Interactions between Chamomile and Treprostinil
This report displays the potential drug interactions for the following 2 drugs:
- chamomile
- treprostinil
Interactions between your drugs
chamomile treprostinil
Applies to: chamomile and treprostinil
Some herbs such as chamomile and fenugreek have coumarin constituents. Theoretically, ingesting large quantities of these herbs may potentiate the risk of bleeding in patients treated with agents that affect hemostasis such as anticoagulants, platelet inhibitors, thrombin inhibitors, thrombolytic agents, or agents that commonly cause thrombocytopenia. However, their effects on the coagulation system have not been studied, and bleeding complications have not been reported in humans. Moreover, pharmacologic effects may be highly variable due to inconsistencies in formulation and potency of commercial herbal products. In one patient, the addition of boldo and fenugreek to a stabilized regimen of warfarin resulted in an increase in INR. The INR returned to normal 1 week following discontinuation of both products but increased again when the patient resumed usage, which subsequently led to a 15% reduction in the weekly warfarin dosage. It is not certain whether the effects on INR are due to boldo or fenugreek, or a combination of both products. Patients should consult a healthcare provider before taking any herbal or alternative medicine. In patients who have used chamomile or fenugreek extensively prior to receiving anticoagulation, antiplatelet or thrombolytic therapy, the potential for an interaction should be considered. Close clinical and laboratory observation for hematologic complications is recommended. Patients should be advised to promptly report any signs of bleeding to their physician, including pain, swelling, headache, dizziness, weakness, prolonged bleeding from cuts, increased menstrual flow, vaginal bleeding, nosebleeds, bleeding of gums from brushing, unusual bleeding or bruising, red or brown urine, or red or black stools.
References (3)
- Miller LG (1998) "Herbal medicinals: selected clinical considerations focusing on known or potential drug-herb interactions." Arch Intern Med, 158, p. 2200-11
- Heck AM, DeWitt BA, Lukes AL (2000) "Potential interactions between alternative therapies and warfarin." Am J Health Syst Pharm, 57, 1221-7; quiz 1228-30
- Lambert JP, Cormier J (2001) "Potential interaction between warfarin and boldo-fenugreek." Pharmacotherapy, 21, p. 509-12
Therapeutic duplication warnings
No warnings were found for your selected drugs.
Therapeutic duplication warnings are only returned when drugs within the same group exceed the recommended therapeutic duplication maximum.
Drug and food/lifestyle interactions
No alcohol/food interactions were found. However, this does not necessarily mean no interactions exist. Always consult your healthcare provider.
Disease interactions
treprostinil Liver Disease
Applies to: Liver Disease
The use of the extended-release tablet formulation of treprostinil is contraindicated in patients with severe hepatic impairment (Child Pugh Class C). There is a marked increase in the systemic exposure to treprostinil in hepatically impaired patients. It is recommended to start patients with mild hepatic impairment (Child Pugh Class A) at 0.125 mg BID with 0.125 mg BID dose increments every 3 to 4 days and to avoid use of treprostinil in patients with moderate hepatic impairment (Child Pugh Class B).
treprostinil Bleeding Associated with Coagulation Defect
Applies to: Bleeding Associated with Coagulation Defect
Treprostinil injection inhibits platelet aggregation and increases the risk of bleeding. Close monitoring is recommended when using this agent in patients with bleeding disorders.
treprostinil Diverticulitis
Applies to: Diverticulitis
The tablet shell of the manufactured form of treprostinil, Orenitram does not dissolve and can lodge in the diverticulum of patients with diverticulosis. Care should be exercised when using this drug in patient with diverticulosis.
treprostinil Hypotension
Applies to: Hypotension
Treprostinil is a pulmonary and systemic vasodilator. In patients with low systemic arterial pressure, treatment with treprostinil injection may produce symptomatic hypotension. Care should be exercised when using this agent in patients at risk.
treprostinil Liver Disease
Applies to: Liver Disease
Severe hepatic impairment (Child Pugh Class C) is a contraindication in patients taking the oral presentation of treprostinil. Treprostinil is substantially metabolized by the liver, primarily by CYP450 2C8. Treprostinil injection clearance is reduced in patients with hepatic insufficiency. In patients with mild or moderate hepatic insufficiency, decrease the initial dose of treprostinil injection to 0.625 ng/kg/min ideal body weight, and monitor closely. Treprostinil injection has not been studied in patients with severe hepatic insufficiency. It is recommended to titrate treprostinil injection slowly in patients with hepatic insufficiency, because such patients will likely be exposed to greater systemic concentrations relative to patients with normal hepatic or renal function.
treprostinil Pulmonary Impairment
Applies to: Pulmonary Impairment
The efficacy of treprostinil inhalant has not been established in patients with significant underlying lung disease. Patients with acute pulmonary infections should be carefully monitored to detect any worsening of lung disease and loss of drug effect.
treprostinil Renal Dysfunction
Applies to: Renal Dysfunction
Treprostinil and its metabolites are excreted mainly through the urinary route. It is recommended to titrate treprostinil injection slowly in patients with renal insufficiency, because such patients will likely be exposed to greater systemic concentrations relative to patients with normal renal function. No dose adjustments are required in patients with renal impairment. Treprostinil is not cleared by dialysis.
chamomile
A total of 58 drugs are known to interact with chamomile.
- Chamomile is in the drug class herbal products.
-
Chamomile is used to treat the following conditions:
- Burns, External (off-label)
- Diarrhea (off-label)
- Fever (off-label)
- Gas (off-label)
- Herbal Supplementation
- Infectious Gastroenteritis (off-label)
- Motion Sickness (off-label)
- Nasal Congestion (off-label)
- Sedation (off-label)
- Skin Rash (off-label)
- Upper Respiratory Tract Infection (off-label)
treprostinil
A total of 343 drugs are known to interact with treprostinil.
- Treprostinil is in the drug class agents for pulmonary hypertension.
- Treprostinil is used to treat Pulmonary Arterial Hypertension.
See also
Report options
Drug Interaction Classification
| Highly clinically significant. Avoid combinations; the risk of the interaction outweighs the benefit. | |
| Moderately clinically significant. Usually avoid combinations; use it only under special circumstances. | |
| Minimally clinically significant. Minimize risk; assess risk and consider an alternative drug, take steps to circumvent the interaction risk and/or institute a monitoring plan. | |
| No interaction information available. |
Further information
Always consult your healthcare provider to ensure the information displayed on this page applies to your personal circumstances.