There is currently insufficient information on the pharmacokinetics of complementary medicines to enable a judgement on whether they are likely to interact with conventional medicines and  whether dosage reduction is necessary in renal impairment. Due to a lack of regulation, adverse effects such as nephrotoxicity may be attributable to impurities rather than the active principle.

Below is an extremely limited list of information on complementary medicines - for specific queries the Welsh Drug Information Centre specialist file and Micromedex may be consulted via pharmacy.
 

Complementary Medicine Issue
St John’s Wort  CyA levels reported due to CYP450 3A4 induction. May therefore  tacrolimus levels
Garlic
Papaya
Danshen
Dong quai
Ginger
↑ INR therefore avoid peri-operatively
Xaiochai hutang ↑ Prednisolone levels
Chinese herb
(Aristolochia)
Juniper
Pennyroyal
Renal damage
Ginko Cyclo-oxygenase inhibitor and PAF antagonist
Echinaecea ‘Immunostimulant’ - stimulates TNF secretion in vitro

 

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