When Drugs & Botanicals Collide
Posted on Wednesday, December 4th, 2019
A lot of folks don’t think to mention herbal supplements and such when their doctor or dentist asks about medication use. Sometimes, it’s from fear of disapproval; others, because botanicals seem so benign compared to “drugs.” They’re “natural,” so they must not count.
But truth be told, mixing pharmaceuticals and herbal medications can in some cases interact badly.
Which brings us to a recent news item out of Oregon State University, where a couple of scientists were testing a new method for evaluating potential interactions.
The method involves rapid protein precipitation and ultra high pressure liquid chromatography and is being used to support clinical studies. In the clinical studies, participants take a drug cocktail along with a botanical supplement — hops, licorice or red clover — to see if the supplement causes any of the drugs to be metabolized differently than they otherwise would.
“Botanicals basically contain natural products with drug-like activities,” [study author Richard] van Breemen said. “Just as a drug may alter the drug-metabolizing enzymes, so can natural products. It can become a real problem when someone takes a botanical supplement and is also on prescription drugs — how do those two interact? It’s not straightforward or necessarily predictable, thus the need for methods to look for these interactions.”
According to their study, published last month in the Journal of Pharmaceutical and Biomedical Analysis, this method was indeed successful. And they found something else along the way: All 18 of the allegedly “pure” blood samples they originally obtained for their study contained drugs.
Every single one contained caffeine. Over 70% contained alprazolam, a/k/a Xanax. Nearly 45% contained dextromethorphan, a common ingredient in over-the-counter cough medicines.
So to put it another way, if you were ever to need a blood transfusion, “your odds of also receiving caffeine, cough medicine and an anti-anxiety drug [would be] pretty good.”
The blood samples came from medical suppliers, who get their stock from blood banks. “Without doing a comprehensive survey of vendors and blood banks,” said van Breemen, “we can only speculate on how widespread the problem is.”
Another thing to consider is that we found drugs that we just happened to be looking for in doing the drug interaction assay validation — how many others are in there too that we weren’t looking for?
No doubt, plenty. According to the most recent CDC data, nearly half of all Americans have taken at least one prescription drug in the past 30 days. That number skyrockets to nearly 70% among adults between the ages of 40 and 79, and 22.4% used at least five drugs.
But that’s life in a culture of a pill for every ill…