicnephritis.(PPP,171)Largedosesmaycausestronggastrointestinalirritation.(BSH,23)

Noneknownforinternalingestion,(HM,54;TGHM,178)althoughpungentprinciplesmayincreaseabsorptionratesandmetabolismofsomepharmacologicalagents.(PPP,103)










30



Evening�Primrose�OilNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

Evening�Primrose�OilOenothera biennisseed

1 Mayhavepotentialtoinstigateundiagnosedtemporallobeepilepsy,especiallyinthosereceivingphenothiazines,butnotconclusive.(PPP,371)Headacheandmildgastrointestinaldisturbanceshavebeenreported.EPOinhibitedplasmaplateletfactor4inoneclinicaltrial.(WHO2,226)

Noneknown.(TGHM,189)Avoidconcomitantusewithphenothiazines.(PPP,371;WHO2,226)


Fe-Max�Iron�Tonic�Phytosynergist®Contraindicated in hemochromatosis and high blood pressure, edema (water retention), congestive heart failure, low blood potassium, pregnancy and lactation.

CodonopsisCodonopsis pilosularoot

1 Noneknown.(CGBLH,154) Noneknown.(CGBLH,154)

Nettle�LeafUrtica dioicaleaf

1 Contraindication:patientswhoareallergictonettlestingsshouldnotapplythefreshorunprocesseddriedleavestopically.(PPP,496)Irrigationtherapy(copiousfluidintake)isnotadvisedifedemaexistsduetoimpairedheartorkidneyfunction.(TGHM,216)Occasional(rare)allergicreactionshavebeenobserved.(BHC,166)

Noneknown.(TGHM,216;ESCOPM,522;CGBLH,343)





AshwagandaWithania somniferaroot

2b,2d HighdosagesofalkaloidsfromWithaniaexhibitprolongedhypotensive,bradycardiacandrespiratorystimulantactions,mayalsohavedepressanteffectonhighercerebralcenters;sedativeeffectshavealsobeendemonstrated.(CAACH,138)

Noneknown.(PPP,601;CGBLH,73)Maypotentiatetheeffectsofbarbiturates.(BSH,124)










31







SteviaStevia rebaudianaleaf

1 Noneknown.(BSH,110) Noinformation.

FeverfewContraindicated in individuals with a known hypersensitivity to Feverfew, parthenolide or other members of the daisy family. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.



Noneknown.(ESCOPM,493;PPP,391;CGBLH,219)Invitrostudiessuggestthatfeverfewmayinhibitplateletaggregation(TCPHP,102),however,resultsfromclinicaltrialssuggestthatnormalclottingmechanismsremainintact.(PPP,387)

Ganoderma�&�ShiitakeContraindicated in cases of known allergy to Shiitake. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

ShiitakeLentinula edodesmushroom


ReishiGanoderma lucidummushroom

1 Raresideeffects(drynessofthemouth,throat,andnasalarea;itchiness;stomachupset;nosebleed;bloodystools)havebeenrecordedafter3to6monthsofcontinuoususe.OneinstanceofskinrashwasobservedfollowingconsumptionofReishiwine.(BSH,55)

Noinformation.

Garlic�5000mgContraindicated in known allergy to Garlic. Contraindicated in lactation. Not to be used during pregnancy unless otherwise directed by a qualified health care professional.













32



Ginkgo�2000mgNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

GinkgoGinkgo bilobaleaf

2d Adversereactions:headaches,mildgastrointestinaldisturbances,andallergicskinreactionsarepossible.(WHO1,163;PPP,414;TGHM,138;HM,166;AEHD3,59;BSH,57;ESCOPM,179)ContraindicatedinhypersensitivityorintolerancetoGinkgopreparations.(TGHM,137;WHO1,162;ESCOPM,179)Hematologicandneurologicconcernbasedoncasereports.(TCPHP,301)Isolatedepisodesofspontaneousbleedinghavebeenreported.(CGBLH,233)

Noneknown.(TGHM,138;WHO1,163)CautionshouldbeexercisedwhenprescribingGinkgowithwarfarinoraspirin.(PPP,414;HM,167)(Althoughnointeractionswithsubstancesthatinhibitbloodcoagulationhavebeenobservedincontrolledstudies.(ESCOPM,179))Theeffectofplatelet-aggregationinhibitorsmaybeincreased.(HM,167)


Golden�Seal�500mgContraindicated in pregnancy, lactation and patients with high blood pressure.




Gotu�Kola�Complex�Contraindicated in known allergy to Gotu Kola. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

Gotu�KolaCentella asiaticaherb

1 Canadianregulationsdonotallowtheherbasanon-medicinalingredientfororaluseproducts.(BSH,26)Allergiccontactdermatitishasbeenassociatedwithtopicalapplication,butitisalowrisk.Furthertestingrevealedthatthesereactionsmaybeduetootheringredientsinthepreparations.(WHO1,83;CGBLH,255)ContraindicatedinknownallergyandallergytoplantsoftheUmbelliferae(carrot)family.(WHO1,82;CGBLH,254)

Noneknown.(WHO1,83;CGBLH,254)

Grape�SeedVitis viniferaseed















33



Gut�Flora�Complex�Contraindicated in pregnancy and lactation. Contraindicated in patients taking anticoagulant drugs.

AnisePimpinella anisumfruitessentialoil

Noinformation. Avoidinthosewithsensitivitytoanethole.Preparationscontainingtheessentialoilshouldnotbeusedduringpregnancyandlactation.(ESCOPM,37)[Editor’snote:Thisinformationisbasedonacautioninhumansatanoraldailydoseof0.5mLoraboveoftheessentialoilandantifertilityeffectsdemonstratedinananimalstudyusingveryhighdoses(50–80mg/kgoftheconstituentanethole,about870–1400mg/kgforthebestqualityessentialoil).]Atanoraldailydoseof0.5mLorabove:usewithcautioninalcoholism,estrogen-dependentcancers,liverdisease,endometriosis.(EOS,113-114,117)

Atanoraldailydoseof0.5mLorabove:usewithcautioninthosetakingacetominophen.(EOS,113-114,117)

Pau�d’ArcoTabebuia avellanedaestem




AndrographisAndrographis paniculataherb

2b Contraindication:pregnancy,(BSH,9;CAACH,100;CGBLH,65)lactation;knownallergytoplantsoftheAcanthaceaefamily.(WHO2,20)Highdosesmaycausegastricdiscomfort,lossofappetiteandvomiting,butgenerallytherearefewsideeffectsanditisnon-toxic.(CAACH,99)Twocasesofurticariahavebeenreported.(WHO2,21;CGBLH,65)


OreganoOriganum vulgareleafessentialoil

Noinformation. Noneknownforanoraldailydoseof0.5mLorabove.(EOS,113-114,156)

Noinformation.

Gymnema�4gNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

GymnemaGymnema sylvestreleaf

Noinformation. Sinceitcontainssaponins,thisherbmaybeagastrointestinalirritant.(PPP,46)

Noneknown.(CGBLH,267)[Editor'snote:Particularcareshouldbeexercisedwherethepatientistakinginsulinororalhypoglycemicdrugs.]

Refer to the MediHerb Herb-Drug Interactions chart (under Hypoglycemic herbs).









34



HawthornNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

HawthornCrataegus monogynaherbfloweringtop

1 Occasionalsideeffectsincludegastrointestinaldisorders,palpitation,headache,dizziness,circulatorydisturbances,sleeplessnessandinneragitation.(CGBLH,270)Aphysicianmustbeconsultedincaseswheresymptomscontinueunchangedforlongerthansixweeksorwhenfluidaccumulatesinthelegs.Medicaldiagnosisisabsolutelynecessarywhenpainsoccurintheregionoftheheart,spreadingouttothearms,upperabdomenortheareaaroundtheneck,orincasesofrespiratorydistress(shortnessofbreath).(TGHM,143;ESCOPM,99;WHO2,77)In1997,itwasnotedthatinCanada,theherbcarriesnewdrugstatusandisnotapproved,asself-treatmentofcardiovascularconditionsisdeemedinappropriate.(TCPHP,257)



Herbal�Throat�Spray�Phytosynergist®Contraindicated in known allergy to plants of the daisy family, and allergy to clove or eugenol. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

Marshmallow�RootAlthaea officinalisroot

1 Asamucilageorrespiratorydemulcent,contraindicatedoratleastinappropriateincongestivebronchial,catarrhalandcongestiveconditionsofthemucosa.(PPP,169,211)

Absorptionofotherdrugstakensimultaneouslymaybedelayed.(BSH,9;HM,245,247;ESCOPM,33;TGHM,166,167;WHO2,9;CGBLH,321)


