In many cases you can take Chinese herbs alongside prescription medicines, but not in every case, and never without the person prescribing the herbs knowing what you are on. That is why the first question I ask at a herbal medicine consultation is what you take, and why I ask it again at every follow-up.
It is an unglamorous question. People sometimes apologise for the length of the list, or leave out the things they think do not count: the aspirin, the antacid, the supplement from the chemist, the pill. Please do not. The list is the foundation of a safe herbal medicine prescription, and a complete list is worth more to me than any other single piece of information you bring.
Why the medication list comes first
Herbs are active substances. That is the whole point of prescribing them. A plant that does something in the body can, in principle, add to, blunt or alter what a medicine is doing, and the reverse is also true. Most of the time the two sit side by side without issue. Some of the time they do not, and the only way I can tell the difference is to know exactly what is in the picture before I write anything.
So the list comes before the formula, not after. I would rather spend ten minutes of your first hour going through it properly than discover something later. You can read how the rest of a prescription is built in how herbal medicine is prescribed. This post is about the safety step that sits in front of all of it.
Two kinds of answer
When a herb and a medicine should not be taken together, the answer is not always “no herbs for you”. There are usually two possibilities.
- Not this herb. The formula is adjusted so that a particular ingredient is left out, or swapped for something that plays a similar role in Chinese medicine theory. You still receive a prescription, just a different one.
- Not at the same time. Some combinations are a question of timing rather than compatibility, and the advice is to take the herbs and the medicine at different times of day, with a gap between them.
Which answer applies depends on the herb, the medicine and you. I do not make that call from memory alone. I check, and if I am not confident I will say so and either leave the herb out or speak to your GP or pharmacist first.
Where extra care is standard
There are categories of medicine where I take particular care as a matter of routine. I am describing categories here, not naming interactions, because the detail depends on the individual prescription and I do not want anyone reading a list and drawing their own conclusions.
- Medicines that thin the blood or affect clotting.
- Medicines for blood pressure.
- Medicines for blood sugar.
- Anything with a narrow dose window, where a small change in how the body handles it matters.
- Anything recently started, recently stopped or recently changed in dose.
If you are on one of these, it does not mean herbs are off the table. It means I go slowly, keep the formula simple, check more, and may ask you to confirm with the doctor who prescribed the medicine before we begin.
Why I ask you to tell your GP and pharmacist
I ask every herbal medicine patient to let their GP and their regular pharmacist know they are taking herbs, and to keep a copy of the formula with their other medication records. There are three reasons.
- Your GP may change a medicine, and it is better if the herbs are already in their notes when they do.
- Your pharmacist sees every prescription filled and is well placed to spot something I cannot.
- If you are ever admitted to hospital, the staff need the whole picture, and “some herbs” is not enough for them to work with.
I am not asking you to seek permission. I am asking you to keep everyone informed. I work alongside conventional care, not around it, and if a doctor has a concern about a herb I will always take that seriously.
The formula is reviewed each visit
A herbal prescription is not a set-and-forget thing. At every follow-up, whether it is a naturopathy review or a Chinese medicine appointment, I go through the medication list again before touching the formula. New medicine? Say so. Stopped one? Say so. Started a supplement a friend recommended? Say so. Each of those can change what I prescribe.
A few practical habits make this easy.
- Bring your bottles, both the medicines and the herbs, to your first visit and any time something has changed.
- Keep a current list in your phone or wallet, with doses.
- Tell me about the over-the-counter things, including supplements, vitamins and anything herbal from a shop.
- Ask. If you are ever unsure whether to take a herb with something new, do not guess. Call or email and I will check.
The FAQs page covers a few of the common questions about herbs and medicines. If yours is not there, ask me directly at your next visit.
Ready to book?
If you would like to talk through whether herbal medicine could sit alongside what you already take, book an initial consultation through the online booking page or call (02) 9341 5775. Bring your medication list, and we will start there.
Ahil Naturopath/Acupuncture is a clinic located near Redfern, Alexandria and Waterloo. We also service areas across Sydney including Botany, Camperdown, Darlinghurst, Erskineville, Eveleigh, Mascot, Newtown, Rosebery, Surry Hills and Zetland.
We offer Acupuncture, Naturopathy, Herbal medicine, Traditional Chinese Medicine (TCM), Cupping, Gua Sha (Scraping) and Moxibustion services in South-East, Eastern and Inner City of Sydney.
This article is general information only and is not a substitute for individual advice from a qualified health practitioner. If you have a health concern, please see your GP or book a consultation.