Herbal Medication and Anesthesia

Disclaimer: The medical effects and drug interactions of herbal preparations are largely unknown. Few scientific studies have been done. Caution should be used in interpreting the information below. We currently recommend that patients discontinue herbals 1 to 2 weeks before anesthesia and surgery. We recognize that this is a conservative stance. However, until further studies are done on herbals, this would appear to be prudent.

Brand Name	Generic Name	Other names	Uses	Issues
Cayenne	capsicum annuum	Cayenne Chili pepper Paprika	External: muscle soreness Internal" GI disorders	Ext: blistering Int: OD-hypothermia
Echinacea	echinacea purpurea	Purple Cone Flower	Colds Wounds/Burns UTIs Bronchitis	hepatotoxicity decreased effectiveness of corticosteroids
Ephedra	ephedra sinica	Ma-Huang Ephedrine Chinese Joint Fir	OTC diet pills Bacteriostatic Antitussive	arrhythmias enhanced sympathomimetic effects w/ MAOIs hypertension with oxytocin
Feverfew	tanacetum parthenium	Feverfew Featherfew Midsummer Daisey	Migraines Antipyretic	inhibits platelets rebound headache 5-15% users develop aphthous ulcers/GI irritation
Garlic	allium sativum	Clove garlic Ajo	Lipid Lowering BP lowering Anti-platelet, antioxidant, antithrombotic properties	enhances warfarin effect
Ginger	zingiber officinale	Black Ginger African Ginger	Antiemetic Antispasmotic	inhibits thromboxane synthetase - bleeding
Ginko (Ginkgo)	ginko biloba	Maidenhair Tree Fossil Tree	Circulatory stimulant	enhances anticoagulant meds
Ginseng	panax ginseng	American Ginseng Chinese Ginseng Korean Ginseng	Adaptogenic Energy enhancer Antioxidant	excessive use: somnolence, hypertonia, edema tachycardia, hypertension w/ other stimulants mastalgia post-menopausal bleeding mania in patients on phenelzine decreases effectiveness of warfarin
Goldenseal	hydrastis canadensis	Orange Root Yellow Root Ground Raspberry Tumeric Root Eye Root	Diuretic Anti-inflammatory Laxative Hemostatic	oxytocic OD: paralysis excretion of free water, not sodium may worsen edema/hypertension
Kava-kava	piper methysticum	Ava Kawa Ava Pepper	Anxiolytic	potentiates sedatives increases suicide risk in depression
Licorice	glycyrrhiza glabra	Licorice Root Sweet Root	GI ulcers Cough/Bronchitis	may increase BP, hypokalemia, edema contraindicated in liver/renal disorders
Milk Thistle	silmarin		liver disease	?
Saw Palmetto	serenoa repens	Sabal Cabbage Palm	BPH Anti-androgenic	hormone therapy interaction
St. John's Wort	hypericium perforatum	Hardhay Amber Goatweed	Depression/anxiety	photosensitizing ?interaction w/MAOIs may prolong anesthesia
Valerian	valeriana officinalis	All-Heal Setwall Vandal Root	Sedative/anxiolytic	may potentiate sedatives
Comfrey Gordolobo tea Mate tea Chinese Medicinal tea tu-san-chi Jin Bu huan Germander Chaparrel leaf Mistletoe Margosa oil Pennyroyal oil		various	various	hepatotoxicity

Royal Pharmaceutical Society's Herbal Medicines:
(The effect/side-effect profile of these herbs are available via A2K or WISCR-IT on MicroMedex)