Dietary Supplements and the Ophthalmologist

Bleeding Effects That May Affect Ocular Surgery

Several dietary supplements may increase clinical bleeding, which may be important when evaluating an ocular hemorrhage or scheduling elective surgery.

Gingko has been linked with postoperative hemorrhage in general surgery, and increased risk is associated with the following agents:^[31] feverfew (Tanacetum parthenium), used to treat headache; garlic (Allium sativum), used as an antibiotic and diuretic; ginger (Zingiber officinale), an antiemetic; and ginseng (Panax spp.), used to treat anxiety and gastric upset.

In various experimental models, the following agents demonstrate at least some antiplatelet activity, although their clinical effects may be highly variable: chondroitin sulfate,^[32] used to treat osteoarthritis; fenugreek (Trigonella foenum-graecum),^[33] used as an antibiotic and to treat diabetes mellitus; and fish oils.^[34]

Many supplements may potentiate the anticoagulant effects of warfarin (Coumadin^®, Bristol-Myers Squibb, Princeton, NJ), including:^[35] borage seed oil (Borago officinalis), a diuretic; chamomile; fenugreek; feverfew; garlic; and ginger. On the other hand, a recent small clinical trial found no significant clinical effect of Coenzyme Q10 (a provitamin and antioxidant) and ginkgo on warfarin.^[36]

Compr Ophthalmol Update. 2005;6(3):153-159. © 2005 Comprehensive Ophthalmology Update, LLC

Cite this: Dietary Supplements and the Ophthalmologist - Medscape - May 01, 2005.