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An Exploratory Study of 2 Outpatient Practices

Catherine C. Peng, PharmD, BCPS; Peter A. Glassman, MBBS, MSc; Lauren E. Trilli, PharmD; Jocelyn Hayes-Hunter, PharmD; Chester B. Good, MD, MPH

Arch Intern Med. 2004;164:630-636.

Background  To explore the incidence and severity of potential interactions between prescription medications and dietary supplements.

Methods  A survey was conducted on dietary supplement use in 458 veteran outpatients currently taking prescription medications. Self-reported dietary supplement use was cross-referenced with each patient's prescription medication list, and potential interactions were identified from several tertiary sources and medical literature searches.

Results  One hundred ninety-seven patients (43%) were currently taking at least 1 dietary supplement with prescription medication(s). The most common products included vitamins and minerals, garlic, Ginkgo biloba, saw palmetto, and ginseng. Among these, 89 (45%) had a potential for drug–dietary supplement interactions of any significance. Most of these interactions (n = 84 [94%]) were not serious based on limited available evidence, giving an incidence of 6% (5/89) of potentially severe interactions among patients taking interacting drugs and dietary supplements and 3% (5/197) among patients taking coincident dietary supplements and medications.

Conclusions  Although the use of dietary supplements appears to be very common among patients who also take prescription medications, most potential drug–dietary supplement interactions found were not serious. However, literature support was sparse at best. Health care providers should continue to inquire about dietary supplement use and consider the potential for interactions, regardless of their severity.

From Pharmacy Services (Drs Peng and Trilli) and the Division of General Internal Medicine (Dr Good), Veterans Affairs Pittsburgh Healthcare System, the Department of Pharmacy and Therapeutics, University of Pittsburgh School of Pharmacy (Dr Trilli), and the Department of Medicine and Pharmacy, University of Pittsburgh School of Medicine (Dr Good), Pittsburgh, Pa; and the Division of General Internal Medicine (Dr Glassman) and Pharmacy Services (Dr Hayes-Hunter), Veterans Affairs Greater Los Angeles–West Los Angeles, The David Geffen School of Medicine at UCLA, University of California–Los Angeles (Dr Glassman), and the Department of Pharmacy, University of Southern California School of Pharmacy (Dr Hayes-Hunter), Los Angeles. Dr Peng is now with the Pharmacy Service, Veterans Affairs Palo Alto Health Care System, Palo Alto, Calif. The authors have no relevant financial interest in this article.

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