Summary of Interactions with Vitamins, Herbs, & Foods
Replenish Depleted Nutrients
NSAIDs cause gastrointestinal (GI) irritation, bleeding, and iron loss. Iron supplements can cause GI irritation. However, iron supplementation is sometimes needed in people taking NSAIDs if those drugs have caused enough blood loss to lead to iron deficiency. If both iron and nabumetone are prescribed, they should be taken with food to reduce GI irritation and bleeding risk.
Reduce Side Effects
Propoxyphene may cause gastrointestinal (GI) upset. Propoxyphene-containing products may be taken with food to reduce or prevent GI upset. A common side effect of narcotic analgesics is constipation. Increasing dietary fiber (especially vegetables and whole-grain foods) and water intake can ease constipation.
The flavonoids found in the extract of licorice (Glycyrrhiza glabra) known as DGL (deglycyrrhizinated licorice) are helpful for avoiding the irritating actions NSAIDs have on the stomach and intestines. One study found that 350 mg of chewable DGL taken together with each dose of aspirin reduced gastrointestinal bleeding caused by the aspirin. DGL has been shown in controlled human research to be as effective as drug therapy (cimetidine) in healing stomach ulcers.
In a controlled human study, people who took stinging nettle with diclofenac obtained similar pain relief compared to people taking twice as much diclofenac with no stinging nettle. More research is needed to determine whether people taking diclofenac might benefit from also taking stinging nettle.
Potential Negative Interaction
It has been argued that ginkgo has a blood-thinning effect and might therefore further increase the risk of bleeing when taken in combination with drugs (including ibuprofen) that thin the blood. However, the bulk of the evidence suggests that ginkgo does not, in fact, have a blood-thinning effect.The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Ibuprofen may cause sodium and water retention. It is healthful to reduce dietary salt intake by eliminating table salt and heavily salted foods.The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
White willow bark (Salix alba) contains salicin, which is related to aspirin. Both salicin and aspirin produce anti-inflammatory effects after they have been converted to salicylic acid in the body. The administration of salicylates like aspirin to individuals taking oral NSAIDs may result in reduced blood levels of NSAIDs. Though no studies have investigated interactions between white willow bark and NSAIDs, people taking NSAIDs should avoid the herb until more information is available.The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
Ibuprofen has caused kidney dysfunction and increased blood potassium levels, especially in older people. People taking ibuprofen should not supplement potassium without consulting with their doctor.
Supplementation may enhance the anti-inflammatory effects of NSAIDs while reducing their ulcerogenic effects. One study found that when various anti-inflammatory drugs were chelated with copper, the anti-inflammatory activity was increased. Animal models of inflammation have found that the copper chelate of aspirin was active at one-eighth the effective amount of aspirin. These copper complexes are less toxic than the parent compounds as well.
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Last Review: 03-24-2015
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