SageSalvia officinalisherb

2b,2d Leafandessentialoilarecontraindicatedinpregnancyandlactation.(CGBLH,394;TGHM,198)Afterprolongedingestionofalcoholextractsorofthepureessentialoil,epileptiformconvulsionscanoccur.(HM,332;TGHM,198)Cautionisadvisedwiththeuseofalcoholicpreparationsandthepureessentialoilbecauseofthepresenceofthujone.(ESCOPM,453;HM,332;TGHM,198)Donotexceedtherecommendeddose,takewithcautionifusinglongterm.(CGBLH,394)

Noneknown.(HM,332;ESCOPM,453;TGHM,198;BSH,102;CGBLH,394)


CalendulaCalendula officinalisflower

Noinformation. Inappropriatewhenthereisalreadyprescriptionofstronganti-inflammatorymedication,(PPP,148)andforthosewithknownsensitivitytomembersoftheCompositaefamily.(ESCOPM,59;WHO2,41;CGBLH,120)Weakskinsensitizationandacaseofanaphylacticshockhasbeenreportedfromtopicaluse(agargle).(CGBLH,120)

Noneknown.(HM,45;ESCOPM,59;TGHM,100,319;CGBLH,120)










35







MyrrhCommiphora molmolresin

2b,2d Contraindicatedinpregnancy,excessiveuterinebleedingandknownallergy.Allergiccontactdermatitishasbeenreported.Nottobeingestedforprolongedperiods(>fewweeks).(CGBLH,335)


CloveSyzygium aromaticumbudessentialoil

Noinformation. Oilofclovemaybeirritatingtomucosaltissues.(TGHM,112)Atanoraldailydoseof0.5mLorabove:usewithcautioninalcoholism,hemophilia,kidneydisease,liverdisease,prostatecancer,systemiclupuserythematosus.(EOS,113-114,131)

Atanoraldailydoseof0.5mLorabove:usewithcautioninthosetakinganticoagulantsoracetominophen.(EOS,113-114,131)

HiPepContraindicated in known allergy to plants of the daisy family. Meadowsweet should be avoided by persons hypersensitive to salicylates. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

Deglycyrrhizinized�LicoriceGlycyrrhiza glabraroot

Noinformation. Deglycyrrhizinizedlicoriceisusuallyfreeofadverseeffects.(BSH,58;BHC,146)

Co-administereddeglycyrrhizinizedlicoriceincreasedthebioavailabilityofnitrofurantoin.(AEHD3,77)






MeadowsweetFilipendula ulmariaherb

1 Contraindicatedincasesofhypersensitivitytosalicylates.(ESCOPM,158)

Noneknown.(TGHM,169;HM,254;ESCOPM,158)Withtheexperimentalanticoagulanteffectofthisherb,cautionshouldbeusedifpatientsaretakingwarfarin,(PPP,481;CGBLH,324)althoughthelevelofsalicylatederivativesmakesinteractionwithanticoagulantagentsunlikely.(ESCOPM,158)

Refer to the MediHerb Herb-Drug Interactions chart (under Meadowsweet and Tannin- or OPC-containing herbs).









36



Horsechestnut�ComplexNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

Butcher’s�BroomRuscus aculeatusroot&rhizome

1 Noneknown.(ESCOPM,438)Inrarecases,gastricdisordersornauseamayoccur.(HM,41;TGHM,99)

Noneknown.(HM,41;TGHM,99;ESCOPM,438)

HorsechestnutAesculus hippocastanumseed

Noinformation. ContraindicatedinknownallergytoplantsoftheHippocastanaceaefamily.(WHO2,144)Adverseeffectsreportedtoincludepruritis,nausea,andgastriccomplaintsinisolatedcasesafteroralintake.(HM,203;ESCOPM,249;WHO2,145)Oralusemaycauseirritationofthegastricmucousmembranesandreflux.Saponinsmaycausehemolysis,butthiseffectisnegligibleattheoraldosescommonlyused.(PPP,454)Horsechestnutshouldnotbeappliedtobrokenorulceratedskin.(PPP,454)Allergicreactionshavebeenreportedfromtopicaluseoftheactiveconstituentescin.(WHO2,145)

Noneknown.(HM,203;PPP,454;ESCOPM,249;CGBLH,281)





LivCo®Contraindicated in pregnancy. Contraindicated during lactation unless otherwise directed by a qualified health care professional. In anemia and cases where iron supplementation, do not take simultaneously with meals or iron supplements.





RosemaryRosmarinus officinalisleaf

2b Contraindications:pregnancy(PPP,100)andhypersensitivitytorosemaryleafandrosemarypreparations,especiallythosecontainingcarnosol.(ESCOPM,430)Cautionmaybewarrantedinwomenwishingtoconceive.(CGBLH,389)

Noneknown.(HM,327;TGHM,197;ESCOPM,430)Avoidconcomitantadministrationofrosemaryduringironintake.Inanemiaandcasesforwhichironsupplementationisrequired,rosemaryshouldnotbetakensimultaneouslywithmealsorironsupplements.(CGBLH,389)














37



Livton®�ComplexContraindicated in pregnancy. Contraindicated during lactation unless otherwise directed by a qualified health care professional. Contraindicated in closure of the gallbladder. In anemia and cases where iron supplementation, do not take simultaneously with meals or iron supplements. Use only with professional supervision in gallstones.

Globe�ArtichokeCynara scolymusleaf

Noinformation. Contraindicatedinclosureofthegallbladder(PPP,437)orobstructionofbileduct.(ESCOPM,119).Precautionswithknownallergiestoartichokeandsimilarplants(Compositaefamily).Thelikelihoodofallergyisverylow,nocasesofallergyreactionafteroralintakehavebeenreported.(TGHM,84;HM,11;ESCOPM,119;CGBLH,240)Useonlywithprofessionalsupervisionincholelithiasis.(PPP,437;HM,11;ESCOPM,119)AswithothermembersoftheCompositaefamily,contactwithfreshplantcancausecontactdermatitis.(PPP,438)Mildgastrointestinaldisturbancesmayoccurinrarecases;allergicreactionsmightoccurinsensitizedpatients.(ESCOPM,119)

Noneknown.(PPP,437;TGHM,85;HM,11;ESCOPM,119;CGBLH,240)








BupleurumBupleurum falcatumroot

1 Contraindicatedindeficient yincough,orliver fireascendingtothehead,suchassomecasesofheadacheandhypertension.(CGBLH,116)Bupleurumhasaslightsedativeeffectinsomepatientsandmayalsoincreasebowelmovementsandflatulence(wind).(CAACH,23;WHO1,73,74;PPP,317)Maycausenauseaandrefluxinsensitivepatients.(PPP,317)

Theuseofalcohol,sedativesandothercentralnervoussystemdepressants,inconjunctionwiththisherb,maycausesynergisticsedativeeffects.(WHO1,73)

Fringe�TreeChionanthus virginicusstembark

1 Theherbisclassifiedasacholereticandcholagogue.Itiseithercontraindicatedoratleastinappropriateinthefollowing:(1)obstructedbileducts,(2)unconjugatedhyperbilirubinemia,(3)acuteorseverehepatocellulardisease,(4)septiccholecystitis(wherethereisriskofperitonitis),(5)intestinalspasmorileus,and(6)livercancer.(PPP,187)










38



Nevaton®Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional. Do not use this product while taking any prescription drug(s) without the advice of your prescribing physician. Avoid excessive exposure to UV irradiation (e.g. sunlight, tanning) when using this product.





DamianaTurnera diffusaleaf

1 Possiblecontraindicationinpatientswithextremelydebilitatedconstitutions.(PPP,234)

Noneknown.(TGHM,326;CGBLH,171)

SkullcapScutellaria laterifloraherb

1 Maybecontraindicatedindepressionandinsomniamarkedbyincreasingrestlessnessduringtheearlyhoursofthemorning.(PPP,233)Highdosesmaycausegiddiness,stupor,confusion,twitching,arrhythmias,andepilepsy.(TCPHP,218)Reportsoftoxicityarelikelyduetoadulterationwithgermander.(BSH,105)


St�John’s�WortHypericum perforatumherbfloweringtop

2d Contraindicatedinthetreatmentofseriousdepressionwithpsychoticsymptoms,suicidalriskorsignsandsymptomsthataresoseverethattheydonotallowthepatient’sfamilyorworkinvolvementstocontinue.(PPP,549;ESCOPM,259)Nottobetakenafterorgantransplants.(ESCOPM,258)ContraindicatedinknownphotosensitivityandknownallergytoplantsoftheClusiaceaefamily.(WHO2,163;CGBLH,420)Maycausemildstomachdiscomfort,skinrash,tiredness,fatigue,headache,sleepdisturbances.Photosensitizationispossibleafterexposuretosunlightandespeciallyinfairskinnedindividuals.(BSH,62;TGHM,215;HM,363;PPP,548;ESCOPM,259;WHO2,163)PatientstakinghigherdosesshouldavoidexcessiveexposuretosunlightandUVradiation.(CGBLH,420)Cautionadvisedinveryseveredebility,especiallyifassociatedwithimmuneordigestivecollapse,renalorhepaticfailure,rampantcancerorstrongregimesofchemotherapy.(PPP,155)Dermatologicandneurologicconcernbaseduponcasereports.(TCPHP,301)Sideeffectsarerareandmild,andincludeminorgastrointestinalirritations,allergicreactions,tirednessandrestlessness.(WHO2,165)Mild,reversibleelevationsofserumliverenzymesnotedinHIV-positivepatients.Maniahasbeennotedasasideeffectbuthasnotbeenconclusivelylinkedtouseoftheherb.Avoiduseofpreparationsmadefromherbharvestedattheonsetoffullflowering,andavoiddispensingthesedimentfromliquidextracts–theresinouscompoundscontainedthereinmaycausesensorynervehypersensitivity.(CGBLH,422)

