A client taking warfarin asks the nurse about using herbal remedies. Which of the following would the nurse instruct the client to avoid? Select all that apply
A) Chamomile
B) St. John's wort
C) Ginkgo biloba
D) Ginger
E) Ginseng
Ans: A, B, C, D, E
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Warfarin, a drug with a narrow therapeutic index, has the potential to interact with many herbal remedies. For example, warfarin should not be combined with any of the following substances, because they may have additive or synergistic activity and increase the risk for bleeding: celery, chamomile, clove, dong quai, feverfew, garlic, ginger, ginkgo biloba, ginseng, green tea, onion, passionflower, red clover, St. John's wort, and turmeric.
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