Sheng dihuang
Rehmannia/Drug Interactions:
AminoglycosidesAminoglycosides: There is animal evidence that the concomitant use of aminoglycosides and rehmannia may decrease toxicity associated with aminoglycoside therapy (16). Anticoagulant/antiplatelet drugsAnticoagulant/antiplatelet drugs: Combination use of rehmannia with anticoagulant drugs may result in additive effects. In an animal model, Man-Shen-Ling (MSL) containing medicinal herbs, such as astragalus and rehmannia, exhibited anticoagulant effects (3). AntihistaminesAntihistamines: A study conducted in rats showed dose dependent inhibition of systemic allergic reaction and anti-IgE antibody induced cutaneous reaction (1). Antihypertensive drugsAntihypertensive drugs: Combination use of rehmannia and antihypertensives may result in additive effects. Liu wei di huang t'ang (decoction of rehmannia with 6 components) showed marked hypotensive effects in rats (28). CorticosteroidsCorticosteroids: According to a case report, rehmannia and corticosteroids may result in a synergistic effect and possibility of reduced side effects (20). One study in rabbits showed that Rehmannia glutinosa used with dexamethasone maintained the therapeutic effect of the glucocorticoid, and relieved side effects of both functional and morphological changes in pituitary and adrenal cortex caused by glucocorticoids (7). Cytotoxic/chemotherapeutic agentsCytotoxic/chemotherapeutic agents: Theoretically, rehmannia may decrease toxicity associated with chemotherapy (8). Shi-Quan-Da-Bu-Tang (SQT), which contains Rehmannia glutinosa, Paeonia lactiflora, Liqusticum wallichii, Angelica sinesis, Glycyrrhiza uralensis, Poria cocos, Atractlyodes macrocephala, Panax ginseng, Astragalus membranaceus, and Cinnamomum cassia, was found to potentate therapeutic activity of chemotherapy, radiotherapy, and prevent or minimize associated adverse events (9). DiureticsDiuretics: Rehmannia may have an additive effect with diuretics. In an animal model, Man-Shen-Ling (MSL) containing medicinal herbs, such as astragalus and rehmannia, caused an increase in renal blood flow and glomerular filtration, the excretion of urea-nitrogen, and a potassium/sodium promoting function (3). In a study in rats Rehmannia glutinosa, increased renal blood flow (29). Hypoglycemic agentsHypoglycemic agents: Rehmannia may interact additively with hypoglycemic drugs because it can cause hypoglycemia (33). Seishin-kanro-to, composed of rehmannia radix, may reduce blood sugar levels in diabetics, according to a mouse study (34). Lipid-lowering agentsLipid-lowering agents: The concomitant use of cholesterol lowering drugs with rehmannia may result in additive effects, according to a case-control study of diabetes mellitus type 2 with hyperlipidemia (14).Thyroid drugsThyroid drugs: Rehmannia may have an additive effect with thyroid drugs. In a study in hyperthyroid rats, Rehmannia glutinosa may lower receptor affinity and the peripheral conversion of T4 to T3 (30). In another study in hyperthyroid rats rehmannia significantly reduced the binding capacity of the beta-adrenergic receptors in the kidney (31). In a study on Sheehan's Syndrome Rehmannia glutinsoa may have improved clinical symptoms and stimulated the hypothalamic-pituitary system (32). Rehmannia/Herb/Supplement Interactions:
Anticoagulant/antiplatelet herbs and supplementsAnticoagulant/antiplatelet herbs and supplements: Concomitant use of anticoagulants with rehmannia may result in an additive effect. In an animal model, Man-Shen-Ling (MSL) containing medicinal herbs such as astragalus and rehmannia, exhibited an anticoagulant effect (3). Antihypertensive herbs and supplementsAntihypertensive herbs and supplements: Combination use of rehmannia with antihypertensive herbs/supplements may result in additive effects. Liu wei di huang t'ang (decoction of rehmannia with 6 components) was evaluated in renal hypertensive rats and showed marked hypotensive effect (28). Corticosteroid herbs and supplementsCorticosteroid herbs and supplements: According to a case report, rehmannia and corticosteroids may result in a synergistic effect and possibility of reduced side effects (20). One study in rabbits showed that Rehmannia glutinosa used with dexamethasone maintained the therapeutic effect of the glucocorticoid, and relieved side effects of both functional and morphological changes in pituitary and adrenal cortex caused by glucocorticoids (7). Diuretic herbs and supplementsDiuretic herbs and supplements: Rehmannia may have an additive effect with diuretics. In an animal model, Man-Shen-Ling (MSL) containing medicinal herbs, such as astragalus and rehmannia, caused an increase in renal blood flow and glomerular filtration, the excretion of urea-nitrogen, and a potassium/sodium promoting function (3). In a study in rats Rehmannia glutinosa increased renal blood flow (29). Hypoglycemic herbs and supplementsHypoglycemic herbs and supplements: Rehmannia may interact additively with hypoglycemic herbs because it can cause hypoglycemia (33). Seishin-kanro-to, composed of rehmannia radix, may reduce blood sugar levels in diabetics, according to a mouse study (34). Lipid-lowering herbs and supplementsLipid-lowering herbs and supplements: The concomitant use of cholesterol lowering herbs with rehmannia may result in additive effects, according to a case-control study of diabetes mellitus type 2 with hyperlipidemia (14).Thyroid active agentsThyroid active agents: Rehmannia may have an additive effect with thyroid herbs. In a study in hyperthyroid rats, Rehmannia glutinosa may lower receptor affinity and the peripheral conversion of T4 to T3 (30). In another study in hyperthyroid rats rehmannia significantly reduced the binding capacity of the beta-adrenergic receptors in the kidney (31). In a study on Sheehan's Syndrome Rehmannia glutinsoa may have improved clinical symptoms and stimulated the hypothalamic-pituitary system (32). Rehmannia/Food Interactions:
Insufficient available evidence.Rehmannia/Lab Interactions:
Coagulation panelCoagulation panel: Theoretically, rehmannia may alter the results of these tests due to anticoagulant effects (3). Fasting blood glucose levelsFasting blood glucose levels: Rehmannia may lower fasting blood glucose levels (33), including in diabetics, according to a case-control study in patients with diabetes mellitus type 2 with hyperlipidemia (14) and a mouse study (34). Lipid profileLipid profile: Rehmannia may reduce LDL cholesterol and raise HDL cholesterol, according to a case-control study in patients with diabetes mellitus type 2 with hyperlipidemia (14).Thyroid panelThyroid panel: According to two studies in hyperthyroid rats, rehmannia may lower receptor affinity and the peripheral conversion of T4 to T3 (30) and reduce the binding capacity of the beta-adrenergic receptors of the kidney (31). Rehmannia glutinosa may have stimulative effects on the hypothalamic-pituitary system, according to a study in patients with Sheehan's Syndrome (32).