Calocurb Information for Healthcare Professionals
- On a medicine prescribed by your Doctor
- Have a chronic/longterm condition (eg Diabetes, Crohn disease)
- If you have acid reflux/ gastritis or similar conditions, and also may be taking over the counter medications for these conditions
Hops extract and prescribed medicines
Hops extract information for healthcare professionals
“In view of its long term use and present use in humans hops is considered to be non-toxic and safe with no significant adverse effects in the condition of use proposed for the monograph. In conclusion, the safety assessment of hops and hop preparations is mainly based on many years of experience from the extensive use in humans, which indicate hop preparations to be safe pharmaceutical agents.”
In the US the use of hops extract, or hops oleoresin, is approved by the U.S. FDA as an essential oil, oleoresin (solvent-free), and natural extractive (including its distillate) which are generally recognized as safe (GRAS).
Which medicines interact with hops extract?
- topical medicines with limited systemic absorption (inhalers, skin creams and ointments, eye and ear drops, enemas etc.)
- non-psychotropic medicines which are principally renally excreted
Medicine |
Evidence base |
Evidence and effect of interaction with St John’s Wort |
Suggested management of patients already taking hops extract (HE) |
HIV protease inhibitors |
Strong |
A clinical study has demonstrated reduced blood levels with possible loss of HIV suppression. |
Measure HIV RNA viral load and stop HE. |
Immunosuppressants |
Strong |
Case reports have demonstrated reduced blood levels with transplant rejection. |
Check cyclosporin or tacrolimus blood levels and stop HE. Levels may increase on stopping HE. The dose of immunosuppressant may need adjusting. |
HIV non-nucleoside reverse transcriptase inhibitors |
Theoretical |
Reduced blood levels with possible loss of HIV suppression is theoretically possible. |
Measure HIV RNA viral load and stop HE. |
Warfarin |
Moderate |
Case reports of reduced anticoagulant effect and need for increased warfarin dose have been reported. |
Check INR and stop HE. Monitor INR closely as this may rise on stopping HE. The dose of warfarin may need adjusting. |
Anticonvulsants (carbamazepine, phenobarbitone, phenytoin) |
Theoretical |
Reduced blood levels with risk of seizures theoretically possible. |
Check anticonvulsant levels and stop HE. Anticonvulsant levels may increase on stopping HE. The dose of anticonvulsant may need adjusting. |
Digoxin |
Moderate |
Isolated case reports of reduced blood levels have been reported. Theoretical loss of control of heart rhythm or heart failure. |
Check digoxin levels and stop HE. Digoxin levels may increase on stopping HE. The dose of digoxin may need adjusting. |
Oral contraceptives |
Weak |
Small numbers of case reports of breakthrough bleeding, Contraceptive failure theoretically possible but no case reports of contraceptive failure have been reported. |
Weigh the benefits of continuing HE against theoretical possibility of reduced contraceptive efficacy. |
Theophylline |
Theoretical |
Reduced blood levels and loss of bronchodilator effect theoretically possible. |
Check theophylline levels and review use of HE. Weigh the benefits of continuing HE against possible adverse effects. Theophylline levels may increase on stopping HE. The dose of theophylline may need adjusting. |
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