Honey

Honey/Drug Interactions:

  • AntibioticsAntibiotics: In laboratory research, honey inhibited the growth of Pseudomonas pyocyanea, Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus uberis, Proteus mirabilis, coliform spp., Klebsiella species, Acinetobacter spp., Streptococcus faecalis, and Streptococcus pyogenes (62; 196; 197; 198). According to a review, honey also exhibited activity against methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin resistant Enterococcus (VRE) and contains viable spores, including clostridia (38).
  • Anticoagulant and antiplatelet agentsAnticoagulant and antiplatelet agents: In human research, bleeding was reported in three individuals receiving manuka honey impregnated calcium alginate dressings (86). In vitro, natural honey exhibited inhibitory effects on platelet aggregation and blood coagulation proteins in which higher concentrations of honey samples elevated whole blood clotting time, showed moderate inhibition of platelet aggregation (IC(50) 5-7.5%), and significantly prolonged aPTT, PT, and TT (199).
  • AnticonvulsantsAnticonvulsants: The rate and extent of absorption of phenytoin in rabbits was increased by honey (200). In vivo, honey treatment decreased the plasma levels of carbamazepine (201). However, significant interactions with carbamazepine during coadministration in humans were lacking (202).
  • AntidiabeticsAntidiabetics: Although honey has been investigated in the treatment of diabetes and lowering plasma glucose (203; 165), honey is composed of sugars (mainly fructose and glucose). Based on its composition, honey may increase plasma glucose when taken orally, and caution is advised in patients taking antidiabetic agents. In human research, honey reduced fasting blood sugar (FBS), increased and decreased HbA1c, and improved fasting C-peptide and two hour postprandial C-peptide (PCP) (83; 93).
  • AntifungalsAntifungals: In laboratory and human research, honey may have antimicrobial (antibacterial/antifungal) properties in the topical application in the management of wound care (204; 205; 206; 207; 208; 209; 210; 211; 212; 213; 89; 214).
  • AntihypertensivesAntihypertensives: Incidents of cardiovascular symptoms, such as hypotension, chest pain, bradycardia, syncope, asystole, various types of heart block, atrial fibrillation, myocardial infarction, as well as other cardiac arrhythmias from honey intoxication have been reported due to grayanotoxins in toxic honey produced from the nectar of Rhododendrons (64; 55; 56; 57; 54; 65; 66; 67; 58; 68; 59; 69; 70; 71; 72; 73; 74; 75; 76; 77; 78; 61; 79; 80; 81; 82; 60).
  • Anti-inflammatoriesAnti-inflammatories: Based on proposed mechanism of action, honey may contribute to prevention of inflammation (3). In human research, honey also caused a significant reduction between pre- and post-treatment in C- reactive protein (CRP) by 3.3% (6.3 ? 4.2 vs. 6.1 ? 4.1; p=0.008, respectively) in subjects who had elevated values (117). In human research, plasma IL-1ra increased significantly posttest for the honey-sweetened drink (25.8%) (101).
  • AntilipemicsAntilipemics: In human research, honey reduced total cholesterol, LDL-C, ratio of LDL-C to HDL-C, and triglyceride, as well as increased HDL-C (83). In human research, compared to the control, honey significantly improved total cholesterol, triglycerides, LDL cholesterol, and HDL cholesterol (93).
  • AntineoplasticsAntineoplastics: In vivo, studies on C3H/He mice exhibited a significant difference between honey-treated mice vs. control with regard to final tumor volume (6). In vitro studies on bladder cancer cells showed that diluted honey affected their growth pattern. Apoptosis was shown by TUNEL assay in bladder cancer cells, which suggests one of the ways by which honey induces cellular death.
  • Antiobesity agentsAntiobesity agents: In human research, honey reduced body weight (83; 84).
  • Cardiovascular agentsCardiovascular agents: Incidents of cardiovascular symptoms, such as hypotension, chest pain, bradycardia, syncope, asystole, various types of heart block, atrial fibrillation, myocardial infarction, as well as other cardiac arrhythmias from honey intoxication have been reported due to grayanotoxins in toxic honey produced from the nectar of Rhododendrons (64; 55; 56; 57; 54; 65; 66; 67; 58; 68; 59; 69; 70; 71; 72; 73; 74; 75; 76; 77; 78; 61; 79; 80; 81; 82; 60). In human research, systemic cardiovascular adverse effects were reported with manuka honey impregnated calcium alginate dressings (86).
  • Cytochrome P450-modifying agentsCytochrome P450-modifying agents: In human research, honey may induce CYP3A4 activity, although lacked an effect with CYP2D6 and CYP2C19 (215). In other human research with healthy participants, honey and artificial honey lacked an effect on CYP3A activity (216).
  • Dental agentsDental agents: In laboratory research, certain types of honey inhibited the formation of amorphous calcium phosphate precipitates, in which the authors suggested may have anticalculus properties useful in toothpastes and mouthwash (217) and compared to chlorhexidine gluconate mouthrinse, honey exhibited antibacterial effects against oral microorganisms (218).
  • Dermatologic agentsDermatologic agents: One patient receiving topical Medihoney experienced a temporary, mild local skin discomfort, however the discomfort resolved on its own within days despite continuation of treatment (118). In human research, dermatitis, ulcer deterioration, erythema, deterioration of surrounding skin, and new ulceration were reported with manuka honey impregnated calcium alginate dressings (86). In human research, contact dermatitis was reported in individuals with leishmaniasis receiving honey-soaked gauze dressings (121) and itching was reported in individuals receiving monofloral aloe honey (130).
  • EthanolEthanol: Nigerian Citrus sinensis Osbeck honey reduces peak blood alcohol (ethanol) levels (219).
  • Gastrointestinal agentsGastrointestinal agents: Incidents of gastrointestinal symptoms, such as nausea and vomiting, from toxic honey ingestion have been reported caused by toxic honey produced from the nectar of Rhododendrons (54; 75; 76; 78). In children, reports of stomach discomfort, nausea, and vomiting were reported following oral honey ingestion (137; 87; 88). In human research, gastrointestinal systemic adverse effects were reported (86) including vomiting (84) and nausea (85).
  • Genitourinary tract agentsGenitourinary tract agents: In human research, urinary tract infections was reported in individuals receiving honey-thick liquid (84).
  • Hematological agentsHematological agents: A 27 year-old, otherwise healthy woman who ingested 75mL of honey brought back from a visit to Turkey, was found to have mild leukocytosis (172).
  • Neurologic agentsNeurologic agents: Incidents of neurologic symptoms, such as mild paralysis, dizziness, impaired consciousness, seizures, sweating, paresthesias, weakness, and convulsions from honey intoxication have been reported due to toxic honey produced from the nectar of Rhododendrons (64; 57; 54; 65; 75; 78; 61; 60). In children, reports of hyperactivity, nervousness, drowsiness, somnolence, and insomnia were reported following oral honey ingestion (87; 88). In human research, fever and fatigue/weakness were reported in individuals receiving honey-thick liquid (84) and pain and burning sensation was reported in individuals receiving monofloral aloe honey (130).
  • Wound-healing agentsWound-healing agents: In human research, compared to the control group, participants treated with unprocessed and unpasteurized honey showed increased rates of wound healing after one week (14.48 ? 1.81 vs. 13.80 ? 1.91, p<0.05), two weeks (14.00 ? 2.12 vs. 11.08 ? 2.53, p<0.05), three weeks (13.64 ? 2.14 vs. 8.84 ? 2.53, p<0.05), four weeks (13.32 ? 2.11 vs. 7.02 ? 2.50, p<0.05), and five weeks (12.62 ? 2.15 vs. 6.55 ? 2.12, p<0.001), a significantly greater reduction in ulcer size for pressure ulcers dressed with honey compared to the control group (56% vs. 13% reductions, p<0.001), and a greater percentage of participants treated with honey showed complete wound healing compared to those in the control group (20% vs. 0%, p<0.05) (96).

