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March 2021

Do Natural Medicines Interact with COVID-19 Vaccines or Treatments?

You might be getting questions about whether natural medicines can interact with COVID-19 vaccines or treatments. New data emerges daily, but here’s what we know so far.

When it comes to COVID-19 treatments, keep your eye out for possible interactions. The FDA issued an Emergency Use Authorization (EUA) for the drug baricitinib in combination with remdesivir for the treatment of COVID-19. Baricitinib is a substrate of OAT3, and dose adjustment is recommended when used with strong OAT3 inhibitors. Quercetin is a flavanol that's been touted in combination “cocktails” for COVID-19. But it has shown strong OAT3 inhibition potential in vitro. There’s also some theoretical evidence that it might interact with remdesivir. While these are only theoretical interactions at this point, it’s something to watch out for, especially in patients with renal impairment and severe COVID-19.

Keep in mind that EUA drugs haven’t been thoroughly evaluated in clinical research the way other drugs have, which limits our knowledge about clinically relevant drug interactions. Thus, practitioners should be cautious about starting any type of “cocktail” in patients that are using EUAs. Additionally, before starting inpatient treatments, such as anticoagulants, make sure to ask about any natural medicines that were used at home that might increase the risk of bleeding or interact with medications.

Regarding COVID-19 vaccines, we still don’t know definitively whether anti-inflammatories will reduce the immune response to a COVID-19 vaccine. Because data on this is limited, and vaccines are in short supply, tell patients to avoid using any natural anti-inflammatory supplements, such as turmeric or ginger, in greater than food amounts on the day of vaccination. You might also hear about using natural medicines as vaccine boosters. For now, don’t recommend this. Currently, the two approved COVID-19 vaccines are mRNA vaccines. There’s no evidence on how natural immune boosters might affect the immune response to this type of vaccine.

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The information in this brief report is intended for informational purposes only, and is meant to help users better understand health concerns. This information should not be interpreted as specific medical advice. Users should consult with a qualified healthcare provider for specific questions regarding therapies, diagnosis and/or health conditions, prior to making therapeutic decisions. Copyright © 2021 Natural Medicines Inc. Commercial distribution or reproduction prohibited. Natural Medicines is the leading provider of high-quality, evidence-based, clinically-relevant information on natural medicine, dietary supplements, herbs, vitamins, minerals, functional foods, diets, complementary practices, CAM modalities, exercises and medical conditions. Monograph sections include interactions with herbs, drugs, foods and labs, contraindications, depletions, dosing, toxicology, adverse effects, pregnancy and lactation data, synonyms, safety and effectiveness.