صفحه 1:
7
nye
5350 a
صفحه 2:
Werbdl / Oncy ۸ مره
ا لك اللا
60 أمواصاءج (1) خام 4
00
۱۹/۹۱
صفحه 3:
4
3561
3259 (92)
533 (15)
2081 (58)
2219 (62)
463 (13)
511 (14.4)
3
3919
3533 (90)
504 (13)
1678 (43)
2263 (58)
411 )110(
459 (11.7)
2
4351
3891 (89)
295 (7)
1707 (39)
2720 (63)
243 (6)
270 (6.2)
Table 1. Enrollees in CHS Study*
Total enrolled: 5849
White: 4925 (84)
Black: 924 (16)
Male: 2478 (42)
Female: 3371 (58)
Study paiod 7
Total users 4373
Rx users. 3994 (91)
CAM users 278 (6)
‘Vitamin/mineral | 1713 (39)
كعك
OTC users 2635 (60)
Rx plus CAM 238 (5)
Rx, CAM, OTC | 264 (6)
= The number in parentheses is the percent of the enrolled
Elmer et al. unpublished
صفحه 4:
4
571
521 (91)
7 (13)
245 (43)
305 (53)
69 (12)
4
2990
2738 (92)
458 (15)
1836 (61)
1914 (64)
394 (13)
Table 1b. Black Enrollees*
Studypaiod 1 2 3
Total users 718 68 665
Rx users 682 (95) 634 (2) 614(@2)
CAM users 4707 26 93 (14)
Vitamin’mineral | 200 (28) 191 (28) 229 (34)
users
OTC was 308 (55) 375051 308 (59)
RxplusCAM | 45(6) AO) 84 (13)
Rx, CAM, OTC
* The number in parentheses is the percent of the enrolled
Table 1c. White Enrollees*
Studypaiod 1 2 3
Total users 3655 3658 325A
Rx users 31201) 3257 (89) 2919 (90)
CAM users 231 (6) 253(7) 411 (13)
Vitaminimineral | 1513 (41) 1516 (41) 1449 (45)
ers
OTC wats 2A2 (61) 25 60 187058)
RxplusCAM__|_193(5) 20900 327(10)
Rx, CAM, OTC
*The number in parentheses is the percent of the enrolled
صفحه 5:
‘Table 3 All users of the top 20 CAM products by rao?
White
00
5.48
437
2.85
2.23
1.33
100
112
100
0.95
0.97
0.69
0.69
0.57
0.55
0.57
0.52
0.52
0.47
0.36
031
‘Black
(%),
76
3.34
0.48
0.36
430
167
0.24
0.48
0.72
0.24
0.48
0.36
0.84
0.48
0.24
0.36
0.24
0.12
0.36
0.36
All
00
5.86
4.20
2.45
192
182
111
0.97
0.91
0.91
0.85
0.65
0.63
0.61
0.53
051
0.49
0.48
0.42
0.36
0.32
CAM Product
Gatlic
Ginkgo
Glucosamine
Lecithin
*1n=5052 for all participants; n=638 for blacks; n=1214 for whites
صفحه 6:
Gteps و Oetevicrcy 1 ON ca DI
A eva ran h(a ON eae ec
—4s the potieot tobi cay herbal
—Oves the herbdl kuve ePPivapy Por the
—4s the ara Panacea (ie. BO Maca ۶
(RELLY takicry?)
AN ae acca as sia
صفحه 7:
ج+صناص اد | ب1-:2) لأمجاسو را خان ودس ادس ©
CT aa Maca
000 eae ar Denes Re Caen
t7 D0O1 EPP ects or eveciag pricarose vil ced risk Por
ات همم رس
NE aca ecg
00 Sno Dire nen Bers marae ec come aa
tohibiiva DP CY POOF
40 SCANS cod
Se As A Go AS ene)
ORT ieee Niece aera
Sel PN CN NS PAROS aS EL icra
OU Dal acl Pal SCAND ccs ced
- حمطصل .ظ) له نله بو Deca!
وم و لیا امن - مر و
صفحه 8:
Grea Ora ah meal اه
oteractioa Report
(Re RS Nes ل RAR ea aU an cae ae
لل لا a cel eracc es oate
Gave buick used thoughout study?
Qoses appropriate?
Gteady state study to discers CY’ icrtuction?
Oe ecco ELIS CaS Cac
Ferra A cast oO DN coals acc
0200 i OPA Nea MCL a OSA SDL cece
1۱ 3?
