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An Overview of the Evidence and Mechanisms of Herb–Drug Interactions

Despite the lack of sufficient information on the safety of herbal products, their use as alternative and/or complementary medicine is globally popular. There is also an increasing interest in medicinal herbs as precursor for pharmacological actives. Of serious concern is the concurrent consumption...

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Autores principales: Fasinu, Pius S., Bouic, Patrick J., Rosenkranz, Bernd
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Research Foundation 2012
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3339338/
https://www.ncbi.nlm.nih.gov/pubmed/22557968
http://dx.doi.org/10.3389/fphar.2012.00069
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author Fasinu, Pius S.
Bouic, Patrick J.
Rosenkranz, Bernd
author_facet Fasinu, Pius S.
Bouic, Patrick J.
Rosenkranz, Bernd
author_sort Fasinu, Pius S.
collection PubMed
description Despite the lack of sufficient information on the safety of herbal products, their use as alternative and/or complementary medicine is globally popular. There is also an increasing interest in medicinal herbs as precursor for pharmacological actives. Of serious concern is the concurrent consumption of herbal products and conventional drugs. Herb–drug interaction (HDI) is the single most important clinical consequence of this practice. Using a structured assessment procedure, the evidence of HDI presents with varying degree of clinical significance. While the potential for HDI for a number of herbal products is inferred from non-human studies, certain HDIs are well established through human studies and documented case reports. Various mechanisms of pharmacokinetic HDI have been identified and include the alteration in the gastrointestinal functions with consequent effects on drug absorption; induction and inhibition of metabolic enzymes and transport proteins; and alteration of renal excretion of drugs and their metabolites. Due to the intrinsic pharmacologic properties of phytochemicals, pharmacodynamic HDIs are also known to occur. The effects could be synergistic, additive, and/or antagonistic. Poor reporting on the part of patients and the inability to promptly identify HDI by health providers are identified as major factors limiting the extensive compilation of clinically relevant HDIs. A general overview and the significance of pharmacokinetic and pharmacodynamic HDI are provided, detailing basic mechanism, and nature of evidence available. An increased level of awareness of HDI is necessary among health professionals and drug discovery scientists. With the increasing number of plant-sourced pharmacological actives, the potential for HDI should always be assessed in the non-clinical safety assessment phase of drug development process. More clinically relevant research is also required in this area as current information on HDI is insufficient for clinical applications.
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spelling pubmed-33393382012-05-03 An Overview of the Evidence and Mechanisms of Herb–Drug Interactions Fasinu, Pius S. Bouic, Patrick J. Rosenkranz, Bernd Front Pharmacol Pharmacology Despite the lack of sufficient information on the safety of herbal products, their use as alternative and/or complementary medicine is globally popular. There is also an increasing interest in medicinal herbs as precursor for pharmacological actives. Of serious concern is the concurrent consumption of herbal products and conventional drugs. Herb–drug interaction (HDI) is the single most important clinical consequence of this practice. Using a structured assessment procedure, the evidence of HDI presents with varying degree of clinical significance. While the potential for HDI for a number of herbal products is inferred from non-human studies, certain HDIs are well established through human studies and documented case reports. Various mechanisms of pharmacokinetic HDI have been identified and include the alteration in the gastrointestinal functions with consequent effects on drug absorption; induction and inhibition of metabolic enzymes and transport proteins; and alteration of renal excretion of drugs and their metabolites. Due to the intrinsic pharmacologic properties of phytochemicals, pharmacodynamic HDIs are also known to occur. The effects could be synergistic, additive, and/or antagonistic. Poor reporting on the part of patients and the inability to promptly identify HDI by health providers are identified as major factors limiting the extensive compilation of clinically relevant HDIs. A general overview and the significance of pharmacokinetic and pharmacodynamic HDI are provided, detailing basic mechanism, and nature of evidence available. An increased level of awareness of HDI is necessary among health professionals and drug discovery scientists. With the increasing number of plant-sourced pharmacological actives, the potential for HDI should always be assessed in the non-clinical safety assessment phase of drug development process. More clinically relevant research is also required in this area as current information on HDI is insufficient for clinical applications. Frontiers Research Foundation 2012-04-30 /pmc/articles/PMC3339338/ /pubmed/22557968 http://dx.doi.org/10.3389/fphar.2012.00069 Text en Copyright © 2012 Fasinu, Bouic and Rosenkranz. http://www.frontiersin.org/licenseagreement This is an open-access article distributed under the terms of the Creative Commons Attribution Non Commercial License, which permits non-commercial use, distribution, and reproduction in other forums, provided the original authors and source are credited.
spellingShingle Pharmacology
Fasinu, Pius S.
Bouic, Patrick J.
Rosenkranz, Bernd
An Overview of the Evidence and Mechanisms of Herb–Drug Interactions
title An Overview of the Evidence and Mechanisms of Herb–Drug Interactions
title_full An Overview of the Evidence and Mechanisms of Herb–Drug Interactions
title_fullStr An Overview of the Evidence and Mechanisms of Herb–Drug Interactions
title_full_unstemmed An Overview of the Evidence and Mechanisms of Herb–Drug Interactions
title_short An Overview of the Evidence and Mechanisms of Herb–Drug Interactions
title_sort overview of the evidence and mechanisms of herb–drug interactions
topic Pharmacology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3339338/
https://www.ncbi.nlm.nih.gov/pubmed/22557968
http://dx.doi.org/10.3389/fphar.2012.00069
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