    • Honey/Herb & Supplement Interactions:

  • AntibacterialsAntibacterials: In laboratory research, honey inhibited the growth of Pseudomonas pyocyanea, Pseudomonas aeruginosa, Escherichia coli, Staphylococcus aureus, Staphylococcus epidermidis, Staphylococcus uberis, Proteus mirabilis, coliform spp., Klebsiella species, Acinetobacter spp., Streptococcus faecalis, and Streptococcus pyogenes (62; 196; 197; 198). According to a review, honey also exhibited activity against methicillin-resistant Staphylococcus aureus (MRSA) and vancomycin resistant Enterococcus (VRE) and contains viable spores, including clostridia (38).
  • Anticoagulant and antiplatelet herbs and supplementsAnticoagulant and antiplatelet herbs and supplements: In human research, bleeding was reported in three individuals receiving manuka honey impregnated calcium alginate dressings (86). In vitro, natural honey exhibited inhibitory effects on platelet aggregation and blood coagulation proteins in which higher concentrations of honey samples elevated whole blood clotting time, showed moderate inhibition of platelet aggregation (IC(50) 5-7.5%), and significantly prolonged aPTT, PT, and TT (199).
  • AnticonvulsantsAnticonvulsants: The rate and extent of absorption of phenytoin in rabbits was increased by honey (200). In vivo, honey treatment decreased the plasma levels of carbamazepine (201). However, significant interactions with carbamazepine during coadministration in humans were lacking (202).
  • AntifungalsAntifungals: In laboratory and human research, honey may have antimicrobial (antibacterial/antifungal) properties in the topical application in the management of wound care (204; 205; 206; 207; 208; 209; 210; 211; 212; 213; 89; 214).
  • Anti-inflammatoriesAnti-inflammatories: Based on proposed mechanism of action, honey may contribute to prevention of inflammation (3). In human research, honey also caused a significant reduction between pre- and post-treatment in C- reactive protein (CRP) by 3.3% (6.3 ? 4.2 vs. 6.1 ? 4.1; p=0.008, respectively) in subjects who had elevated values (117). In human research, plasma IL-1ra increased significantly posttest for the honey-sweetened drink (25.8%) (101).
  • AntilipemicsAntilipemics: In human research, honey reduced total cholesterol, LDL-C, ratio of LDL-C to HDL-C, and triglyceride, as well as increased HDL-C (83). In human research, compared to the control, honey significantly improved total cholesterol, triglycerides, LDL cholesterol, and HDL cholesterol (93).
  • AntineoplasticsAntineoplastics: In vivo, studies on C3H/He mice exhibited a significant difference between honey-treated mice vs. control with regard to final tumor volume (6). In vitro studies on bladder cancer cells showed that diluted honey affected their growth pattern. Apoptosis was shown by TUNEL assay in bladder cancer cells, which suggests one of the ways by which honey induces cellular death.
  • Antiobesity agentsAntiobesity agents: In human research, honey reduced body weight (83; 84).
  • AntioxidantsAntioxidants: In healthy participants, honey supplementation plus exercise increased seminal interleukin (IL) levels (IL-1beta, IL-6, IL-8), tumor necrosis factor (TNF)-alpha, and malondialdehyde levels and significantly increased in seminal superoxide dismutase, catalase, and total antioxidant capacity concentrations (p<0.008) (220).
  • Cardiovascular agentsCardiovascular agents: Incidents of cardiovascular symptoms, such as hypotension, chest pain, bradycardia, syncope, asystole, various types of heart block, atrial fibrillation, myocardial infarction, as well as other cardiac arrhythmias from honey intoxication have been reported due to grayanotoxins in toxic honey produced from the nectar of Rhododendrons (64; 55; 56; 57; 54; 65; 66; 67; 58; 68; 59; 69; 70; 71; 72; 73; 74; 75; 76; 77; 78; 61; 79; 80; 81; 82; 60). In human research, systemic cardiovascular adverse effects were reported with manuka honey impregnated calcium alginate dressings (86).
  • Cytochrome P450-modifying agentsCytochrome P450-modifying agents: In human research, honey may induce CYP3A4 activity, although lacked an effect with CYP2D6 and CYP2C19 (215). In other human research with healthy participants, honey and artificial honey lacked an effect on CYP3A activity (216).
