Afr J Tradit Complement Altern Med. 2011;8(5):152-63. doi: 10.4314/ajtcam.v8i5S.8. Epub 2011 Jul 03.
Patient counseling about herbal-drug interactions.
African journal of traditional, complementary, and alternative medicines : AJTCAM
Md Sarfaraj Hussain
Affiliations
Affiliations
- Faculty of Pharmacy, Integral University, Dasauli, Kurshi road, Lucknow-226026, Uttar Pradesh, India. [email protected]
PMID: 22754069
PMCID: PMC3252717 DOI: 10.4314/ajtcam.v8i5S.8
Abstract
Many people have the mistaken notion that, being natural, all herbs and foods are safe; this is not so. Very often, herbs and food may interact with medications you normally take, result in serious reactions. During the latter part of this century the practice of herbalism has become mainstream throughout the world. This is due remove to the recognition of the value of traditional medical systems in the world. Herbal medicines are mixtures of more than one active ingredient. The multitude of pharmacologically active compounds obviously increases the likelihood of interactions taking place. Hence, the likelihood of herb-drug interactions is theoretically higher than drug-drug interactions because synthetic drugs usually contain single chemical entity. Case reports and clinical studies have highlighted the existence of a number of clinically important interactions, although cause-and-effect relationships have not always been established. Herbs and drugs may interact either pharmacokinetically or pharmacodynamically. The predominant mechanism for this interaction is the inhibition of cytochrome P-450 3A4 in the small intestine; result in a significant reduction of drug presystemic metabolism. An additional mechanism is the inhibition of Pglycoprotein, a transporter that carries drug from the enterocyte back to the gut lumen, result in a further increase in the fraction of drug absorbed. Some herbal products (e.g. St. John's wort) have been shown to lower the plasma concentration (and/or the pharmacological effect) of a number of conventional drugs including cyclosporine, indinavir, irinotecan, nevirapine, oral contraceptives and digoxin. The data available so far, concerning this interaction and its clinical implications are reviewed in this article. It is likely that more information regarding such interaction would crop up in the future, awareness of which is necessary for achieving optimal drug therapy.
Keywords: Cytochrome P-450; Herbal Preparation; Herbal drug; drug-drug interaction; herbal-drug interaction
References
- Clin Pharmacol Ther. 2004 Jan;75(1):89-100 - PubMed
- J Clin Psychiatry. 2003 May;64(5):609-11 - PubMed
- BMJ. 1996 Aug 3;313(7052):253-8 - PubMed
- JAMA. 1998 Nov 11;280(18):1569-75 - PubMed
- Br J Pharmacol. 2008 Mar;153 Suppl 1:S82-9 - PubMed
- Nat Prod Rep. 1997 Apr;14(2):111-44 - PubMed
- Chem Rev. 2004 Sep;104(9):3947-80 - PubMed
- J Intern Med. 1997 Apr;241(4):337-9 - PubMed
- J Arthroplasty. 2005 Jan;20(1):125-6 - PubMed
- Pediatr Emerg Care. 1997 Oct;13(5):350-3 - PubMed
- AAPS J. 2006 Mar 10;8(1):E101-11 - PubMed
- Age Ageing. 2001 Nov;30(6):523-5 - PubMed
- Pharmacotherapy. 1999 Jul;19(7):870-6 - PubMed
- Ann Pharmacother. 2004 Feb;38(2):257-60 - PubMed
- Nutr Clin Pract. 2005 Feb;20(1):33-51 - PubMed
- JAMA. 1971 Dec 27;218(13):1924-7 - PubMed
- Atherosclerosis. 2003 Apr;167(2):367 - PubMed
- Aust N Z J Med. 1995 Jun;25(3):258 - PubMed
- Diabetes Care. 2000 Sep;23(9):1221-6 - PubMed
- J Psychopharmacol. 2002 Dec;16(4):401 - PubMed
- Ann Pharmacother. 1995 Dec;29(12):1274-83 - PubMed
- Ceylon Med J. 2002 Mar;47(1):19-21 - PubMed
- Int J Clin Pharmacol Ther. 2004 Mar;42(3):139-48 - PubMed
- Am Fam Physician. 1999 Mar 1;59(5):1239-45 - PubMed
- Acad Emerg Med. 2002 Nov;9(11):1162-7 - PubMed
- J Am Geriatr Soc. 2001 Jun;49(6):838 - PubMed
- Phytomedicine. 2003 Nov;10(8):688-99 - PubMed
- Expert Opin Drug Metab Toxicol. 2005 Oct;1(3):487-503 - PubMed
- Ann Thorac Surg. 1998 Sep;66(3):941-2 - PubMed
- Mol Psychiatry. 1999 Jul;4(4):333-8 - PubMed
- Expert Opin Pharmacother. 2005 Feb;6(2):233-53 - PubMed
- J Pharmacol Exp Ther. 2006 Mar;316(3):1369-77 - PubMed
- Protein Eng. 1995 Aug;8(8):737-47 - PubMed
- Prog Clin Biol Res. 1986;213:545-58 - PubMed
- Life Sci. 2006 Mar 27;78(18):2146-57 - PubMed
- Ann Intern Med. 1998 Dec 15;129(12):1061-5 - PubMed
- Expert Opin Drug Metab Toxicol. 2005 Dec;1(4):641-54 - PubMed
- Br J Clin Pharmacol. 2002 Jan;53(1):75-82 - PubMed
- Fundam Clin Pharmacol. 2005 Feb;19(1):1-16 - PubMed
- Cell Mol Neurobiol. 1999 Jun;19(3):309-23 - PubMed
- Lancet. 2002 Oct 12;360(9340):1155-62 - PubMed
- Kathmandu Univ Med J (KUMJ). 2007 Jul-Sep;5(3):421-30 - PubMed
- Am J Med. 2002 Oct 15;113(6):506-15 - PubMed
- Adv Pharmacol. 1997;43:7-35 - PubMed
- J Clin Psychopharmacol. 2002 Feb;22(1):46-54 - PubMed
- Pharmacopsychiatry. 1997 Sep;30 Suppl 2:77-80 - PubMed
- J Altern Complement Med. 2002 Jun;8(3):293-308 - PubMed
- J Pharm Pharmacol. 1995 May;47(5):402-6 - PubMed
- Br J Clin Pharmacol. 1998 May;45(5):496-500 - PubMed
- Drug Metab Rev. 1979;9(2):221-36 - PubMed
- Br J Clin Pharmacol. 2001 Nov;52(5):587-95 - PubMed
- Am J Ther. 2006 Jan-Feb;13(1):24-31 - PubMed
- Transplantation. 2001 Jan 27;71(2):239-41 - PubMed
- Eur J Drug Metab Pharmacokinet. 1995 Jan-Mar;20(1):55-60 - PubMed
- Genome Biol. 2000;1(6):REVIEWS3003 - PubMed
- Arzneimittelforschung. 1993 Feb;43(2):119-22 - PubMed
- Drugs. 1987;34 Suppl 1:159-69 - PubMed
- Br J Clin Pharmacol. 2004 May;57(5):592-9 - PubMed
Substances
MeSH terms
Publication Types