Noneknown.(TGHM,215;HM,363)MaypotentiatepharmaceuticalMAO-inhibitors.(BSH,62,173)RecommendphysicianconsultationwhentakenwithMAOinhibitors,SSRIs,andtricyclics(PPP,549)Reducedbloodlevelshavebeenreportedwithrespecttocyclosporin,indinavirandpotentiallyotherantiretroviralproteaseandtranscriptaseinhibitors,theanticoagulantsphenprocoumonandwarfarin,theophyllineanddigoxin.ItremainsanopenquestionwhetherStJohn’swortpreparationsalsointeractwithoralcontraceptives,particularlylowdosecontraceptives(<50mcgofestrogen).(ESCOPM,259)Contraindicatedinpatientstakingirinotecan.Noclinicaladverseeffectshavebeenreportedforphenytoinoranyotheranticonvulsantdrug.(CGBLH,421)

Refer to the MediHerb Herb-Drug Interactions chart (under St John’s Wort and Tannin- or OPC-containing herbs).









39



ProstaCoNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional. The National Institute on Aging recommends that men get regular medical checkups with a thorough prostate exam.

Nettle�RootUrtica dioicaroot

Noinformation. ContraindicatedinknownallergytoplantsoftheUrticaceaefamily.(WHO2,337)CommissionEadvisesthatnettlerootisusefulfortheproblemsassociatedwithanenlargedprostate.However,theyadvisethatitsuseforBPHshouldoccurunderprofessionalsupervision.(PPP,496)Difficultiesinmicturitionrequireatalltimesclarificationbyaphysician;consultationwithaphysicianisnecessaryespeciallyincasesbloodintheurineandacuteurineretention.(ESCOPM,529)Maycausemildgastrointestinaltroubleandallergicskinreactions(rarely).(PPP,496;TGHM,216;ESCOPM,529;WHO2,338)

Noneknown.(TGHM,217;ESCOPM,529)

Saw�PalmettoSerenoa repensfruit

1 Stomachproblemsorgastrointestinaldistressinrarecases.(HM,338;TGHM,201;BSH,107;ESCOPM,478)CommissionEsuggestsregularconsultationwithaphysicianwhenusingthisherbfortreatmentofenlargedprostate.Thiscautionisbasedonassumptionthatthisherbtreatsonlysymptomswithouteliminatinghypertrophicconcerns.(BSH,107)Noadverseeffectsareexpectedifusedasrecommended.(PPP,524)

Noneknown.(HM,338;TGHM,201;PPP,530;ESCOPM,478;CGBLH,400)

CrataevaCrataeva nurvalastembark


PulmaCoContraindicated in pregnancy and lactation.




Malabar�Nut�TreeAdhatoda vasicaleaf

Noinformation. Contraindicatedinpregnancyexceptatbirth.Unlikelythatabortifacientdosescanbeachievedbyoraluseoftheherb,butitisbesttobecautious.(CAACH,93)

Noinformation.

GrindeliaGrindelia camporumherb

Noinformation. Highdosescanproducekidneyandstomachirritation.(BSH,59)















40







FennelFoeniculum vulgareseedessentialoil

Noinformation. Inrarecases,allergicreactionsaffectingskinandrespiratorysystem.(HM,126;TGHM,128)Avoidinthosewithsensitivitytoanethole.Preparationscontainingtheessentialoilshouldnotbeusedduringpregnancyandlactation.(ESCOPM,163)Highdoses(greaterthan0.1–0.6mL/day)arecontraindicatedinpregnancy,infantsandtoddlers.(TGHM,128)Veryhighdosesshouldbeavoidedinhepaticdisorders.(Normalrecommendeddailydosage:5–20drops.)(PPP,382)Shouldnotbetakenatanoraldailydoseof0.5mLorabove.(EOS,113-114,136)

Interactionbetweenfenneloilanddrugsinhumansisnotknown.(TGHM,128;HM,126;PPP,382;AEDH1,138)

Rehmannia�ComplexContraindicated in individuals with a known hypersensitivity to Feverfew, parthenolide or other members of the daisy family. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.


1 Contraindicatedindeficient yincough,orliver fireascendingtothehead,suchassomecasesofheadacheandhypertension.(CGBLH,116)Bupleurumhasaslightsedativeeffectinsomepatientsandmayalsoincreasebowelmovementsandflatulence(wind).(CAACH,23;WHO1,73,74;PPP,317)Maycausenauseaandrefluxinsensitivepatients.(PPP,317)


RehmanniaRehmannia glutinosaroot

2d Contraindicatedwithdiarrheaandindigestion.(BSH,95)Sideeffectsmayincludemilddiarrhea,abdominalpain,dizziness,lackofenergy,palpitationsandedema.(BSH,95;PPP,521)


HemidesmusHemidesmus indicusroot

4 Althoughmildlyimmunosuppressant,therearenoreportedsideeffects.(CAACH,118)




Noneknown.(ESCOPM,493;PPP,391;CGBLH,219)In vitrostudiessuggestthatfeverfewmayinhibitplateletaggregation(TCPHP,102),however,resultsfromclinicaltrialssuggestthatnormalclottingmechanismsremainintact.(PPP,387)









41



ResCo®Contraindicated in high blood pressure, edema (water retention), congestive heart failure, low blood potassium, pregnancy and lactation.

Licorice�Glycyrrhiza glabraroot




MulleinVerbascum thapsusleaf

1 Noneknown.(CGBLH,333) Noneknown.(HM,271;TGHM,173;CGBLH,333)

EuphorbiaEuphorbia hirtaherb

2d Largedosesmaycausenauseaandvomiting,anditmayoccasionallycauseepigastricdistresswithnausea.(CGBLH,199)


















42



FennelFoeniculum vulgarefruitessentialoil



ThymeThymus vulgarisleafessentialoil

Noinformation. Noneknownforanoraldailydoseof0.5mLorabove.(EOS,113-114,176)Substantialdosesshouldbeavoidedinpregnancy.(BSH,116)

Noinformation.

ResCo�Phytosynergist®Contraindicated in high blood pressure, edema (water retention), congestive heart failure, low blood potassium, pregnancy and lactation. Contraindicated in known allergy to Elecampane.

MulleinVerbascum thapsusleaf

1 Noneknown.(CGBLH,333) Noneknown.(HM,271;TGHM,173;CGBLH,333)





ElecampaneInula heleniumroot

2b,2c Occasionalallergicreactionsmayoccur.(BHC,87)Largedosescausesvomiting,diarrhea,cramps,spasms,andsymptomsofparalysis.(BSH,64;TGHM,329)RegulatedintheU.S.asanallowableflavoringagentinalcoholicbeveragesonly.(BSH,64)CautionisadvisedinknownsensitivitytoelecampaneortoothermembersoftheCompositaefamily.(CGBLH,193)











43



EuphorbiaEuphorbia hirtaherb

2d Largedosesmaycausenauseaandvomiting,anditmayoccasionallycauseepigastricdistresswithnausea.(CGBLH,199)









FennelFoeniculum vulgarefruitessentialoil



Rhodiola�&�GinsengNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional. Discontinue during an acute infection or fever.

RhodiolaRhodiola rosearoot


Korean�GinsengPanax ginseng root

2d Contraindicatedforhypertension.(BSH,81;HM,174;CGBLH,297)Contraindicatedwithsignsofheat,acuteinfections,acuteasthma,hypertension,excessivemenstruationornosebleeds.(PPP,429;CAACH,41)Consumingcaffeinewithginsengincreasestheriskofoverstimulationandgastrointestinalupset.(BSH,81;BHC,116)Concurrentusewithamphetaminesshouldbeavoided.(CGBLH,297)Higherdosescanoverstimulateandaggravateinsomnia,irritability,depression,headache,palpitation,hypertension,andcancausetremor,euphoria,skineruptions,menstrualabnormalities,diminishedsexualfunctionandweightloss.(BSH,81;CAACH,40)Theuseofginsengisnotassociatedwithseriousadverseeffectsiftakenattherecommendeddoselevel.(ESCOPM,212)Maycausesideeffectsrelatedtoanestrogen-likeactivityinwomen.(CGBLH,298)Mayreducebloodglucoselevels,diabeticpatientsshouldconsultwithphysician.(WHO1,176;ESCOPM,212)

Mayinteractwithmonoamineoxidaseinhibitorphenelzineandalsowithwarfarin,(PPP,429;WHO1,176)althoughstudiesareneededtoverifythepotentialinteractionwithwarfarinandtheunderlyingmechanism.(ESCOPM,212)Donotusewithstimulants,includingexcessiveuseofcaffeine.(HM,174;PPP,429)










44



SaligesicContraindicated in known allergy or sensitivity to salicylates. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

Willow�BarkSalix purpureastembark

1 Norelevantinformationfoundinreferencetexts.[Editor'snote:However,usewithcautionduringlactationassalicylatesexcretedinbreastmilkmaycauserashesinbabies.(HealthcareprofessionalsshouldbeawareofthepossibilityofReye'ssyndrome,anacutesepsis-likeillnessencounteredexclusivelyinchildrenbelow15yearsofage.Thecauseisunknown,althoughviralagentsanddrugs,especiallysalicylates,havebeenimplicated.)]

