This list of commonly used herbal supplements shows the potential problems that could occur if you take the supplement at the same time that you are taking other medicines. Unfortunately, there is very little scientific information available about the way herbs and drugs interact.

Always tell your doctor if you are taking any supplements to help treat your medical conditions, or to maintain your health or well-being. You should stop taking most of these products at least two weeks before any surgery. Your pharmacist can provide more information on these and other supplements that may interact with your prescription medicines or affect your health.

Herbal Supplement	Common Uses	Possible Problems	May Interact With
Dong Quai (Angelica)	To treat menopausal symptoms, PMS, irregular menstruation cycles.	Enhances bleeding.	Drugs that hinder the clotting of blood.
Echinacea	To treat colds, flu, and mild infections, especially upper respiratory infections (chest colds).	May cause injury to the liver; may cause intestinal/ stomach upset.	Drugs that may cause injury to the liver; synthetic hormones; some anti-cancer drugs.
Ephedra (Ma Huang, Ephedrine, Pseudo-ephedrine)	To treat asthma and coughs; to stimulate weight loss.	May cause seizures; may cause adverse cardiac events, such as irregular heartbeat, high blood pressure, stroke, or heart attack.	Some heart medications; general anesthesia; some antidepressants; medicines that increase blood pressure; decongestants; stimulants.
Garlic	To decrease cholesterol and blood clot formation.	Enhances bleeding.	Drugs that hinder the clotting of blood.
Ginger	To relieve nausea.	Enhances bleeding; may affect the central nervous system; may lower blood pressure; may cause irregular heartbeat; may lower blood glucose levels.	Drugs that hinder the clotting of blood; medicines that increase blood pressure; cardiac drugs; drugs that lower blood sugar level; may increase the effects of sedatives.
Ginkgo Biloba	To improve circulation, especially to brain; also for memory loss, dizziness, and headache.	Enhances bleeding; may cause cramps and/or muscle spasms.	Drugs that hinder the clotting of blood.
Ginseng	To increase energy and reduce stress.	Enhances bleeding; may cause irregular heartbeat and/or increase blood pressure; may cause mania.	Drugs that hinder the clotting of blood; stimulants; medicines that lower blood pressure; some antidepressants; digoxin (a heart drug); may increase the effects of steroids and estrogens.
Goldenseal	Used as a mild antibiotic to treat sore throats and upper respiratory infections.	Increases fluid retention; may increase blood pressure; may cause nausea or nervousness.	Drugs that increase urination; medicines that lower blood pressure.
Kava Kava	To treat anxiety, nervousness, and insomnia.	May cause upset stomach; may cause liver damage and/or stimulate an allergic skin reaction that causes a yellow discoloration of skin.	May increase the effects of sedatives, muscle relaxants, anesthetics, and antidepressants.
Licorice	To treat hepatitis and peptic ulcers.	May increase blood pressure; may lower levels of potassium in the blood; may cause swelling.	Medicines that lower blood pressure; may increase the effects of steroids.
SAM-e (S-adenosyl-L-methionine)	To treat depression or osteoarthritis.	May induce drowsiness; may cause nausea and/or upset stomach.	May increase the effects of some antidepressants.
St. John's Wort	To treat mild depression, anxiety, or seasonal affective disorder.	Enhances bleeding.	May increase the effects of anti-depressants; decreases the effectiveness of medications given to organ-transplant patients.
Valerian	To treat insomnia or anxiety.	May induce drowsiness; may cause digestion problems.	Enhances the effects of sedatives.

Developed by the AAOS Committee on Complementary and Alternative Medicine; references available on request.