Botanical-Drug Interactions: A Scientific Perspective
Reads0
Chats0
TLDR
The potential pharmacokinetic and pharmacodynamic bases of such interactions are discussed, as well as the challenges associated with the interpretation of the available data and prediction of botanical-drug interactions.Abstract:
There is a continued predisposition of concurrent use of drugs and botanical products. A general lack of knowledge of the interaction potential together with an under-reporting of botanical use poses a challenge for the health care providers and a safety concern for patients. Botanical-drug interactions increase the patient risk, especially with regard to drugs with a narrow therapeutic index (e.g., warfarin, cyclosporine, and digoxin). Examples of case reports and clinical studies evaluating botanical-drug interactions of commonly used botanicals in the US are presented. The potential pharmacokinetic and pharmacodynamic bases of such interactions are discussed, as well as the challenges associated with the interpretation of the available data and prediction of botanical-drug interactions. Recent FDA experiences with botanical products and interactions including labeling implications as a risk management strategy are highlighted.read more
Citations
More filters
Journal ArticleDOI
Herb-herb combination for therapeutic enhancement and advancement: theory, practice and future perspectives.
TL;DR: An overview of the traditional concept and practice of herb-herb combination in Chinese medicine is presented, and the available scientific and clinical evidence to support the combined use of herbs is highlighted.
Journal ArticleDOI
Herb–Drug Interactions: Challenges and Opportunities for Improved Predictions
TL;DR: Integration of in silico models that estimate the pharmacokinetics of individual constituents should facilitate prospective identification of herb–drug interactions and help provide definitive information to both consumers and clinicians about the risk of adding herbal products to conventional pharmacotherapeutic regimens.
Journal ArticleDOI
Botanicals and Their Bioactive Phytochemicals for Women's Health.
TL;DR: Although botanicals are perceived as natural safe remedies, it is important for women and their healthcare providers to realize that they have not been rigorously tested for potential toxic effects and/or drug/botanical interactions.
Journal ArticleDOI
Updates on the clinical evidenced herb-warfarin interactions
Beikang Ge,Zhen Zhang,Zhong Zuo +2 more
TL;DR: In summary, herb-warfarin interaction, especially the clinical effects of herbs on warfarin therapy should be further investigated through multicenter studies with larger sample sizes.
Journal ArticleDOI
Pharmacokinetic Interactions of Herbs with Cytochrome P450 and P-Glycoprotein
Hyun-Jong Cho,In-Soo Yoon +1 more
TL;DR: Ten popular medicinal and/or dietary herbs are reviewed as perpetrators of CYP- and P-gp-mediated pharmacokinetic herb-drug interactions to provide robust fundamentals for optimizing CYP and/ or P- gp substrate drug-based therapy.
References
More filters
Journal ArticleDOI
Herb-drug interactions
TL;DR: Patients should caution patients against mixing herbs and pharmaceutical drugs, as many reports of herb-drug interactions are sketchy and lack laboratory analysis of suspect preparations.
Journal ArticleDOI
St. John's wort induces hepatic drug metabolism through activation of the pregnane X receptor
Linda B. Moore,Bryan Goodwin,Stacey A. Jones,G. Bruce Wisely,Cosette J. Serabjit-Singh,Timothy M. Willson,Jon L. Collins,Steven A. Kliewer +7 more
TL;DR: It is shown that hyperforin, a constituent of St. John's wort with antidepressant activity, is a potent ligand for the pregnane X receptor, an orphan nuclear receptor that regulates expression of the cytochrome P450 (CYP) 3A4 monooxygenase.
Journal ArticleDOI
Indinavir concentrations and St John's wort
TL;DR: St John's wort reduced the area under the curve of the HIV-1 protease inhibitor indinavir by a mean of 57% (SD 19) and decreased the extrapolated 8-hindinavir trough by 81% in healthy volunteers, which could lead to the development of drug resistance and treatment failure.
Journal ArticleDOI
Pharmacokinetic-Pharmacodynamic Consequences and Clinical Relevance of Cytochrome P450 3A4 Inhibition
TL;DR: The clinical importance of any drug interaction depends on factors that are drug-, patient- and administration-related and is likely to be dependent on interindividual differences in CYP3A4 tissue content, pre-existing medical conditions and, possibly, age.
Journal ArticleDOI
Predicting in vivo drug interactions from in vitro drug discovery data
TL;DR: The principles underlying the generation of in vitro drug metabolism data are described and commonly encountered uncertainties and sources of bias and error that can affect extrapolation of drug–drug interaction information to the clinical setting are highlighted.