Rosemary
Rosemary/Drug Interactions:
AminophyllineAminophylline: Based on in vitro evidence, rosemary may increase skin permeability and percutaneous absorption of aminophylline in human skin (176). AnalgesicsAnalgesics: Based on human evidence, inhalation of the essential oil of rosemary may affect subjective perception of pain although without reducing pain sensitivity (6). Antianxiety drugsAntianxiety drugs: In clinical study, inhalation of rosemary essential oil reduced anxiety (177; 178; 156; 179; 157). AntibioticsAntibiotics: Based on laboratory study, rosemary essential oils may act antagonistically with ciprofloxacin (148). Incorporation of carnosic acid and carnosol into the growth medium at 10mcg/mL caused a 32- and 16-fold potentiation of the activity of erythromycin against an erythromycin-effluxing strain, respectively (11). Rosemary and several of its constituents, including carnosic acid and carnosol, have exhibited antibacterial effects against various Gram-positive and Gram-negative bacteria in vitro including oral planktonic bacteria (180), Bacillus subtilis, Escherichia coli, Enterococcus faecalis, Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus (MRSA), H[2]O[2]-producing lactobacilli, Bacillus brevis FMC3, Bacillus megaterium DSM32, Micrococcus luteus LA 2971, Mycobacterium smegmatis RUT, Listeria monocytogenes SCOTT A, Streptococcus thermophilus, Pseudomonas fluorescens, Yersinia enterocolitica O:3 P 41797, Propionibacterium acnes (ATCC 6919), Staphylococcus epidermidis, Propionibacterium acnes, and Staphylococcus aureus ME/GM/TC Resistant (ATCC 33592) (25; 16; 26; 27; 181; 118; 182; 183; 184; 185; 186; 187; 188; 189; 190; 191; 184; 192; 193; 194; 195; 118; 196; 197; 198; 112; 1; 199; 12). Anticoagulants/antiplatelet drugsAnticoagulants/antiplatelet drugs: Rosemary has shown significant antithrombotic activity in vitro and in vivo in mice (14; 200). The antithrombotic mechanism may involve a direct inhibitory effect on platelets. In rat study, oral rosmarinic acid decreased fibronectin and fibrin in the glomerulus (44). Theoretically, concurrent use may increase the risk of bleeding. Antidiabetic agentsAntidiabetic agents: Based on animal study, rosemary extract may increase blood sugar levels in both diabetics and nondiabetics (147). However, laboratory studies have indicated that rosemary extracts may theoretically lower glucose levels (110; 72), a hypothesis substantiated in animal study (201; 91). Antihypertensive drugs vAntihypertensive drugs: Based on in vitro study, water extracts of rosemary may inhibit angiotensin I-converting enzyme (ACE) (110). Anti-inflammatory drugsAnti-inflammatory drugs: Based on in vitro study, rosemary may have anti-inflammatory activity (202; 203). However, in rat study, injection of the rosemary constituent 1,8-cineole produced inflammatory edema in the hind paw (175). Antineoplastic agentsAntineoplastic agents: Based on in vitro study, rosemary may increase the intracellular accumulation of commonly used chemotherapeutic agents, including doxorubicin and vinblastine, in cancer cells that express P-glycoprotein (204; 87). However, rosemary extract likely does not affect accumulation or efflux of doxorubicin in cells that lack P-glycoprotein. An increase in the activation of caspase-3 in high-risk pre-B acute lymphoblastic leukemia cells has been observed in vitro during coadministration of carnosol and chemotherapeutic agents (77). Furthermore, a lower percentage of caspase-3-positive cells progressed to an apoptotic phenotype during coadministration compared to treatment with chemotherapeutics alone. Antiobesity agentsAntiobesity agents: In mice fed a high-fat diet, rosemary leaf extract induced a significant reduction of weight and fat mass gain, an effect that may be related to the inhibition of pancreatic lipase activity, as determined in vitro (115). Carnosic acid and carnosol from rosemary inhibited the in vitro differentiation of mouse preadipocytes, 3T3-L1 cells, into adipocytes, possibly mediated by the activation of the antioxidant-response element (ARE) and induction of phase 2 enzymes (120). Antispasmodic agentsAntispasmodic agents: Rosemary oil produced spasmolytic effects in circular smooth-muscle strips of the guinea pig stomach accompanied by agonistic effects on alpha(1) and alpha(2) adrenergic receptors in vitro (205). The antispasmodic effects of alcoholic extracts of Rosmarinus officinalis have also been evaluated in isolated guinea pig ileum using acetylcholine and histamine as spasmogens (206). CyclosporineCyclosporine: