. 2021 Apr 17;148(2):461–473. doi: 10.1007/s00432-021-03625-3

Table 5.

Likely interactions between CAM supplements and concomitant diseases' treatment in 13 patients

	Drug	CAM supplement	Interaction (likely)/effect
1	Ciprofloxacin	Magnesium	Reduced absorption of ciprofloxacin (Walker and Wright 1991)
2	CYP acting drugs	Chinese herbs	Chinese herbs are rated as likely interacting, CYP effects likely (Zeller et al. 2013)
2	Multiple drugs	Ginger	Several drugs of the patient could interact with ginger^a
3	Multiple drugs	Ginger	Several drugs of the patient could interact with ginger^a
4	Ciprofloxacin	Beetroot	Iron, magnesium, calcium: reduced absorption of ciprofloxacin (Walker and Wright 1991)
	Ciprofloxacin	Iron	Reduced absorption of ciprofloxacin (Walker and Wright 1991)
	Multiple drugs	Ginger	Several drugs of the patient could interact with ginger^a
5	Multiple drugs	Chinese herbs	Chinese herbs are rated as likely interacting, CYP effects likely (Zeller et al. 2013)
5	Multiple drugs	Ginger	Several drugs of the patient could interact with ginger^a
6	Levothyroxine	Minerals	Calcium, iron: reduced absorption of levothyroxine (Benvenga et al. 2017)
6	Acetylsalicylic acid	Vitamin E	Increased bleeding risk (Liede et al. 1998)
7	CYP3A4 acting drugs	Nigella sativa	Inhibition of CYP2D6 and CYP3A4 by Nigella sativa (Al-Jenoobi et al. 2010)
8	Multiple drugs	Ginger	Several drugs of the patient could interact with ginger^a
9	Multiple drugs	Chinese herbs	Chinese herbs are rated as likely interacting, CYP effects likely (Zeller et al. 2013)
10	Ciprofloxacin	Magnesium	Reduced absorption of ciprofloxacin (Walker and Wright 1991)
11	Acetylsalicylic acid	Vitamin E	Increased bleeding risk (Liede et al. 1998)
12	Levothyroxine	Calcium	Reduced absorption of levothyroxine (Benvenga et al. 2017)
13	Multiple drugs	Chinese herbs	Chinese herbs are rated as likely interacting, CYP effects likely (Zeller et al. 2013)

^aGinger: increased bleeding risks (e.g. with warfarin, NSAIDs) (Hodges and Kam 2002; Huebner 2012, p. 180; Shalansky et al. 2007); additional hypotonic effects (Huebner 2012, p. 180; Suekawa et al. 1984) with antihypertensive drugs; possibly additional sedating effects with sedating drugs; effects on drug glucoronidation (Huebner 2012, p. 180); CYP interactions regarding CYP2C9, CYP2C19 and CYP3A4 effecting multiple drugs (e.g. amlodipine, atorvastatin, pantoprazole) (Cho and Yoon 2015; Kim et al. 2012; Kimura et al. 2010)