صفحه 9:
Relative bevels مط :02 خام
0 من و۱
انث داكا
2۱0۷0۵
09
۳۹۹96
Govrerd
Other
صفحه 10:
Favors Placebo
Favors Garlic
150 135 ~120 105 -90 -75 -60 -45 -30 -15 0 15 30 45
Total Cholesterol Reduction, mg/dl
Neil et al. (9)
Bordia (13)
Plengvidhya et al. (14)
Vorberg and Schneider (15)
‘Auer et al. (16)
‘Mader (17)
De A Santos and Griinwald (18)
Jain et al. (19)
Saradeth et al. (20)
Adler and Holub (21)
‘McCrindle et al. (22)
Isaacsohn et al. (23)
Berthold et al. (24)
Meta-Analysis
Overall
Similar Methods"
High-Quality Trials*
Stevinson et al. Ann Int Med 13,
صفحه 11:
مساو بت مت حبص تست
یت رت یت اه سا
87 year old male
2g of garlic per day for “years”
PROM LA تاه ا
bleeding time of 11.5 min (normal = 3 min)
day 3 post surgery bleed time of 5 min (after
stopping garlic)
Other reports:
Garlic and TURP bleeding (German et al. Br J
Urology 1995;76:518).
Garlic and surgery bleeding (Burnham BE; Plastic
Reconstr Surgery 1995;95:213).
صفحه 12:
Garlic
وچ سس
SQV اهس لله رتوو sov
اس جه جه
1 23 4 5 6 7 8 9۱۵۱۱ ۱2 13 14 15 16 17 18 1920 21 22 23 24 25 26 27 28 29 30 31 32.33 34.35 36 37 38.39
۱ ۱ ۱
PK PK PK
Piscitelli et al. Garlic and Saquinavir. Clin Infect
Dis 2002;34:234-238. N=10 Garlic=GarliPure
(Natrol)(BID)
صفحه 13:
3 5 8 8 8
8 4 ؟ ؟ 8 8 8 Page bbe
ny ADs
جرد نس
صفحه 14:
Post-Gatle
garlic
Pro-Garlie
Pre-Ginseng Post-Ginseng
cul
nial
2, Comparison of presupplementation and postsupplementation phenotypic ratios (I-hy-
droxymidazolanvmidazolam) for CYP3A4. A, St John’s wort (SIW); B, garlic oil: C, G biloba: D,
P ginseng. Gray circles, Individual values; black circles, group means. Asterisks, Statistically
5 5
rmaco
Post-Ginkgo
0 ل 3s
2002 شهب ا
PreSW "Post SJW
(Hydroxymigazolarnimidazciam) Serum Ratios
Pro-Ginkgo
cant difference from baseline.
صفحه 15:
ع
5
2
8
=
:
0
3
8
8
g
5
<
36
Time (hours)
صفحه 16:
بروجدوسد حالو8)
اس لاي ا ل لا
لدي تا
له سوه لصوم sarecnaied a aaa ل
مروت هت رت
طم ان اليد Bi همم مه
cd هر و Bel (mara ern cart ac (ON
a rE RR as eta
حا و كام قن مما ال
ا te. ی وت وا
صفحه 17:
A B
08 0.8}
0.6} 0.6}
04 0.4
024 0.24
١ 0
۱ Pre-Milk Thistle Post-Milk Thistle
.0.8 .08
كمه 06
بح
fe (a es
(Paraxanthine/caffeine) Serum Ratios
Pre-Echinacea_' Post-Echinacea
صفحه 18:
16 1
sad A كمد 8
124 124
14 11
08 oe
9 06.
aa 3
لمعه 92
3
لمعا لادوم 7 5
Pre-Mik Thistle
(Hydroxymidazolam/midazolam) Serum Ratios
لاق 00
صفحه 19:
ٍِ
1
g
i
(aur) eauese9}5
14 هس0۴
91
Cl caffeine (CYP
12 crossover,
extract for 8d
Gorski et al.
