Interactions of herbal remedies with prescription cardiovascular medications

Herbal medicinal use has increased dramatically in recent years. The increasing use of these products is of concern, and their use may not be recognized by the treating physicians. Many of these remedies have potential for adverse interactions with medications commonly prescribed for various cardiovascular disorders. Despite their widespread use, limited data exists regarding the efficacy of herbs such as echinacea, garlic, ginseng, gingko, ephedra, and St. John's wort. Of special concern is the ability of herbal remedies to potentiate effects of prescription drugs with a narrow margin of safety. An increasing awareness of the potential for harmful effects of herbal remedies has given the impetus for aggressive interventions to inquire about the use of these agents and systematic reporting of adverse events emanating from their use. This review briefly summarizes important adverse interactions of commonly used herbal remedies with prescription cardiovascular medications.