15 Although some drug combinations with goldenseal may be protected, till knowledge from additional human scientific trials are available, clinicians should suggest towards using goldenseal in combination with most other medications. Less generally, herb-drug interactions could manifest as pharmacodynamic interactions, which contain direct pharmacologic actions of an herbal complement which might be unrelated to adjustments in blood concentrations. Risk of a pharmacodynamic interaction occurs when an herbal complement has a direct effect on the mechanism of action of a coadministered drug. Direct pharmacologic results of an herbal complement may antagonize or exacerbate the drug’s scientific effects with out changing the drug’s focus. In most cases, a change in drug dosage will not counter a pharmacodynamic herb-drug interplay.