Table 5.

Table 5.

Examples of Selected Herb Use and Drug Interactions

Herb	Use	Potential Interactions with Prescription Medications
Immortal (Spider Milkweed)	Orally, for arthritis, asthma, cough, edema, syphilis, valvular insufficiency, senile heart, to strengthen weak heart muscles following pneumonia, and for diuresis. Topically, for warts.	Digoxin, diuretics
Plumajillo (Pleurisy Root)	Orally, for cough, pleurisy, uterine disorders, shortness of breath, pain, spasms, and to promote sweating; for bronchitis, pneumonitis, and influenza.	Digoxin, diuretics, estrogen
Canella (Cinnamon)	Orally, for colds, poor circulation, and as a bitter tonic. In foods, as a cooking spice.	None known
Clavo (Cloves)	Orally, clove for dyspepsia, as an expectorant, for diarrhea, hernia, halitosis, flatulence, nausea, and vomiting. Topically, for toothache, postextraction alveolitis, pain, a dental anesthetic, mouth and throat inflammation. In combination with other ingredients, topically for premature ejaculation. In foods and beverages, as a flavoring agent. In manufacturing, in toothpaste, soaps, cosmetics, and perfumes.	Antiplatelet and anticoagulant agents
Comino (Cumin)	Orally, as an antiflatulent, stimulant, antispasmodic, diuretic, aphrodisiac, for stimulating menstrual flow, treating diarrhea, colic, and flatulence. In foods, spices, and beverages, as a flavoring agent. In manufacturing, as a cosmetic fragrance.	Antidiabetic agents
Manzanilla (Chamomile)	Orally, for flatulence, travel sickness, nasal mucous membrane inflammation, allergic rhinitis, nervous diarrhea, attention deficit-hyperactivity disorder, restlessness, insomnia, gastrointestinal spasms, inflammatory diseases of the gastrointestinal tract, gastrointestinal ulcers associated with NSAIDs and alcohol consumption, and as an antispasmodic for menstrual cramps. Topically, for hemorrhoids, leg ulcers; for skin, anogenital, and mucous membrane inflammation; for bacterial skin diseases; for treating or preventing chemotherapy- or radiation-induced oral mucositis. Via inhalation, for inflammation and irritation of the respiratory tract. In foods and beverages, as a flavoring agent. In manufacturing, in cosmetics, soaps, and mouthwashes.	Benzodiazepines; CNS depressants (eg, fentanyl, morphine, etc.); contraceptive drugs; cytochrome P450 1a2 (Cyp1a2) substrates (eg, amitriptyline, haloperidol, verapamil, propranolol, theophylline, ondansetron, etc.); cytochrome P450 3a4 (Cyp3a4) substrates (eg, lovastatin, itraconazole, ketoconazole, fexofenadine, triazolam, etc.); estrogens; tamoxifen; warfarin
Ajo (Garlic)	Orally, for hypertension, hyperlipidemia; for prevention of coronary heart disease, age-related vascular changes and atherosclerosis; for reducing reinfarction and mortality rate post-myocardial infarction, earaches, chronic fatigue syndrome, and menstrual disorders; for HIV-drug induced lipid disorders and Helicobacter pylori infection; for prevention of colorectal, gastric, breast, lung, and prostate cancer; for bladder cancer, benign prostatic hyperplasia, diabetes, arthritis, allergies, traveler’s diarrhea, colds and flu; for immune system stimulation, prevention of tick bites, and prevention and treatment of bacterial and fungal infections; for diarrhea, amoebic and bacterial dysentery, tuberculosis, bloody urine, diphtheria, whooping cough, scalp ringworm, hypersensitive teeth, and vaginal trichomoniasis; for fever, cough, headache, stomachache, sinus congestion, athlete’s foot, gout, rheumatism, hemorrhoids, asthma, bronchitis, shortness of breath, arteriosclerosis, low blood pressure, hypoglycemia, hyperglycemia, and snakebites; as a diuretic, stimulant, cathartic, aphrodisiac; for enhancing circulation, fighting stress and fatigue.	Anticoagulant and antiplatelet agents; contraceptives; cyclosporine; cytochrome P450 2e1 (Cyp2e1) substrates (eg, acetaminophen, ethanol, theophylline, etc.); cytochrome P450 3a4 (Cyp3a4) substrates (eg, lovastatin, itraconazole, ketoconazole, fexofenadine, triazolam, etc.); non-nucleoside reverse transcriptase inhibitors; saquinavir
Jengibre (Ginger)	Orally, for motion sickness, morning sickness, colic, dyspepsia, flatulence, chemotherapy-induced nausea, rheumatoid arthritis, osteoarthritis, loss of appetite, post-operative nausea and vomiting, migraine headache, anorexia, upper respiratory tract infections, cough, bronchitis, and as a diaphoretic, diuretic, and a stimulant. Fresh ginger: Orally, for treating acute bacterial dysentery, baldness, malaria, orchitis, poisonous snake bites, rheumatism, and toothaches. Dried ginger: orally, for chest pain, low back pain, and stomach pain. Topically, for thermal burns and as an analgesic. In foods and beverages, as a flavoring agent. In manufacturing, as a fragrance component in soaps and cosmetics.	Antiplatelet and anticoagulant agents; antidiabetic agents; calcium channel blockers
Granada (Pomegranate)	Orally, for hypertension, heart failure, myocardial ischemia, atherosclerosis, hyperlipidemia, acidosis, hemorrhage, HIV disease, tapeworm infestations, diarrhea, dysentery, and opportunistic intestinal worms; for preventing prostate cancer, and as an astringent and abortifacient; for chronic obstructive pulmonary disease, influenza, stomatitis, periodontal disease, erectile dysfunction, diabetes, and cancer. Topically, as a gargle for sore throat and to treat hemorrhoids.	Antiplatelet and anticoagulant agents; antidiabetic agents; ACE inhibitors; antihypertensive agents; cytochrome P450 3a4 (Cyp3a4) substrates (eg., lovastatin, itraconazole, ketoconazole, fexofenadine, triazolam, etc.); cytochrome P450 2D6 (CYP2D6) substrates (eg, amitriptyline, fluoxetine, codeine, tramadol, ondansetron, etc.)
