Filipendula ulmaria

Meadowsweet/Drug Interactions:

  • AcetaminophenAcetaminophen: Acetaminophen may interact with meadowsweet to increase the risk of bleeding (16). The incidence of nephrotoxicity may be augmented when acetaminophen and meadowsweet are used in combination due to salicylate content of meadowsweet.
  • AntibioticsAntibiotics: Cephalosporins that contain the MTT side chain and parenteral penicillins may inhibit platelet aggregation. Theoretically, when used in combination with meadowsweet, there may be increased risk for hemorrhage. Tetracycline has also been reported to increase the anticoagulant effects of animal heparin, and theoretically may have the same result with the plant heparin found in meadowsweet.
  • Anticoagulant/antiplateletsAnticoagulant/antiplatelets: Meadowsweet has antiplatelet activity and contains a plant heparin; the risk of bleeding may be enhanced when used with other anticoagulant or antiplatelet drugs (16; 19).
  • AntihistaminesAntihistamines: First generation anithistamines, such as diphenhydramine, chlorpheniramine, and brompheniramine, have been reported to decrease the anticoagulant effects of animal heparin, and may have the same result with the plant heparin found in meadowsweet.
  • EthanolEthanol: The consumption of ethanol in combination with products containing salicylates could increase the risk of gastric mucosal damage.
  • NarcoticsNarcotics: Meadowsweet may induce muscle relaxation and potentiate narcotic effects.
  • NitroglycerinNitroglycerin: Nitroglycerin (intravenous) may decrease the anticoagulant effect of animal heparin, and theoretically may have the same effect with the plant heparin found in meadowsweet.
  • Non-steroidal anti-inflammatory drugs (NSAIDS)Non-steroidal anti-inflammatory drugs (NSAIDS): Non-steroidal anti-inflammatory drugs (NSAIDs), particularly aspirin, have the potential to interact with herbal supplements that are known to possess antiplatelet activity, such as meadowsweet, enhancing the risk of bleeding (16).
  • SalicylatesSalicylates: Due to its salicylate content, meadowsweet could cause drug interactions similar to those of the salicylates or aspirin. The use of meadowsweet with other salicylates could potentiate both therapeutic and adverse effects. The adverse effects of salicylates could include impairing the effects of beta-adrenergic blockers, ACE inhibitors, loop diuretics, thiazide diuretics, probenecid, and sulfinpyrazone. High salicylate levels may increase the effects or toxicity of alcohol, anticoagulants, antiplatelet agents (e.g., ticlopidine, clopidogrel, and IIb/IIa antagonists) carbonic anhydrase inhibitors, heparin and low molecular weight heparins, methotrexate, older sulfonylureas (i.e., tolazamide, tolbutamide), and valproic acid.

    • Meadowsweet/Herb/Supplement Interactions:

  • Anticoagulant/antiplateletsAnticoagulant/antiplatelets: Meadowsweet has antiplatelet activity; the risk of bleeding may be enhanced when used with other anticoagulant or antiplatelet herbs (16).
  • CalciumCalcium: The use of animal heparin for more than six months may interfere with calcium absorption . Since meadowsweet contains a plant heparin, it could have the same effect when taken for extended periods.
  • Narcotic herbsNarcotic herbs: Meadowsweet may induce muscle relaxation and potentiate narcotic effects.
  • Salicylate-containing herbsSalicylate-containing herbs: The use of meadowsweet with other herbs containing salicylate constituents could potentiate both therapeutic and adverse effects. Some of these herbs include black cohosh, poplar, sweet birch, white willow, and wintergreen. The adverse effects of high salicylate levels could include impairing the effects of beta-adrenergic blockers, ACE inhibitors, loop diuretics, thiazide diuretics, probenecid, and sulfinpyrazone. High salicylate levels may increase the effects or toxicity of alcohol, anticoagulants, antiplatelet agents (e.g., ticlopidine, clopidogrel, and IIb/IIa antagonists) carbonic anhydrase inhibitors, heparin and low molecular weight heparins, methotrexate, older sulfonylureas (i.e., tolazamide, tolbutamide), and valproic acid.
  • TincturesTinctures: The consumption of ethanol in combination with products containing salicylates could increase the risk of gastric mucosal damage.

    • Meadowsweet/Food Interactions:

  • Calcium-containing foodsCalcium-containing foods: The use of animal heparin for more than six months can interfere with calcium absorption. Since meadowsweet contains a plant heparin, it could have the same effect when taken for extended periods.
  • Spices containing salicylatesSpices containing salicylates: Spices like curry powder, paprika, and licorice contain high amounts of salicylates (i.e., 6mg/100g compared to an ordinary diet of 10-200mg per day). When consumed in combination with meadowsweet they could lead to salicylate accumulation.

    • Meadowsweet/Lab Interactions:

  • Activated partial thromboplastin time (aPTT)Activated partial thromboplastin time (aPTT): The plant heparin found in meadowsweet flowers could also effect aPTT measurements used to monitor heparin anticoagulation therapy. However, this may not be a false positive. Due to structural similarities, the plant heparin found in meadowsweet may have additive anticoagulation effects when used in combination with animal heparin.
  • Glucose testsGlucose tests: Meadowsweet could affect test results known to be affected by salicylates and therefore could lead to false negative results for glucose oxidase based urinary glucose tests, as well as false positive results for the cupric sulfate method.
  • Thyroid hormonesThyroid hormones: Meadowsweet could affect test results known to be affected by salicylates and therefore, could cause interference with T3 and T4 measurements.