Topic: FLAGYL: Milk Thistle & Vitamin E, C Intrfere with Action
CaliforniaLyme
Frequent Contributor (5K+ posts)
Member # 7136
posted
HARMFUL EFFECT:
Treatment with both METRONIDAZOLE and MILK THISTLE (SILYMARIN) may result in less metronidazole in your blood. PROOF:
This interaction has been reported in people (1). WHAT TO DO:
Being treated with both metronidazole and silymarin (milk thistle) may result in decreased metronidazole effectiveness. Your doctor may decide that treating you with both metronidazole and silymarin is the best option and may change your dose of metronidazole if necessary. If you take metronidazole, talk with your doctor before you take silymarin (milk thistle), and tell your doctor about all medicines and supplements that you take.
1: Helicobacter. 2002 Oct;7(5):310-6. Links
Vitamin C and E supplements to lansoprazole-amoxicillin-metronidazole triple therapy may reduce the eradication rate of metronidazole-susceptible Helicobacter pylori infection.
Chuang CH, Sheu BS, Huang AH, Yang HB, Wu JJ. Department of Internal Medicine, National Cheng Kung University, Tainan, Taiwan.
AIM: To test whether vitamin C and E supplements to triple therapy can improve the Helicobacter pylori eradication rate and gastric inflammation.
METHODS: A total of 104 H. pylori-infected patients were randomized to receive: either lansoprazole, amoxicillin, and metronidazole twice daily for 1 week (triple-only group) or lansoprazole, amoxicillin, metronidazole plus vitamin C (250 mg) and vitamin E (200 mg) twice daily for 1 week, followed immediately by vitamin C and E once daily for 6 consecutive weeks (triple-plus-vitamin group). Eight weeks after the completion of triple therapy, patients were assessed for the effectiveness of H. pylori eradication. The severity of gastric inflammation in histology was assessed for the acute and chronic inflammation scores.
RESULTS: Intention-to-treat and per-protocol eradication rates were 59.1% and 64.4% in the triple-only group, and 40% and 44% in the triple-plus-vitamin group. In the patients infected with metronidazole susceptible isolates, the triple-only group had a higher intention-to-treat eradication rate than those in the triple-plus-vitamin group. However, for the metronidazole resistance isolates, the intention-to-treat eradication rates between the two groups were not different. The improvements of both acute and chronic inflammation scores in histology were not different between the two groups.
CONCLUSION: Adding vitamin C and E to triple therapy cannot improve the H. pylori eradication rate and gastric inflammation. For patients with metronidazole susceptible strain infection, adding these vitamins may even reduce the eradication rate of triple therapy.
PMID: 12390211
1: Arch Biochem Biophys. 1987 Jun;255(2):419-27.Links Generation of radical anions of nitrofurantoin, misonidazole, and metronidazole by ascorbate.Rao DN, Harman L, Motten A, Schreiber J, Mason RP. Nitrofurantoin, misonidazole, and metronidazole were reduced to their corresponding nitro anion radicals by ascorbate in anaerobic solutions at high pH. The nitrofurantoin anion radical could be detected at neutral pH. In neutral solutions, the nitro anion radicals of misonidazole and metronidazole were too unstable to be observed by electron spin resonance spectroscopy. At neutral pH, solutions containing ascorbate, nitrofurantoin, or misonidazole consumed oxygen. The addition of superoxide dismutase, catalase, or both superoxide dismutase and catalase decreased the rate of oxygen consumption. These results show that nitro anion radicals are formed by reduction with ascorbate, and superoxide anion radical and hydrogen peroxide are produced by reactions of these radicals with oxygen.
PMID: 3036006
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