Over-the-counter medicine, herbal remedies and vitamin & mineral supplements are widely available and commonly used. It is important you check with your doctor or cardiologist before taking any over-the-counter medicine, herbal medicines and supplements. Remedies such as St John’s Wort can interact with some medicines prescribed for heart conditions and alter their effectiveness.
Herbal remedies
The safety of many herbal remedies is unknown, many people consider herbal remedies to be safe because they are ‘natural’. Not all herbal remedies (unlike prescribed medication) have been thoroughly tested which means that they are unlicensed, and ingredients can vary depending on the manufacturer.
The MHRA (Medicines and Healthcare products Regulatory Agency) advises not to buy herbal medicine abroad or by mail order due to unknown quality and safety, and only buy herbal medication which states clearly what it contains.
St John’s Wort
St John’s Wort is a plant. It is often used as a ‘herbal remedy’ or ‘complementary therapy’ to treat certain conditions including some forms of depression and pain. Although it is widely available, there is limited clinical evidence for its use for people with medical conditions and taking other medications. It is important to seek guidance from your cardiologist or doctor before taking St John’s Wort.
St John’s Wort interacts with many types of medication for different conditions. For people with cardiomyopathy, it may cause interactions with the following types of medication:
- anticoagulants, used to thin the blood and reduce the risk of blood clots;
- beta blockers, used to treat some of the symptoms of cardiomyopathy and heart failure by reducing the rate and force of the heart’s contraction.
- calcium channel blockers are used to treat some of the symptoms of cardiomyopathy and heart failure by reducing the force of the heart’s contraction.
- If you are considering taking St John’s Wort it is important to talk to your doctor or a pharmacist about any possible interactions with your current medications.
Vitamin & mineral supplements
For most people, vitamin & mineral supplements are not necessary unless they have been prescribed by a health professional. Many different types can be bought in shops and on the internet, some of which make claims about improving general health. However, many of the claims made about the benefits of supplements are not backed up by evidence.
It is also worth remembering that tablet forms of vitamins and minerals are in a concentrated form, which in some instances can potentially cause unwanted adverse effects. A healthy balanced diet will provide most people with the nutrients needed, information about a healthy diet can be found here.
People diagnosed with cardiomyopathy who are prescribed medications, are advised to ask their community pharmacist for advice before buying over-the-counter medicine and supplements and are advised to avoid complimentary medicines, especially herbal remedies, without checking first with their cardiologist, cardiac nurse, GP or community pharmacist.
Over-the-counter medicines
Many people take over-the-counter treatment or medications (where you don’t need a prescription) for things like headaches, colds and hay fever. However, for people who have medical conditions and take medication, it is important to be aware of the possible effects of other medicines on their medical condition, and on any medication they are already taking.
The impact on existing conditions
Taking medications for another condition, for example, a cold or hay fever, can have an impact on someone’s existing condition, such as making symptoms worse. This depends on the medication they are taking, and the condition they have. For example, some common medicines for colds and hay fever contain an ingredient called pseudoephedrine. This is a decongestant that helps to relieve a blocked nose. This ingredient is also a stimulant and can cause side effects of arrhythmias, palpitations and high blood pressure. For this reason, it may not be recommended for people with cardiomyopathy.
The patient information leaflet (PIL) that comes with medication will list any known ‘cautions’ between the medication and any existing condition. For example, this might contain wording such as ‘this medication is not suitable for people who have a heart condition’.
Medication interactions
Medications can interact with each other, and this affects how they work. Interactions can increase or reduce the effectiveness of either or both medications. For example, aspirin is commonly taken as a painkiller. However, it also has some blood-thinning effects and is sometimes taken to reduce the risk of blood clots. Aspirin can interact with:
- anticoagulants (blood thinners) such as warfarin
- ACE inhibitors (used to treat symptoms of heart failure and high blood pressure)
- diuretics (water tablets).
If you are taking any of these medications for your cardiomyopathy you might like to talk to your doctor or pharmacists about what painkillers might be suitable for you. Read more about aspirin from the NHS.
Known interactions between medications are usually included in the patient information leaflet (PIL) that comes with medication, and may list this under ‘contraindications’ or ‘interactions’. You can find many PILs online on the eMC (electronic medicines compendium) website.
If you have cardiomyopathy you can talk to your pharmacist about any questions you have about medications. It is also a good idea to mention that you have cardiomyopathy and any medications you are taking for this, before buying any over-the-counter medications, supplements and complementary medications.