Noneknown.(ESCOPM,446)Interactionslikethoseencounteredwithsalicylatesmayarise,however,thereisnodefiniteevidenceforthistodate.(HM,410;TGHM,230)

Refer to the MediHerb Herb-Drug Interactions chart (under Willow Bark and Tannin- or OPC-containing herbs).

SilymarinNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional. In anemia and cases where iron supplementation is required, do not take simultaneously with meals or iron supplements.













45



St�John's�Wort�1.8gNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional. Do not use this product while taking any prescription drug(s) without the advice of your prescribing physician. Avoid excessive exposure to UV irradiation (e.g. sunlight, tanning) when using this product.

St�John's�WortHypericum perforatumherbfloweringtop












46



Thyroid�ComplexContraindicated in pregnancy and lactation. Contraindicated in hyperthyroidism and related cardiac problems.

BladderwrackFucus vesiculosuswholeplant

2b,2c,2d Contraindicatedinhyperthyroidism,cardiacproblemsassociatedwithhyperthyroidism,pregnancyandlactation.(BHC,38;CGBLH,103)Long-termtherapeuticuseisnotrecommended.(BSH,54)Kelp(speciesundefined)hascausedtransienthyperthyroidism,raisedlevelsofthyroidstimulatinghormone,andinlargedoses(asafood–probablynotbladderwrack)hascausedsubclinicalhypothyroidism,Hashimoto'sthyroiditisandrareextrathyroidaleffectsinsusceptibleindividuals.(CGBLH,103)Inrarecasesallergicreactionsinvolvingseriousoverallreactionsmayoccur.(TGHM,315)Marineorganisms,includingbladderwrack,naturallyaccumulatearsenic.However,thisismainlyorganicallyboundandrapidlyexcreted.ForthisreasontheWorldHealthOrganizationhasestablishedatolerableweeklyintakeonlyforinorganicarsenicwhichispresentinbladderwrackatconsiderablylowerlevels.(AEHD1,42)However,isolatedcasesofadverseeffectshavebeenattributedtoarsenicintakefromvariousseaweeds.(AEHD1,42)

Noneknown.(HM,213)Mayinteractwiththyroidreplacementtherapies(thyroxine).(CGBLH,103)Cautionindicatediftakingiodine-containingdrugs.(AEHD3,44)


Withania�(Ashwaganda)Withania somniferaroot






TribulusNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

TribulusTribulus terrestrisherb(aerialparts)

Noinformation. Duetothepresenceofsaponins,thisherbmaybeagastrointestinalirritant.(PPP,46)

ThisherbmayincreaseFSHinwomen,whichinturnincreaseslevelsofestrogen.(PPP,46)









47



UriCo�Phytosynergist®Contraindicated in known allergy to plants of the daisy family. Contraindicated in high blood pressure, edema (water retention), congestive heart failure, low blood potassium, pregnancy and lactation. Not to be taken long-term.

Couch�GrassAgropyron repensrhizome

Noinformation. Copiousfluidintakeandherbaltreatmentisinadvisableifedemaduetocardiacorrenalinsufficiencyispresent.(TGHM,118)Theuseofthisdiureticmaybeinappropriateandpossiblyevencontraindicatedinrenalfailureanddiabetes.(PPP,222)










BuchuBarosma betulinaleaf

2b,2d Occasionalgastrointestinalintoleranceandirritationonemptystomach.(PPP,311;BHC,44)Contraindicatedinkidneyinflammation.(BSH,19)

Noneknown.(PPP,311;BSH,19;TGHM,317;CGBLH,111)









48



Valerian�ComplexNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

ValerianValeriana officinalisroot&rhizome

1 Canaggravateasensationoftirednessordrowsiness,particularlyinhigherdoses.(PPP,587;WHO1,273)Overdosecanresultinblurredvision,erraticheartbeat,headache,nausea,restlessness,visualillusions,evenspasmodicmovements.(PPP,588;BSH,120)Verylargedosesmaycausebradycardiaandarrhythmias,anddecreaseintestinalmotility.(WHO1,274)Canadaallowsproductscontainingvalerianforuseassleepingaidsandsedatives.(TCPHP,64)Hepaticandneurologicconcernbaseduponcasereports,althoughinthecaseofallegedhepatotoxicitycoingestantswereinvolved.(TCPHP,301)

Noneknown.(TGHM,226;ESCOPM,540;HM,397)MayincreasetheeffectsofCNSdepressantsoralcoholwhentakentogether,(PPP,587;AEHD3,172;WHO1,273)althoughhumanstudiesindicatethatthisisunlikelyforalcohol.(CGBLH,447)Theherbmaybeexpectedtohaveatleastanadditiveeffectwithbarbiturates,alcohol,benzodiazepines,andotherCNSdepressants.(TCPHP,64)


Passion�FlowerPassiflora incarnataherb

1 Hypersensitivityispossibleinveryrarecases.Maycausedrowsiness.Onecaseofnausea,bradycardiaandventriculararrhythmiahasbeenreported.(ESCOPM,4)Herbalsedativessuchaspassionflowerarealsocontraindicatedinpatientswithdepressionandinsomniamarkedbyincreasingrestlessnessduringtheearlyhoursofthemorning.(PPP,233)


Spiny�JujubeZizyphus spinosaseed

2b Basedonanimalexperiments,theherbhasanticonvulsantandhypotensiveproperties;sedativeeffectshavebeenobserved.(CAACH,88)Notedasuterinestimulant.(BSH,125)

Zizyphushassynergisticeffectswithmanysedativesandhypnotics.(CAACH,88)









49



Vitanox®Contraindicated in pregnancy. Contraindicated during lactation unless otherwise directed by a qualified health care professional. Contraindicated in closure of the gallbladder. Use only with professional supervision in gallstones. In anemia and cases where iron supplementation, do not take simultaneously with meals or iron supplements.

RosemaryRosmarinus officinalisleaf

2b Contraindications:pregnancy(PPP,100)andhypersensitivitytorosemaryleafandrosemarypreparations,especiallythosecontainingcarnosol.(ESCOPM,430)Cautionmaybewarrantedinwomenwishingtoconceive.(CGBLH,389)

Noneknown.(HM,327;TGHM,197;ESCOPM,430)Avoidconcomitantadministrationofrosemaryduringironintake.Inanemiaandcasesforwhichironsupplementationisrequired,rosemaryshouldnotbetakensimultaneouslywithmealsorironsupplements.(CGBLH,389)


Green�TeaCamellia sinensisleaf

Classnotdefinedforgreentea.

Usecautiouslyinpatientswithhighlyinflamed,ulceratedordamagedgastrointestinaltissue.(PPP,37)

Tannin-containingherbsmayreducetheabsorptionofpharmacologicalsubstancese.g.metalions(ironsupplements)andthiamine.Avoidconcurrentconsumption.(PPP,37,103)

Refer to the MediHerb Herb-Drug Interactions chart (under Polyphenolic- or Flavonoid-containing herbs and Tannin- or OPC-containing herbs).





Grape�SeedVitis viniferaseed











50



Wild�Yam�ComplexContraindicated in pregnancy. Contraindicated during lactation unless otherwise directed by a qualified health care professional. Discontinue during an acute infection or fever. Do not use this product while taking any prescription drug(s) without the advice of your prescribing physician. Avoid excessive exposure to UV irradiation (e.g. sunlight, tanning) when using this product.