  • Dental agentsDental agents: In laboratory research, certain types of honey inhibited the formation of amorphous calcium phosphate precipitates, in which the authors suggested may have anticalculus properties useful in toothpastes and mouthwash (217) and compared to chlorhexidine gluconate mouthrinse, honey exhibited antibacterial effects against oral microorganisms (218).
  • Dermatologic herbs and supplementsDermatologic herbs and supplements: One patient receiving topical Medihoney experienced a temporary, mild local skin discomfort, however the discomfort resolved on its own within days despite continuation of treatment (118). In human research, dermatitis, ulcer deterioration, erythema, deterioration of surrounding skin, and new ulceration were reported with manuka honey impregnated calcium alginate dressings (86). In human research, contact dermatitis was reported in individuals with leishmaniasis receiving honey-soaked gauze dressings (121) and itching was reported in individuals receiving monofloral aloe honey (130).
  • Gastrointestinal agentsGastrointestinal agents: Incidents of gastrointestinal symptoms, such as nausea and vomiting, from toxic honey ingestion have been reported caused by toxic honey produced from the nectar of Rhododendrons (54; 75; 76; 78). In children, reports of stomach discomfort, nausea, and vomiting were reported following oral honey ingestion (137; 87; 88). In human research, gastrointestinal systemic adverse effects were reported (86) including vomiting (84) and nausea (85).
  • Genitourinary tract herbs and supplementsGenitourinary tract herbs and supplements: In human research, urinary tract infections was reported in individuals receiving honey-thick liquid (84).
  • HematologicsHematologics: A 27 year-old, otherwise healthy woman who ingested 75mL of honey brought back from a visit to Turkey, was found to have mild leukocytosis (172).
  • HypoglycemicsHypoglycemics: Although honey has been investigated in the treatment of diabetes and lowering plasma glucose (203; 165), honey is composed of sugars (mainly fructose and glucose). Based on its composition, honey may increase plasma glucose when taken orally, and caution is advised in patients taking herbs or supplements that alter blood sugar. In human research, honey reduced fasting blood sugar (FBS), increased and decreased HbA1c, and improved fasting C-peptide and two hour postprandial C-peptide (PCP) (83; 93).
  • HypotensivesHypotensives: Incidents of cardiovascular symptoms, such as hypotension, chest pain, bradycardia, syncope, asystole, various types of heart block, atrial fibrillation, myocardial infarction, as well as other cardiac arrhythmias from honey intoxication have been reported due to grayanotoxins in toxic honey produced from the nectar of Rhododendrons (64; 55; 56; 57; 54; 65; 66; 67; 58; 68; 59; 69; 70; 71; 72; 73; 74; 75; 76; 77; 78; 61; 79; 80; 81; 82; 60).
  • Neurologic agentsNeurologic agents: Incidents of neurologic symptoms, such as mild paralysis, dizziness, impaired consciousness, seizures, sweating, paresthesias, weakness, and convulsions from honey intoxication have been reported due to toxic honey produced from the nectar of Rhododendrons (64; 57; 54; 65; 75; 78; 61; 60). In children, reports of hyperactivity, nervousness, drowsiness, somnolence, and insomnia were reported following oral honey ingestion (87; 88). In human research, fever and fatigue/weakness were reported in individuals receiving honey-thick liquid (84) and pain and burning sensation was reported in individuals receiving monofloral aloe honey (130).
  • Wound-healing agentsWound-healing agents: In human research, compared to the control group, participants treated with unprocessed and unpasteurized honey showed increased rates of wound healing after one week (14.48 ? 1.81 vs. 13.80 ? 1.91, p<0.05), two weeks (14.00 ? 2.12 vs. 11.08 ? 2.53, p<0.05), three weeks (13.64 ? 2.14 vs. 8.84 ? 2.53, p<0.05), four weeks (13.32 ? 2.11 vs. 7.02 ? 2.50, p<0.05), and five weeks (12.62 ? 2.15 vs. 6.55 ? 2.12, p<0.001), a significantly greater reduction in ulcer size for pressure ulcers dressed with honey compared to the control group (56% vs. 13% reductions, p<0.001), and a greater percentage of participants treated with honey showed complete wound healing compared to those in the control group (20% vs. 0%, p<0.05) (96).

