Drug Interactions

medication-image-for-blogI’m often asked whether golden paste would interfere with a drug that someone is taking. I can’t answer individual questions. That just gets too close to giving medical advice for me to be comfortable with it. But I did get permission to quote an article from the Turmeric User Group on Facebook about pharmaceutical interactions in general. This was written by Judith Jenness, a critical care nurse. I hope it will provide some help with medication interactions. I did some very minor editing to make it more readable, but otherwise, it is exactly as published in the Turmeric User Group files.

If you have a question about interactions that isn’t answered by this article, you can ask in the group and someone will provide the information.

Pharmaceuticals and Turmeric, by Judith Jenness

Over the counter meds: Right up front, please read the ingredients on any OTC meds you buy, including cold medicines, pain compounds,etc . Many of them already contain aspirin or tylenol in particular; and neither of them is entirely benign. You should always be aware of what your total medication load is, including prescription meds, over the counter meds and herbals. And you should always let your health care practitioners know what things you are ingesting that may or may not affect your health or have interactions. This doesn’t mean that you can’t use turmeric or other things you have found efficacious, just that you need to educate yourself.

Anti-coagulants and turmeric: Turmeric has anticoagulant effects similar to those of commonly prescribed NSAIDs and aspirin. It directly effects platelet adhesion.If you are taking Coumadin (warfarin) , then it is relatively easy to measure effects because you are already having frequent INR checks, or in some cases are already monitoring your own levels.If you have been prescribed some of the newer anticoagulants (Eliquis, Xarelto, Plavix, for example), then it is more problematic. These drugs are not monitored, so any interactions with turmeric may not be noted. You need to work with your physician, and know whether or not a dietary addition that could increase clotting time is a problem.

Anti-hyperglycemics and insulin: Turmeric can possibly reduce insulin resistance. This means that you must be aware of and monitor your glucose levels regularly.

Chemotherapy: There a great many chemo drugs that are actually known to be enhanced by turmeric, whether for cancer or things like rheumatoid arthritis and other autoimmune diseases. There are also drugs that may not work well with turmeric. Please ask us for specific examples of research data …AND always work with your oncologist or rheumatologist. We will be glad to point you towards the most recent research data.

Anti-depressants: Turmeric has some antidepressant effects, specifically in terms of MAO inhibition. This means that if you are taking a drug which should not be taken with MAO inhibitors, you should check in with your physician before adding turmeric to your daily life. Additionally, the piperine in the golden paste formulation can possibly slow down metabolism of many drugs, and make their side effects greater. These include such drugs as SSRI’s, SSNRIs ( Zoloft, Paxcil, Prozac are examples) and tricyclic antidepressants (amitryptilline for example) Turmeric has a mild MAO-Inhibitor effect; any cautions about MAOI-s and dietary items in combinations with tricyclics and SSRIs and SSNRIs should be noted. The interaction can cause general malaise all the way to serotonin syndrome, which can be fatal. Bottom line: MANY commonly prescribed antidepressants, anti-psychotics, anti-anxiety drugs are extremely powerful drugs with rotten side-effects. Please be very careful if you are using any psychotropic drugs and adding in any herbal or dietary substance to your daily regime. Some people are very sensitive to even very small alterations in dosages. You need to know what class of drugs you are taking and you MUST work closely with your physician if you are taking these drugs, or attempting to wean off them.

Narcotics: The piperine in the golden paste can possibly slow metabolism of narcotics like morphine, fentanyl, codeine. This means that side effects can be increased. If you are taking narcotics of any sort, especially long term, then you need to work with your physician when adding any substance to your diet that can change how the drugs work in your body. Please, even when you find that your pain is relieved by using turmeric, do not stop using any narcotic suddenly.

Anti-seizure medications: the piperine in the golden paste can possibly slow down metabolism of drugs such as phenobarbital, phenytoin (Dilantin) and benzodiazepines like valium, midazolam, ativan, serax. This means that the therapeutic blood levels and effects may be increased. Please make sure that your physician or veterinarian is aware that you are adding turmeric and black pepper to your diet.

