Acyclovir-Hydrocortisone

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Drug Information

Summary of Interactions with Vitamins, Herbs, & Foods

Types of interactions: Beneficial Adverse Check

Replenish Depleted Nutrients

  • Vitamin B12

    Neomycin can decrease absorption or increase elimination of many nutrients, including calcium, carbohydrates, beta-carotene, fats, folic acid, iron, magnesium, potassium, sodium, and vitamin A, vitamin B12, vitamin D, and vitamin K.1 , 2 Surgery preparation with oral neomycin is unlikely to lead to deficiencies. It makes sense for people taking neomycin for more than a few days to also take a multivitamin-mineral supplement.

  • Vitamin K

    Several cases of excessive bleeding have been reported in people who take antibiotics.5 , 6 , 7 , 8 This side effect may be the result of reduced vitamin K activity and/or reduced vitamin K production by bacteria in the colon. One study showed that people who had taken broad-spectrum antibiotics had lower liver concentrations of vitamin K2 (menaquinone), though vitamin K1 (phylloquinone) levels remained normal.9 Several antibiotics appear to exert a strong effect on vitamin K activity, while others may not have any effect. Therefore, one should refer to a specific antibiotic for information on whether it interacts with vitamin K. Doctors of natural medicine sometimes recommend vitamin K supplementation to people taking antibiotics. Additional research is needed to determine whether the amount of vitamin K1 found in some multivitamins is sufficient to prevent antibiotic-induced bleeding. Moreover, most multivitamins do not contain vitamin K.

  • Calcium

    Oral corticosteroids reduce absorption of calcium and interfere with the activation and metabolism of the vitamin,15 , 16 , 17 , 18 , 19 increasing the risk of bone loss. Doctors can measure levels of activated vitamin D (called 1,25 dihydroxycholecalciferol) to determine whether a deficiency exists; if so, activated vitamin D is only available by prescription. A study of rheumatoid arthritis patients treated with low amounts of prednisone found that those who received 1,000 mg of calcium per day plus 500 IU of vitamin D per day for two years experienced no bone loss during that time period.20 An analysis of properly conducted trials concluded that supplementation with vitamin D and calcium was more effective than placebo or calcium alone in protecting against corticosteroid-induced osteoporosis.21 Most doctors recommend 1,000 mg of calcium and 400–800 IU vitamin D per day for the prevention of osteoporosis.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Chromium

    Preliminary data suggest that corticosteroid treatment increases chromium loss.29 Double-blind trials are needed to confirm these observations.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Vitamin B6

    Corticosteroids may increase the loss of vitamin B6.31 One double-blind study of people with asthma failed to show any added benefit from taking 300 mg per day of vitamin B6 along with inhaled steroids.32 Therefore, while small amounts of vitamin B6 may be needed to prevent deficiency, large amounts may not provide added benefit. Some doctors recommend that people taking corticosteroids for longer than two weeks supplement with at least 2 mg of vitamin B6 per day.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Reduce Side Effects

  • Calcium and Vitamin D

    Oral corticosteroids reduce absorption of calcium35 and interfere with the activation and metabolism of the vitamin,36 , 37 , 38 , 39 increasing the risk of bone loss. Doctors can measure levels of activated vitamin D (called 1,25 dihydroxycholecalciferol) to determine whether a deficiency exists; if so, activated vitamin D is only available by prescription. A study of rheumatoid arthritis patients treated with low amounts of prednisone found that those who received 1,000 mg of calcium per day plus 500 IU of vitamin D per day for two years experienced no bone loss during that time period.40 An analysis of properly conducted trials concluded that supplementation with vitamin D and calcium was more effective than placebo or calcium alone in protecting against corticosteroid-induced osteoporosis.41 Most doctors recommend 1,000 mg of calcium and 400–800 IU vitamin D per day for the prevention of osteoporosis.

  • Chromium

    Preliminary data suggest that supplementation with chromium (600 mcg per day in the form of chromium picolinate) may prevent corticosteroid-induced diabetes.49 Double-blind trials are needed to confirm these observations.