Anis Estrella (Star Anise)	Orally, for respiratory infections and inflammation, influenza, avian flu, gastrointestinal upset, flatulence, loss of appetite, infant colic, cough, and bronchitis; for increasing milk secretion, promoting menstruation, facilitating childbirth, increasing libido, and treating symptoms of male climacteric. Through inhalation, for respiratory tract congestion. In foods and beverages, as a culinary spice and flavoring agent. In manufacturing, as a fragrance component in soaps, cosmetics, perfumes, and toothpaste, and to mask undesirable odors in drug products.	None known
Estafiate (Wormwood)	Orally, for loss of appetite, indigestion and digestive disorders, biliary dyskinesia, fever, and liver disease; as an anthelmintic, aphrodisiac, tonic, antispasmodic, and to stimulate sweating and the imagination. Topically, for healing wounds and insect bites and as a counterirritant. In foods, wormwood as a flavoring agent. In manufacturing, as a fragrance component in soaps, cosmetics, and perfumes, and as an insecticide.	Anticonvulsants
Cundeamore (Bitter Gourd)	Orally, for diabetes, psoriasis, gastrointestinal upset, ulcers, colitis, constipation, intestinal worms, kidney stones, fever, hepatic disease, and to induce menstruation. Topically, for skin abscesses and wounds, and anorectal herpes lesions.	Antidiabetic agents
Savila (Aloe Vera)	Orally, for osteoarthritis, inflammatory bowel diseases, fever, itching and inflammation, as a general tonic, for gastroduodenal ulcers, diabetes, asthma, and radiation-related mucositis. Topically, for burns, wound healing, psoriasis, sunburn, frostbite, inflammation, osteoarthritis, and cold sores; and as an antiseptic and a moisturizer.	Oral medications (in general); sevoflurane; diuretics; digoxin; antidiabetic agents
Una de Gato (Cat’s Claw)	Orally, for diverticulitis, peptic ulcers, colitis, gastritis, hemorrhoids, parasites, Alzheimer’s disease, chronic fatigue syndrome, wound healing, arthritis, asthma, allergic rhinitis, cancer (especially of the urinary tract), glioblastoma, gonorrhea, dysentery, birth control, bone pain, “cleansing” the kidneys, and viral infections, including herpes zoster, herpes simplex, and human immunodeficiency virus (HIV).	Antihypertensive agents; immunosuppressants; cytochrome P450 3a4 (Cyp3a4) substrates (eg, lovastatin, itraconazole, ketoconazole, fexofenadine, triazolam, etc.)
Pelos de Elote (Corn Silk)	Orally, for cystitis, urethritis, nocturnal enuresis, prostatitis, inflammation of the urinary tract, diabetes, hypertension, and as a diuretic for congestive heart failure.	Antihypertensive agents; antidiabetic agents; diuretics; corticosteroids; warfarin
Oregano	Orally, for respiratory tract disorders, including cough, asthma, croup, and bronchitis; for gastrointestinal disorders, such as dyspepsia and bloating; for dysmenorrhea, rheumatoid arthritis, urinary tract infections, headaches, heart conditions, intestinal parasites, allergies, sinusitis, arthritis, cold and flu, earaches, and fatigue. Topically, for acne, athlete’s foot, dandruff, insect and spider bites, canker sores, gum disease, toothaches, psoriasis, seborrhea, ringworm, rosacea, muscle pain, varicose veins, and warts, and as an insect repellent. In foods and beverages, as a culinary spice and a preservative.	None known
Limon (Lemon)	Orally, as a source of vitamin C in the treatment of scurvy and colds; as a digestive aid, an anti-inflammatory, diuretic, and to improve vascular permeability. In foods, as a food and flavoring agent.	None known
Valeriana (Valerian)	Orally, as a sedative-hypnotic for insomnia and as an anxiolytic for restlessness; for mood disorders such as depression, mild tremors, epilepsy, attention deficit-hyperactivity disorder, and chronic fatigue syndrome; for muscle and joint pain, asthma, hysterical states, excitability, hypochondria, headaches, migraine, stomach upset, menstrual cramps and symptoms associated with menopause, including hot flashes and anxiety. Topically, as a bath additive for restlessness and sleep disorders. In manufacturing, as flavoring in foods and beverages.	Alcohol; benzodiazepines; CNS depressants; cytochrome P450 3a4 (Cyp3a4) substrates (eg, lovastatin, itraconazole, ketoconazole, fexofenadine, triazolam, etc.)
Tomillo (Thyme)	Orally, for bronchitis, pertussis, sore throat, colic, arthritis, dyspepsia, gastritis, diarrhea, enuresis, dyspraxia, flatulence, skin disorders, as a diuretic, urinary disinfectant, anthelmintic, and as an appetite stimulant. Topically, for laryngitis, tonsillitis, stomatitis, and halitosis; as a counterirritant, an antiseptic in mouthwashes and liniments, and for alopecia areata. Otically, as an antibacterial and antifungal ingredient. In foods, as a flavoring agent. In manufacturing, in perfumes, soaps, cosmetics, and toothpastes.	Antiplatelet and anticoagulant agents
Epasote (Wormseed)	Orally, for ascaris and oxyuris infestations.	None known