ShatavariAsparagus racemosusroot


St�John's�WortHypericum perforatum herbfloweringtop













51







Black�CohoshCimicifuga racemosaroot

2b,2c Contraindicatedinpregnancy(exceptduringthelastmonthtoassistwithbirth),lactationandinwomenwithestrogen-dependenttumorssuchasbreastcancer.(PPP,307;CGBLH,96)Occasionalgastrointestinaldiscomfortmayoccurandlargedosesmaycausevertigo,headache,nausea,impairedvision,vomiting,andimpairedcirculation.Anestrogeniceffectandloweringofbloodpressurehavebeenrecorded.(BSH,29-30;BHC,35;HM,25;PPP,307-308;ESCOPM,80;CGBLH,96)Canadianregulationsdonotallowtheherbasanon-medicinalingredientfororaluseproducts.(BSH,30)

Noneknown.(TGHM,90;HM,25;PPP,307;ESCOPM,80)Blackcohoshdemonstratedanantiproliferativeeffectin vitrowhencombinedwithtamoxifen.Whetherthisfavorableinteractionalsoappliesin vivohasnotbeenestablished.(CGBLH,96)

Korean�GinsengPanax ginsengroot












52



Withania�ComplexContraindicated in high blood pressure, edema (water retention), congestive heart failure, low blood potassium, pregnancy and lactation. Discontinue during an acute infection or fever.








Withania�(Ashwaganda)Withania somniferaroot












53



Korean�GinsengPanax ginsengroot




Wormwood�ComplexContraindicated in pregnancy and lactation.

StemonaStemona sessilifoliaroot


Black�WalnutJuglans nigragreenhulls

2d Prolongeduseisnotadvisedduetothepresenceofsignificantquantitiesofjuglone,aknownmutageninanimals.CarcinogeniceffectsassociatedwiththechronicexternaluseofJuglans regiahavebeenobserved,butareinconclusiveinregardtoJuglans nigra.(BSH,65;TGHM,381)

Noneknown.(TGHM,227;HM,402)

WormwoodArtemisia absinthiumherb

2b,2c,2d Contraindications:gastricandduodenalulcers,pregnancy,lactation,hyperacidity,knownsensitivitytowormwoodorothermembersoftheCompositaefamily.(ESCOPM,4;CGBLH,469)Thetoxicologicalriskfromuseofconventionalwormwoodpreparationsisconsideredtobeverylow.(ESCOPM,4)Therecommendeddosagerangemustnotbeexceeded.(CGBLH,469)Asabitter,thisherbiscontraindicatedoratleastinappropriateinduodenalulcerationandconditionsinvolvingdrycoughandsomekidneydiseases.(PPP,173)Wormwoodcontainsapproximately1.5–1.7%essentialoilwhichcontainsaneurotoxincalledthujone.Intoxicdoses,thujoneactsasaconvulsantpoison.Therefore,thepureessentialoilmustnotbeused.(TGHM,233;BSH,158)Regulatoryrestrictionsrequirefinishedfoodproductstobethujone-freeintheU.S.andothercountries.(BSH,15)Toxicologicalconcernnotindicated,exceptinlongtermuse.(BSH,15)

Noneknown.(BSH,15;TGHM,233;ESCOPM,4;CGBLH,469)

CloveSyzygium aromaticumbudessentialoil

Noinformation. Oilofclovemaybeirritatingtomucosaltissues.(TGHM,112)Atanoraldailydoseof0.5mLorabove:usewithcautioninalcoholism,hemophilia,kidneydisease,liverdisease,prostatecancer,systemiclupuserythematosus.(EOS,113-114,131)

Atanoraldailydoseof0.5mLorabove:usewithcautioninthosetakinganticoagulantsoracetominophen.(EOS,113-114,131)









54

Liquid Extracts


Albizia�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

Albizia�Albizia lebbekbark

Noinformation. Noneknown.(CAACH,94)Sincetheherbcontainssaponins,itmaybeagastrointestinalirritant.Itmayalsobecontraindicatedoratleastinappropriateintopicalapplicationtoopenwounds,patientswithceliacdisease,andsomeupperdigestiveirritations.(PPP,46,170)

Noneknown.(CAACH,95;CGBLH,59)

Ashwaganda�1:1�StandardizedNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

AshwagandaWithania somniferaroot



Astragalus�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional. Discontinue during an acute infection or fever.

AstragalusAstragalus membranaceusroot

1 Contraindications:notadvisableinacuteinfections.(PPP,277;CAACH,19;CGBLH,77)

Noneknown.(PPP,277;WHO1,56;BSH,17;CGBLH,77)

Bacopa�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.




Bilberry�1:1Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

BilberryVaccinium myrtillusfruit

1 Veryhighdosesshouldbeusedcautiouslyinpatientswithhemorrhagicdisordersandinthosetakingwarfarinorantiplateletdrugs.(PPP,301)Mildsideeffectsaffectingthegastrointestinal,cutaneousandnervoussystemsobservedinasmallpercentageofpatients.(CGBLH,93)

Noneknown.(HM,18;TGHM,88;ESCOPM,346)Possibleinteractionwithwarfarinandantiplateletdrugsinveryhighdoses.(PPP,301)


Black�Cohosh�1:2�Quantified ActivityContraindicated in pregnancy, lactation, and in women with estrogen-dependent tumors such as breast cancer. Caution in patients with liver problems, who frequently use alcohol or take any medications.

Black�CohoshCimicifuga racemosaroot

2b,2c Contraindicatedinpregnancy(exceptduringthelastmonthtoassistwithbirth),lactationandinwomenwithestrogen-dependenttumorssuchasbreastcancer.(PPP,307;CGBLH,96)Occasionalgastrointestinaldiscomfortmayoccurandlargedosesmaycausevertigo,headache,nausea,impairedvision,vomiting,andimpairedcirculation.Anestrogeniceffectandloweringofbloodpressurehavebeenrecorded.(BSH,29-30;BHC,35;HM,25;PPP,307-308;ESCOPM,80;CGBLH,96)Canadianregulationsdonotallowtheherbasanon-medicinalingredientfororaluseproducts.(BSH,30)

Noneknown.(TGHM,90;HM,25;PPP,307;ESCOPM,80)Blackcohoshdemonstratedanantiproliferativeeffectin vitrowhencombinedwithtamoxifen.Whetherthisfavorableinteractionalsoappliesin vivohasnotbeenestablished.(CGBLH,96)









55

Liquid Extracts


Black�Walnut�Hulls�1:10Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

Black�WalnutJuglans nigrahulls

2d Prolongeduseisnotadvisedduetothepresenceofsignificantquantitiesofjuglone,aknownmutageninanimals.CarcinogeniceffectsassociatedwiththechronicexternaluseofJuglans regiahavebeenobserved,butareinconclusiveinregardtoJuglans nigra.(BSH,65;TGHM,381)

Noneknown.(TGHM,227;HM,402)

Bladderwrack�1:1Contraindicated in pregnancy and lactation. Contraindicated in hyperthyroidism and cardiac problems.

BladderwrackFucus vesiculosusherb

2b,2c,2d Contraindicatedinhyperthyroidism,cardiacproblemsassociatedwithhyperthyroidism,pregnancyandlactation.(BHC,38;CGBLH,103)Long-termtherapeuticuseisnotrecommended.(BSH,54)Kelp(speciesundefined)hascausedtransienthyperthyroidism,raisedlevelsofthyroidstimulatinghormone,andinlargedoses(asafood–probablynotbladderwrack)hascausedsubclinicalhypothyroidism,Hashimoto’sthyroiditisandrareextrathyroidaleffectsinsusceptibleindividuals.(CGBLH,103)Inrarecasesallergicreactionsinvolvingseriousoverallreactionsmayoccur.(TGHM,315)Marineorganisms,includingbladderwrack,naturallyaccumulatearsenic.However,thisismainlyorganicallyboundandrapidlyexcreted.ForthisreasontheWorldHealthOrganizationhasestablishedatolerableweeklyintakeonlyforinorganicarsenicwhichispresentinbladderwrackatconsiderablylowerlevels.(AEHD1,42)However,isolatedcasesofadverseeffectshavebeenattributedtoarsenicintakefromvariousseaweeds.(AEHD1,42)

Noneknown.(HM,213)Mayinteractwiththyroidreplacementtherapies(thyroxine).(CGBLH,103)Cautionindicatediftakingiodine-containingdrugs.(AEHD3,44)


Bugleweed�1:2Contraindicated in pregnancy and lactation. Contraindicated in hypothyroidism and enlargement of the thyroid without functional disorder.

BugleweedLycopusspp.herb

2b,2c,2d Contraindicatedinthyroidhypofunction,enlargementofthethyroidwithoutfunctionaldisorders,(TGHM,99;BSH,72)pregnancyandlactation.(AEHD2,248;CGBLH,113)Adversereactionsoccurringoccasionallyincludeundesiredthyroidaleffects(includingenlargedthyroid)andheadache.(AEHD2,248)

Noneknown.(TGHM,99)Donottakewiththyroidmedications.(BSH,72;TGHM,99)Administrationoftheherbinterfereswithdiagnosticproceduresusingradioactiveisotopes.(TGHM,99;AEHD2,248;CGBLH,113)


Bupleurum�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.


1 Contraindicatedindeficientyin cough,orliver fireascendingtothehead,suchassomecasesofheadacheandhypertension.(CGBLH,116)Bupleurumhasaslightsedativeeffectinsomepatientsandmayalsoincreasebowelmovementsandflatulence(wind).(CAACH,23;WHO1,73,74;PPP,317)Maycausenauseaandrefluxinsensitivepatients.(PPP,317)










56

Liquid Extracts


Burdock�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.



