Use of herbal remedies and potential drug interactions in rheumatology outpatients

Abstract
Gingko biloba, devil’s claw, ginger, and garlic may have antiplatelet or other anticoagulant effects,5– 8 and have been associated with haemorrhagic complications.9 These remedies may therefore exacerbate the gastrointestinal bleeding risk of non-steroidal anti-inflammatory drugs (NSAIDS) or corticosteroids. Echinacea may be hepatotoxic8 and exacerbate this adverse effect of disease modifying antirheumatic drugs (DMARDS).