Pharmacol Ther
2004;75:89-100
before and after
400mg QID
Echinacea
purpurea root
iN
4
صفحه 20:
—
Close) ai) T en Outta
Pharmacol Ther
2004;75:89-100
N=12 crossover,
before and after
400mg QID Echinacea
purpurea root extract
for 8d
Open circle is
echinacea
A= midazolam IV (CYP
‘3A4)
Midazolam Blood
Concentration (ng/mL)
5
8
5
Midazolam Blood
Concentration (ng/mL)
صفحه 21:
Aad
° Gurway
3 ار مت ۱ و اه
۱۳ همه
Oruy tercrtocst @keanvarodyannic! doo't qive io puieus tobtary
DO a oR ad
هت بر يهنن De ccs hela)
موس مب سا تم سرت سا
Oe و thee
مس مرا
۱۱ سک ار
اس سس ت۱5
۱ Toone
او eM Ae A A eMC
2
صفحه 22:
Anew study in the
Journal of the American
Medical Association
shows that Ginkgold helps
e-related
صفحه 23:
فرصم موف رسیم موه معط منود cane sete
6 تن ۳
حم معو و اه جه
]902,091,020 ا 00 ا
991,088[ 2 مم سم سس 2000 Deegan
)007,029 | هدم مه هه و 682 cee
| ,069 عدم هم سم 0 م 7 ما
faccaa es co ۳ رفن( مد
5 eet sated 73 0 حت مسر
ای یراع لت وا ای دی مدا ميا
ta ea) 06 1-922,040) توت
ارت | عون سدم سم بر مت
۳ we ave )0a0.072)
و
ود و مداد مين
قم اقم | هدم 03 Bon
Deegan 2000 00 [923,048
]007,029 | موم 1682 nea
)087,007 0%
| رم | مم
ع مانت درب
صفحه 24:
صفحه 25:
صفحه 26:
۱
Regression
1: عمیالع۷
Type of Inhibition Ki (ug/ml)
0.6 11.2 دنا
crt ادم Competitive
21 21.2 ۱
و ۳۹ Competitive
Competitive 133.1 oe
sy cogil
0
CYP1A2
CYP2A6
CYP2C9
CYP2D6
FS
صفحه 27:
Tolbutamide Human Study (CYP 2C9
probe} Subjects (3 males, 3 females)
-Subjects ingested 500mg
tolbutamide and collected 6-12 hour
urine (Control phase)
-Followed by a 2 week wash-out
period
-Subjects then ingested two 60mg
Ginkgo biloba extract tablets 2 times
a day for 3 days
-The morning of day 4 patients
received a 500mg dose of
Tolbuéakbaitamide along with the ginkgéo ۳
collected,6;12. howr total watt os
صفحه 28:
Control Ginkgo
] 680+ 323 , 610 + 327
صفحه 29:
Diclofenac-Ginkgo Interaction (CYP
2C9 probe)
12 healthy non-smoking subjects were
recruited (8 males 4 females)
50 mg diclofenac potassium (immediate
release) was administered every 12 hours for
14 days
On day 8, 120 mg of Ginkgo biloba extract
was added to the diclofenac regimen.
On days 7 and 14 plasma collected at times
(0, 0.5, 1,2,4,6,8,10, and 12 hrs)
Day 14 Blood
draw |
‘Ginkgo biloba 120 mg every 12 hours
12 hour urine ectea
صفحه 30:
Comparison of Didofenac Clearances from Plasma
‘ontrol
084.64 + 0.36
Mohutsky et al. Am J Ther 2006;13:24-31
صفحه 31:
Ginkgo biloba - Diclofenac Tolbutamide
Human Studies Conclusions
9 ۱۱۱۱۱۱ توت aU elm aI)
metabolic ratio between the two arms of the
۲ (tolbutamide alone and
tolbutamide + Ginkgo)
9 No difference was seen between the
clearances of the two arms of the study
( diclofenac alone and diclofenac +
Ginkgo)
۰ Ginkgo extract does not appear to
interact with CYP2C9 substrates in
صفحه 32:
مانمع همهم ١ ۳008
(Hydroxymigazolarnimidazciam) Serum Ratios
Pro-Ginkgo Post-Ginkgo Pre-Ginseng Post-Ginseng
2, Comparison of presupplementation and postsupplementation phenotypic ratios (I-hy-
droxymidazolanvmidazolam) for CYP3A4. A, St John’s wort (SIW); B, garlic oil: C, G biloba: D,
P ginseng. Gray circles, Individual values; black circles, group means. Asterisks, Statistically
cant difference from baseline,
صفحه 33:
C0Q10 and Ginkgo on Warfarin
Placebo 1 مرمی
Engelsen et al, Thromb Haemost 2002;87:1075-6. N=21, double blind, crossover.
