Herbal medicines and postoperative haemorrhage

@article{Jayasekera2005HerbalMA,
  title={Herbal medicines and postoperative haemorrhage},
  author={Narlaka Jayasekera and Arif Ali Baig Moghal and Fadhil Kashif and Lakshman Delgoda Karalliedde},
  journal={Anaesthesia},
  year={2005},
  volume={60}
}
A 65-year-old man with gross osteoarthritis of the left hip was prepared for elective total hip arthroplasty. He had a history of chronic obstructive pulmonary disease, early Alzheimer’s dementia and adenocarcinoma of the prostate. He was on oral diclofenac sodium, intramuscular goserelin acetate and a brown liquid herbal medicine (one tablespoon twice a day). At pre-operative assessment the patient was advised to discontinue the herbal and non-steroidal anti-inflammatory medicine 2 weeks prior… 
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TLDR
An increasing number of patients are taking herbal medicines such as echinacea, garlic, ginkgo biloba, ginseng, St John's Wort, valerian, ephedra, kava, grapefruit juice and ginger, which may have some benefits, but adverse effects such as increased bleeding tendencies and drug interactions are associated with their use.
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The case of a 56 year old man who suffered a spontaneous intracerebral haemorrhage after regular self medication with the herbal preparation, Ginkgo biloba leaf extract is described, and the possible
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TLDR
A case is reported of a woman who developed this complication and was subsequently found to have been taking Gingko biloba extract tablets which may have predisposed her to developing the haemorrhage.
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TLDR
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