  • Probiotics

    A common side effect of antibiotics is diarrhea, which may be caused by the elimination of beneficial bacteria normally found in the colon. Controlled studies have shown that taking probiotic microorganisms—such as Lactobacillus casei, Lactobacillus acidophilus, Bifidobacterium longum, or Saccharomyces boulardii—helps prevent antibiotic-induced diarrhea.51

    The diarrhea experienced by some people who take antibiotics also might be due to an overgrowth of the bacterium Clostridium difficile, which causes a disease known as pseudomembranous colitis. Controlled studies have shown that supplementation with harmless yeast—such as Saccharomyces boulardii 52 or Saccharomyces cerevisiae (baker’s or brewer’s yeast)53—helps prevent recurrence of this infection.

    Treatment with antibiotics also commonly leads to an overgrowth of yeast (Candida albicans) in the vagina (candida vaginitis) and the intestines (sometimes referred to as “dysbiosis”). Controlled studies have shown that Lactobacillus acidophilus might prevent candida vaginitis.54

Support Medicine

  • Licorice

    When applied to the skin, glycyrrhetinic acid (a chemical found in licorice (Glycyrrhiza glabra)) increases the activity of hydrocortisone.59 This effect might allow for less hydrocortisone to be used when combined with glycyrrhetinic acid, but further study is needed to test this possibility.60

  • Probiotics
    In one study, taking 500 mg of Saccharomyces boulardii twice daily enhanced the effectiveness of the antibiotic vancomycin in preventing recurrent clostridium infection.63 Therefore, people taking antibiotics who later develop diarrhea might benefit from supplementing with saccharomyces organisms.
  • Citrus Root Bark

    The alkaloid citrusinine-1 from the root bark of citrus plants has been shown to enhance the antiviral activity of acyclovir.65 Further research is needed to determine whether taking citrus root bark would increase the effectiveness of acyclovir in humans.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Cloves

    Animal studies have shown that other herbs, including Geum japonicum, Rhus javanica, Syzygium aromaticum, and Terminalia chebula enhance the antiviral activity of acyclovir.67 Controlled human studies are needed to determine whether taking these herbs would increase the effectiveness of acyclovir in humans.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Flavonoids

    The flavonoids quercetin, quercitrin, and apigenin enhanced the antiviral activity of acyclovir in test tube studies.69 Controlled research is needed to determine whether taking quercetin or other flavonoid supplements would increase the effectiveness of acyclovir in humans.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Geum japonicum

    Animal studies have shown that other herbs, including Geum japonicum, Rhus javanica, Syzygium aromaticum, and Terminalia chebula enhance the antiviral activity of acyclovir.71 Controlled human studies are needed to determine whether taking these herbs would increase the effectiveness of acyclovir in humans.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Rhus javanica

    Animal studies have shown that other herbs, including Geum japonicum, Rhus javanica, Syzygium aromaticum, and Terminalia chebula enhance the antiviral activity of acyclovir.73 Controlled human studies are needed to determine whether taking these herbs would increase the effectiveness of acyclovir in humans.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Terminalia chebula

    Animal studies have shown that other herbs, including Geum japonicum, Rhus javanica, Syzygium aromaticum, and Terminalia chebula enhance the antiviral activity of acyclovir.75 Controlled human studies are needed to determine whether taking these herbs would increase the effectiveness of acyclovir in humans.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Tripterygium wilfordii

    Test tube studies show that triptofordin C-2 increases the antiviral activity of acyclovir against the herpes virus.77 Controlled human research is needed to determine whether taking tripterygium would increase the effectiveness of acyclovir in humans.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Zinc and Biotin

    Children with alopecia areata who supplemented 100 mg of zinc and 20 mg biotin each day, combined with topical clobetasol, showed more improvement compared to children who took oral corticosteroid drugs.79 Controlled research is needed to determine whether adding oral zinc and biotin to topical clobetasol therapy is more effective than clobetasol alone. However, until more information is available, caregivers should consider that children with alopecia who are currently taking oral corticosteroids might benefit from switching to supplements of zinc and biotin along with topical clobetasol.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.

Reduces Effectiveness

  • Khat

    Khat (Catha edulis) is an herb found in East Africa and Yemen that has recently been imported into the United States. Studies have shown that chewing khat significantly reduces the absorption of ampicillin,81 which might reduce the effectiveness of the antibiotic. Therefore, people taking ampicillin should avoid herbal products that contain khat.