Rx=1 month with 2 week washout. Dose of warfarin did not change
صفحه 34:
4.00
0.00
48 ) 48 96 144 ۱92
Time (h)
Jiang et al. Br J Clin Pharmacol 2005;59:425-432.
N=12 ginkgo for 7d; warfarin alone or in combination
with ginkgo or ginger
صفحه 35:
278 از Bask eta
“ale, Meet ney conten yee or ol ent ai ad ect eh
ei
هه
مه
۳
0
سس
مسو
م
rage
9
eto
Ec grr
هم تسود سل
cass pepe a
Cherie
Papen pcos
0200
apna pre
phen mete
i tne
he ie el مس سس ee
صفحه 36:
مس مسا ما Cee
سس مسرت
اتحدص حامر وص رك جنات ل .اك اك عشيصطه() ٠
mee od .6-660م99:©96: 900009
ا ل ل ل
BU Cae cs come 02222
SO Cae MCU Bn 900)09:00:96۵-
ل ل اك لاعت NSN aT
۳ oe Die Rance
© Ovkushy et d. Oso U Dker ia press. Oo ef Pet oP
thbutawide (ECO). D=C wresspver
۱ cat oe DOD cane
(eee ODA Neer cash rs phe) OA Cee cron Nn Ca DAS ares Cand
۱ Le oe
صفحه 37:
ممم )5 homoeygoue EM (n = 6) ‘heterorygous EM (n= .ها
6
52 3-5
OO eats ۰ ۹ wo
Pavers) Time ho Tina ow)
omesyg0us EM (n= 6) heterosypous EM (n= 8)
ra z ور
De 1 2
3 مه
(Cates i
aad 2 i Psp
ات موی a و ee 0 7
160۷ 0 هل تومیر 6) 0 Pur
۳۹ = 000
13 ۳ 1
1 7
i Esco
8 1
5 i
1 9 1
Tne thous) Time thou) 535
صفحه 38:
۱ ببو
SEN a hen ro RE
عروع م دا کت NA Mad a rca ad
SO eer eo A ae fel ane Ooi a
و سره مس رگ زارت OSM acl
تم ماس یم مت مه
De MC Ra
~ Product selevioct bok Por GLP extract
— Ovse: CO OOwzy tubs, COTO)
LO Ne ea Ma in cd
سر ما OU
صفحه 39:
Soy and Menopausal and Postmenopausal
problems
*Hot flashes- maybe helps
. مون كزع جوم !و50 eva 502 صاعط
*Long consumption of soy associated with
lower rates of breast, endometrial and
prostate cancers (Asian cultures)
*Soy and some soy isoflavones have
unknown effects on estrogen receptor
ماجان‌هتاه رهظ احط بممصهن اععمدط متتانوو
ارو(
*Soy may slightly inhibit protate cancer
ارو
¢Soy-Cardiovascular Benefits Favorable
۱۳۳ an cholecterol halance: “heart
صفحه 40:
صفحه 41:
(C7,
RO EE. at Ree A od ARR aod
مس هرس مت دب سر هت رت رواب را syrpiows;
تسس هسام سس مس
— @<Peivi ~ood but use to brecst paaer sway be
مس
اه ۶
ره مت
سم 0 ۶۱
و ا
مس و مهار کرت مه و۱ Ree
BO Nee Aa et Od
۱4 رف Tea
صفحه 42:
Oar ean ei Nel cena eas (ele coast
۱ (۳۹ h(cliccaasiti
Mera RO ا ا ا eee
999,95
2).
