Cheng gives a thoughtful and useful presentation on herbal interactions with cardiac drugs. Besides the herbs mentioned, one should be aware of an increased bleeding risk when ginkgo biloba is taken with certain other medications, including aspirin (as told to me by a detail person from a manufacturer of herbal products). Warfarin and nonsteroidal anti-inflammatory drugs also fit in this category. Thus far, my office has been visited by at least 2 such companies. Whether or not we are proponents of their products, we should take advantage of the education they can provide us, so that we can better counsel our patients. While it is important to be critical of claims of efficacy that have not been substantiated in reasonable clinical trials, these producers may be best qualified to provide information concerning potential adverse affects and interactions.