Potential Negative Interaction

  • none

Explanation Required 

  • Licorice

    Licorice (Glycyrrhiza glabra) extract was shown to decrease the elimination of prednisone in test tube studies.83 If this action happens in people, it might prolong prednisone activity and possibly increase prednisone-related side effects. A small, controlled study found that intravenous (iv) glycyrrhizin (an active constituent in licorice) given with iv prednisolone prolonged prednisolone action in healthy men.84 Whether this effect would occur with oral corticosteroids and licorice supplements is unknown.

    An animal study has shown that glycyrrhizin prevents the immune-suppressing actions of cortisone—the natural corticosteroid hormone produced by the body.85 More research is necessary to determine if this action is significant in humans taking oral corticosteroids. Until more is known, people should not take licorice with corticosteroids without first consulting a doctor.

  • Aloe

    In animal research, applying aloe (Aloe vera) gel topically along with a topical corticosteroid enhanced the hormone’s anti-inflammatory activity in the skin.89 No human research has investigated this effect.

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
  • Magnesium

    Corticosteroids may increase the body’s loss of magnesium.91 Some doctors recommend that people taking corticosteroids for more than two weeks supplement with 300–400 mg of magnesium per day. Magnesium has also been reported to interfere with the absorption of dexamethasone.92

    The interaction is supported by preliminary, weak, fragmentary, and/or contradictory scientific evidence.
The Drug-Nutrient Interactions table may not include every possible interaction. Taking medicines with meals, on an empty stomach, or with alcohol may influence their effects. For details, refer to the manufacturers’ package information as these are not covered in this table. If you take medications, always discuss the potential risks and benefits of adding a new supplement with your doctor or pharmacist.

References

1. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

2. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

3. Roe DA. Drug-Induced Nutritional Deficiencies, 2d ed. Westport, CT: Avi Publishing, 1985, 157-8 [review].

4. Holt GA. Food & Drug Interactions. Chicago: Precept Press,1998, 183.

5. Suzuki K, Fukushima T, Meguro K, et al. Intracranial hemorrhage in an infant owing to vitamin K deficiency despite prophylaxis. Childs Nerv Syst 1999;15:292-4.

6. Huilgol VR, Markus SL, Vakil NB. Antibiotic-induced iatrogenic hemobilia. Am J Gastroenterol 1997;92:706-7.

7. Bandrowsky T, Vorono AA, Borris TJ, Marcantoni HW. Amoxicllin-related postextraction bleeding in an anticoagulated patient with tranexamic acid rinses. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82:610-2.

8. Kaiser CW, McAuliffe JD, Barth RJ, Lynch JA. Hypoprothrombinemia and hemorrhage in a surgical patient treated with cefotetan. Arch Surg 1991;126:524-5.

9. Conly J, Stein K. Reduction of vitamin K2 concentration in human liver associated with the use of broad spectrum antimicrobials. Clin Invest Med 1994;17:531-9.

10. Suzuki K, Fukushima T, Meguro K, et al. Intracranial hemorrhage in an infant owing to vitamin K deficiency despite prophylaxis. Childs Nerv Syst 1999;15:292-4.

11. Huilgol VR, Markus SL, Vakil NB. Antibiotic-induced iatrogenic hemobilia. Am J Gastroenterol 1997;92:706-7.

12. Bandrowsky T, Vorono AA, Borris TJ, Marcantoni HW. Amoxicllin-related postextraction bleeding in an anticoagulated patient with tranexamic acid rinses. Oral Surg Oral Med Oral Pathol Oral Radiol Endod 1996;82:610-2.

13. Kaiser CW, McAuliffe JD, Barth RJ, Lynch JA. Hypoprothrombinemia and hemorrhage in a surgical patient treated with cefotetan. Arch Surg 1991;126:524-5.

14. Conly J, Stein K. Reduction of vitamin K2 concentration in human liver associated with the use of broad spectrum antimicrobials. Clin Invest Med 1994;17:531-9.

15. Hahn TJ, Halstead LR, Baran DT. Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 1981;52:111-5.

16. Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Family Phys 1991;44:1651-8.

17. Chesney RW, Mazess RB, Hamstra AJ, et al. Reduction of serum-1,25-dihydroxyvitamin-D, in children receiving glucocorticoids. Lancet 1978;ii:1123-5.

