But two brief research letters published in the Feb. 12 edition of the British medical journal The Lancet indicate that St. John’s Wort is not safe for those taking two types of prescription medication and raise concerns about possible interactions with other prescription drugs online.

One of the drugs examined, indinavir, is a type of drug called a protease inhibitor, which helps suppress HIV, the virus that causes AIDS. Researchers at the National Institutes of Health (NIH) in Bethesda, Md., gave indinavir to eight healthy volunteers in a regimen similar to that used by people who are HIV positive. They measured the drug’s appearance in and disappearance from the subjects’ blood, a procedure that helps determine how often and how much of a drug must be taken to reach an effective level. For two weeks after these procedures, the subjects took regular doses of St. John’s Wort. Then, they were given indinavir again, and its level in their blood was assessed.

The NIH investigators found that two weeks of St. John’s Wort treatment resulted in indinavir levels that were significantly lower than they had been before subjects took the herbal remedy. “Drug interactions with [herbal] supplements do occur, and might have profound clinical consequences,” the authors stated. For example, they noted that in HIV-infected people, “[drug] resistance may quickly develop in the presence of antiviral concentrations.”

In another research letter, investigators from the University Hospital in Zurich, Switzerland, reported that two heart transplant patients had lower than expected levels of cyclosporine in their blood when they were taking St. John’s Wort. Cyclosporine levels returned to normal when the patients stopped taking the herbal preparation.

Cyclosporine is a drug taken by people who have had organ transplants. It suppresses their immune systems so they do not reject the transplanted organs. If the levels of cyclosporine are not kept within a particular therapeutic range, transplanted organs may be damaged or totally rejected.

The concern about St. John’s Wort and interactions with other medications is not limited to indinavir and cyclosporine. St. John’s Wort contains compounds that activate the body’s system for metabolizing drugs, according to the Swiss investigators. This means the dose of medication, such as cyclosporine or indinavir, that is usually effective might well be too low if St. John’s Wort is used at the same time. St. John’s Wort may also affect other medications that are metabolized by the same body system.

Neither St. John’s Wort, nor most other preparations sold as dietary supplements in the United States, have been tested as thoroughly as regulated, approved pharmaceuticals. Much remains to be learned about their purity, safety and effectiveness. Consumers who are taking medications on a regular basis should check with their physicians or pharmacists before adding herbal products to their personal pharmacies.

Even though you are meticulous about dental hygiene and faithfully visit your dentist twice a year, it is still possible that you have gum disease. Experts estimate that 75% of individuals older than 35 are unaware that they suffer from some sort of gingival problems. Regrettably, ignorance will not keep you from developing more serious gum disease or periodontal disease, which can cause tooth loss and cosmetic issues. Medications are often overlooked as a major cause of gum problems. It might be wise to check out the medications that you take if you are worried about having healthy teeth and gums.

What medications can result in gum problems? Many common medications change the natural flow of saliva, causing you to have a dry mouth. Saliva is a natural substance that contains anti-bacterial agents that can help keep in check the bacteria that cause plaque to form and gum disease to develop. If there is not enough saliva, bad bacteria are more likely to grow and cause various gum problems, cavities, and malodorous breath.

Quite a few medications can cause gum problems; the culprits include anti-depressants, some blood pressure medications, and antihistamines. As a matter of fact, hundreds of drugs can cause you to experience dry mouth that could lead to gum disease. Possibly when you take these medication you notice that your mouth is dry or that you have a bad taste in your mouth. Even if you do not notice these things, your gum health may be deteriorating due to a lack of sufficient saliva.

What can be done if you are worried about your medicines resulting in gum issues? If your physician cannot find an alternative medication for you to take that would cause less mouth dryness, there are some things you can do to help reduce your risk of developing gum disease.

An alternative is to enjoy sugar free gum which contains xylitol. Chewing will encourage saliva production and the xylitol will help decrease the production of bacteria that can cause gum disease. Studies have shown that xylitol can reduce the possibility of dental cavities.

