Significant Interactions

Controlled studies are not available therefore interactions are based on evidence of activity and are largely theoretical and speculative, x-j-v HYPOGLYCAEMIC AGENTS

\jy Theoretically an additive effect is possible, resulting in increased hypoglycaemic effects — caution. Possible beneficial interaction when used under professional supervision.

^pv CONTRAINDICATIONS AND PRECAUTIONS

Vi/ Avoid bitter melon seed or the outer rind due to the presence of toxic lectins and avoid use of bitter melon in peoplewith glucose-6-phosphate dehydrogenase deficiency (Ulbricht & Basch 2005).

When low doses of bitter melon extract were ingested for up to 2 months in experimental models, no signs of nephrotoxicity, hepatotoxicity or adverse effects on Bitter melon 127

food intake, growth organ weights and haematological parameters were observed.

However, toxicity and even death in laboratory animals have been reported when extracts in high doses were administered intravenously or intraperitoneally (Kusamran etal 1998).

/TN. PREGNANCY USE

v£/ Based on experimental studies in animal models and traditional use, bitter melon is contraindicated in pregnancy.

PRACTICE POINTS/PATIENT COUNSELLING

• Bitter melon is used as a traditional remedy for diabetes mellitus. Evidence from experimental studies and case reports support moderate hypoglycaemic activity; however, controlled studies have not yet been conducted.

• Traditionally, bitter melon has also been used as a treatment for gastrointestinal complaints, worms, constipation, headaches, skin conditions, viral infections and as an emmenagogue.

• According to experimental studies, bitter melon and/or its various constituents exert lipid-lowering, antibacterial, anthelmintic, abortifacient, antineoplastic and analgesic activities.

• Bitter melon is contraindicated in pregnancy and people with glucose-6-phosphate dehydrogenase deficiency.

• Avoid bitter melon seed or the outer rind, which have toxic lectins.

ANSWERS TO PATIENTS' FREQUENTLY ASKED QUESTIONS

What will this herb do for me?

According to preliminary research, bitter melon may lower blood glucose levels and aid in the management of diabetes. When will it start to work?

This is difficult to predict. Diabetics should monitor their blood glucose readings when taking bitter melon. Are there any safety issues?

Bitter melon is contraindicated in pregnancy and people with glucose-6-phosphate dehydrogenase deficiency. The seeds and outer rind should be avoided because they contain toxic lectins. Diabetic patients should monitor their blood glucose when taking bitter melon to prevent hypoglycaemia.

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