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台灣老年學暨老年醫學會﹒之 011
I~
EVIDENCE OF POTENTIAL HARMFUL
INTERACTIONS BETWEEN ASPIRIN/CLOPIDOGREL
AND TRADITIONAL CHINESE MEDICINE
ASPIRIN/CLOPIDOGREL 與中藥間潛在交互作用
之實話探討 到「黨「的口 i!i Tsai HH1 ,2, Lin HWI,2, Lin CC3 莖聾莖1，2 、林香汶口、林正介 3 1 中國醫藥大學藥學系、 2 中國醫藥大學附設醫院藥劑部、 3 中國醫藥大學醫學院 吋 MM 叫 ， 問 f e 削 1EI--poex
ji -i 1Jg 句 EmR en ha Background: Given a 79-year-old man was prescribed with clopidogrel to preventstroke, it was noticed that he also visited Traditional Chinese Medicine (TCM) Department in the same hospital to seek help for his pain problem. Through electronic chart review and literature search, it was confimled that some ingredients in his TCM remedy were interacted with clopidogrel. As for the most 'common antiplatelet agents used for the elderly, it is unclear for what extent the evidence would be about their interactions with TCM. The aim of this study was to conduct a systematic review to examine the evidence of interactions between aspirinlclopidogrel and TCM.
Metbods: Information related to interactions between aspirinlclopidogrel and TCM was retrieved from eight interaction-based textbooks, five web resources and several primary biomedical joumals. The literature search was conducted in PubMed, EMBASE, Airiti Library, and CNKI, etc. The search years were from 2000 to 2010 and the languages were restricted to English and Chinese. One standardized data abstraction checklist was used to extract al1 relevant data. Herbs or natural products not used as a TCM were excluded for further analysis. The corresponding mechanisms and severity ratings of interactions were retrieved from MicroMedex@ and Lexi-Interact@.
Results: A total of 63 pairs of interactions were identified. Aspirin and clopidogrel were documented to interact with 36 and 27 individual TCM, respectively. 35% (22 pairs)
for their evidence describing the correspon<;ling mechanisms and severity. All ofthese interactions were attributable to pharmacodynamic mechanisms and rated as moderate or m句 or interactions. 百le antiplatelet effect of aspirin and clopidogrel may be enhanced by Asian ginseng, clove, dong quai, garlic, and ginger,
口l' sy ha fa, re ap identified were mterachons of pr ur etc.
Conclusions: Aspirin and clopidogrel were documented to have harmful interactions with some common used TCM. These combinations may increase the risk of bleeding and need to be monitored careful旬，especially for the elderly users.
