Warfarin Chamomile

The term pasaon flower is used to denote many of the approximately 400 species of the herb. F saon flower has been used in medicine to treat pain, anxiety, and insomnia. Some herbalists use the herb to treat symptoms of parkinsonism. F saon flower is often used in combination with other herbs , such a valerian, chamomile, and hops, for promoting relaxation, rest and sleep. Although no adverse reactions have been reported, large doses may cause CNS depression. The use of passion flower is contraindicated in pregnancy and in patientstaking the monoamine oxidase inhibitors (MAOIs). Fission flower contains coumarin, and the risk of bleeding may be increased when used in patientstaking warfarin and pasaon flower. 

Matricaria recutita, known as German chamomile, is also purported to have antispasmodic properties. It is taken most often as a tea up to four times a day. Benzodiazepine, alcohol, and warfarin users should be cautioned against taking this product because it can cause drowsiness, and it contains coumarin derivatives.20... 

Coumarin constituents (black cohosh, chamomile, fenugreek, horse chestnut, sweet melilot, tonka beans, sweet woodruff). Naturally occurring coumarins are only weakly anticoagulant, but improper storage causes the production of dicoumarol by microbial transformation. Woodruff may contain constituents of warfarin... 

A single case report describes a woman stabilised on warfarin who developed a marked increase in her HSR with bleeding complications five days after she started using two chamomile products. 

A 70-year-old woman stabilised on warfarin with an INR of 3.6 started drinking 4 to 5 cups of chamomile tea daily for chest congestion, and using a chamomile-based skin lotion 4 to 5 times daily for foot oedema. About 5 days later she developed ecchymoses and was found to have an INR of 7.9, a retroperitoneal haematoma and other internal haemorrhages. ... 

Chamomile has been indicated as an herb with the theoretical potential for interacting with warfarin due to the coumarin content of the herb (Heck et al. 2000). The cou-marin content, however, consists of the coumarin derivatives herniarin and umbelliferone. Herniarin has been shown to have hemostatic activity (Ahmad and Misra 1997) and umbelliferone has shown no evidence of anticoagulant activity (Egan et al. 1990 Feuer 1974 Pelkonen et al. 1997). The flavonoid apigenin has been shown to inhibit platelet aggregation in vitro (Landolfi et al. 1984 Teng et al. 1985). 

---