Term
| Dietary supplements according to the Dietary Supplement Health and Education Act (DSHEA): |
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Definition
– Is intended to supplement the diet
– Contains one or more dietary ingredients (including vitamins, minerals, herbs or other botanicals, amino acids, and certain other substance) or their constituents
– Is intended to be taken by mouth, in forms such as tablet, capsule, powder, softgel, gelcap, or liquid
– Is labeled as being a dietary supplement |
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Term
| “Botanical” is used synonymously |
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Definition
for “herb”
– May contain one herb or a mix of herbs, all included herbs must be listed on the label
• Although regulated by the FDA, guidelines are different much less strict than for prescription medications
• Little if any testing has been done on pregnant or nursing women or children (except for folic acid!) |
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Definition
• Per FDA regulations, supplements can be marketed before any evidence or data demonstrating their safety or effectiveness. This data is only required before they are actually sold.
• Claim types:
1. Health claims
2. Structure/function claims 3. Nutrient content claims
• Must meet quality standards for packaging and manufacturing
• Once on the market, the FDA collects data such as side effect reports and if deems unsafe, action is taken while the Federal Trade Commission (FTC) monitors advertising |
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Definition
• Used for centuries to treat: mental disorders, nerve pain, malaria, and topical balm for wounds, burns, and insect bites.
• Known interaction with (but not limited to): cyclosporine, Indinavir, digoxin, SSIRs, oral contraceptives, Coumadin, TCAs and benzodiazepines |
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Term
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Definition
• Popular for treating symptoms of mild to moderate benign prostatic hypertrophy (BPH)
• Should not be used if taking other medications for BPH
• Slows blood clottingincreased risk for bruising or bleeding if also taking blood thinners like warfarin
• Reduces effectiveness of hormonal therapies (estrogens, OCPs) |
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Term
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Definition
• Helps regulate sleep
• Helpful with insomnia, jet lag, shift work sleep disorders
• Causes drowsiness->avoid with alcohol or other sedatives (benzodiazepines, antihistamines, opioid analgesics, muscle relaxers)
• May increase blood sugar->interfere with diabetes management |
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Term
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Definition
• Hormone; natural or synthetic
• Precursor to androgens and estrogens, levels naturally decrease after age 30
• Taken for many reasons: vaginal atrophy, Alzheimer’s disease, improve athletic performance, sexual dysfunction, SLE, Sjogren’s syndrome, osteoporosis, fibromyalgia, IBD, Parkinson’s disease, weight loss
• Avoid if hormone sensitive conditions: breast, uterine or ovarian CA, endometriosis, fibroids |
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Term
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Definition
• Fruit of the chaste tree
• Used frequently for reproductive concerns including menstrual cramping, menopause symptoms, and infertility
• Limited research available
• Generally well tolerated
• Avoid if taking OCPs, HRT, hormone sensitive conditions, or dopamine-related medication (antipsychotics, Parkinson’s disease treatments) |
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Term
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Definition
Some drugs, like statins used to lower cholesterol, are broken down by enzymes. Grapefruit juice can block the action of these enzymes, increasing the amount of drug in the body and may cause more side effects.
Other drugs, like Allegra (fexofenadine) used to treat allergies, are moved by transporters into the body’s cells. Grapefruit juice can block the action of transporters, decreasing the amount of drug in the body and may cause the drug to not work as well. |
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Term
| Grapefruit impacts the CYP3A4 enzyme and can interact with (but not limited to): |
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Definition
– Some statin drugs to lower cholesterol, such as Zocor (simvastatin) and Lipitor (atorvastatin).
– Some drugs that treat high blood pressure, such as Procardia and Adalat CC (both nifedipine).
– Some organ-transplant rejection drugs, such as Sandimmune and Neoral (both cyclosporine).
– Some anti-anxiety drugs, such as buspirone.
– Some corticosteroids that treat Crohn’s disease or ulcerative colitis, such as Entocort EC and Uceris (both budesonide).
– Some drugs that treat abnormal heart rhythms, such as Pacerone and Nexterone (both amiodarone).
– Some antihistamines, such as Allegra (fexofenadine). |
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Term
| Higher concern drug interactions w grapefruit |
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Definition
• Higher concern for drugs that have a narrow therapeutic range
-Carbamazepine, Cyclosporin, Digoxin, Levothyroxine, Phenytoin, Warfarin |
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Term
| supplement interaction risks |
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Definition
Black Cohosh-Little risk
Echinacea-Little risk
Garlic-Prolonged exposure may reduce efficacy of drugs with disposition dependent on ABCB1 transporter
Ginkgo Biloba-Little risk in low doses
Ginseng-Induces activity of CYP3A
Goldenseal-Potent inhibitor of CYP3A and CYP2D6
Kava-Mixed results, possible increased effects of CNS depressants
St. John’s Wort-Potent inducer of CYP450 |
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