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» LymeNet Flash » Questions and Discussion » Medical Questions » Buhner herbs - drug interactions?

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Author Topic: Buhner herbs - drug interactions?
ldfighter
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Reposting from another thread in case anyone knows the answer:

About doing Buhner's core protocol with abx - I'm wondering about drug interactions. I know Buhner says they can be done together, but I've also read that resveratrol and cat's claw can both inhibit CYP3A4 which is affected by so many drugs. Has Buhner addressed this anywhere (CYP enzymes specifically)?

Maybe it's just in vitro, or maybe you'd need massive quantities of the herbs to make a difference. But here's one article that concerned me:
http://tinyurl.com/yo8ful
"...inactivation of CYP3A4 by resveratrol may cause clinically relevant drug interactions with CYP3A4 substrates."

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ldfighter
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or any info on drug interactions with cat's claw, resveratrol?
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AliG
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Here's some CYP3A4 ligands as listed in -CYP3A4, From Wikipedia, the free encyclopedia


Selected inducers, inhibitors and substrates of CYP3A4[3]


Substrates
Often mentioned: [4]

* calcium channel blockers
o diltiazem
o nifedipine
o felodipine
o verapamil
* immunosuppressants
o ciclosporin
o tacrolimus
o sirolimus
* Chemotherapeutic
o cyclophosphamide
o docetaxel
o doxorubicin
o etoposide
o ifosfamide
o paclitaxel
o tamoxifen
o teniposide
o vinblastine
o vindesine
o gefitinib
* benzodiazepines
o flunitrazepam
o midazolam
o alprazolam
o triazolam
* azole antifungals
o ketoconazole
o itraconazole

* tricyclic antidepressants
o amitriptyline
o imipramine
o clomipramine
* macrolide
o erythromycin
o clarithromycin

* SSRIs
o citalopram
o fluoxetine and norfluoxetine
o sertraline
* statins
o atorvastatin
o lovastatin
o simvastatin
* PDE5 inhibitors
o sildenafil
* buspirone (anxiolytic)
* haloperidol (antipsychotic)
* venlafaxine (SNRI)
* amiodarone (antiarrhythmic)
* ethinylestradiol (hormonal contraceptive)
* kinins (vasodilators, smooth muscle contractors)

Other:

* protease inhibitors
o indinavir
o ritonavir
o saquinavir
o nelfinavir
* Mirtazapine (NaSSA)
* nefazodone (5-HT2A receptor antagonist)
* pimozide (antipsychotic)
* reboxetine (antidepressant)
* zopiclone (hypnotic)
* non-nucleoside reverse transcriptase inhibitors
o nevirapine
* alfentanil (analgesic)
* budesonide (glucocorticoid)
* donepezil (acetylcholinesterase inhibitor)
* esomeprazole (proton pump inhibitor)
* omeprazole (proton pump inhibitor)
* finasteride (antiandrogen)
* glibenclamide (antidiabetic)
* cisapride (5-HT4 receptor agonist)
* terfenadine (H1-receptor antagonist)
* toremifene (SERM)
* barbiturates
o phenobarbital
* carbamazepine (anticonvulsant, mood stabilizing)
* codeine (analgesic, antitussive, antidiarrheal)
* dextromethorphan (antitussive)
* digoxin (Antiarrhythmic)
* ergot alkaloids (circulation, neurotransmission)
* estradiol (sex hormone)
* fentanyl (analgesic)
* ivabradine (in angina pectoris)
* levonorgestrel (hormonal contraceptive)
* lidocaine (local anesthetic, antiarrhythmic)
* methadone (analgesic, anti-addictive)
* mifepristone (abortifacient)
* montelukast (leukotriene receptor antagonist)
* ondansetron (5-HT3 antagonist)
* paracetamol (analgesic, antipyretic)
* quinidine (class I antiarrhythmic)
* quinine (antipyretic, anti-smallpox, analgesic)
* testosterone (androgen)
* theophylline (stimulant)
* valproate (anticonvulsant, mood-stabilizing)
* warfarin (anticoagulant)
* tetrahydrocannabinol (psychoactive)
* Antipsychotics
* Aripiprazole
* Risperidone
* Ziprasidone


Inhibitors:

Strong: [5]

* fluconazole (antifungal)
* ritonavir (protease inhibitor)
* macrolide antibiotics
o erythromycin
o telithromycin
o clarithromycin
* azole antifungals
o ketoconazole
o itraconazole

* nefazodone (5-HT2A receptor antagonist)
* bergamottin (constituent of grapefruit juice)
* quercetin (check your vitamins?)

