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November 28, 2001

Use of Herbal Medications Before Surgery

Author Affiliations

Stephen J.LurieMD, PhD, Senior EditorIndividualAuthorJody W.ZylkeMD, Contributing EditorIndividualAuthor

JAMA. 2001;286(20):2542-2544. doi:10.1001/jama.286.20.2542

To the Editor: Dr Ang-Lee and colleagues1 discussed the use of herbal treatments during perioperative care. However, since they only used MEDLINE and The Cochrane Library, their data may be incomplete, as much of the literature on herbal medicine is not listed in these databases. Some of the herbs for which the authors found no adverse effects are, in fact, associated with adverse effects. Aloe, for instance, may increase the action of hypoglycemic drugs2 and potentiate the effects of cardiac glycosides and antiarrhythmic drugs.3 Cascara might also potentiate cardiac glycosides and antiarrhythmic drugs.3 Goldenseal has the potential to increase the effects of antihypertensives and calcium channel blockers, and to decrease the effects of anticoagulants.3

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