National Conference to Examine Effects of Dietary Supplements in Patients Taking Blood Thinning Medications|
Leading Experts will Discuss Current Knowledge, Assess Need for Clinical Guidelines
The National Heart, Lung, and Blood Institute will convene a conference
this week to evaluate the risks of interactions between dietary
supplements and prescription blood-thinning medications which are
used by four million Americans to ward off heart attack or stroke.
Experts from the National Institutes of Health and the Food and
Drug Administration will join academic, patient advocacy and industry
representatives to assess current knowledge, identify strategies
for clinical guidelines, and determine opportunities for further
The NIH Conference on Dietary Supplements, Coagulation, and Antithrombotic
Therapies will be held January 13 and 14, 2005, at the Masur Auditorium
of the National Institutes of Health (NIH) in Bethesda, Maryland.
It is sponsored by the National Heart, Lung, and Blood Institute
(NHLBI), in collaboration with the Office of Dietary Supplements
(ODS), the National Center for Complementary and Alternative Medicine
(NCCAM), the NIH Clinical Center (CC), the National Institute of
Neurological Disorders and Stroke (NINDS), the NIH Foundation,
and the Office of Rare Diseases (ORD) at NIH.
“With up to 52 percent of the U.S. population reporting
dietary supplement use, it is important that we fully understand
how these substances can affect widely-used drugs, such as warfarin
and aspirin,” said NHLBI Acting Director Barbara Alving,
To date, there have been few systematic examinations of the effects
of dietary supplements when taken with prescribed anti-thrombotic
(anti-coagulant or anti-platelet) therapies. According to the Natural
Medicines Comprehensive Database, approximately 180 dietary supplements
have the potential to interact with warfarin, a common blood thinner,
and more than 120 may interact with aspirin, and other anti-platelet
agents such as clopidogrel, ticlopidine, and dipyridamole. Dietary
supplements include herbal remedies, vitamins, minerals, other
botanical products, fibers, amino acids, proteins, organ tissues,
and metabolites for digestion.
Known interactions with prescribed anti-coagulants and their effects
- Anise and Dong Quai have anti-coagulant effects;
- Omega 3-fatty acids in fish oil, ajoene in garlic, ginger, Ginkgo,
and vitamin E have anti-platelet properties;
- Fucus and Danshen can have a heparin-like blood thinning effect;
- St. John’s Wort and American Ginseng alter drug metabolism;
- Other supplements, such as high dose vitamin E, Alfalfa, and Coenzyme
Q10 may affect blood clotting.
“We plan to obtain a variety of perspectives on this issue
so that we have a better understanding of managing patients’ drug
regimens,” said Ahmed Hasan, M.D., Ph.D., medical officer
with NHLBI’s Division of Blood Diseases and Resources. “It
is important to increase our knowledge on this issue so that we
may better inform and educate our patients,” he added.
- New Tools and Methodologies for Research and Clinical
(Friday, January 14, 8:00 a.m.)
This session will address methods and best practices for researching
and monitoring interactions in patients using dietary supplements.
- Panel of Experts: Opinions and Research Priorities
(Friday, January 14, 10:30 a.m.)
This multi-disciplinary panel will explore known drug and supplement
interactions including anecdotal evidence, and develop an inventory
of research needs.
- Public Health Concerns: Facts, Fictions, and Gaps in
(Friday, January 14, 1 p.m.)
This section will include presentations on the perspectives of
academia, the FDA, and the dietary supplement industry to assess
the need for clinical guidelines.
- Dialogue with Patient Care Organizations
(Friday, January 14, 2:45 p.m.)
Speakers for this session include representatives from the Platelet
Disorder Support Association, the National Consumers League, the
American Medical Association, the American Society of Hematology,
the American Heart Association, the American Herbal Products Association,
the American Society of Clinical Nutrition, the American Dietetic
Association, and the American Society of Health System Pharmacists.
Details and agenda for the conference are available at http://www.nhlbi.nih.gov/meetings/coagulation/index.htm.
Reporters can register onsite at the conference or in advance by
contacting the NHLBI Communications Office at (301) 496-4236
or firstname.lastname@example.org. To request an interview with a conference
speaker, please call (301) 496-4236. Following the conference, a bibliography will be available at http://ods.od.nih.gov.
NHLBI is part of the National Institutes of Health (NIH), the
Federal Government's primary agency for biomedical and behavioral
research. NIH is a component of the U.S. Department of Health and
Human Services. Additional information about heart, lung, and blood
diseases and NHLBI-supported research and educational programs
are available online at the NHLBI website, www.nhlbi.nih.gov.