Abstract: . . .  not reduce enlargement (PDR, 2002) One case report of cholestatic hepatitis (NMCD, 2004) ? effectiveness of estrogens and oral contraceptives; ? risk of bleeding when used with other anticoagulant antiplatelet drugs (NMCD, 2004) Page 14 Werneke et al: Complementary alternative medicine for cancer 488 Valerian is a hypnotic, but evidence on its effectiveness remains inconclusive although a mechanism of action had been postulated (Stevinson and Ernst, 1999). Valerian inhibits CYP 3A4 and can potentiate . . .
. . .  enlargement (PDR, 2002) One case report of cholestatic hepatitis (NMCD, 2004) ? effectiveness of estrogens and oral contraceptives; ? risk of bleeding when used with other anticoagulant antiplatelet drugs (NMCD, 2004) Page 14 Werneke et al: Complementary alternative medicine for cancer 488 Valerian is a hypnotic, but evidence on its effectiveness remains inconclusive although a mechanism of action had been postulated (Stevinson and Ernst, 1999). Valerian inhibits CYP 3A4 and can potentiate the effect . . .
. . .  2002) One case report of cholestatic hepatitis (NMCD, 2004) ? effectiveness of estrogens and oral contraceptives; ? risk of bleeding when used with other anticoagulant antiplatelet drugs (NMCD, 2004) Page 14 Werneke et al: Complementary alternative medicine for cancer 488 Valerian is a hypnotic, but evidence on its effectiveness remains inconclusive although a mechanism of action had been postulated (Stevinson and Ernst, 1999). Valerian inhibits CYP 3A4 and can potentiate the effect of other sedatives. . . .
. . .  (Matthews, 1998; Benjamin 2001); possibly adverse effects on male and female fertility (Ondrizek, 1999); one case report of Stevens- Johnsons syndrome possibly attributed to Ginkgo (NMCD, 2004) Antithrombolytic agents including warfarin (PDR, 2000); evidence for effects on CYP1A2, 2C9, 2D6 and 3A4 inconsistent: CYP2C19: inhibition (Sparreboom, 2004); CYP2D6: potentially of no clinical significance (Markowit . . .
. . .  tamoxifen (Ingram et al, 2002; Kenny et al, 2004) Mastalgia: ? -linolenic acid (GLA) is metabolized to dihomo- ? -linolenic acid (DGLA): a precursor of the prostaglandin-E1 (PGE1), which is inflammatory (Darlington and Stone, 2001) Menopause: as above Cancer: only in vitro evidence available (Menendez et al, 2002) Mastalgia: evidence inconclusive (Gateley et al, 1992; Blommers et al, 2002; Ingram et al, 2002) Menopause: inconclusive, reduction of episodes of night time flushing (Chenoy et al, 1994) . . .
. . .  amiodarone, methotrexate, and ketoconazole (Miller, 1998) Mistletoe: lectins including viscumin Stimulation of cytokins (Riberau-Gayon et al, 1997; Mansky et al, 2003); modulation of neutrophile response (Pelletier et al, 2001) Not effective on systematic review of ten RCTs (Ernst et al, 2003); improvement of quality of life (Ernst et al, 2003; Schuhmacher et al, 2003; Piao et al, 2004; Semiglasov et al, 2004) Angioedema (Piao et al, 2004); ? intracerebral pressure and allergic reactions (Ernst et al, . . .
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