A 2013 Consumer Report survey reported that only about a quarter of the population actually checks with their pharmacist about drug interactions.

Are you part of that 25%?

Don’t wait to be informed, inform yourself. If you decide to opt-in to a self-care program, you likely share our belief that no one will ever be more invested in your health, wellbeing and safety than you.

Of course, you should review all herbal supplements, vitamins, OTC drugs and prescription drugs with your physician and/or pharmacist, even if it seems tedious to list them all out. Taking pictures of the bottles may help!

If you tend to run out of time at your appointment, it may help do your homework first, starting with seeing if any medications that you are on have warnings about taking particular supplements at the same time. Then you can reach out to your doctor if you have specific questions.

Here are three tools you can use to look up your drugs and possible supplement interactions:

https://www.drugs.com/drug_interactions.html

https://www.webmd.com/interaction-checker/default.htm

https://reference.medscape.com/drug-interactionchecker (requires free registration)

Note that missing information has been found from most of these online checkers so it can’t hurt to check multiple sources. 

Why is it crucial to check for potential supplement interactions with your migraine medications?

Many herbs change how your body metabolizes drugs that go through the liver. Another common issue is herbs that can interfere with or exacerbate the blood-thinning capabilities of warfarin and aspirin. Triptan drugs taken with certain herbs such as feverfew (or antidepressants) can lead to serotonin syndrome. Finally, if an herb has a similar effect to a drug (such as St. John’s Wort, which is sometimes used as an antidepressant) it can enhance the effect of the drug to a dangerous level.

Herbs that are often cited for having drug interactions include but are not limited to (including 6 in bold that you should be on alert for if you are taking certain migraine drugs):

  • Black Cohosh
  • Milk Thistle
  • Echinacea *
  • Garlic (large amounts) *
  • Ginger (large amounts)
  • Ginkgo Biloba * +
  • Ginseng * +
  • Goldenseal
  • CoQ10
  • Cranberry
  • Evening primrose oil
  • “Liver support” blends
  • Valerian root +
  • St John’s Wort *+
  • Saw palmetto
  • Melatonin
  • Kava
  • High dose vitamin C and other antioxidants
  • Feverfew*
  • Butterbur
  • Green tea extracts

* These 6 common herbs were identified by researchers at the University of Utah in 2003 to cause problems specifically with the metabolism of certain migraine medications (triptans and tricyclic antidepressants). 

+ These 4 herbs are known to worsen migraines and cluster headaches in some people on their own.

Further reading and examples:

So should supplements be avoided because they are too dangerous? 

That’s not what we are trying to say here. The point is to protect yourself by asking questions and giving your doctor a complete list of supplements. In a future article we will review common medications that actually deplete important nutrients and may require supplementation to avoid complications! 

Some more tips for staying safe with supplements 

  • Don’t buy supplements at the supermarket or big box stores (this is where expensive pee can be found).
  • Avoid buying through online resellers such as Amazon, if you can, because of rampant problems in the supply chain such as fraud, tampering, incorrect storage and shipping practices that can damage the product.
  • Introduce new supplements one at a time, starting with 1/4 or 1/2 of a dose and increasing every few days to watch for reactions.

Disclaimer: We aren’t doctors, nor do we play them on TV. This information may not be construed as medical advice – speak with your doctor about any questions (which is somewhat redundant with what we are saying in this whole article, but just in case you missed the message… talk to your own health care provider about changes in your protocol!). Important! Do not stop taking your medication unless directed to do so by your doctor.

Leave a comment! Did any of these herbal interactions surprise you?

Migraine 6 Common Migraine Drug and Supplement Interactions to Watch Out For