Calendula�1:2Contraindicated in known allergy to plants of the daisy family. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

CalendulaCalendula officinalisflower

Noinformation. Inappropriatewhenthereisalreadyprescriptionofstronganti-inflammatorymedication,(PPP,148)andforthosewithknownsensitivitytomembersoftheCompositaefamily.(ESCOPM,59;WHO2,41;CGBLH,120)Weakskinsensitizationandacaseofanaphylacticshockhasbeenreportedfromtopicaluse(agargle).(CGBLH,120)

Noneknown.(HM,45;ESCOPM,59;TGHM,100,319;CGBLH,120)

Californian�Poppy�1:2Contraindicated in pregnancy and lactation.

Californian�PoppyEschscholtzia californicaherb

2b,2d Thisherbshouldberestrictedinitsapplicationtoexperiencedandwell-trainedpractitioners.(PPP,232)Thereisatheoreticallyincreasedriskofneurotoxicityandotheradverseeffects(althoughnoknownincidence).(PPP,233)Thefollowingcasesshouldbeapproachedwithcaution:(1)concurrentprescriptionofpowerfulanalgesics,(2)paininchildren,(3)neurologicaldisease,(4)depressionandpsychosis,(5)liverandkidneydisease,and(6)historyofallergicoranaphylacticreactions.(PPP,232)

Noneknown.(CGBLH,124)MaypotentiatepharmaceuticalMAO-inhibitors.(BSH,49)

Cat’s�Claw�1:2�Quantified ActivityContraindicated in pregnancy and lactation.

Cat’s�ClawUncaria tomentosainnerbark

4 Contraindicatedinpatientsundergoingskingraftsandorgantransplants;hemophiliacsprescribedfreshbloodplasma;simultaneousadministrationofcertainvaccines,hormonetherapies,thymusextracts,andinsulinandchildrenunderthreeyearsofage.(BSH,119)Usewithcautioninpregnancyandlactation.Diarrheaandindigestionhavebeenreportedinseveralpatients.(CGBLH,131)


Celery�Seed�1:2�Quantified ActivityContraindicated in kidney disorders. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

Celery�SeedApium graveolensfruit

2b,2d Apium graveolenscancauserareallergicreactions,evenendinginanaphylacticshock(‘celery-carrot-mugwort’allergicreaction).(TGHM,320;BHC,57)Cancontainphototoxicfuranocoumarins.(TGHM,320)TheBHCrecommendsthatceleryiscontraindicatedinkidneydisordersandpregnancy,(BHC,57)althoughnoevidencehasbeenfoundforthecontraindicationinpregnancy.(CGBLH,134)Asadiuretic,inappropriateandpossiblycontraindicatedinrenalfailureanddiabetes.(PPP,222;BSH,11)











57

Liquid Extracts


Chamomile�High�Grade�1:2�Quantified ActivityContraindicated in known allergy to plants of the daisy family. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.





Chaste�Tree�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

Chaste�TreeVitex agnus-castusfruit

2b,2d Contraindicatedinconjunctionwithprogesteronedrugs,thecontraceptivepill,orHRT.(PPP,332;BSH,123;ESCOPM,9)TheherbmayaggravatepurespasmodicdysmenorrheanotassociatedwithPMS.(PPP,332)Rareoccurrencesofitching,urticariaandheadachehavebeenreported.(PPP,333;BSH,123;HM,63;TGHM,108;ESCOPM,9;CGBLH,142)Shouldbeusedcautiouslyduringpregnancyandonlyintheearlystagesfortreatinginsufficientcorpuslutealfunction.(CGBLH,142)

Mayinteractantagonisticallywithdopaminereceptorantagonists,progesteronedrugs,contraceptivepillorHRT.(PPP,332;HM,63;TGHM,108;CGBLH,142)

Chinese�Skullcap�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.




Cinnamon�Quills�1:2Contraindicated in pregnancy and lactation. Contraindicated in known allergy to cinnamon and Peruvian balsam.

CinnamonCinnamomum cassiastembark

2b,2d Asanaromatic,theherbmaybecontraindicatedorinappropriateingastroesophagealreflux.(PPP,171,211)Allergicreactionsoftheskinandmucosahavebeenreported.(WHO1,102;HM,66;TGHM,110;BSH,31)Theherbiscontraindicatedinpregnancy,casesofstomachorduodenalulcers,andinpatientswithanallergytocinnamon,cinnamonbarkoil,cinnamaldehydeorPeruvianbalsam.(WHO1,101;HM,66;TGHM,110;ESCOPM,93)Cinnamondoesnotpresentanyspecialriskinpregnancy,butprolongeduseoftheessentialoilshouldberestrictedduringpregnancy.(AEHD1,111)


Cleavers�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

CleaversGalium aparineherb

1 Thisherbmaybeprovocativetoskindisease,andcareneedstobetakentoreducetheprospectsformajorexacerbations.(PPP,254)










58

Liquid Extracts


Coleus�1:1�Quantified ActivityContraindicated in hypotension. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

ColeusColeus forskohliiroot

Noinformation. Contraindicatedinhypotension.(CAACH,106)Usecautiouslyinpepticulcer.(CGBLH,156)

Forskolinhastheabilitytopotentiatemanydrugs.Usecautiouslyinpatientstakingprescribedmedication,especiallyhypotensiveandantiplateletdrugs.(CAACH,106;CGBLH,156)


Corn�Silk�1:1Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

Corn�SilkZea maysstyles&stigma

1 Maybeinappropriateandpossiblyevencontraindicatedwithrenalfailureanddiabetes.(PPP,222)RegulatedintheU.S.asanallowableingredientincertainlistedfoods.(BSH,125)


Cramp�Bark�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

Cramp�BarkViburnum opulusbark

Noinformation. Nauseaandvomitingmayoccurwithlargedoses.(CGBLH,100)Canadianregulationsdonotallowcrampbarkasanon-medicinalingredientfororaluseproducts.(BSH,122)


Damiana�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

DamianaTurnera diffusaleaf

1 Possiblecontraindicationinpatientswithextremelydebilitatedconstitutions.(PPP,234)


Dandelion�Leaves�1:1Contraindicated in closure of the gallbladder. Use only with professional supervision in gallstones. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

Dandelion�Taraxacum officinaleleaf

2d Contraindicatedwithocclusionofthebileducts,gallbladderempyema(includingcholecystitis),andobstructiveileus.(ESCOPM,499-500;BSH,114;HM,80;TGHM,120;CGBLH,173)Duetothebittersubstanceswithinthisherb,itmayalsocausegastrichyperacidityandincreasedulcerpain.(TGHM,120;BSH,114)Contactallergiescausedbysesquiterpenelactonesinthelatexhavebeenrarelyobserved.(HM,80;TGHM,119)


Dandelion�Root�1:2Contraindicated in closure of the gallbladder. Use only with professional supervision in gallstones. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

Dandelion�Taraxacum officinaleroot











59

Liquid Extracts


Dong�Quai�1:2Contraindicated in the first trimester of pregnancy, especially in higher doses. Do not use in severe menorrhagia. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

Dong�Quai�Angelica polymorpha(Angelica sinensis)root




Echinacea�Premium�Blend�1:2�Quantified ActivityContraindicated in known allergy to plants of the daisy family. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.





Echinacea�Echinacea angustifoliaroot












60

Liquid Extracts


Echinacea�Purpurea�1:2�Quantified ActivityContraindicated in known allergy to plants of the daisy family. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.





Echinacea�Purpurea�1:3�GlycetractContraindicated in known allergy to plants of the daisy family. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.





Eleuthero�1:2�StandardizedNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional. Discontinue during an acute infection or fever.













61

Liquid Extracts


Eyebright�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

EyebrightEuphrasia officinalisherb

1 Nocontraindicationsnoted.(PPP,376;CGBLH,203) Noneknown.(TGHM,330;PPP,376;CGBLH,202)

Garlic�1:1Contraindicated in known allergy to Garlic. Contraindicated in lactation. Not to be used during pregnancy unless otherwise directed by a qualified health care professional.





Ginger�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.





Ginkgo�2:1�StandardizedNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.













62

Liquid Extracts


Globe�Artichoke�1:2Contraindicated in closure of the gallbladder. Use only with professional supervision in gallstones. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

Globe�ArtichokeCynara scolymusleaf

Noinformation. Contraindicatedinclosureofthegallbladder(PPP,437)orobstructionofbileduct.(ESCOPM,119).Precautionswithknownallergiestoartichokeandsimilarplants(Compositaefamily).Thelikelihoodofallergyisverylow,nocasesofallergyreactionafteroralintakehavebeenreported.(TGHM,84;HM,11;ESCOPM,119;CGBLH,240)Useonlywithprofessionalsupervisionincholelithiasis.(PPP,437;HM,11;ESCOPM,119)AswithothermembersoftheCompositaefamily,contactwithfreshplantcancausecontactdermatitis.(PPP,438)Mildgastrointestinaldisturbancesmayoccurinrarecases;allergicreactionsmightoccurinsensitizedpatients.(ESCOPM,119)

Noneknown.(PPP,437;TGHM,85;HM,11;ESCOPM,119;CGBLH,240)

Golden�Seal�1:3�Quantified ActivityContraindicated in pregnancy and lactation. Contraindicated in patients with high blood pressure.




