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- The Magic Pill Within
Interactions between Essential Oils and Medications
04/05/2008 - By Carole Preen A medication is a licensed drug taken to cure or reduce symptoms of an illness or medical condition. Medications are generally divided into two groups: over the counter (OTC) medications, which are available in pharmacies and supermarkets
without special restrictions, and prescription only medicines (POM), which must be prescribed by a doctor. Most OTC medication is generally considered to be safe enough that most persons will not hurt themselves accidentally by taking it as instructed.
Drugs have one of three main functions:
1. stimulate a body process
2. inhibit a body process
3. replace a chemical in the body
Aromatherapy massage and the topical use of essential oils can also do all three and, when you use the right combination, will work in synergy with medication. You may be able to manage some undesirable side effects, for example anxiety. You may also be able to work with a GP to reduce medications or remove the need for some altogether - such as anti-depressants. However, you need to be aware of anti-inflammatories, muscle relaxants, anticoagulants (such as warfarin), analgesics and other medications that alter sensation. Some medications can affect skin sensitivity and you need to make allowances for this. You also need to be aware of the side-effects of drugs as symptoms that clients/patients present with may be caused by their medication and you will need to refer them back to their GP for it to be adjusted or changed if possible. Always ask clients/patients to bring a list of their medications with them, including their dosages. You can then use reference material to check it out. You can now access the British National Formulary online at www.bnf.org.uk where registration is free. Choose essential oils that work with the medication wherever possible. The same guidance should be used for certain chronic pathologies. Think about what you are trying to achieve.
Examples (quotations taken from www.wikipedia.org)
Medication that stimulates a body process:
'Antidepressants work by increasing the amount of neurotransmitters active in the synapse, thereby enhancing neuronal activity and increasing the responsiveness of mood.'
Medication that inhibits a body process: 'ACE inhibitors are used for controlling blood pressure, treating heart failure and preventing kidney damage in people with hypertension or diabetes. ACE inhibitors are medications that slow (inhibit) the activity of the enzyme, which decreases the production of angiotensin II. As a result, the blood vessels enlarge or dilate, and the blood pressure is reduced. This lower blood pressure makes it easier for the heart to pump blood and can improve the function of a failing heart. In addition, the progression of kidney disease due to high blood pressure or diabetes is slowed.'
Medication that replaces a chemical in the body: 'Levothyroxine is a synthetic (man-made) version of the principle thyroid hormone, thyroxine (T4). It is used for patients with hypothyroidism.'We also need to look at interactions with medications. This is where the BNF comes in very useful as you can look up the chemicals contained within that drug. A drug interaction can be defined as an interaction between a drug and another substance (i.e. essential oil) that prevents the drug from performing as expected. This definition applies to interactions of drugs with other drugs (drug-drug interactions), as well as drugs with food (drug-food interactions) and other substances.
How do drug interactions occur?
There are several mechanisms by which drugs interact with other drugs, food, and other substances. An interaction can result when there is an increase or decrease in:
1. the absorption of a drug into the body.
2. distribution of the drug in the body.
3. changes made to the drug by the body (metabolism).
4. elimination of the drug from the body.
Most of the important drug interactions result from a change in the absorption, metabolism, or elimination of a drug. Drug interactions also may occur when two drugs that have similar (additive) effects or opposite (cancelling) effects on the body are administered together. This would be true when using essential oils as they enter the blood stream via dermal absorption, in much the same way as certain topical medications do. (It would of course be wise not to apply essential oils to the same area as any transdermal drugs.) Another source of drug interactions occurs when one drug alters the concentration of a substance that is normally present in the body. The alteration of this substance reduces or enhances the effect of another drug that is being taken. The drug interaction between warfarin (Coumadin) and vitamin K-containing products is a good example of this type of interaction: warfarin acts by reducing the concentration of the active form of vitamin K in the body. Therefore, when vitamin K is taken, it reduces the effect of warfarin. Methyl salicylate and eugenol essential oils may potentiate the effects of warfarin. Drug interactions with essential oils may lead to an increase or decrease in the beneficial or the adverse side-effects of the given drugs. When an essential oil increases the benefit of the administered drugs without increasing side-effects, both substances may be combined to increase the control of the condition that is being treated. For example, for patients using drugs that reduce blood pressure by different mechanisms you may use essential oils that have hypotensive therapeutic effects because the blood pressure lowering effect achieved by both substances may be better than with the drug alone. An undesirable opposite effect would be if you used a hypertensive essential oil in this example. Interactions that are of greatest concern are those that reduce the desired effects or increase the adverse effects of the drugs. Essential oils that reduce the absorption or increase the metabolism or elimination of other drugs tend to reduce the effects of the other drugs. This may lead to failure of therapy or warrant an increase in the dose of the affected drug. Conversely, drugs that increase absorption or reduce the elimination or metabolism of other drugs increase the concentration of the other drugs in the body and lead to more side-effects. This is another reason why understanding the chemistry of essential oils is so important.