You will want to drink a good bit of water to stay hydrated. Research indicates that the catechins found in green tea are helpful in decreasing gum inflammation and help improve oral health. Drinking green tea during the day will help keep your mouth moist and it may also be helpful to the mouth and gums. Using a humidifier while you sleep can assist in keeping your mouth hydrated at night.

Remember to see your dentist regularly if you have gum issues caused by your medications. Removing plaque along the gum line on a regular basis can also be helpful in the prevention of possible gum disease.

There are a few reasons you should NOT take Zanaflex medication: if you have allergies to any Zanaflex ingredient; if you take ciprofoxacin or fluvoxamine.
If these apply to you, let your doctor know right away.

Before you use generic Zanaflex: There are some medical conditions which possibly can interact with Zanaflex.

Inform your physician or pharmacist if you suffer from any medical conditions specifically in the following areas:
- if you are pregnant, planning to become pregnant, or are breast-feeding;
- if you are taking any prescription or nonprescription medicine, herbal preparation, or dietary supplement;
- if you have allergies to medicines, foods, or other substances;
- if you have liver or kidney problems or prostate problems.

There are some medicines that may interact with Zanaflex:
Inform your physician if you are taking additional drug, specifically any of the following: Acyclovir, antiarrhythmics (eg, amiodarone, mexiletine, propafenone), cimetidine, famotidine, fluvoxamine, hormonal contraceptives (eg, birth control pills), quinolone antibiotics (eg, ciprofloxacin), ticlopidine, verapamil, or zileuton because they may increase the risk of Zanaflex’s side effects.

This list may not include all the interactions that are possible. If you take any other medicines, you should ask your physician if they will interact with Zanaflex. Before you begin, stop or change the dose of any medication you should check with your physician.

Using Zanaflex drug:
Follow the directions your doctor gives you for using Zanaflex.
Read the label for exact dosing instructions.
Zanaflex is taken orally.
Food can alter the way your body absorbs and uses the medicine Zanaflex. It is important that you talk with your doctor to find out the most effective way to take your medicine, particularly when you are thinking about changing your dose, or if your doctor is prescribing a dose form of Zanaflex which is different from the one you are currently taking (such as tablets or capsules.)
Do not end your use of Zanaflex suddenly. If you are required to stop using Zanaflex your physician will slowly reduce your dose to stop symptoms of withdrawal, which could be high blood pressure, rapid heartbeat, tremor, anxiety and muscle tension.
Take any missed doses of Zanaflex as soon as possible. If it is close to your next dosage simply pass over the forgotten one and get back to your normal routine. Never take two doses at once.

Talk to your doctor about any questions you have about Zanaflex.

For your safety, it is important to know the following information: Zanaflex can make you drowsy, dizzy, lightheaded, or faint. Side effects may worsen when used with alcohol or other medicines. Be careful when using Zanaflex. Wait to drive or do other potentially unsafe tasks until you know how you react to it.
Do not consume alcohol or use drugs that could bring on fatigue while using Zanaflex as it could ramp up their side effects. If you want to know which medicines may make you drowsy, let the pharmacist know what your questions are.
The side effects of Zanaflex are dizziness, lightheadedness and fainting; they can be magnified by alcohol, hot weather, excessive exercise, or fever. Sit up and stand slowly, especially in the morning, to prevent this. If you experience these, sit or lie down.
Don’t change from Zanaflex tablets to capsules unless your doctor tells you to. Switching to another form after you have started to take one can increase the risk of side effects. If you find that you have received something different from the medicine you usually take, ask your doctor or the pharmacist prior to taking Zanaflex.

