Older people should be especially mindful of interactions such as these, since they are much more likely than younger people to have heart problems and may be taking a half-dozen prescription drugs or more, Dr. Jahangir says.
Many heart patients—and even some doctors—aren’t aware of the dangers of mixing heart drugs and herbal products, he adds. Doctors rarely ask for a detailed list of the alternative remedies that patients take, and patients seldom volunteer that information. “Patients will typically discuss prescription or over-the-counter medicines, but in their minds these [herbal] compounds are not medicines,” Dr. Jahangir says.
Mixing heart medicine and herbal products is made even more risky by the lack of scientific evidence and regulation for herbal products and other dietary supplements, the report suggests. Although the potency of some herbal products can rival that of some prescription medicines, they are not subject to the same checks that prescription drugs are.
Few herbal products have been widely tested for safety and efficacy in randomized, placebo-controlled trials, as the U.S. Food and Drug Administration (FDA) requires of prescriptions drugs. Moreover, the FDA does not approve dietary supplements before they appear on the market, and monitors the safety and purity of herbal products only if consumers report side effects or other problems. As a result, many popular herbal products haven’t been proven to work, and some contain impurities or inconsistent amounts of the active ingredient.
“The public believes there is a check on everything, which is not true at all,” says Dr. Jahangir.
For her part, Dr. Giardina recommends that heart patients—and anyone else, for that matter—steer clear of herbal products.
“Frankly, I would just avoid them all,” she says. “Go into your medicine cabinet and get rid of anything you bought in an herbal store that you take in a pill form. Save your money and go buy a pair of shoes.”
