dehydroepiandrosterone (generic name)

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Interactions

Interactions with Drugs

DHEA may interfere with the way the body processes certain drugs using the liver's "cytochrome P450" enzyme system. As a result, the levels of these drugs may be increased in the blood, and may cause increased effects or potentially serious adverse reactions. Central nervous system agents, including carbamazepine and phenytoin, induce the P450 enzymes that metabolize DHEA and DHEA-S and therefore can decrease circulating concentrations of these hormones. Patients using any medications should check the package insert and speak with a qualified healthcare professional, including a pharmacist, about possible interactions.

DHEA may increase blood sugar levels. Caution is advised when using medications that may also lower blood sugar such as metformin (Glucophage®). A qualified healthcare professional should closely monitor patients taking drugs for diabetes by mouth or insulin. Medication adjustments may be necessary.

DHEA may increase the risk of blood clotting. Patients who take anticoagulants (blood thinners) or antiplatelet drugs (such as aspirin) to prevent blood clots should discuss the use of DHEA with a healthcare professional. Examples of blood thinning drugs include warfarin (Coumadin®), heparin, and clopidogrel (Plavix®). The risk of blood clots is also increased by smoking or by taking other hormones (such as birth control pills or hormone replacement therapy), and these should not be combined with DHEA unless under medical supervision.

DHEA may alter heart rates or rhythm, and should be used cautiously with heart medications or drugs that may also affect heart rhythm. Alcohol may increase the effects of DHEA.

Although it is not widely studied, there are some reports that drugs such as canrenoate, anastrozole (Arimidex®), growth hormones, methylphenidale, amlodipine, nicardipine, and other calcium channel blockers like diltiazem (Cardizem®) and alprazolam (Xanax®) may increase DHEA levels in the body, which could lead to increased side effects when taken with DHEA supplements. In theory, increased hormone levels may occur if DHEA is used with estrogen or androgen hormonal therapies. DHEA may interact with psychiatric drugs such as clozapine (Clozaril®).

DHEA may interact with GABA-receptor drugs used for seizures or pain. DHEA may decrease the effectiveness of methadone. DHEA may add to the effects of clofibrate or contribute to tamoxifen resistance in breast cancer.

DHEA use has been suggested to result in a decreased rate of developing protective antibody titer after influenza vaccination.

Drugs that reduce the normal levels of DHEA produced by the body include dopamine, corticosteroids such as dexamethasone, drugs used to treat endometriosis such as danazol, opiate painkillers, and antipsychotics. Metopirone, alprazolam, and benfluorex may increase blood DHEA levels. Many other interactions are possible; check with a qualified healthcare professional, including a pharmacist, for a thorough list.

Interactions with Herbs and Dietary Supplements

Based on laboratory and animal studies, DHEA may interfere with the way the body processes certain herbs or supplements using the liver's "cytochrome P450" enzyme system. As a result, the levels of other herbs or supplements may become too high in the blood. It may also alter the effects that other herbs or supplements possibly have on the P450 system.

DHEA may raise blood sugar levels or cause insulin resistance, and may add to the effects of herbs/supplements that may also increase blood sugar levels, such as arginine, cocoa, ephedra (when combined with caffeine), or melatonin. DHEA may work against the effects of herbs/supplements that may decrease blood sugar levels, such as Aloe vera, American ginseng, and bilberry. Serum glucose levels should be monitored closely by a qualified healthcare professional while using DHEA. Dosing adjustments may be necessary.

In theory, DHEA may increase the risk of blood clotting, and may add to the effects of herbs/supplements that may also increase the risk of clotting, such as coenzyme Q10 or Panax ginseng. DHEA may work against the effects of herbs/supplements that may "thin" the blood and reduce the risk of clotting, such as Ginkgo biloba, garlic, and saw palmetto.

It is not known what effects occur when DHEA is used with herbs that are believed to have hormonal effects in the body. Examples of agents with possible estrogen-like (phytoestrogenic) effects in the body include alfalfa, black cohosh, and bloodroot.

DHEA may alter heart rates or rhythms. Caution is advised in patients taking herbs/supplements that may alter heart function or that include cardiac glycosides. Examples include adonis, balloon cotton, and foxglove/digitalis.

Chromium picolinate may increase blood DHEA levels. Carnitine and DHEA may have additive effects. Based on animal research, DHEA may increase melatonin secretion and prevent breakdown of vitamin E in the body.

Although it is not widely studied, there are some reports that DHEA may also interact with fiber, flavanoids, polyunsaturated fatty acids, probiotics, soy protein, and yam. Caution is advised.

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