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Dr. Bob is Robert Hsiung, MD,
bob@dr-bob.orgShown: posts 1 to 4 of 4. This is the beginning of the thread.
Posted by Franz on November 9, 2002, at 13:04:04
Hello,
I am starting low dose Klonopin and as I am new to this weird benzodiazepine (it is different from other, but this is subject for another post) I would like to know about interactions.
I am interested in klonopin/drugs/herbs interactions.
I frequently use a variety of teas/herbs like ginseng, Gotu kola, Rosmarinus, green tea, Rhodiola, gingko. Not high doses.
The only reference I found in the web is:
Summary of Interactions for Benzodiazepines
Depletion or interference
None knownAdverse interaction
AlcoholSide effect reduction/prevention
None knownSupportive interaction
VinpocetineReduced drug absorption/bioavailability
None knownAdverse interaction
Kava*
Thanks
Posted by Larry Hoover on November 9, 2002, at 15:39:10
In reply to Klonopin interactions with drugs/herbs/etc ?, posted by Franz on November 9, 2002, at 13:04:04
> Hello,
>
> I am starting low dose Klonopin and as I am new to this weird benzodiazepine (it is different from other, but this is subject for another post) I would like to know about interactions.
>
> I am interested in klonopin/drugs/herbs interactions.Rather than just give you the answer, I'll tell you how you can search it out for yourself.
The most prominent form of interaction between two drugs, or an herb and a drug, involves the cytochrome P450 enzymes. It's an archaic naming system, but it stuck.
To check which enzyme system is involved in clearing a drug, you can check the detailed pharmacology at a site like www.rxlist.com, where it is found under the generic name clonazepam, or you can enter it into a search engine like that at www.google.com. At google, your search terms would be "clonazepam" and "P450", without the quotes. You'll find, after a brief search, that clonazepam is metabolized and cleared by the enzyme called CYP3A3/4.
What you want to do is to see if anything else you take does anything to affect the function of that enzyme. For example, Serzone (nefazodone) almost totally stops it from functioning. In that case, you can have the effects of an overdose without actually overdosing on clonazepam. All SSRIs will inhibit this enzyme to some extent. St. Johns wort activates the enzyme, so you get less effect from the clonazepam, given the normal dose. Any other substance than is normally cleared by that enzyme (called a substrate) will also reduce the action of the enzyme with respect to clonazepam, via competitive inhibition.
> I frequently use a variety of teas/herbs like ginseng, Gotu kola, Rosmarinus, green tea, Rhodiola, gingko. Not high doses.
Once you have identified an enzyme to focus your attention on, then you can do google searches on e.g. "Rhodiola" and "3A4" and so on. I don't know of a better way to learn about your medications than to search for the answer yourself.
> The only reference I found in the web is:
>
> Summary of Interactions for Benzodiazepines
>
> Depletion or interference
> None known
>
> Adverse interaction
> Alcohol
>
> Side effect reduction/prevention
> None known
>
> Supportive interaction
> Vinpocetine
>
> Reduced drug absorption/bioavailability
> None known
>
> Adverse interaction
> Kava*Well, I hope you do better searching for info the way I've described. It's not fool-proof, but you can see that what you found doesn't mention things I discovered in a very quick search.
> ThanksIf you have trouble with the terminology or anything, ask more questions. I'm happy to help you find your own understanding.
Lar
Posted by Larry Hoover on November 9, 2002, at 15:43:06
In reply to Klonopin interactions with drugs/herbs/etc ?, posted by Franz on November 9, 2002, at 13:04:04
> Hello,
>
> I am interested in klonopin/drugs/herbs interactions.
>
> I frequently use a variety of teas/herbs like ginseng, Gotu kola, Rosmarinus, green tea, Rhodiola, gingko. Not high doses.A quick look at gingko showed that it can seriously alter P450 enzyme activity. Take a look here:
http://www.herbalremedies.com/ginbilginlea.html
Posted by Rick on November 10, 2002, at 17:23:43
In reply to Klonopin interactions with drugs/herbs/etc ?, posted by Franz on November 9, 2002, at 13:04:04
> Hello,
>
> I am starting low dose Klonopin and as I am new to this weird benzodiazepine (it is different from other, but this is subject for another post) I would like to know about interactions.
>
> I am interested in klonopin/drugs/herbs interactions.
>
> I frequently use a variety of teas/herbs like ginseng, Gotu kola, Rosmarinus, green tea, Rhodiola, gingko. Not high doses.If it's not high doses, then none of those should present a problem, although some like Gotu Kola may increase any Klonopin-induced sedation. Watch out for any excessive sedation, and for any signs of (unlikely but theoretically possible) interaction-induced liver dysfunction, such as yellowing of the skin. (Search on liver disease symptoms on the net.) And get a liver function test a few times a year. And don't take Kava with Klonopin.
I've used Panax Ginseng, Rhodiola Rosea (aka Arctic Root) and Ginkgo with Klonopin (but not more than one herb at a time). I've avoided trying out Gotu Kola despite positive reports, given that it can raise blood sugar.
You have more risk from buying low quality, possibly contaminated brands of these herbs than from mixing them with Klonopin at low doses.
Rick
This is the end of the thread.
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