[AnnieBL]

Hi Lotus,

Thanks again for all the good information. It's good to know these things, but if we were frightened off by every possible side effect we'd never be able to take any medically active substance , natural or artificial, nor for that matter would we be able to eat anything. In our litigious society, manufacturers and suppliers are so anxious to cover their backsides with an endless list of warnings accompanying everything that we tend just to tune them out (and I suspect that Big Pharma at least relies on those who watch their ads for their latest and greatest overpriced drug simply to tune out the gabbled background refrain of side effects). Of course side effects can and do occur, but I tend to treat anything I'm starting on with caution and have on the whole been fairly lucky, except recently for gabapentin. For most people most of the time, most of the side effects don't occur, but when they do....

For what use it may be to you or anyone else, I am commenting (within square brackets) below on items in your reply to me. These comments apply strictly to my own experience and certainly do not necessarily apply to anyone else!

Hi Annie,

Ultimately I wouldn't mix the PM, imo I wouldn't want it to lose potency along the way to E receptors because of an interaction making it less active. I have a list of supplements that when taken with certain meds will increase plasma concentrations. Meaning it will boost certain supplements, just as grapefruit juice does. I have reservations sharing the info openly for fear of somebody without experience harming themselves. I think WebMD and drugs.com has some of the best supplement interaction info out there. Peggy made a nice list here, http://www.breastnexus.com/showthread.php?tid=19869 I'm going to add to the list ASAP, btw I added Horse Chestnut to it though.

[Yes, WebMD and drugs.com are very useful. I've never noted any interactions with horse chestnut. I have seen it stated that one shouldn't take it for more than six months without medical advice and I've been taking it for more than 8 years. I tell my medical advisers about it whenever the opportunity arises but a majority simply aren't interested. They think it's just a herb and can't do anything useful.]

Grapefruit juice reduces warfarin effectiveness, so I'd skip the juice for now.

[I was in fact taking grapefruit juice in quantity together with warfarin for a long time before I ever knew that it was a potential problem, and I don't believe it had much effect on my INR scores. The information I was then given was that it -increased- warfarin effectiveness. It sometimes seems to me that almost everything is reported as being capable of modifying the effectiveness of warfarin, but in practice my experience has been that very few of them actually do so to any noticeable extent. The biggest effect I ever encountered was from amiodarone, which greatly increased its potency, while dark green vegetables containing vitamin K can significantly reduce its effectiveness and the effect of antibiotics is unpredictable but sometimes significant.]

Shatavari- might act like a diuretic
http://www.webmd.com/vitamins-supplements/ingredientmono-1167-ASPARAGUS%20RACEMOSUS.aspx?activeIngredientId=1167&activeIngredientName=ASPARAGUS%20RACEMOSUS

[I find that the asparagus family in general is mildly diuretic, but in common with most other plant based diuretics that I have encountered, it does not seem to have a significant effect on blood pressure. I have the impression from the literature that I have seen that while Lasix and HCTZ are often said to work by reducing the volume of blood that the heart has to pump, in fact their real primary mode of action is something else that is not yet fully understood.]

Maca
http://www.webmd.com/vitamins-supplements/ingredientmono-555-MACA.aspx?activeIngredientId=555&activeIngredientName=MACA
http://www.drugs.com/npp/maca.html

Horse chestnut might act like a diuretic and might decrease blood sugar
http://www.webmd.com/vitamins-supplements/ingredientmono-1055-HORSE%20CHESTNUT.aspx?activeIngredientId=1055&activeIngredientName=HORSE%20CHESTNUT
[Not that I've noticed.]

oxybutynin-This medication may cause blurred vision and may impair your thinking or reactions.
http://www.drugs.com/oxybutynin.html

[For me, the most tiresome side effect is dry eyes, for my wife, dry mouth. Our NP tried me out instead on Toviaz (fesoteridine) which is seemingly being pushed by Pfizer as having less severe side effects. She (the NP) had a whole shelf full of free samples, but I found no improvement in the dry eyes and it was less effective than the oxybutinin, and would probably have been more expensive.]

Dutasteride-a potent androgen, localized edema, serious skin reactions. Tamsulosin plasma concentrations may be elevated, increasing tamsulosin exposure. Do not coadminister tamsulosin-containing products with strong CYP3A4 inhibitors (GFJ) http://www.drugs.com/ppa/dutasteride-tamsulosin-hydrochloride.html

[I have never taken Dutasteride. When I started on oxybutinin to control the spasms caused by my bladder stones (I am supposed finally to have laser lithotripsy at the end of this month to get rid of these) I asked if I need continue with the tamsulosin if the spasms were caused by the stones and not by BPH, but was told that it worked synergistically with the oxybutynin.]

Diltiazem
Grapefruit and grapefruit juice may interact with diltiazem and lead to potentially dangerous effects. http://www.drugs.com/diltiazem.html

[Not that I've noticed. As a CCB, diltiazem has the advantage that it helps stabilize heart rate and meant that I was able to go off digoxin. It is a little less effective than digoxin (which is yet another drug that acts as an antiandrogen and probably contributed to the final collapse of my testosterone levels), but it is good to be off something as potentially dangerous as digoxin.]

PABA - Decreases breakdown of estrogen in your body so you have more free estrogen.

Coenzyme Q10: CoQ10
http://www.webmd.com/vitamins-and-supplements/lifestyle-guide-11/supplement-guide-coenzymeq10-coq10

Ramipril
http://www.drugs.com/ramipril.html
http://www.drugs.com/drug-class/angiotensin-converting-enzyme-inhibitors.html

[I understand that ramipril is also protective against type 2 diabetes. An oddity, due I am told to some peculiar deal between drug companies is that ramiprilHCT is very substantially cheaper than ramipril on its own. This is how I came to be taking HCTZ in place of Lasix. A side benefit is that some insurance companies have a peculiar hang-up about lasix and either won't cover you or penalize you heavily if you take it. They seem to think that anyone who takes it is about to expire from heart failure.]

Just some caution concerning the interactions!!!

Hugs