صفحه 43:
ار ساموت رم و را 9
دمص گت هی وت اسف تم ری کات
دوصحب متاعددام لج دك
۱ O TSEC E trast ict
ginseng (50mg/d ginsenosides) American Annals of Internal Medicine
Pe ا ea MEY EO ال م a ON در
صفحه 44:
3
8
=
و
4
8
5
0
96
صفحه 45:
Time (h)
صفحه 46:
صفحه 47:
4
Pro-Garle ” Post-Garle
(Hydroxymidazolarsimidazolam) Serum Ratios
Pre-Ginkgo Post-Ginkgo Pre-Ginseng _Post-Ginseng
2. Comparison of presupplementation and postsupplementation phenotypic ratios (I-hy-
«droxymidazolam/midazolam) for CYP3A4, A, St John’s wort (SIW): B, garlic oil; C, G biloba; D,
P ginseng. Gray circles, Individual values: black circles, group means. Asterisks, Stati
صفحه 48:
بجوت :8)
as ee a a a od ل اا ا
poteds (hoproved “qualiy oP Pe”) ced tr dabetes
ا
Oruy 000 ل ا ا لا
©0890 a ee eee Te en kod
yseeey (Pucex quaquPvius) but wobe wt Coreca
Rae ae oer es
۲ aN Et ی مس
با mee IR er ks]
(ON eae dea is is oe
a eer
صفحه 49:
صفحه 50:
© H. perforatum extract
WS 5570 (N=186)
© Placebo (N=189)
7
2
an
ric
go
a8
ga
0
ge
z3
ge
Fe
8ع
un
17
4
co
ge
56
14 21 28
Day of Treatment
Lecrubier et al. Am J Psychiatry 2002;159:1361 n=375
صفحه 51:
اما ور سم ها
متسه
) ویس -
AS ed
صفحه 52:
A
300) Heart transplantation
Hypenein times
3
1001
Feb 99 Mar99Apr99. Ma قو نود
=
Time (month,
صفحه 53:
60
48
(© Before St John’s Wort
@ After St John's Wort
Time. h
24
12
JwyBu ‘vee ‘uoHesUs0v09
0028107۷ 9۵58۵4
صفحه 54:
© 2
= 3 2
an 24g SY
3
3 ; 3 6
26] 32") so 5 3° 3
ع 2 5
3 ۶ 2 |“ 7
3 1 8 م ]7
8 ا iy
3, 8 5 ع
ما ©
aay ۳ 9 3
9۹
=
a
° 9
ه Ss 5
Control SUW Control SJW Control هلال/
Fig 3. Comparison of intestinal P-glycoprotein/MDR1 and CYP3A4/villin expression ratios and
erythromycin breath tests in humans. Eight healthy male volunteers were treated with St John’s
wort extract for 14 days. Duodenal biopsy specimens (A, B) and !4C-erythromycin breath tests
(EMBRT; C) were performed before treatment (control) and after treatment (SJW). Intestinal
P-glycoprotein (A) and CYP3A4/villin (B) expression ratios were determined by densitometric
analysis of Western blots and are given as the geometric means of 3 individual biopsy specimens
‘obtained before and after treatment with St John’s wort.
0 urd
صفحه 55:
Summary of SJW Interactions
(adapted from Henderson et al. Br J Clin Pharmacol 2002;54:349-346)
‘Management
Stop and measure
viral load
Stop and measure
viral load
Stop and adjust warfarin
dose
Stop and adjust
cyclosporine dose
Stop and use alternate
birth conizol
Stop and adjust
anticonvulsant dose
Stop and aqjust digoxin
dose
Stop and adjust
theophylline dose
Stop
Stop
Effect
T
CYP
Induce Ad
Induce AT
Tnduce 209
Induce P-_
Glycoprotein
Induce 3A4
Induce 4
Induce P-
Induce 1A2
serotonin
serotonin
Drug
HIV protease inhibitors
(nefinavir ritonavor saquinavir)
HIV nonnudeoside RTT
(cfavirerz, nevirapine)
‘warfarin
cydosporin
oral contraceptives
‘anticonvulsants
digoxin
Theophylline
Tiiptans
(sumatriptan)
SSRI
(fluoxetine sertraline, etc)
صفحه 56:
CU Aa]
0 ai
EN EVs andar Rr cae cd
میت
۱۳ powbiee wi ver wedouiow wess
weer close woulortay; possible phoisecstiviy
— Drury nteractovst « problew! Is a PPSO tecdhucer
ی( تسام و لو
۶ ۲ امس مس
ما he a LORS h yg aid ew
anal
~ Deset about SOOwy MO Por treukvect
BG eer reeedgenras eth:
مومت مه یت با او مت Te
مس
صفحه 57:
Cave (Kava Kava)
— Oses
اانا
0 aca
ل ل ها
0 عم حول 0000۵ وان کت
Groat ara 8
ره وه cL) LN SCA Ca ANCL