18. Nielsen HK, Eriksen EF, Storm T, Mosekilde K. The effects of short-term, high-dose prednisone on the nuclear uptake of 1,25-dihydroxyvitamin D3 in monocytes from normal human subjects. Metabolism 1988;37:109-14.

19. Avioli LV. Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid therapy. J Lab Clin Med 1977;23:399-404.

20. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1996;125:961-8.

21. Amin S, LaValley PM, Simms RW, Felson DT. The role of vitamin D in corticosteroid-induced osteoporosis. Arthritis Rheum 1999;42:1740-51.

22. Hahn TJ, Halstead LR, Baran DT. Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 1981;52:111-5.

23. Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Family Phys 1991;44:1651-8.

24. Chesney RW, Mazess RB, Hamstra AJ, et al. Reduction of serum-1,25-dihydroxyvitamin-D, in children receiving glucocorticoids. Lancet 1978;ii:1123-5.

25. Nielsen HK, Eriksen EF, Storm T, Mosekilde K. The effects of short-term, high-dose prednisone on the nuclear uptake of 1,25-dihydroxyvitamin D3 in monocytes from normal human subjects. Metabolism 1988;37:109-14.

26. Avioli LV. Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid therapy. J Lab Clin Med 1977;23:399-404.

27. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1996;125:961-8.

28. Amin S, LaValley PM, Simms RW, Felson DT. The role of vitamin D in corticosteroid-induced osteoporosis. Arthritis Rheum 1999;42:1740-51.

29. Ravina A, Slezak L, Mirsky N, et al. Reversal of corticosteroid-induced diabetes mellitus with supplemental chromium. Diabet Med 1999;16:164-7.

30. Ravina A, Slezak L, Mirsky N, et al. Reversal of corticosteroid-induced diabetes mellitus with supplemental chromium. Diabet Med 1999;16:164-7.

31. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 83.

32. Sur S, Camara M, Buchmeier A, et al. Double-blind trial of pyridoxine (vitamin B6) in the treatment of steroid-dependent asthma. Ann Allergy 1993;70:147-52.

33. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 83.

34. Sur S, Camara M, Buchmeier A, et al. Double-blind trial of pyridoxine (vitamin B6) in the treatment of steroid-dependent asthma. Ann Allergy 1993;70:147-52.

35. Hahn TJ, Halstead LR, Baran DT. Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 1981;52:111-5.

36. Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Family Phys 1991;44:1651-8.

37. Chesney RW, Mazess RB, Hamstra AJ, et al. Reduction of serum-1,25-dihydroxyvitamin-D, in children receiving glucocorticoids. Lancet 1978;ii:1123-5.

38. Nielsen HK, Eriksen EF, Storm T, Mosekilde K. The effects of short-term, high-dose prednisone on the nuclear uptake of 1,25-dihydroxyvitamin D3 in monocytes from normal human subjects. Metabolism 1988;37:109-14.

39. Avioli LV. Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid therapy. J Lab Clin Med 1977;23:399-404.

40. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1996;125:961-8.

41. Amin S, LaValley PM, Simms RW, Felson DT. The role of vitamin D in corticosteroid-induced osteoporosis. Arthritis Rheum 1999;42:1740-51.

42. Hahn TJ, Halstead LR, Baran DT. Effects off short term glucocorticoid administration on intestinal calcium absorption and circulating vitamin D metabolite concentrations in man. J Clin Endocrinol Metab 1981;52:111-5.

43. Trovato A, Nuhlicek DN, Midtling JE. Drug-nutrient interactions. Am Family Phys 1991;44:1651-8.

44. Chesney RW, Mazess RB, Hamstra AJ, et al. Reduction of serum-1,25-dihydroxyvitamin-D, in children receiving glucocorticoids. Lancet 1978;ii:1123-5.

45. Nielsen HK, Eriksen EF, Storm T, Mosekilde K. The effects of short-term, high-dose prednisone on the nuclear uptake of 1,25-dihydroxyvitamin D3 in monocytes from normal human subjects. Metabolism 1988;37:109-14.

46. Avioli LV. Serum 25-hydroxyvitamin D concentrations in patients receiving chronic corticosteroid therapy. J Lab Clin Med 1977;23:399-404.

47. Buckley LM, Leib ES, Cartularo KS, et al. Calcium and vitamin D3 supplementation prevents bone loss in the spine secondary to low-dose corticosteroids in patients with rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial. Ann Intern Med 1996;125:961-8.

