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reduce the drug’s therapeutic effectiveness, potentially rendering the patient a
nonresponder. Conversely, discontinuation of St. John’s wort may lead to elevated
digoxin levels and an increased risk of toxicity. The underlying mechanism is thought to
involve induction of the P-glycoprotein drug efflux transporter, which enhances
digoxin clearance from the body.
Iron: Tannic acids present in St. John's Wort may inhibit the absorption of iron.
Photosensitizers, such as tetracyclines, sulfonamides, thiazides, quinolones, piroxicam
and others should be avoided.

Ginkgo Leaves

Medicinal uses
Used for the symptomatic management of mild to moderate cerebrovascular
insufficiency, including dementia syndromes associated with primary degenerative,
vascular, or mixed origins. Typical symptoms that may benefit from treatment include
memory impairment, reduced concentration, depressive mood, dizziness, tinnitus,
and headache.
Drug Interactions
Antithrombolytic Agents (anticoagulants, antiplatelets and aspirin) — Spontaneous
bleeding has been associated with the herb due to its potent inhibitory effect on the platelet-
activating factor (PAF).

Ginseng

Medicinal uses
Radix Ginseng is utilized as a preventive and restorative remedy to improve mental and
physical performance. It is commonly indicated for states of fatigue, weakness, exhaustion,
and reduced concentration, as well as to support recovery during periods of convalescence.

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