Peng Catherine C, Glassman Peter A, Trilli Lauren E, Hayes-Hunter Jocelyn, Good Chester B
Pharmacy Services, Veterans Affairs Pittsburgh Healthcare System, PA, USA.
Arch Intern Med. 2004 Mar 22;164(6):630-6. doi: 10.1001/archinte.164.6.630.
To explore the incidence and severity of potential interactions between prescription medications and dietary supplements.
A survey was conducted on dietary supplement use in 458 veteran outpatients currently taking prescription medications. Self-reported dietary supplement use was cross-referenced with each patient's prescription medication list, and potential interactions were identified from several tertiary sources and medical literature searches.
One hundred ninety-seven patients (43%) were currently taking at least 1 dietary supplement with prescription medication(s). The most common products included vitamins and minerals, garlic, Ginkgo biloba, saw palmetto, and ginseng. Among these, 89 (45%) had a potential for drug-dietary supplement interactions of any significance. Most of these interactions (n = 84 [94%]) were not serious based on limited available evidence, giving an incidence of 6% (5/89) of potentially severe interactions among patients taking interacting drugs and dietary supplements and 3% (5/197) among patients taking coincident dietary supplements and medications.
Although the use of dietary supplements appears to be very common among patients who also take prescription medications, most potential drug-dietary supplement interactions found were not serious. However, literature support was sparse at best. Health care providers should continue to inquire about dietary supplement use and consider the potential for interactions, regardless of their severity.
探讨处方药与膳食补充剂之间潜在相互作用的发生率及严重程度。
对458名正在服用处方药的退伍军人门诊患者的膳食补充剂使用情况进行了一项调查。将自我报告的膳食补充剂使用情况与每位患者的处方药清单进行交叉对照,并从多个三级资料来源和医学文献检索中确定潜在的相互作用。
197名患者(43%)目前正在服用至少一种与处方药合用的膳食补充剂。最常见的产品包括维生素和矿物质、大蒜、银杏、锯棕榈和人参。其中,89名患者(45%)存在任何显著意义的药物-膳食补充剂相互作用的可能性。根据有限的现有证据,这些相互作用中的大多数(n = 84 [94%])并不严重,在服用相互作用药物和膳食补充剂的患者中,潜在严重相互作用的发生率为6%(5/89),在同时服用膳食补充剂和药物的患者中为3%(5/197)。
尽管在同时服用处方药的患者中,膳食补充剂的使用似乎非常普遍,但发现的大多数潜在药物-膳食补充剂相互作用并不严重。然而,文献支持充其量也很稀少。医疗保健提供者应继续询问膳食补充剂的使用情况,并考虑相互作用的可能性,无论其严重程度如何。