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Some herbal supplements pose a potential risk of adverse herb/prescription interactions. Other botanicals should be avoided altogether because they are not safe, cautions Doug Murray, PharmD, director of pharmacy and clinical services at Kershaw County Medical Center in Camden, SC, and an adjunct professor at the University of South Carolina College of Pharmacy in Columbia.
These herbs might still be found in some stores, or people could find them in the wild, he says. They include:
• Blue cohosh: The black cohosh is safe, but the blue cohosh is believed to increase a person’s blood pressure and provoke angina.
• Chaparral: It’s carcinogenic and toxic.
• Comfrey: This is potentially a hepatotoxin. It damages the liver and is carcinogenic when taken internally. People sometimes use it to promote bone healing, Murray notes.
• Deadly nightshade: As its name suggests, this herb should be avoided because it can be poisonous and produces chemicals similar to atropine, which is used as an anticholinergic.
Murray says he also worries about people buying herbs from questionable sources, such as small, fly-by-night manufacturers, because the quality and even the actual ingredients may not be inspected. (A list of herbal usage guidelines providers may wish to share with patients appears on p. 67.)