Let's look at some examples:
Erythromycin is an antibiotic that prevents bacteria from producing proteins, which interferes with bacterial growth and multiplication, while not affecting human cells. It can be used to treat acne on the skin. This medication can increase sensitivity to sunlight, wind, or cold. It would therefore be unwise to use any phototoxic essential oils. The same applies to many other drugs including Risperdal - generic name Risperidone - which is an atypical antipsychotic drug often prescribed for treatment of schizophrenia and the psychotic features of bipolar disorder and other mental illnesses. Rare side-effects can be darkening of skin colour, dry skin, or increased sensitivity of the skin to sun. People undergoing cancer treatments are also likely to experience skin sensitivity. Tamoxifen is a drug used to treat breast cancers stimulated by the production of oestrogen and it suppresses the natural manufacture of oestrogen. Some essential oils, like those of the Apiaceae family, contain natural plant oestrogens and are often used to help women with menopausal symptoms. Their use is contraindicated not only when Tamoxifen or any similar drug is being administered but ever after in order to prevent stimulating a recurrence of the cancer. Another important aspect is peppermint oil with anyone suffering from atrial fibrillations as it exacerbates the condition and will counteract medication for atrial fibrillation. This actually includes using peppermint toothpaste and sucking peppermints too. Eating grapefruits is contraindicated for patients on retro-viral drugs for HIV. Therefore, until research is done to state otherwise, grapefruit essential oil should not be used when treating HIV patients, even though it is acknowledged that the flavonoids are not found in the essential oil and the furanocoumarins are much higher in the juice than in the oil. Oils containing 1,8 cineole may decrease the effectiveness of barbiturates, even via inhalation. Patients going for surgery should be told to stop using oils containing 1,8 cineole before going into hospital. Daily use of known sedative essential oils is inadvisable for anyone on sedative/hypnotic medication or within 24 hours of a general anaesthetic. Only a handful of common drugs can be covered here but it is essential that we appreciate the importance of always observing the same rules when working with anyone who is on medication, whether OTC or prescribed.
Those rules are:
Check why an OTC remedy is being taken and, if necessary, suggest that a medical diagnosis may be required rather than self-diagnosis and treatment.
Ensure medical permission to treat the patient/client is obtained where relevant.
Do a detailed case study and ask about changes which have occurred, both negative and positive, since being on the medication.
Remember some people are very knowledgeable about their medication whereas others are not.
Research the condition and also the effects, side-effects and desired outcome of the medication. Literature, the Internet and self-help / support groups provide invaluable information, sometimes about suitable essential oils and dilutions.
Select essential oils that have no ability to interfere with the desired effects of the medication and initially use reduced dilution ratios.
Patch test if skin sensitivity may have been exacerbated (24 hours).
References
http://en.wikipedia.org
http://www.medicinenet.com/warfarin/article.htm
Rhiannon Harris - Conference Summary Notes - www.essentialorc.com
Carole Preen
AC Office
Tel: 0870 7743477
Website:www.aromatherapycouncil.co.uk
To join the register the annual fee is £60.00, which is equivalent to just 16 pence a day in order to give you the credibility and status you deserve as a professional aromatherapist.
AC AGM Minutes 12th July 2006 available at www.aromatherapy-regulation.org.uk BMA, Complementary and alternative medicine - submission to public petitions committee 13 January 2003 Cancer Research UK http://www.cancerhelpuk.org/trials/understanding/default.asp? page=18284 Charlton Dr. Ed, The Management of Postoperative Pain Update in