ePP ert)
۱ RNS Pao Ee ل
pr herxp
يي و و رن A
Oe NIACIN cea Ncl oa
۱ ira cah OCLC. Vcral ceca Va A ie
صفحه 58:
“Coxe Prow the Keats Pood stone:
DN tN PA bet DUI Ext BN DAC]
”
OS ROD 126:60 00-260:0,0626©
0 ا ل IRIN Ca Nt ae ae
Nea a Cac
Nn Sea Tira aT ال
SR aed
SEN Nh arate NE Ne Path ne DOA صا ie صا )060605
۱ Re ec Ne eat
صفحه 59:
ام رم ۱6
4 0
رارکت دمم اللا
Por و ۱9 هت
۱
Se a a سس
ها مت هنت hte
— Oroy itteractioes! «wt wih vier undolyics or
~ Pdioeet dol take (Cave uotl hepuipionicip risk ty
لمحت
- © عمصاوصض Aura ST Us of
0 2
0 سوساج ae
صفحه 60:
entia e ons of Goldense
P2D6 a م 4 3
2 : آه
gc oe ۳
io 2 3
oa هه 2 H
oo 9 1 2 5
eee! Re ee = ۰ 1
0 مد 8
0 = 5 ۰
0 ه أهه 5 2 1
Eos os 1 ۲
ey eta ۳ aco er 200 4 426
صفحه 61:
oo
Oars a Nea ea
لذ لسر / / Ferre
Py
Andrographis panucula تمك لوط ههه‌طوه8: ty
۱
تمنرو ودهط لام معتافومة 020000
0
Eire سور Erigeron hawthorn طحه زفاه‌زدج
هعنهه ota لاه مجوتیح وصنههن5 horse chestnut bark
01
0 علتسمسفط. See و نو وصعن
Baikal skullcap _clove oil 0 00 02
نا oea اه كناعلمع. 00 kava
مونم ممم
| تس licorice 01
ن 025221 CC Oe eg معطه منک همنده
router) nay نموه موعلمتو Shinpi bark
0 منصهنزه متسه 5
لله مومع ستو
لتو tecls Soe ete willow Screg
و و ا
صفحه 62:
يي يي لي ا
Ginkgo - case reports of bleeds alone and in
حتنورعه طفنه صمتاممتطهمی ۶ 0 tc
Decree Rend nea NES
Garlic - eR ل Bo
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Ginseng - decreased INR with warfarin (Panax quinquifolius)
صفحه 63:
Table 4a Significant Risk of CAM-drug Adverse Interaction
Potential Event Mechanism? Number? Occurrences‘
n=294 with CAM plus conventional med combinations with significant risk
Risk of bleeds
Aspirin
Garlic?82527 PD 147 214
Ginkgo PD 102 127
Warfarin
Garlic?52” PD 13 16
Ginkgo” PD 7 7
Ginseng? ۲0 3 3
Ticlopidine
Garlic232527 PD 4 6
Ginkgo®##0315¢ PD 2 3
Pentoxifylline
Ginkgo*#031 PD 3 3
Total 281 (5.6%) 380
صفحه 64:
۱۵0 رل
Significant Risk of CAM-drug Adverse Interaction
Potential Event Mechanism Number” ___ Occurrences”
Decreased drug benefit
Digoxin
St John’s wor?*4 = PK® 2 2
Felodipine ۱
۱ 2
Tamoxifen.
Garlic ۳ 4 5
Other 9
Furosemide/Aloe® PD 3 3
Thyrid/Kdp* PD 2 2
Grand Total 294 393
Garlic interactions: 168 241
Ginkgo interactions: 114 140
Garlic plus ginkgo: 282 (96%) 381 (97%)
صفحه 65:
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صفحه 66:
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صفحه 67:
0 woorgewedt (i., herbal/dinrgy
(2 سناع مر
literature analysis (Fugh-Berman and Ernst, Herbal
Da mM eC ها ار
Br J Clin Pharmacol 2001;52:587-595)
* 108 reported cases of suspected interactions
* 69% “unable to be evaluated”
* 19% possible interactions
* 13% (14) well documented
* 11/14 involved warfarin
* 7/14 involved St. John’s wort
صفحه 68:
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صفحه 72:
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صفحه 73:
00 ON i eB ica
*Scott GN and Elmer GW. Update on natural
product-drug interactions. Am J Health-Syst Pharm
2002;59:339-347
¢Ernst E. The risk-benefit profile of commonly used
herbal therapies: ginkgo, St. John’s wort, ginseng,
echinacea, saw palmetto and kava. Ann Intern Med
2002;136:42-53
*Izzo AA. Herb-drug interactions: an overview of
the clinical evidence. Fundam Clin Pharmacol.
2005 Feb;19(1):1-16.
*Ernst E. Prescribing herbal medications
صفحه 74:
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