Botanical products-drug interactions: Focus on garlic, ginkgo and ginseng

Garlic, ginkgo, and ginseng are, respectively, the second, first, and fourth top-selling botanical supplements in U.S. retail outlets (1). Their retail sales are impressive, totalling US $35, $46, and $31 million, respectively. These 2002 figures look impressive but actually represent a substantial decline in comparison to those of 2001 (-17%, -35%, and -33%, respectively). Given this nevertheless huge popularity, it is important for health care professionals to advise patients responsibly about the proper use of these products. This chapter summarizes our current knowledge with an emphasis on botanical product-drug interactions.