Rosemary may potentially interact with cyclosporine (149).Cytochrome P450-metabolized agentsCytochrome P450-metabolized agents: Results from in vitro and rat study suggest that rosemary may selectively induce P450 enzymes in the liver, particularly CYP 2B, CYP 1A1, CYP 2B1/2, and CYP 2E1 (150; 151; 152). DiureticsDiuretics: In animal study, rosemary demonstrated diuretic effects, decreasing electrolytes (207). Rosemary has been shown to increase the permeability of furosemide in vitro (208). Hormonal agentsHormonal agents: Based on human evidence, a combination botanical supplement (Curcuma longa, Cynara scolymus, Rosmarinus officinalis, Schisandra chinensis, Silybum marinum, and Taraxacum officinalis) decreased dehydroepiandrosterone, dehydroepiandrosterone sulfate, androstenedione, and estrone sulfate levels in women (209). Based on evidence from mouse study, rosemary may enhance the liver's rate of deactivating estrogen in the body (145). Iron saltsIron salts: Rosemary has been shown to decrease iron absorption (146). LithiumLithium: According to case reports, rosemary may precipitate lithium toxicity due to its diuretic properties (155). SalicylatesSalicylates: Based on in vitro evidence, rosemary may contain high levels of salicylates (153). Rosemary/Herb/Supplement Interactions:
AnalgesicsAnalgesics: Based on human evidence, inhalation of the essential oil of rosemary may affect subjective perception of pain although without reducing pain sensitivity (6). AntibacterialsAntibacterials: Based on laboratory study, rosemary essential oils may act antagonistically with ciprofloxacin (148). Rosemary and several of its constituents, including carnosic acid and carnosol, have exhibited antibacterial effects against various Gram-positive and Gram-negative bacteria in vitro including oral planktonic bacteria (180), Bacillus subtilis, Escherichia coli, Enterococcus faecalis, Pseudomonas aeruginosa, methicillin-resistant Staphylococcus aureus (MRSA), H[2]O[2]-producing lactobacilli, Bacillus brevis FMC3, Bacillus megaterium DSM32, Micrococcus luteus LA 2971, Mycobacterium smegmatis RUT, Listeria monocytogenes SCOTT A, Streptococcus thermophilus, Pseudomonas fluorescens, Yersinia enterocolitica O:3 P 41797, Propionibacterium acnes (ATCC 6919), Staphylococcus epidermidis, Propionibacterium acnes, and Staphylococcus aureus ME/GM/TC Resistant (ATCC 33592) (25; 16; 26; 27; 181; 118; 182; 183; 184; 185; 186; 187; 188; 189; 181; 190; 191; 184; 192; 193; 194; 195; 118; 196; 197; 198; 112; 1; 199; 12). Anticoagulants and antiplateletsAnticoagulants and antiplatelets: Rosemary has shown significant antithrombotic activity in vitro and in vivo in mice (14; 200). The antithrombotic mechanism may involve a direct inhibitory effect on platelets. In rat study, oral rosmarinic acid decreased fibronectin and fibrin in the glomerulus (44). Theoretically, concurrent use may increase the risk of bleeding. Anti-inflammatory herbsAnti-inflammatory herbs: Based on in vitro study, rosemary may have anti-inflammatory activity (202; 203). However, in rat study, injection of the rosemary constituent 1,8-cineole produced inflammatory edema in the hind paw (175). Antiobesity herbs and supplementsAntiobesity herbs and supplements: In mice fed a high-fat diet, rosemary leaf extract induced a significant reduction of weight and fat mass gain, an effect that may be related to the inhibition of pancreatic lipase activity, as determined in vitro (115). Carnosic acid and carnosol from rosemary inhibited the in vitro differentiation of mouse preadipocytes, 3T3-L1 cells, into adipocytes, possibly mediated by the activation of the antioxidant-response element (ARE) and induction of phase 2 enzymes (120). AntispasmodicsAntispasmodics: Rosemary oil produced spasmolytic effects in circular smooth-muscle strips of the guinea pig stomach accompanied by agonistic effects on alpha(1) and alpha(2) adrenergic receptors in vitro (205). The antispasmodic effects of alcoholic extracts of Rosmarinus officinalis have also been evaluated in isolated guinea pig ileum using acetylcholine and histamine as spasmogens (206). AnxiolyticsAnxiolytics: In clinical study, inhalation of rosemary essential oil reduced anxiety (177; 178; 156; 179; 157). Cardiovascular herbs and supplementsCardiovascular herbs and supplements: In laboratory study, water extracts of rosemary inhibited rabbit lung angiotensin I-converting enzyme (ACE) by 90.5% (110). Cytochrome P450 substratesCytochrome P450 substrates: Results from in vitro and rat study suggest that rosemary may selectively