EDINBURGH, SCOTLAND — Patients with rheumatologic conditions are
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increasingly using herbal and over-the-counter agents for symptom
relief, at times placing themselves at risk of harmful drug
interactions.
In a survey of 238 outpatients seen at three centers in the United
Kingdom, 44% reported that they had used at least one herbal or OTC
remedy during the past 6 months, Dr. Wendy A. Holden said at the annual
meeting of the British Society for Rheumatology.
“This is a much higher percentage than in the general
population,” said Dr. Holden of the Nuffield Orthopaedic Centre,
Oxford, England.
The most commonly used remedies were cod liver oil cod liver oil
an oil pressed from the fresh liver of the cod and purified. It is one of the best-known natural sources of vitamin D, and a rich source of vitamin A. Because cod liver oil is more easily absorbed than other oils, it was formerly widely used as a nutrient and tonic, , by 35%;
glucosamine, and/or chondroitin, by 21%; and evening primrose oil evening primrose oil
one of the few plant oils containing ?-linolenic acid. Obtained from seeds of Oenothera biennis, it is used for its anti-inflammatory effects in the treatment of skin diseases. , by
11%.
Overall, 26 (11%) of the patients were using products that could
have potentially hazardous interactions with their conventional
medications. Among 120 patients taking disease-modifying agents, 5 were
also using echinacea, which is potentially hepatotoxic if used long
term. Of the 238 patients, 24 were taking ginkgo, garlic, devil’s
claw, and starflower oil–all of which can have antiplatelet or other
anticoagulant effects–in combination with nonsteroidal
anti-inflammatory drugs or corticosteroids. Reports also suggest that
devil’s claw can cause gastrointestinal disturbances.
Health care workers should always inquire specifically about herbal
remedies when taking a drug history, and both patients and clinicians
need more education on the risks and potential interactions of these
remedies, Dr. Holden advised.
Other possible hazards have also been reported among patients
taking analgesic drugs. Hepatotoxicity and nephrotoxicity neph·ro·tox·ic·i·ty
n.
The quality or state of being toxic to kidney cells.
nephrotoxicity(ne