48. Amin S, LaValley PM, Simms RW, Felson DT. The role of vitamin D in corticosteroid-induced osteoporosis. Arthritis Rheum 1999;42:1740-51.

49. Ravina A, Slezak L, Mirsky N, et al. Reversal of corticosteroid-induced diabetes mellitus with supplemental chromium. Diabet Med 1999;16:164-7.

50. Ravina A, Slezak L, Mirsky N, et al. Reversal of corticosteroid-induced diabetes mellitus with supplemental chromium. Diabet Med 1999;16:164-7.

51. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].

52. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].

53. Schellenberg D, Bonington A, Champion CM, et al. Treatment of Clostridium difficile diarrhoea with brewer's yeast. Lancet 1994;343:171-2.

54. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].

55. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].

56. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].

57. Schellenberg D, Bonington A, Champion CM, et al. Treatment of Clostridium difficile diarrhoea with brewer's yeast. Lancet 1994;343:171-2.

58. Elmer GW, Surawicz CM, McFarland LV. Biotherapeutic agents. A neglected modality for the treatment and prevention of selected intestinal and vaginal infections. JAMA 1996;275:870-6 [review].

59. Teelucksingh S, Mackie ADR, Burt D, et al. Potentiation of hydrocortisone activity in skin by glycyrrhetinic acid. Lancet 1990;335:1060-3.

60. Chen MF, Shimada F, Kato H, et al. Effect of glycyrrhizin on the pharmacokinetics of prednisolone following low dosage of prednisolone hemisuccinate. Endocrinol Jpn 1990;37:331-41.

61. Teelucksingh S, Mackie ADR, Burt D, et al. Potentiation of hydrocortisone activity in skin by glycyrrhetinic acid. Lancet 1990;335:1060-3.

62. Chen MF, Shimada F, Kato H, et al. Effect of glycyrrhizin on the pharmacokinetics of prednisolone following low dosage of prednisolone hemisuccinate. Endocrinol Jpn 1990;37:331-41.

63. Surawicz CM, Elmer GW, Speelman P, et al. Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: A prospective study. Gastroenterol 1989;96:981-8.

64. Surawicz CM, Elmer GW, Speelman P, et al. Prevention of antibiotic-associated diarrhea by Saccharomyces boulardii: A prospective study. Gastroenterol 1989;96:981-8.

65. Yamamoto N, Furukawa H, Ito Y et al. Anti-herpesvirus activity of citrusinine-I, a new acridone alkaloid, and related compounds. Antiviral Res 1989;12:21-36.

66. Yamamoto N, Furukawa H, Ito Y et al. Anti-herpesvirus activity of citrusinine-I, a new acridone alkaloid, and related compounds. Antiviral Res 1989;12:21-36.

67. Kurokawa M, Nagasaka K, Hirabayashi T et al. Efficacy of traditional herbal medicines in combination with acyclovir against herpes simplex virus type 1 infection in vitro and in vivo. Antiviral Res 1995;27:19-37.

68. Kurokawa M, Nagasaka K, Hirabayashi T et al. Efficacy of traditional herbal medicines in combination with acyclovir against herpes simplex virus type 1 infection in vitro and in vivo. Antiviral Res 1995;27:19-37.

69. Mucsi I, Gyulai Z, Beladi I. Combined effects of flavonoids and acyclovir against herpesviruses in cell cultures. Acta Microbiol Hung 1992;39:137-47.

70. Mucsi I, Gyulai Z, Beladi I. Combined effects of flavonoids and acyclovir against herpesviruses in cell cultures. Acta Microbiol Hung 1992;39:137-47.

71. Kurokawa M, Nagasaka K, Hirabayashi T et al. Efficacy of traditional herbal medicines in combination with acyclovir against herpes simplex virus type 1 infection in vitro and in vivo. Antiviral Res 1995;27:19-37.

72. Kurokawa M, Nagasaka K, Hirabayashi T et al. Efficacy of traditional herbal medicines in combination with acyclovir against herpes simplex virus type 1 infection in vitro and in vivo. Antiviral Res 1995;27:19-37.

73. Kurokawa M, Nagasaka K, Hirabayashi T et al. Efficacy of traditional herbal medicines in combination with acyclovir against herpes simplex virus type 1 infection in vitro and in vivo. Antiviral Res 1995;27:19-37.