    • Honey/Food Interactions:

  • Flavoring agentsFlavoring agents: Co-administration of honey significantly increased the serum levels of glycyrrhetic acid (GA) after oral administration of glycyrrhizin (GZ) in rabbits (221).

    • Honey/Lab Interactions:

  • A1cA1c: In human research, honey increased and decreased HbA1c (83; 93).
  • AlbuminAlbumin: In a case report, 80g of natural honey consumed daily for 21 days elevated albumin levels in a 40 year-old female with AIDS (222). In human research, honey significantly increased albumin (140).
  • C-peptideC-peptide: In human research, honey improved fasting C-peptide and two hour postprandial C-peptide (PCP) (93).
  • Complement hemolytic activity (CH50)Complement hemolytic activity (CH50): In human research, honey significantly increased CH50 levels (140).
  • CopperCopper: In a case report, 80g of natural honey consumed daily for 21 days elevated copper levels in a 40 year-old female with AIDS (222).
  • HemoglobinHemoglobin: In human research, honey significantly increased hemoglobin (140).
  • Lipid levelsLipid levels: In human research, honey reduced total cholesterol, LDL-C, ratio of LDL-C to HDL-C, and triglyceride, as well as increased HDL-C (83). In human research, compared to the control, honey significantly improved total cholesterol, triglycerides, LDL cholesterol, and HDL cholesterol (93).
  • Liver enzymesLiver enzymes: In human research, honey increased glutamate pyruvate transaminase (GPT) levels (83).
  • LymphocytesLymphocytes: In a case report, 80g of natural honey consumed daily for 21 days elevated percentage of lymphocytes in a 40 year-old female with AIDS (222). In human research, honey significantly increased lymphocytes (140).
  • Nitric oxideNitric oxide: In a case report, 80g of natural honey consumed daily for 21 days elevated nitric oxide production in a 40 year-old female with AIDS (222) and according to a review, honey was noted as increasing nitric oxide end products (223).
  • PlateletsPlatelets: In a case report, 80g of natural honey consumed daily for 21 days elevated platelet count in a 40 year-old female with AIDS (222).
  • ProstaglandinsProstaglandins: In a case report, 80g of natural honey consumed daily for 21 days decreased prostaglandins level in a 40 year-old female with AIDS (222) and according to a review, honey was noted as decreasing prostaglandin levels (223).
  • ProteinProtein: In human research, honey significantly increased protein (140).
  • Serum glucoseSerum glucose: In human research, honey lowered plasma glucose (203; 165). In human research, honey reduced fasting blood sugar (83) and improved mean fasting serum glucose (93).
  • Serum proteinSerum protein: In a case report, 80g of natural honey consumed daily for 21 days elevated serum protein levels in a 40 year-old female with AIDS (222).