Inform your physician or dentist that you ingest Zanaflex before you get any medical or dental treatment, emergency care or surgery.
Check with your physician before taking more than the prescribed dose or if you use it longer than it was prescribed for.
When you take Zanaflex, you may have to have to undergo some lab tests like liver tests. These tests can be used to check for side effects and to monitor your condition. Make certain that you go to every doctor and lab appointment.
Use Zanaflex with care for the ELDERLY; they might be extra susceptible to its effects.
Zanaflex shouldn’t be prescribed for CHILDREN; safety and efficacy in children has not yet been established.
BREAST-FEEDING AND PREGNANCY: There is no conclusive evidence whether or not Zanaflex causes harm to fetuses. Let your doctor know if you become pregnant. If you are pregnant you will want to talk about the risks and benefits of Zanaflex. Scientists are unsure if Zanaflex is excreted in breast milk. Anyone who is breast-feeding, or plans to breast-feed at the same time they are using Zanaflex, should check with their physician. Talk about any risks or possible harm to your baby.

Possible Zanaflex Side Effects: All medications can cause side effects, but most people have no, or only minor, side effects.

There are some common side effects such as becoming constipated, dizzy, drowsy, flushed, tired, weak, or having a dry mouth; call your physician if any of these side effects are persistent or if they are bothering you.

Get medical attention immediately if you experience any of these side effects: Severe allergic reactions (rash; hives; itching; difficulty breathing; tightness in the chest; swelling of the mouth, face, lips, or tongue); change in emotions, mood, or behavior; hallucinations; increased muscle spasms; muscle weakness; slow heartbeat; trouble urinating or lack of bladder control; urinary tract infection; yellowing of the skin or eyes.

There might be other possible side effects. Call the person who provides your health care with any questions regarding the side effects.

Proper storage: To be stored properly, Zanaflex medicine should be stored at a temperature of 77 degrees F (25 degrees C). Storage for short periods are allowed at between 15 and 30 degrees C. Do not store near heat, light, or moisture. Zanaflex should not be kept in a bathroom. It is important to keep Zanaflex away from kids and pets.

General information: Only the patient who has been given the prescription should take Zanaflex.
This medicine should not be shared with anyone else.
Call your doctor if you find that your symptoms are not going away, or if they worsen.

This is only a summary. It does not have all the information available about Zanaflex. If you have concerns regarding the medication you are using or need further information, ask your physician, pharmacist, or other health care provider.

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First, ask your doctor if he or she has any samples of the medication they can give you, especially if you only need to take the medicine for a short time. A lot of these are given to doctors as free samples by pharmaceutical representatives; your doctor will most likely be happy to give some to you. You may need to ask your doctor about samples, as they might not otherwise think of it because of other things on their minds.

If you have a prescription drug plan and you are prescribed a medication for a long period of time, it’s important to ensure that you have a good understanding of your benefits. Your drug plan may have a formulary, which is a listing of preferred medications. Medication that is on the formulary is likely to be more affordable than similar drugs that are not on it. If your medicine isn’t listed on the formulary, ask your doctor if there is another drug on the list which you could take.

If generic drugs are available, they can be your best option. If you must pay for your medications yourself, you can save a significant amount of money this way. Your co-pay will be lower for generic drugs with many prescription drug plans. Again, ask your doctor if a generic medication would be effective for your treatment.

Mail-order programs are available for a wide range of prescription drug plans. This can be a convenient and cost saving way to get your medications. For about the same price as a one-month supply from your local pharmacy, you can obtain a three-month supply of the same medication.

If you shop at your local pharmacy, using your insurance isn’t always the cheapest method to purchase your medicine. For example, if your insurance charges a flat fee of $15 for generic drugs, but the cost of the drug is only $10, make sure to ask the pharmacy to process your prescription without insurance.

Many grocery stores or mass merchandisers publish coupons in the newspapers that can be used for prescriptions. A number of pharmacies are so keen to have your business, that they will offer you a gift certificate of $10 or $25 if you start filling your prescriptions with them. Transferring a prescription is easy — it usually only takes a phone call to give the new pharmacy information about the prescription.

If you still have trouble paying for your medication, you should ask your doctor about drug manufacturers who offer programs to help. You can often get the necessary paperwork to apply for these programs at your doctor’s office.