Brief communication: American ginseng reduces warfarin's effect in healthy patients - A randomized, controlled trial

被引:153
作者
Yuan, CS [1 ]
Wei, G [1 ]
Dey, L [1 ]
Karrison, T [1 ]
Nahlik, L [1 ]
Maleckar, S [1 ]
Kasza, K [1 ]
Ang-Lee, M [1 ]
Moss, J [1 ]
机构
[1] Univ Chicago, Pritzker Sch Med, Tang Ctr Herbal Med Res, Comm Clin Pharmacol & Pharmacogen,Anticoagulat Con, Chicago, IL 60637 USA
关键词
D O I
10.7326/0003-4819-141-1-200407060-00011
中图分类号
R5 [内科学];
学科分类号
1002 ; 100201 ;
摘要
Background: People using prescription medication often concurrently take herbal supplements. in a case report, the anticoagulant effect of warfarin decreased after patients consumed ginseng. Objective: To evaluate the interactions between American ginseng and warfarin. Design: Randomized, double-blind, placebo-controlled trial. Setting: General Clinical Research Center, University of Chicago, Chicago, Illinois. Participants: 20 healthy patients. Intervention: in this 4-week study, 20 patients received warfarin for 3 days during weeks 1 and 4. Beginning in week 2, patients were assigned to receive either American ginseng or placebo. Measurements: International normalized ratio (INR) and plasma warfarin level. Results: The peak INR statistically significantly decreased after 2 weeks of ginseng administration compared with placebo (difference between ginseng and placebo, -0.19 [95% Cl, -0.36 to -0.07]; P = 0.0012). The INR area under the curve (AUC), peak plasma warfarin level, and warfarin AUC were also statistically significantly reduced in the ginseng group as compared with the placebo group. Peak INR and peak plasma warfarin level were positively correlated. Limitations: The study sample consisted of young, healthy volunteers in a research setting rather than patients taking therapeutic doses of warfarin. Conclusions: American ginseng reduces warfarin's anticoagulant effect. When prescribing warfarin, physicians should ask patients about ginseng use.
引用
收藏
页码:23 / 27
页数:5
相关论文
共 20 条
[1]   Herbal medicines and perioperative care [J].
Ang-Lee, MK ;
Moss, J ;
Yuan, CS .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2001, 286 (02) :208-216
[2]   Ginseng pharmacology - Multiple constituents and multiple actions [J].
Attele, AS ;
Wu, JA ;
Yuan, CS .
BIOCHEMICAL PHARMACOLOGY, 1999, 58 (11) :1685-1693
[3]  
BEERS MH, 1999, MERCK MANUAL DIAGNOS, P902
[4]   The risk-benefit profile of commonly used herbal therapies: Ginkgo, St. John's wort, ginseng, echinacea, saw palmetto, and kava [J].
Ernst, E .
ANNALS OF INTERNAL MEDICINE, 2002, 136 (01) :42-53
[5]  
Gruenwald J., 2000, PDR HERBAL MED, P346
[6]   Clinically important drug interactions with anticoagulants - An update [J].
Harder, S ;
Thurmann, P .
CLINICAL PHARMACOKINETICS, 1996, 30 (06) :416-444
[7]  
HOLANDER M, 1973, NONPARAMETRIC STAT M, P78
[8]   Probable interaction between warfarin and ginseng [J].
Janetzky, K ;
Morreale, AP .
AMERICAN JOURNAL OF HEALTH-SYSTEM PHARMACY, 1997, 54 (06) :692-693
[9]   Human P450 metabolism of warfarin [J].
Kaminsky, LS ;
Zhang, ZY .
PHARMACOLOGY & THERAPEUTICS, 1997, 73 (01) :67-74
[10]   Recent patterns of medication use in the ambulatory adult population of the United States - The Slone survey [J].
Kaufman, DW ;
Kelly, JP ;
Rosenberg, L ;
Anderson, TE ;
Mitchell, AA .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2002, 287 (03) :337-344