induce P450 enzymes in the liver, particularly CYP 2B, CYP 1A1, CYP 2B1/2, and CYP 2E1 (150; 151; 152). DiureticsDiuretics: In vitro evidence suggests that rosemary may enhance the effects of herbal agents used for diuresis (208; 155). In animal study, rosemary demonstrated diuretic effects, decreasing electrolytes (207). Rosemary has been shown to increase the permeability of furosemide in vitro (208). Hormonal herbs and supplementsHormonal herbs and supplements: Based on human evidence, a combination botanical supplement (Curcuma longa, Cynara scolymus, Rosmarinus officinalis, Schisandra chinensis, Silybum marinum, and Taraxacum officinalis) decreased dehydroepiandrosterone, dehydroepiandrosterone sulfate, androstenedione, and estrone sulfate levels in women (209). Based on evidence from mouse study, rosemary may enhance the liver's rate of deactivating estrogen in the body (145). Based on in vitro evidence, rosemary may decrease cortisol levels (210). HypoglycemicsHypoglycemics: Based on animal study, rosemary extract may increase blood sugar levels in both diabetics and nondiabetics (147). However, laboratory study has indicated that rosemary extracts may theoretically lower glucose levels (110; 72), a hypothesis substantiated in animal study (201; 91). IronIron: Based on clinical study, rosemary may decrease iron absorption (146). LycopeneLycopene: In lab study, the polyphenols rosmarinic acid and carnosic acid (derived from rosemary) interacted with lycopene synergistically, inhibiting LDL oxidation in a dose-dependent manner (211). Rosemary/Food Interactions:
Iron-containing foodsIron-containing foods: Based on clinical study, rosemary may decrease iron absorption (146). Lycopene-containing foodsLycopene-containing foods: In lab study, the polyphenols rosmarinic acid and carnosic acid (derived from rosemary) interacted with lycopene in a synergistically, inhibiting LDL oxidation in a dose-dependent manner (211). Rosemary/Lab Interactions:
Blood glucoseBlood glucose: Based on animal study, rosemary extract may increase blood sugar levels in both diabetics and nondiabetics (147). However, laboratory studies have indicated that rosemary extracts may theoretically lower glucose levels (110; 72), a hypothesis substantiated in animal study (201; 91). Blood pressureBlood pressure: In laboratory study, water extracts of rosemary inhibited rabbit lung angiotensin I-converting enzyme (ACE) by 90.5% (110). ChlorideChloride: In rat study, aqueous extracts of rosemary significantly increased urinary excretion of chloride (207). Coagulation panelCoagulation panel: Rosemary has shown significant antithrombotic activity in vitro and in vivo in mice (14; 200). The antithrombotic mechanism may involve a direct inhibitory effect on platelets. In rat study, oral rosmarinic acid decreased fibronectin and fibrin in the glomerulus (44). CortisolCortisol: Based on in vitro evidence, rosemary may decrease cortisol levels (210). Creatinine clearanceCreatinine clearance: In rat study, aqueous extracts of rosemary significantly decreased creatinine clearance (207). Electroencephalogram (EEG)Electroencephalogram (EEG): Human study investigating the effects of rosemary aromatherapy on alertness and electroencephalogram (EEG) activity found that patients showed decreased frontal alpha- and beta-power, suggesting increased alertness (179). In other research, subjects with a greater baseline relative to the right frontal EEG activation shifted left during exposure to rosemary aroma, while those with greater baselines relative to left frontal EEG activation shifted right (212). Estrogen levelsEstrogen levels: Based on evidence from mouse study, rosemary may enhance the liver's rate of deactivating estrogen in the body (145). IronIron: Based on a clinical study, rosemary may decrease iron absorption (146). Lithium concentrationsLithium concentrations: According to case reports, rosemary may result in increased lithium serum concentrations due to its diuretic properties (155). Liver function testsLiver function tests: In animal study, rosemary normalized the increase in bilirubin level and alanine aminotransferase activity in plasma induced by CCl4 (54). PotassiumPotassium: In rat study, aqueous extracts of rosemary significantly increased urinary excretion of potassium (207). SodiumSodium: In rat study, aqueous extracts of rosemary significantly increased urinary excretion of sodium (207). TriglyceridesTriglycerides: In animal study, hepatic triglyceride levels were decreased following rosemary extract administration (115).