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Medicines 2015, 2(3), 157-185;

Commonly Used Dietary Supplements on Coagulation Function during Surgery

Department of Anesthesia & Critical Care, University of Chicago, Chicago, IL 60637, USA
Author to whom correspondence should be addressed.
Academic Editor: James D. Adams
Received: 30 May 2015 / Revised: 12 July 2015 / Accepted: 22 July 2015 / Published: 27 July 2015
(This article belongs to the Special Issue Herbal Medicines and Natural Products)
Full-Text   |   PDF [259 KB, uploaded 27 July 2015]


Background: Patients who undergo surgery appear to use dietary supplements significantly more frequently than the general population. Because they contain pharmacologically active compounds, dietary supplements may affect coagulation and platelet function during the perioperative period through direct effects, pharmacodynamic interactions, and pharmacokinetic interactions. However, in this regard, limited studies have been conducted that address the pharmacological interactions of dietary supplements. To avoid possible bleeding risks during surgery, information about the potential complications of dietary supplements during perioperative management is important for physicians. Methods: Through a systematic database search of all available years, articles were identified in this review if they included dietary supplements and coagulation/platelet function, while special attention was paid to studies published after 1990. Results: Safety concerns are reported in commercially available dietary supplements. Effects of the most commonly used natural products on blood coagulation and platelet function are systematically reviewed, including 11 herbal medicines (echinacea, ephedra, garlic, ginger, ginkgo, ginseng, green tea, kava, saw palmetto, St John’s wort, and valerian) and four other dietary supplements (coenzyme Q10, glucosamine and chondroitin sulfate, fish oil, and vitamins). Bleeding risks of garlic, ginkgo, ginseng, green tea, saw palmetto, St John’s wort, and fish oil are reported. Cardiovascular instability was observed with ephedra, ginseng, and kava. Pharmacodynamic and pharmacokinetic interactions between dietary supplements and drugs used in the perioperative period are discussed. Conclusions: To prevent potential problems associated with the use of dietary supplements, physicians should be familiar with the perioperative effects of commonly used dietary supplements. Since the effects of dietary supplements on coagulation and platelet function are difficult to predict, it is prudent to advise their discontinuation before surgery. View Full-Text
Keywords: dietary supplements; natural products; surgery; coagulation; platelet function; bleeding dietary supplements; natural products; surgery; coagulation; platelet function; bleeding
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited (CC BY 4.0).

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Wang, C.-Z.; Moss, J.; Yuan, C.-S. Commonly Used Dietary Supplements on Coagulation Function during Surgery. Medicines 2015, 2, 157-185.

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