74. Kurokawa M, Nagasaka K, Hirabayashi T et al. Efficacy of traditional herbal medicines in combination with acyclovir against herpes simplex virus type 1 infection in vitro and in vivo. Antiviral Res 1995;27:19-37.

75. Kurokawa M, Nagasaka K, Hirabayashi T et al. Efficacy of traditional herbal medicines in combination with acyclovir against herpes simplex virus type 1 infection in vitro and in vivo. Antiviral Res 1995;27:19-37.

76. Kurokawa M, Nagasaka K, Hirabayashi T et al. Efficacy of traditional herbal medicines in combination with acyclovir against herpes simplex virus type 1 infection in vitro and in vivo. Antiviral Res 1995;27:19-37.

77. Hayashi K, Hayashi T, Ujita K, Takaishi Y. Characterization of antiviral activity of a sesquiterpene, triptofordin C-2. J Antimicrob Chemother 1996;37:759-68.

78. Hayashi K, Hayashi T, Ujita K, Takaishi Y. Characterization of antiviral activity of a sesquiterpene, triptofordin C-2. J Antimicrob Chemother 1996;37:759-68.

79. Camacho FM, Garcia-Hernandez MJ. Zinc aspartate, biotin, and clobetasol propionate in the treatment of alopecia areata in childhood. Pediatr Dermatol 1999;16:336-8 [letter].

80. Camacho FM, Garcia-Hernandez MJ. Zinc aspartate, biotin, and clobetasol propionate in the treatment of alopecia areata in childhood. Pediatr Dermatol 1999;16:336-8 [letter].

81. Attel OA, Ali AA, Ali HM. Effect of khat chewing on the bioavailability of ampicillin and amoxicillin. J Antimicrob Chemother 1997;39:523-5.

82. Attel OA, Ali AA, Ali HM. Effect of khat chewing on the bioavailability of ampicillin and amoxicillin. J Antimicrob Chemother 1997;39:523-5.

83. Tamura Y, Nishikawa T, Yamada K, et al. Effects of glycyrrhetinic acid and its derivatives on delta-4-5-alpha- and 5-beta-reductase in rat liver. Arzneimittelforschung 1979;29:647-9.

84. Chen MF, Shimada F, Kato H, et al. Effect of glycyrrhizin on the pharmacokinetics of prednisolone following low dosage of prednisolone hemisuccinate. Endocrinol Jpn 1990;37:331-41.

85. Kumagai A, Nanaboshi M, Asanuma Y, et al. Effects of glycyrrhizin on thymolytic and immunosuppressive action of cortisone. Endocrinol Jpn 1967;14:39-42.

86. Tamura Y, Nishikawa T, Yamada K, et al. Effects of glycyrrhetinic acid and its derivatives on delta-4-5-alpha- and 5-beta-reductase in rat liver. Arzneimittelforschung 1979;29:647-9.

87. Chen MF, Shimada F, Kato H, et al. Effect of glycyrrhizin on the pharmacokinetics of prednisolone following low dosage of prednisolone hemisuccinate. Endocrinol Jpn 1990;37:331-41.

88. Kumagai A, Nanaboshi M, Asanuma Y, et al. Effects of glycyrrhizin on thymolytic and immunosuppressive action of cortisone. Endocrinol Jpn 1967;14:39-42.

89. Davis RH, Parker WL, Murdoch DP. Aloe vera as a biologically active vehicle for hydrocortisone acetate. J Am Podiatric Med Assoc 1991;81:1-9.

90. Davis RH, Parker WL, Murdoch DP. Aloe vera as a biologically active vehicle for hydrocortisone acetate. J Am Podiatric Med Assoc 1991;81:1-9.

91. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 83.

92. Naggar VF, Khalil SA, Gouda MW. Effect of concomitant administration of magnesium trisilicate on GI absorption of dexamethasone in humans. J Pharm Sci 1978;67:1029-30.

93. Holt GA. Food & Drug Interactions. Chicago: Precept Press, 1998, 83.

94. Naggar VF, Khalil SA, Gouda MW. Effect of concomitant administration of magnesium trisilicate on GI absorption of dexamethasone in humans. J Pharm Sci 1978;67:1029-30.