Gotu�Kola�1:1�StandardizedContraindicated in known allergy to Gotu Kola. Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

Gotu�KolaCentella asiaticaherb

1 Canadianregulationsdonotallowtheherbasanon-medicinalingredientfororaluseproducts.(BSH,26)Allergiccontactdermatitishasbeenassociatedwithtopicalapplication,butitisalowrisk.Furthertestingrevealedthatthesereactionsmaybeduetootheringredientsinthepreparations.(WHO1,83;CGBLH,255)ContraindicatedinknownallergyandallergytoplantsoftheUmbelliferae(carrot)family.(WHO1,82;CGBLH,254)

Noneknown.(WHO1,83;CGBLH,254)

Gymnema�1:1Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

GymnemaGymnema sylvestreleaf

Noinformation. Sinceitcontainssaponins,thisherbmaybeagastrointestinalirritant.(PPP,46)

Noneknown.(CGBLH,267)[Editor’snote:Particularcareshouldbeexercisedwherethepatientistakinginsulinororalhypoglycemicdrugs.]

Refer to the MediHerb Herb-Drug Interactions chart (under Hypoglycemic herbs).









63

Liquid Extracts


Hawthorn�Berries�1:2�Quantified ActivityNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

HawthornCrataegus monogynafruit

1 Aphysicianmustbeconsultedincaseswheresymptomscontinueunchangedforlongerthansixweeksorwhenfluidaccumulatesinthelegs.Medicaldiagnosisisabsolutelynecessarywhenpainsoccurintheregionoftheheart,spreadingouttothearms,upperabdomenortheareaaroundtheneck,orincasesofrespiratorydistress(shortnessofbreath).(TGHM,143;ESCOPM,99;WHO2,77)In1997,itwasnotedthatinCanada,theherbcarriesnewdrugstatusandisnotapproved,asself-treatmentofcardiovascularconditionsisdeemedinappropriate.(TCPHP,257)



Horsechestnut�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional. May cause gastric upset in some patients. Do not apply to broken or ulcerated skin.

HorsechestnutAesculus hippocastanumseed

Noinformation. ContraindicatedinknownallergytoplantsoftheHippocastanaceaefamily.(WHO2,144)Adverseeffectsreportedtoincludepruritis,nausea,andgastriccomplaintsinisolatedcasesafteroralintake.(HM,203;ESCOPM,249;WHO2,145)Oralusemaycauseirritationofthegastricmucousmembranesandreflux.Saponinsmaycausehemolysis,butthiseffectisnegligibleattheoraldosescommonlyused.(PPP,454)Horsechestnutshouldnotbeappliedtobrokenorulceratedskin.(PPP,454)Allergicreactionshavebeenreportedfromtopicaluseoftheactiveconstituentescin.(WHO2,145)

Noneknown.(HM,203;PPP,454;ESCOPM,249;CGBLH,281)

Horsetail�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

HorsetailEquisetum arvenseherb

2d Contraindicatedincardiacorrenaldysfunction.(BSH,47;BHC,93)ProductssoldinCanadaarerequiredtobecertifiedasfreefromanythiaminase-likeeffect.(BSH,47)Powderedherbnotrecommendedforchildrenorprolongeduse.(BSH,48)Toxicityisreportedtobesimilartonicotinepoisoninginchildrenwhochewedthestem.(BSH,48)Classifiedasanherbaldiuretic,maybeinappropriateorpossiblyevencontraindicatedinrenalfailureanddiabetes.(PPP,222)Noirrigationtherapy(copiousfluidintake)incaseofedemaduetoimpairedheartandkidneyfunction.(TGHM,151;HM,209)










64

Liquid Extracts


Korean�Ginseng�1:2�StandardizedNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional. Discontinue during an acute infection or fever.

Korean�GinsengPanax ginsengmainroot




Licorice�1:1Contraindicated in high blood pressure, edema (water retention), congestive heart failure, low blood potassium, pregnancy and lactation.













65

Liquid Extracts


Licorice�High�Grade�1:1�Quantified ActivityContraindicated in high blood pressure, edema (water retention), congestive heart failure, low blood potassium, pregnancy and lactation.





Marshmallow�Root�1:5�GlycetractNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

MarshmallowAlthaea officinalisroot

1 Asamucilageorrespiratorydemulcent,contraindicatedoratleastinappropriateincongestivebronchial,catarrhalandcongestiveconditionsofthemucosa.(PPP,169,211)

Absorptionofotherdrugstakensimultaneouslymaybedelayed.(BSH,9;HM,245,247;ESCOPM,33;TGHM,166,167;WHO2,9;CGBLH,321)


Milk�Thistle�1:1�Quantified ActivityNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional. In anemia and cases where iron supplementation is required, do not take simultaneously with meals or iron supplements.





Milk�Thistle�1:1�Glycetract�Quantified ActivityNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional. In anemia and cases where iron supplementation is required, do not take simultaneously with meals or iron supplements.













66

Liquid Extracts


Mistletoe�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

MistletoeViscum albumherb

2d CanadianregulationsdonotallowEuropeanmistletoeinfoods.(BSH,123)


Motherwort�1:2Contraindicated in pregnancy. Contraindicated during lactation unless otherwise directed by a qualified health care professional.

MotherwortLeonurus cardiacaherb

2b Bestavoidedinearlypregnancy.(CGBLH,331)Excessdosagemaycausediarrhea,uterinebleeding,andstomachirritation.(BSH,69)


Nettle�Leaf�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

NettleUrtica dioicaleaf

1 Contraindication:patientswhoareallergictonettlestingsshouldnotapplythefreshorunprocesseddriedleavestopically.(PPP,496)Irrigationtherapy(copiousfluidintake)isnotadvisedifedemaexistsduetoimpairedheartorkidneyfunction.(TGHM,216)Occasional(rare)allergicreactionshavebeenobserved.(BHC,166)

Noneknown.(TGHM,216;ESCOPM,522;CGBLH,343)

Nettle�Root�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional. The National Institute on Aging recommends that men get regular medical checkups with a thorough prostate exam.

NettleUrtica dioicaroot

Noinformation. ContraindicatedinknownallergytoplantsoftheUrticaceaefamily.(WHO2,337)CommissionEadvisesthatnettlerootisusefulfortheproblemsassociatedwithanenlargedprostate.However,theyadvisethatitsuseforBPHshouldoccurunderprofessionalsupervision.(PPP,496)Difficultiesinmicturitionrequireatalltimesclarificationbyaphysician;consultationwithaphysicianisnecessaryespeciallyincasesbloodintheurineandacuteurineretention.(ESCOPM,529)Maycausemildgastrointestinaltroubleandallergicskinreactions(rarely).(PPP,496;TGHM,216;ESCOPM,529;WHO2,338)

Noneknown.(TGHM,217;ESCOPM,529)

Oats�Seed�1:1Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

OatsAvena sativaseed

1 Risksofadverseeffectsonlyinthosepatientswithextremelydebilitatedconstitutions.(PPP,234)

Noneknown.(HM282;TGHM,176;BSH,18;CGBLH,349)









67

Liquid Extracts


Oregon�Grape�1:2Contraindicated in pregnancy and lactation.

Oregon�GrapeBerberis aquifolium (Mahonia aquifolium)root

2b Canadianregulationsrequirebilinguallabelwarningagainstuseinpregnancyandisanunacceptablenon-medicinalingredientinoraluseproducts.(BSH,73)Contraindicatedinpregnancy,andjaundicedneonates.(CGBLH,80)Thisherbisclassifiedasacholereticandcholagogue.Itiseithercontraindicatedoratleastinappropriateinthefollowing:(1)obstructedbileducts,(2)unconjugatedhyperbilirubinemia,(3)acuteorseverehepatocellulardisease,(4)septiccholecystitis(wherethereisriskofperitonitis),(5)intestinalspasmorileus,and(6)livercancer.(PPP,187)Asanalterative,thisherbmaybeprovocativetoskindisease,andcareneedstobetakentoreducetheprospectsofexacerbations.(PPP,254)

Berberine,analkaloidconstituentofthisherb,maypotentiateotherdrugswhichdisplacetheproteinbindingofbilirubin.(PPP,295)

Pau�d’Arco�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional. Contraindicated in patients taking anticoagulant drugs.

Pau�d’ArcoTabebuia avellanedaebark




Poke�Root�1:5Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional. Contraindicated in lymphocytic leukemia and gastrointestinal irritation.