Anti-hypertensives and diuretics: Typically, four classes of drugs are prescribed to reduce high blood pressure: ACE inhibitors; Beta-blockers; Calcium channel blockers; Diuretics. Because either turmeric or piperine in black pepper can possibly interact with or increase effects, you should be monitoring your blood pressure regularly. ACE inhibitors are commonly used to decrease blood pressure by modulating action and production of a specific hormone (Angiotensin Converting Enzyme). Examples:benezapril (Lotensin), Captopril (Capten), enalapril (Vasotec), Lisinopril (prinavil or Zestril), Ramipril (altace) as well as others. *Turmeric also has a mild ACE inhibiting action, so the effects of this class of drugs could be increased by taking turmeric. Beta blockers basically block a particular part of the autonomic nervous system to decrease ‘fight or flight” reactions. They slow heart rate, decrease blood.pressure. Examples: Propranolol Hydrochloride, Timolol, Metoprolol, Atenolol, and Nadolol. *Piperine in black pepper can possibly increase the effects of beta blockers. Calcium channel blockers reduce blood pressure by relaxing blood vessels. Examples: Verapamil (Isoptin, Calan SR, and Verelan), Amlodipine (Norvasc), Felodipine (Plendil),sustained-release nifedipine (Procardia X) *Turmeric also has mild calcium channel blocking effects, so could increase the effects of these drugs. Diuretics: reduce blood pressure indirectly by increasing urine output, which clears excess fluid from the body and lungs. Diuretics also help relax artery walls, thereby reducing blood pressure.*Turmeric is also a mild diuretic. Generally there seem not to be any specific interactions with any of the commonly prescribed diuretic drugs.

Antibiotics: In general, golden paste can safely be taken with most antibiotics with rare exceptions. It is not recommended to use with antibiotics in the fluoroquinolone class, as it is known to decrease their antimicrobial effects. This includes most commonly, Ciprofloxacin (and gemifloxacin, levofloxacin, moxifloxacin, ofloxacinef); and Baytril (enrofloxacin) used in animals. If you have a question about a specific antibiotic, ask your doctor, vet or pharmacologist, or post a query on the TUG page.

Antirejection medications: If you have had a transplant of any sort, your first resource when adding any dietary items or herbals must be your medical team. Curcumin has actually been studied with specific drugs used post transplant with some positive results, BUT some of the drugs used to suppress rejection have very, very tight tolerances as to effectiveness vs toxicity. Please consult with your specialist and/or pharmacist BEFORE adding turmeric and black pepper to your diet.

Welcome to the brand new New Naturals blog!

Here we’ll share some thoughts that I hope will help you use spices more effectively in your life, and your pets’ lives. We’ll discuss current ideas about the therapeutic use of spices, toss out some recipes and let you know what’s new in the world of herbs and spices.

Feel free to ask questions, but please do understand that we can’t provide medical advice.

To start out, I wanted to bring up something that has been of concern recently to many turmeric users. An article posted in the Journal of Medicinal Chemistry in December 2016 describes curcumin as a “missile that continually blows up on the launchpad, never reaching the atmosphere or its intended target,” and curcumin research as having “entered the steep section of the hyperbolic black hole of natural products.” The article went on to denigrate curcumin in language that made the average turmeric fan’s blood boil. It was quoted in multiple other publications with predictable reactions ranging from condemnation of “Big Pharma” to accusations that government would soon make turmeric illegal, etc.

There is one single important–essentially important–thing to point out about this article. It refers repeatedly to curcumin as a “drug lead.” In pharmacy industry parlance, a “drug lead” is anything which has potential to become an economically viable product. The authors of the article are not interested in the use of turmeric as a food. Most of the virulent reaction to the article seems to have missed that fact.Curcumin may or may not be a good drug lead, but that whole discussion is irrelevant to us as users of the spice, turmeric. Moreover, turmeric is registered as a food with the FDA. It will not be made illegal nor does ‘Big Pharma’ have any particular interest in it.

What about curcumin, then? Will it be outlawed or forced into the status of a drug? Probably not, but if that happens, the companies who have promoted curcumin as a miracle cure for everything under the sun have only themselves to blame. I wince–and I hope you do too–every time I see another sensational headline proclaiming some company’s supplement as THE MOST BIOAVAILABLE CURCUMIN ON THE MARKET!!, or UNIQUELY FORMULATED!!! or whatever that company’s marketing director thought would bring in sales. They carefully skirt the margins of legality by quoting medical research to back up their claim–curcumin inhibits this and reduces that and balances something else. “We aren’t claiming any therapeutic benefits for it,” they righteously proclaim. “We’re just quoting the research.”

So what was the result of that? The result was the aforementioned article blasting the validity of the research. If the research upon which you base your claims is no good, then your claims just became worthless. How this will shake out is anyone’s guess at this point. But it should not have any effect on us as consumers of turmeric as a food.  Turmeric has been a valued food for three thousand years, and it’s not going to change any time soon.

So if anyone points out that article and wants to know what you think, just shrug and say “That’s about curcumin as a profitable drug. Nothing to do with how I add turmeric to my diet.”

As always, we suggest you join the Facebook Turmeric User Group for scientifically accurate answers to turmeric questions. Information for this article came in part from a similar article by Liz Wallis in the files of TUG.