PARTE II: Dificultades que surgen EN LOS ANÁLISIS DE COMPARABILIDAD
6. Interpretación y uso de los datos recabados y determinación de la remuneración de plena
indicated in children. Avoid in patients with known hypersensitivity to aloe or with nausea, vomiting or signs and symptoms of gastrointes- tinal obstruction. Avoid excessive use and long- term use (more than 2 weeks), as potassium losses may occur, which may alter cardiac electrophysiology.
Use with caution in people with thyrotoxicosis.
A case study of depression of thyroid hor- mones in a woman taking A. vera juice has been reported (Pigatto & Guzzi 2005). The patient consumed 10 mL daily for 11 months and labo- ratory testing showed reduced levels of thyroxine (T4) and triiodothyronine (T3). Levels returned to normal progressively after discontinuing the aloe juice and the patient achieved full clinical remission after 16 months. Reduced serum levels of the thyroid hormones T3 and T4 have been reported for A. vera in vivo (Kar et al 2002).
Caution is suggested with topical applications that contain A. vera as they may enhance sensi- tivity to ultraviolet light (Xia et al 2007).
man after 4 years of using oral and topical aloe. Patch tests for aloe were positive in this patient (Morrow et al 1980). Transient stinging and a mild itching sensation at oral lichen planus lesions have also been reported (Choonhakarn et al 2008).
SIGNIFICANT INTERACTIONS
A. vera juice was found to inhibit both CYP3A4
and CYP2D6 by both CYP and non-CYP mecha- nisms (Djuv & Nilsen 2012). The estimated IC50 inhibition values were suggestive of no major inter- ference in humans; however some degree of caution and acknowledgement should be exercised.
Hypoglycaemic agents
Oral A. vera may have hypoglycaemic activity, therefore additive effects are theoretically possible — observe patients taking this combination.
Digoxin
Excessive or long-term use of oral A. vera may result in lowered potassium levels, which can alter the mechanism of action of digoxin on the heart. Avoid combination.
Laxatives
Additive effects are theoretically possible with oral aloe latex inducing griping pains. Use with caution.
Topical cortisone preparations
In addition to its own anti-inflammatory effects, animal studies have shown that A. vera increases the absorption of hydrocortisone by hydrating the
stratum corneum, inhibits hydrocortisone’s suppres- sive effects on wound healing and increases wound tensile strength — possible beneficial interaction (Davis et al 1994a).
Vitamins C and E
Concurrent prescription of oral A. vera (both gel and latex) with vitamins C and E shows improved absorption and increased plasma life of vitamin con- centration for both vitamins when taken together (Vinson et al 2005).
Paclitaxel and doxorubicin
In vitro evidence suggests that aloe-emodin antago- nises the cytotoxic effects on both paclitaxel and doxorubicin (Radovic et al 2012). While the clini- cal relevance of this remains unknown, caution should be observed in patients concurrently taking aloe with either of these chemotherapeutic agents.
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