Data provided by Applied Health
side effects, nutrient depletions, herbal interactions and health notes:
• Use of alcohol should be avoided.1
• Vitamin C may help to delay or prevent the tolerance effect assoicated with long term use of nitrates.2
• N-acetyl cysteine may increase the effectiveness of isosorbide and delay development of nitrate tolerance.3
• These herbs may have cardioactive properties and should therefore be avoided while using Imdur: Blue Cohosh, Coltsfoot, Devil’s Claw, Fenugreek, Figwort, Ginseng, Panax, Goldenseal, Hawthorn, Horehound, Mate, Mistletoe, Motherwort, Shepherd’s Purse, and Wild Carrot.4
• Natural licorice products, Ginseng and Ephedra (Ma huang) may cause hypertension and should therefore be avoided by those with high blood pressure.5
References1 Allison, R.D. et al: Effects of alcohol and nitroglycerin in vascular responses in man. Angiology, 1971, 22: 211-222.
1 Facts and Comparisons, Clinisphere 2.0, Wolters Kluwer Company, 2000
1 Pronsky, Z Food Medication Interactions, 11th edition, 1999
2 Bassenge E, Fink N, Skatchkov M, Fink B. Dietary supplement with vitamin C prevents nitrate tolerance. J Clin Invest 1998;102:67-71
2 Watanabe H, Kakihana M, Ohtsuka S, Sugishita Y. Randomized, double-blind, placebo-controlled study of the preventive effect of supplemental oral vitamin C on attenuation of development of nitrate tolerance. J Am Coll Cardiol 1998;31:1323-29
3 Svendsen JH, Klarlund K, Aldershvile J, Waldorff S. N-Acetylcysteine modifies the acute effects of isosorbide-5-mononitrate in angina pectoris patients evaluated by exercise testing. J Cardiovasc Pharmacol 1989;13:320-23
3 Boesgaard S, Aldershvile J, Pedersen F, Pietersen A, Madsen JK, Grande P. Continuous oral N-acetylcysteine treatment and development of nitrate tolerance in patients with stable angina pectoris. J Cardiovasc Pharmacol. 1991 Jun;17(6):889-93.
3 Boesgaard S, Aldershvile J, Poulsen HE. Preventive administration of intravenous N-acetylcysteine and development of tolerance to isosorbide dinitrate in patients with angina pectoris. Circulation. 1992 Jan;85(1):143-9.
4 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996:21,45,63,282.
4 PDR for Herbal Medicines, 2nd edition, Medical Economics Company, 2000
5 Newall CA, Anderson LA, Phillipson JD. Herbal Medicines: A Guide for Health-care Professionals. London: The Pharmaceutical Press, 1996.
5 Brinker, F Herb Contraindications and Drug Interactions, Eclectic Medical Publications, 1998
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The information in Drug Watch is provided as a courtesy to NewsTarget readers by Applied Health Solutions in cooperation with Healthway Solutions. Although the information is presented with scientific references, we do not wish to imply that this represents a comprehensive list of considerations about any specific drug, herb or nutrient. Nor should this information be considered a substitute for the advice of your doctor, pharmacist, or other healthcare practitioner. Please read the disclaimer about the intentions and limitations of the information provided on these pages. It is important to tell your doctor and pharmacist about all other drugs and nutritional supplements that you are taking if they are recommending a new medication. Copyright © 2007 by Applied Health Solutions, Inc. All rights reserved.