Table 4.

Herb functions and drug interactions. (Courtesy of Anita Chen Marshall, DOAM, PharmD, LAc)

Herb pharmacological functions	Drug interactions
Elevate blood pressure and stimulate heart muscle Sympathomimetic: Ma Huang (Herba Ephedrae), Qing Pi (Pericarpium Citri Reticulatae Viride), Zhi Shi (Fructus Aurantii Immaturus), Zhi Ke (Fructus Aurantii) Hypertensive: Gan Cao (Radix Glycyrrhizae) Positive inotropic: ChenPi (Pericarpium Citri Reticulatae), Fu Zi (Radix Aconiti Lateralis Praeparata), Ren Shen (Radix Ginseng), Wu Zhu Yu (Fructus Evodiae) Note: Hypotensive: Gou Teng (Ramulus Uncariae cum Uncis), Di Long (Pheretima), and Ginkgo biloba (Folium Ginkgo) may cause hypotension when used with antihypertensive drugs	Antihypertensive drugs: Caution: may increase risk of hypertension Calcium channel blockers: amlodipine (Norvasc), nifedipine (Procardia, Adalat), efonidipine (Landel), felodipine (Plendil) Beta-blockers: metoprolol (Lopressor), labetalol (Normodyne, Trandate), propranolol (Inderal), carvedilol (Coreg) ACE inhibitors: lisinopril (Prinivil, Zestril), benazepril, (Lotensin), captopril (Capoten) Angiotensin receptor blockers: losartan (Cozaar), valsartan (Diovan)
Improve blood circulation, inhibit platelet aggregation Dan Shen (Radix Salviae Miltiorrhizae), Ji Xue Teng (Caulis Spaatolobi), San Qi (Panax Notoginseng), Tao Ren (Semen Persicae), Pu Huang (Pollen Tyhpae) ((He, LS et al. 2016)	Anticoagulant and antiplatelet drugs Caution: may lead to prolonged PTT and excessive bleeding. Examples: warfarin (Coumadin), heparin, apixaban (Eliquis)
Drain damp effect (increase urine output) Fu Ling (Poria), .Zhu Ling (Polyporus), Che Qian Zi (Semen Plantaginis), Ze Xie (Rhizoma Alismatis), Bai Zhu (Rhizoma Atractylodis Macrocephalae)	Diuretic drugs Caution: may lead to excessive fluid and electrolyte loss Examples: hydrochlorothiazide (Microzide), furosemide (Lasix), spironolactone(Aldactone)
Lower blood sugar Zhi Mu (Radix Anemarrhenae), Shi Gao (Gypsum Fibrosum), Shan Yao (Rhizoma Dioscorea), Huang Qi (Radix Astragalus), Xuan Shen (Scrophularia ningpoensis), Cang Zhu (Rhizoma Atractylodis)	Antidiabetic drugs Caution: may cause hypoglycemia metformin (Glucophage), tolbutamide (Orinase), glipizide (Glucotrol), glyburide (Glynase, Micronase), pioglitazone (Actos), insulin
Calm the mind (shen) sedative Suan Zao Ren (Semen Ziziphi Spinosae), Yuan Zhi (Radix Polygalae), Chai Hu (Radix Bupleuri), Tien Ma (Rhizoma Gastrodiae), Ye Jiao Teng (Caulis Polygoni Multiflori), He Huang Pi (Cortex Albiziae), Fu Shou (Fructus Citri Sarcodactylis)	CNS suppressant drugs Caution: may cause excessive drowsiness and sedation Opioids: morphine, codeine, hydrocodone, oxycodone Antidepressants: selective serotonin reuptake inhibitors (SSRI), fluoxetine (Prozac), fluvoxamine (Luvox CR), paroxetine (Paxil) Antipsychotics: aripiprazole (Abilify), quetiapine (Seroquel) Antiseizure: phenytoin(Dilantin), pregabalin (Lyrica) gabapentin(Neurontin) Benzodiazepines: diazepam (Valium), Lorazepam (Ativan), Alprazolam (Xanax) OTC sleep aids: valerian, kava, melatonin, diphenhydramine (Benadryl), doxylamine (Unisome)