Beware cinnamon-drug interactions

Jan. 18, 2014 @ 11:27 AM

Q. My husband takes Coumadin (warfarin) for atrial fibrillation. We recently began taking a mixture of honey and cinnamon. Does cinnamon interact with Coumadin?
He also has hypertension and takes medication for that. Does he need to discuss this with his doctor? We don't want to create a problem by taking the honey-and-cinnamon mixture.

A. Cinnamon has become very popular for its medicinal properties. People with type 2 diabetes may use it to help control blood sugar (Annals of Family Medicine, September/October 2013). Cinnamon also might help normalize cholesterol levels and reduce joint inflammation.
The trouble is that the most common form in the supermarket is cassia cinnamon, which often contains a compound called coumarin. Some people are susceptible to liver damage if they take too much of this spice.
Because it affects drug-metabolizing enzymes CYP2D6 and CYP3A4, coumarin might theoretically interact with the blood thinner warfarin as well as with a number of blood pressure medications. Your husband should ask his doctor to check whether cinnamon would pose a problem with his other drugs.
Q. I've been on Cymbalta for six years. My rheumatologist prescribed it for fibromyalgia neuropathy in my feet. (It felt like my feet were in a bonfire all the time.)
When I first began taking it, the pain stopped. But I developed depression and high blood pressure and gained a lot of weight.
Last October, my husband lost his job. The Cymbalta was going to be nearly $600 a month. Since my liver enzymes were high, I decided to wash out of it.
It took three weeks to taper from 120 mg to nothing. The withdrawal produced "brain zaps" and violent outbursts in which I hit my beloved husband of 20 years, threw things and terrorized the dogs. I hit myself until I got bruises. My husband hid our guns and my medications because of the suicidal threats I made. I can't sleep, and the pain from the fibro is worse than ever.
Will this ever stop? I feel like I'm at the Hotel California, where "You can check-out any time you like, but you can never leave!"

A. Cymbalta is prescribed for depression, anxiety, nerve and muscle pain as well as fibromyalgia. Patients are not always told when they start this medication that stopping it can be challenging.
We have heard from hundreds of people that the symptoms of withdrawing from duloxetine (Cymbalta), desvenlafaxine (Pristiq), escitalopram (Lexapro), venlafaxine (Effexor) and similar drugs include electric shocklike sensations (brain zaps), dizziness, anxiety, irritability and hostility, digestive difficulties and nerve tingling.
Although the symptoms can last for weeks, they usually fade. We are sending you our Guide to Dealing With Depression, which discusses withdrawal and provides some nondrug alternatives for depression. Anyone who would like a copy, please send $3 in check or money order with a long (No. 10), stamped (66 cents), self-addressed envelope to: Graedons' People's Pharmacy, No. E-7, P.O. Box 52027, Durham, NC 27717-2027. It also can be downloaded for $2 from our website: www.peoplespharmacy.com.
Q. I used Domeboro solution to get rid of my plantar wart. I soaked my foot in the solution once a day. Within two weeks' time, the wart fell off and didn't return.
A. Domeboro solution is an old-fashioned approach. The aluminum acetate powder is dissolved in water to treat skin irritations such as athlete's foot and poison ivy. We did not know it would heal plantar warts.

In their column, Joe and Teresa Graedon answer letters from readers. Write to them via their website: www.PeoplesPharmacy.com.