unspecified:

* amiodarone (antiarrhythmic)
* aprepitant (Substance P antagonist)
* cimetidine (H2-receptor antagonist)
* ciprofloxacin (antibiotic)
* ciclosporin (immunosuppressant)
* diltiazem (calcium channel blocker)
* imatinib (anticancer)
* echinacea (immunostimulator)
* enoxacin (antibacterial)
* ergotamine (in migraine)
* metronidazole (antibacterial)
* mifepristone (abortifacient)
* non-nucleoside reverse transcriptase inhibitors [6]
o efavirenz
o nevirapine
* gestodene (hormonal contraceptive)
* mibefradil (in angina pectoris)
* protease inhibitors
o saquinavir
o indinavir
* SSRIs
o fluoxetine
* star fruit
* piperine
* verapamil (calcium channel blocker)


Inducers:

Often mentioned: [4]

* barbiturates
o phenobarbital
* carbamazepine (anticonvulsant, mood stabilizing)
* hyperforin (constituent of St Johns Wort)
* non-nucleoside reverse transcriptase inhibitors [6]
o efavirenz
o modafinil
o nevirapine
* phenytoin (anticonvulsant)
* rifampicin (bactericidal)

Other:

* dexamethasone (anti-inflammatory, immunosuppressant)
* felbamate (anticonvulsant)
* glucocorticoids (blood glucose increase, immunosuppressive)
* griseofulvin (antifungal)
* pioglitazone (hypoglycemic)
* primidone (anticonvulsant)
* topiramate (anticonvulsant)
* troglitazone (hypoglycemic)
* rifabutin (in tuberculosis) ?


WOW! all those antidepressants, sleep aids, antifungals, some vitamins & fruits, pain meds, ABX, etc. So many things!!!! Scary stuff!!!!

[ 09. January 2008, 06:03 PM: Message edited by: AliG ]

--------------------
Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner.

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EyeBob
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I would go to naturaldatabaseconsumer.com and register to use the site.

It will walk you through the myriad of potential drug/herb, herb/herb, and drug/drug interactions. I have used the site because I trust it's thoroughness.

I was concerned about using the Buhner herbs with my ABX, and despite what Buhner says, you cannot use any of his protocol with some ABX, like plaquenil. They appear safe to use (according to this website) with clarithromycin and/or tetracycline. I have not researched any others.

FWIW, I have no financial connection to the site.

BT

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ldfighter
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What concerns me too is that the research is still being done on these herbs. Andrographis looks very promising for many things, but a new study concluded that it might cause drug-drug interactions in humans through CYP3A and 2C9 inhibition. Which *might* make it a no-no in combination with Biaxin or other macrolides, as well as many other drugs.

Study is here: http://www.ncbi.nlm.nih.gov/pubmed/18053665

Another good list of drugs that are metabolized by (or inhibit) various enzymes including CYP3A:
http://medicine.iupui.edu/flockhart/table.htm

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valymemom
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I would recommend Buhner's book Healing Lyme as a good resource for understanding the complexity of Bb.
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robi
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Impressive!

--------------------
Now, since I put reality on the back burner, my days are jam-packed and fun-filled. ..........lily tomlin as 'trudy'

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robi
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There is a group on yahoo that is dedicated to the use of Buhner's Protocol. One can go there, read and learn for themselves. IMHO ABX are the first line of defense, but not the sole solution to this illness.

--------------------
Now, since I put reality on the back burner, my days are jam-packed and fun-filled. ..........lily tomlin as 'trudy'

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AliG
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quote:
Originally posted by valymemom:
I would recommend Buhner's book Healing Lyme as a good resource for understanding the complexity of Bb.

I'll second that!!! I thought it was a GREAT resource for that!! [Big Grin]


I just read about Artemisinin in one of Dr.S's books and there was a list of warnings & possible interactions. I don't believe that I had seen this information in Buhner's book. [Roll Eyes]

[Frown]

--------------------
Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner.

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AliG
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quote:
Originally posted by cave76:

Buhner's advice should be taken with a grain of salt.


One thing I liked about him is that he actually points out his own potential for bias in the book. He also posts error corrections for his books on his website. ....ya gotta respect that. [Big Grin]

--------------------
Note: I'm NOT a medical professional. The information I share is from my own personal research and experience. Please do not construe anything I share as medical advice, which should only be obtained from a licensed medical practitioner.

Posts: 4881 | From Middlesex County, NJ | Registered: Jul 2006  |  IP: Logged | Report this post to a Moderator
   

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