August 27, 2015

Sage

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Are there any interactions with medications?



Drying medications (Anticholinergic drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Common sage (Salvia officinalis) and Spanish sage (Salvia lavandulaefolia) might increase levels of certain chemicals in the body that work in the brain, heart, and elsewhere. Some drying medications called "anticholinergic drugs" can also these same chemicals, but in a different way. These drying medications might decrease the effects of these sage species, and these sage species might decrease the effects of drying medications.

Some of these drying medications include atropine, scopolamine, some medications used for allergies (antihistamines), and some medications used for depression (antidepressants).



Estrogens
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Geraniol, a chemical in Spanish sage (Salvia lavandulaefolia), might have some of the same effects as estrogen. However, geraniol found in Spanish sage isn't as strong as estrogen pills. Taking Spanish sage along with estrogen pills might decrease the effects of estrogen pills.

Some estrogen pills include conjugated equine estrogens (Premarin), ethinyl estradiol, estradiol, and others.



Medications changed by the liver (Cytochrome P450 2C19 (CYP2C19) substrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some medications are changed and broken down by the liver. Sage might decrease how quickly the liver breaks down some medications. Taking sage along with some medications that are broken down by the liver might increase the effects and side effects of some medications. Before taking sage as a medicine, talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications that are changed by the liver include omeprazole (Prilosec), lansoprazole (Prevacid), and pantoprazole (Protonix); diazepam (Valium); carisoprodol (Soma); nelfinavir (Viracept); and others.



Medications changed by the liver (Cytochrome P450 2C9 (CYP2C9) substrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some medications are changed and broken down by the liver. Sage might decrease how quickly the liver breaks down some medications. Taking sage along with some medications that are broken down by the liver can increase the effects and side effects of some medications. Before taking sage as a medicine, talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications that are changed by the liver include diclofenac (Cataflam, Voltaren), ibuprofen (Motrin), meloxicam (Mobic), and piroxicam (Feldene); celecoxib (Celebrex); amitriptyline (Elavil); warfarin (Coumadin); glipizide (Glucotrol); losartan (Cozaar); and others.



Medications changed by the liver (Cytochrome P450 2D6 (CYP2D6) substrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some medications are changed and broken down by the liver. Sage might decrease how quickly the body breaks down some medications. Taking sage along with some medications that are changed by the liver can increase the effects and side effects of your medication. Before taking sage as a medicine, talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications that are changed by the body include amitriptyline (Elavil), codeine, desipramine (Norpramin), flecainide (Tambocor), fluoxetine (Prozac), ondansetron (Zofran), tramadol (Ultram), and others.



Medications changed by the liver (Cytochrome P450 2E1 (CYP2E1) substrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some medications are changed and broken down by the liver. Common sage might increase how quickly the liver breaks down some medications. Taking common sage along with some medications that are changed by the liver might decrease the effects and side effects of your medication. Before taking common sage as a medicine, talk to your healthcare provider if you take any medications that are changed by the liver.

Some medications that are changed by the liver include acetaminophen, chlorzoxazone (Parafon Forte), ethanol, theophylline, and drugs used for anesthesia during surgery such as enflurane (Ethrane), halothane (Fluothane), isoflurane (Forane), and methoxyflurane (Penthrane).



Medications changed by the liver (Cytochrome P450 3A4 (CYP3A4) substrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some medications are changed and broken down by the liver. Sage might decrease how quickly the liver breaks down some medications. Taking sage along with some medications that are broken down by the liver might increase the effects and side effects of these medications. Before taking sage as a medicine, talk to your healthcare provider if you are taking any medications that are changed by the liver.

Medications that might be affected include certain heart medications called calcium channel blockers (diltiazem, nicardipine, verapamil), cancer drugs (etoposide, paclitaxel, vinblastine, vincristine, vindesine), fungus-fighting drugs (ketoconazole, itraconazole), glucocorticoids, alfentanil (Alfenta), cisapride (Propulsid), fentanyl (Sublimaze), lidocaine (Xylocaine), losartan (Cozaar), midazolam (Versed), and others.



Medications for Alzheimer's disease (Acetylcholinesterase (AChE) inhibitors)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Common sage (Salvia officinalis) and Spanish sage (Salvia lavandulaefolia) might increase certain chemicals in the brain, heart, and elsewhere in the body. Some medications used for Alzheimer's disease also affect these chemicals. Taking these species of sage along with medications for Alzheimer's disease might increase effects and side effects of medications used for Alzheimer's disease.



