The Polypharmacy Network

Polypharmacy Prevention
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What You Should Know About Evening Primrose Oil?
By: Joanne Jansen PharmD and Anjanette Dymerski PharmD
Many people consider herbal supplements safe since they are natural. However, even natural things can be bad for you; for example, a bite from a black widow spider is natural and not good. Always discuss any new supplements with your doctor or pharmacist before taking them to make sure they do not interact with your medications or cause worsening of a disease you have.

It is important to remember that natural supplements and vitamins are not regulated by the Food and Drug Administration (FDA). This means that there may be ingredients in the products that are not listed. There is also no guarantee that the ingredients listed on the bottle are accurate.

Evening primrose oil is often used to improve menopause symptoms such as hot flashes. It is also used for eczema, psoriasis, rheumatoid arthritis and osteoporosis. Although there may be benefit when used for osteoporosis if used in combination with fish oil and calcium, it does not seem to be useful for the other conditions.

Although some people may benefit from evening primrose oil, there are many reasons you may not want to take it. Evening primrose oil may interact with some drugs and change or increase their effects. For instance, evening primrose oil interacts with all of these drugs and more:
• Anticoagulants / Antiplatelets (blood thinners)
     o warfarin (Coumadin®)
     o clopidogrel (Plavix®)
     o dipyridamole (Persantine®, Aggrenox®)
     o aspirin
     o ticlopidine (Ticlid®)
     o enoxaparin (Lovenox®)
     o heparin
• NSAIDs
     o Ibuprofen (Advil®, Motrin®)
     o Naproxen (Aleve®, Naprosyn®)
     o Indomethacin (Indocin®)
     o Ketoprofen
     o Meloxicam (Mobic®)
     o Diclofenac (Voltaren®)
     o Oxaprozin (Daypro®)
     o Celecoxib (Celebrex®)
     o Piroxicam (Feldene®)

Ginkgo can cause problems in people with certain diseases. If you have one of the following, discuss with your doctor or pharmacist whether you should take ginkgo:
• Bleeding problems
• Epilepsy
• Schizophrenia

Other things you should know about ginkgo:
• Tell your doctor you are taking this drug before you have surgery. You may need to stop it two weeks before surgery to prevent bleeding problems.
• Tell your doctor or pharmacist you are taking this drug before you start any new medications.
• Evening primrose oil is generally well tolerated and rarely causes side effects when used properly.

More information available at the Natural Products Database of The Pharmacist’s Letter.