Poke�RootPhytolacca decandraroot

3 Contraindications:pregnancy,lactation,lymphocyticleukemiaandgastrointestinalirritation.(PPP,517;CGBLH,376)Toxiceffectsfromlargedosesmayincludenausea,vomiting,profusesweatingandsalivation.(PPP,517;AEHD2,255-256)Accuratemeasurementofdriedplanttincturevolumesisvitaltoensurethatthesafedosageisnotexceeded.(CGBLH,376)Topicalapplicationofherbshouldberestrictedtodriedplanttincturesandtheeyesshouldbeavoided.(PPP,517;CGBLH,376)Possiblecardiovasculareffects:muscleweaknessandspasms;possibleneurologicaleffects:headache,dizziness,tremor,confusion,anddyspnea,anddiarrheahavebeenreported.(TCPHP,239)Canadianregulationsdonotallowpokerootinfoods.(BSH,85)Severalcasereportsindicatecontraindicationwithcardiacconditions.(AEHD2,257;PPP,516)

Noneknown.(PPP,517)Concurrentusewithimmunosuppressivedrugsshouldbeavoided.(CGBLH,376)

Red�Clover�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

Red�CloverTrifolium pratenseflower

2b Maybeprovocativetoskindisease.Careneedstobetakentoreducetheprospectsformajorexacerbations.(PPP,255)










68

Liquid Extracts


Rehmannia�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

RehmanniaRehmannia glutinosaroot

2d Contraindicatedwithdiarrheaandindigestion.(BSH,95)Sideeffectsmayincludemilddiarrhea,abdominalpain,dizziness,lackofenergy,palpitationsandedema.(BSH,95;PPP,521)


Sage�1:2�Quantified ActivityContraindicated in pregnancy. Contraindicated during lactation unless otherwise directed by a qualified health care professional.





Sarsaparilla�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

SarsaparillaSmilax ornataroot&rhizome

1 Risks:takingtheherbmayleadtogastricirritationandtemporarykidneyimpairment(diuresis).Theabsorptionofsimultaneouslyadministeredsubstancesmaybeincreased.Theeliminationofothersubstances(e.g.,hypnotics)isaccelerated.Thiscancauseanuncontrolledconditionofincreasedordecreasedactionofherbstakensimultaneously.(TGHM,372)Theseconcernsaretheoretical,andnotestablishedbyanimalstudiesorcasereports.(CGBLH,397)

CommissionEadvisesofpotentialdruginteractionswithhypnotics,digitalisglycosides,andbismuth.However,nootherreferencesubstantiatestheseconcerns.(BSH,108)Suchconcernswouldbealleviatedbynottakingsarsaparillasimultaneouslywithdrugmedication.(CGBLH,397)

Saw�Palmetto�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional. The National Institute on Aging recommends that men get regular medical checkups with a thorough prostate exam.

Saw�PalmettoSerenoa repensfruit

1 Stomachproblemsorgastrointestinaldistressinrarecases.(HM,338;TGHM,201;BSH,107;ESCOPM,478)CommissionEsuggestsregularconsultationwithaphysicianwhenusingthisherbfortreatmentofenlargedprostate.Thiscautionisbasedonassumptionthatthisherbtreatsonlysymptomswithouteliminatinghypertrophicconcerns.(BSH,107)Noadverseeffectsareexpectedifusedasrecommended.(PPP,524)

Noneknown.(HM,338;TGHM,201;PPP,530;ESCOPM,478;CGBLH,400)

Schisandra�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.













69

Liquid Extracts


Skullcap�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.




St�John’s�Wort�1:2�Quantified ActivityNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional. Do not use this product while taking any prescription drug(s) without the advice of your prescribing physician. Avoid excessive exposure to UV irradiation (e.g. sunlight, tanning) when using this product.

St�John’s�WortHypericum perforatumfloweringherb












70

Liquid Extracts


St�John’s�Wort�High�Grade�1:2�Quantified ActivityNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional. Do not use this product while taking any prescription drug(s) without the advice of your prescribing physician. Avoid excessive exposure to UV irradiation (e.g. sunlight, tanning) when using this product.

St�John’s�WortHypericum perforatumfloweringherb




Tienchi�Ginseng�1:2Contraindicated in pregnancy. Contraindicated during lactation unless otherwise directed by a qualified health care professional.

Tienchi�GinsengPanax notoginsengroot

2b Contraindicatedinpregnancy.(CAACH,45;CGBLH,433) Noneknown.(BSH,82;CGBLH,433)

Turmeric�1:1Contraindicated in pregnancy. Contraindicated during lactation unless otherwise directed by a qualified health care professional. Contraindicated in closure of the gallbladder. Use only with professional supervision in gallstones.













71

Liquid Extracts


Uva�Ursi�1:2Contraindicated in pregnancy and lactation. Not suitable for prolonged use.

Uva�UrsiArctostaphylos uva-ursileaf

2b,2d Largedosesmaycausenauseaandvomiting.(HM,391;BHC,212)Mayalsocausecrampingandconstipation,duetohightannincontent.Notsuitableforlong-termuse.(PPP,284;ESCOPM,536;CGBLH,444)Contraindications:kidneydisorders,renalfailure,whichmaybetheoretical,andpregnancy.(BHC,212;PPP,223,284;BSH,13;ESCOPM,536-537)

Shouldnotbegivenwithtreatmentsthatwillleadtotheproductionofacidicurine(leadingtoareductionofantibacterialeffect).Thehightannincontentcouldinterferewiththeabsorptionofsomenutrients.(CGBLH,444)


Valerian�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

ValerianValeriana officinalisroot

1 Canaggravateasensationoftirednessordrowsiness,particularlyinhigherdoses.(PPP,587;WHO1,273)Overdosecanresultinblurredvision,erraticheartbeat,headache,nausea,restlessness,visualillusions,evenspasmodicmovements.(PPP,588;BSH,120)Verylargedosesmaycausebradycardiaandarrhythmias,anddecreaseintestinalmotility.(WHO1,274)Canadaallowsproductscontainingvalerianforuseassleepingaidsandsedatives.(TCPHP,64)Hepaticandneurologicconcernbaseduponcasereports,althoughinthecaseofallegedhepatotoxicitycoingestantswereinvolved.(TCPHP,301)

Noneknown.(TGHM,226;ESCOPM,540;HM,397)MayincreasetheeffectsofCNSdepressantsoralcoholwhentakentogether,(PPP,587;AEHD3,172;WHO1,273)althoughhumanstudiesindicatethatthisisunlikelyforalcohol.(CGBLH,447)Theherbmaybeexpectedtohaveatleastanadditiveeffectwithbarbiturates,alcohol,benzodiazepines,andotherCNSdepressants.(TCPHP,64)


White�Peony�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.

White�PeonyPaeonia lactifloraroot

1 Consultwithaphysicianwhenpatienthasbreastcancercondition.(PPP,244)Theherbreducestestosteroneproductionfromovariesbutnotfromadrenalglands.(CAACH,31)

Noneknown.(CGBLH,458)ShouldnotbecombinedwithFritillaria verticillata,Cuscuta japonicaandRheum officinale.(WHO1,199)Cautionshouldbeexercisedwhenusedwithestrogenicdrugsoranticoagulantdrugs.(PPP,244;CGBLH,458)

Wild�Yam�1:2�Quantified ActivityNot to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.












72

Liquid Extracts


Wormwood�1:5Contraindicated in pregnancy and lactation.

WormwoodArtemisia absinthiumherb

2b,2c,2d Contraindications:gastricandduodenalulcers,pregnancy,lactation,hyperacidity,knownsensitivitytowormwoodorothermembersoftheCompositaefamily.(ESCOPM,4;CGBLH,469)Thetoxicologicalriskfromuseofconventionalwormwoodpreparationsisconsideredtobeverylow.(ESCOPM,4)Therecommendeddosagerangemustnotbeexceeded.(CGBLH,469)Asabitter,thisherbiscontraindicatedoratleastinappropriateinduodenalulcerationandconditionsinvolvingdrycoughandsomekidneydiseases.(PPP,173)Wormwoodcontainsapproximately1.5–1.7%essentialoilwhichcontainsaneurotoxincalledthujone.Intoxicdoses,thujoneactsasaconvulsantpoison.Therefore,thepureessentialoilmustnotbeused.(TGHM,233;BSH,158)Regulatoryrestrictionsrequirefinishedfoodproductstobethujone-freeintheU.S.andothercountries.(BSH,15)Toxicologicalconcernnotindicated,exceptinlongtermuse.(BSH,15)

Noneknown.(BSH,15;TGHM,233;ESCOPM,4;CGBLH,469)

Yellow�Dock�1:2Not to be used during pregnancy and lactation unless otherwise directed by a qualified health care professional.





Contraindications and Cautions for MediHerb

Documents

Transcript of Contraindications and Cautions for MediHerb