Herbal Supplement Drug Interactions: What NCLEX Nurses Must Know
Learn critical herbal supplement and drug interactions for the NCLEX. Covers St. John wort, ginkgo, garlic, ginseng, and patient teaching points.
Herbal Supplement Drug Interactions for NCLEX
Herbal supplements are used by millions of Americans, yet many patients do not disclose their use to healthcare providers. The NCLEX tests your knowledge of common herbal supplements, their interactions with prescribed medications, and important patient teaching points.
St. John Wort
St. John Wort is commonly used for mild to moderate depression. It induces cytochrome P450 enzymes, which can decrease the effectiveness of many medications including oral contraceptives, warfarin, cyclosporine, HIV protease inhibitors, and SSRIs. Combining St. John Wort with SSRIs or MAOIs can cause serotonin syndrome. Teach patients to inform their provider before using this supplement and to avoid concurrent use with prescription antidepressants.
Ginkgo Biloba
Ginkgo is used to improve memory and cognitive function. It has antiplatelet properties that increase bleeding risk, especially when combined with anticoagulants (warfarin, heparin), antiplatelet agents (aspirin, clopidogrel), or NSAIDs. Advise patients to discontinue ginkgo at least 2 weeks before surgery. Monitor for signs of bleeding including bruising, nosebleeds, and blood in stool.
Garlic Supplements
Garlic supplements are used for cardiovascular health and cholesterol reduction. Like ginkgo, garlic has antiplatelet effects and can increase bleeding risk with anticoagulants. It can also decrease the effectiveness of saquinavir (an HIV medication) and may potentiate the effects of antihypertensive medications, causing excessive blood pressure lowering.
Ginseng
Ginseng is used for energy and stress reduction. It can decrease the effectiveness of warfarin and may cause hypoglycemia when combined with insulin or oral hypoglycemics. It may also interact with MAOIs, causing headache and tremor. It has estrogenic effects and should be avoided in hormone-sensitive conditions.
Nursing Assessment and Teaching
Always ask patients about supplement use during medication reconciliation. Teach patients that natural does not mean safe and that supplements can have serious interactions with prescribed medications. Advise patients to consult their healthcare provider before starting any supplement. For more pharmacology content, explore our pharmacology flashcards and review herbal interaction cheat sheets.