Medications for diabetes (Antidiabetes drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Sage might decrease blood sugar. Diabetes medications are also used to lower blood sugar. Taking sage along with diabetes medications might cause your blood sugar to go too low. Monitor your blood sugar closely. The dose of your diabetes medication might need to be changed.

Some medications used for diabetes include glimepiride (Amaryl), glyburide (DiaBeta, Glynase PresTab, Micronase), insulin, pioglitazone (Actos), rosiglitazone (Avandia), chlorpropamide (Diabinese), glipizide (Glucotrol), tolbutamide (Orinase), and others.



Medications for high blood pressure (Antihypertensive drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Common sage (Salvia officinalis) seems to lower blood pressure. Taking common sage along with medications for high blood pressure might cause your blood pressure to go too low. On the other hand, Spanish sage (Salvia lavandulaefolia) might increase blood pressure. Taking Spanish sage along with medications for high blood pressure might reduce the effects of these medications.

Some medications for high blood pressure include captopril (Capoten), enalapril (Vasotec), losartan (Cozaar), valsartan (Diovan), diltiazem (Cardizem), Amlodipine (Norvasc), hydrochlorothiazide (HydroDIURIL), furosemide (Lasix), and many others.



Medications moved by pumps in cells (P-glycoprotein substrates)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Some medications are moved by pumps into cells. Common sage (Salvia officinalis) might make these pumps less active and increase how much of some medications get absorbed by the body. This might increase the side effects of some medications.

Some medications that are moved by these pumps include etoposide, paclitaxel, vinblastine, vincristine, vindesine, ketoconazole, itraconazole, amprenavir, indinavir, nelfinavir, saquinavir, cimetidine, ranitidine, diltiazem, verapamil, corticosteroids, erythromycin, cisapride (Propulsid), fexofenadine (Allegra), cyclosporine, loperamide (Imodium), quinidine, and others.



Medications used to prevent seizures (Anticonvulsants)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Medications used to prevent seizures affect chemicals in the brain. Sage may also affect chemicals in the brain. By affecting chemicals in the brain, sage may decrease the effectiveness of medications used to prevent seizures.

Some medications used to prevent seizures include phenobarbital, primidone (Mysoline), valproic acid (Depakene), gabapentin (Neurontin), carbamazepine (Tegretol), phenytoin (Dilantin), and others.



Sedative medications (Benzodiazepines)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Common sage (Salvia officinalis) might cause sleepiness and drowsiness. Medications that cause sleepiness and drowsiness are called sedatives. Taking common sage along with sedative medications might cause too much sleepiness.

Some of these sedative medications include clonazepam (Klonopin), diazepam (Valium), lorazepam (Ativan), and others.



Sedative medications (CNS depressants)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Sage might cause sleepiness and drowsiness. Medications that cause sleepiness are called sedatives. Taking sage along with sedative medications might cause too much sleepiness.

Some sedative medications include clonazepam (Klonopin), lorazepam (Ativan), phenobarbital (Donnatal), zolpidem (Ambien), and others.



Various medications used for glaucoma, Alzheimer's disease, and other conditions (Cholinergic drugs)
Interaction Rating: Moderate Be cautious with this combination.
Talk with your health provider.

Common sage (Salvia officinalis) and Spanish sage (Salvia lavandulaefolia) might increase certain chemicals in the brain, heart, and elsewhere in the body. Some medications used for glaucoma, Alzheimer's disease, and other conditions also affect these chemicals. Taking these species of sage with these medications might increase the chance of side effects.

Some of these medications used for glaucoma, Alzheimer's disease, and other conditions include pilocarpine (Pilocar and others), donepezil (Aricept), tacrine (Cognex), and others.

Dosing considerations for Sage.

The following doses have been studied in scientific research:

BY MOUTH:
  • For treating Alzheimer's disease: 1 gram of sage per day. A dose of sage extract, gradually increased over time to 2.5 mg three times daily, has also been used.
APPLIED TO THE SKIN:
  • For treatment of herpes labialis (cold sores): A cream containing 23 mg/gram each of sage extract and rhubarb extract has been applied every 2 to 4 hours while awake, with treatment starting within 1 day of the first symptoms and continuing for 10 to 14 days.

Therapeutic Research Faculty copyright

Report Problems to the Food and Drug Administration

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit the FDA MedWatch website or call 1-800-FDA-1088.


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