Alcohol and Herbal Remedies

Over 50% of Canadians now consume natural health products in the form of traditional herbal products, vitamins and mineral supplements, and homeopathic preparations.

People often think of herbal remedies as "natural". They may not think of them as drugs, which they are. 

Women are the main consumers of herbal remedies (66% of all herbal users) in Canada. Many seniors are enthusiastic about using herbal drugs. Approximately 22% of women aged 65 and over and 20% of men over 65 use them.

There are many things to recognize about herbal remedies. First of all, there are few standards in this area, so a person may not know what he or she is really buying. Second, the levels of active ingredient in the herbal remedies can vary from preparation to preparation. Third, the quality will vary greatly from manufacturer to manufacturer. Last, it is not easy to get Canadian based health information on them.

There is a good article on herbals and aging available on the Internet: “ What Physicians Should Know about Herbal Medicines: Potential Herb-Drug Interactions in Older People” Volume 4, Number 5, June/July 2001, Pages 28,29, of Geriatrics and Aging.

See:  www.geriatricsandaging.com

There are several herbal drugs that you should not take if you drink alcohol. Here are a few:

Echinacea

What Do People Usually Take Echinacea For?

It is often used for the relief of sore throat due to colds or for relieving the symptoms of mild skin conditions and eruptions.

Why Not Take Alcohol with It? Echinacea has been reported to potentially cause damage to the liver. The liquid products are primarily made in crude alcohol, which can cause further liver damage.

Kava-Kava

What Do People Usually Take Kava-Kava For?

Kava kava is often used as an herbal sedative to calm and reduce anxiety.

Why Not Alcohol? Kava-kava can add to the effects of substances that depress (slow down) the central nervous system, causing over sedation.  Kava-kava can increase the effects of central nervous system depressants like alcohol.

In 2002, Health Canada issued a stop sale for all products containing kava kava because of reports of serious liver problems. Play it safe, don't use it.

Valerian

What Do People Usually Take Valerian For?

It is commonly used to deal with pain and promote sleep. It acts as a muscle relaxant

Why Not Alcohol?

Like kava-kava, valerian may add to the effects of sedatives, especially benzodiazepines (like Valium and barbiturates), as well as alcohol.

St. John's Wort

What Do People Usually Take St. John's Wort For?

St.John's Wort is taken by people as remedy for a range of disorders including nervousness, tension, insomnia, nervous headache, and neuralgic pain. Some people take it as a mild anti-depressant.

What to Watch Out For

The primary warning given for St. John's Wort is  "do not take it if you are on anti-depressants". Both the St. John's Wort and the anti-depressant will elevate levels of chemicals in the brain.  Taken together, this makes that effect stronger. Here is one situation where more is not better. People can experience a pattern of side effects described as "serotonin syndrome". This includes vomiting, restlessness, dizziness, and headaches.

Why Not Alcohol? 

Some companies producing St. John's Wort carry an alcohol warning on the packaging.  Because alcohol is a central nervous system depressant, it may be working against the effects of the St. John's Wort.

References and Resources

If  you are interested in learning about what some of the clinical  trials on gingko and several other herbal drugs have found, check out this site produced by the Horticultural Department at Purdue University in the United States www.hort.purdue.edu/newcrop/proceedings1999/v4-442.html#ginkgo. Among other things, the webpage describes whether there is research to support the claims of calming effects of several miscellaneous herbs (lavender, lemon balm etc). It was last updated in 2001, which means it does not reflect some of the new cautions on Kava Kava, or Ephedra.

Another useful site is Edward's Hospital listing  of the Complementary Therapies Natural Health Encyclopedia.  In the Herbs & Supplements  guide, you can find the scientific information and evidence on natural remedies and their uses. More than 200 hundred herbs, vitamins, and supplements are covered.

Kava Kava 

Melanie Johns Cupp,  March 1, 1999, Herbal Remedies: Adverse Effects and Drug Interactions, American Academy of Family Physicians. See: www.aafp.org/afp/990301ap/1239.html  Also has a patient handout on herbal products.

Valerian

Schulz V, Hansel R, Tyler VE. Rational Phytotherapy: A Physician's Guide to Herbal Medicine. 3rd ed. Berlin, Germany: Springer-Verlag; 1998:81 as cited in The Natural Pharmacist: www.tnp.com/encyclopedia/substance/94/287/

St. John's Wort

Health Canada (April, 2000) Information Backgrounder: Potential Drug Interactions with St. John's Wort.  See  www.hc-sc.gc.ca/english/protection/warnings/2000/2000_36e.htm

This site does not identify the alcohol-herbal interaction for St. John's Wort.

The Hypericum Homepage contains considerable amount of information on St. John's Wort. www.hypericum.com/hyp14.htm

Other

Nonprescription Drug Manufacturers Association of Canada, Self Medication Digest, January 1998, www.ndmac.ca/publicat/F-smd.html

DerMarderosian, A. (Ed.). (1999). Potential herb-drug interactions and specific herb-drug interactions. Guide to popular natural products (pp. 239-248). St. Louis, MO: Facts and Comparisons.

Foster, S. & Tyler, V. E. (1999). Tyler's honest herbal: A sensible guide to the use of herbs and related remedies. (4th ed.). New York: Haworth Herbal Press.

Herbs and drugs can make a bad mix. (1999, July). Tufts University Health and Nutrition Letter, 17:3.

Natural medicines comprehensive database: www.NaturalDatabase.com

Peirce, A. (1999). The American Pharmaceutical Association practical guide to natural medicines. New York: William Morrow.

Robbers, J. E., & Tyler, V. E. (1999). Tyler's herbs of choice: The therapeutic use of phytomedicinals. New York: Haworth Herbal Press.

Page last updated Tuesday January 25, 2005

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