title: Herbal product use in a patient with polypharmacy.
abstract: A 70-year-old homebound patient was experiencing new onset porthostatic hypotension and lightheadedness. The pharmacist conducted a thorough medication review, which revealed the use of several herbal products, including St. John's wort, in addition to several prescription medications. The pharmacist counseled the patient on the potential hazards of using herbal products with prescription medications. This prompted the patient to discontinue all herbal supplements with the subsequent resolution of his lightheadedness and orthostasis. He also experienced improvement in his pain control. Pharmacists need to be vigilant in establishing a dialogue with their patients about the pros and cons of herbal product use, particularly with prescription medications.
authors.affiliation: Geriatric Pharmacotherapy Program, Virginia Commonwealth University School of Pharmacy, Richmond 23298-0533, USA. kacappuzzo@vcu.edu
authors.forename: Kimberly A
authors.initials: KA
authors.lastname: Cappuzzo
mesh_terms: D000368:Aged; D000701:Analgesics, Opioid / Q000627:therapeutic use; D004244:Dizziness / Q000209:etiology; D041743:Herb-Drug Interactions; D006801:Humans; D007024:Hypotension, Orthostatic / Q000209:etiology; D008297:Male; D008691:Methadone / Q000627:therapeutic use; D010003:Osteoarthritis / Q000188:drug therapy; D010146:Pain / Q000188:drug therapy; D010946:Plants, Medicinal / Q000009:adverse effects*; D019338:Polypharmacy
chemical_list: D000701:Analgesics, Opioid; D008691:Methadone