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Decreased absorption of midazolam in the stomach due to low pH induced by co-administration of Banha-sasim-tang
OBJECTIVES: Banha-sasim-tang (BST), which consists of seven different herbs, is one of the most popular herbal formulae for treating gastrointestinal disorders in Eastern Asia. The commonly used herbal medicine is often co-administered with other therapeutic drugs, which raises the possibility of he...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
The Korean Society of Environmental Health and Toxicology
2016
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5080787/ https://www.ncbi.nlm.nih.gov/pubmed/27503469 http://dx.doi.org/10.5620/eht.e2016016 |
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author | Jo, Jun Hyeon Kim, Sun Joo Nam, Woong Shik Seung, Eun Ji Lee, Sangkyu |
author_facet | Jo, Jun Hyeon Kim, Sun Joo Nam, Woong Shik Seung, Eun Ji Lee, Sangkyu |
author_sort | Jo, Jun Hyeon |
collection | PubMed |
description | OBJECTIVES: Banha-sasim-tang (BST), which consists of seven different herbs, is one of the most popular herbal formulae for treating gastrointestinal disorders in Eastern Asia. The commonly used herbal medicine is often co-administered with other therapeutic drugs, which raises the possibility of herb–drug interactions and may modify the clinical safety profile of therapeutic drugs. METHODS: We investigated the potential herb–drug interactions between BST extract and midazolam (MDZ) in mice. The area under the plasma concentration-time curve (AUC) of MDZ and 1ʹ-hydroxymidazolam (1ʹ-OH-MDZ) was evaluated for both oral and intraperitoneal administration of MDZ, following oral administration of BST (0.5 and 1 g/kg). RESULTS: It was found that the AUC of MDZ and 1ʹ-OH-MDZ was lower in case of oral administration of MDZ. Administration of BST extract was not associated with hepatic cytochrome P450 activity. BST extract induced a strong reduction in pH and it has been reported that oral mucosal absorption of MDZ is lower at low pH. The decreased absorption rate of MDZ might be caused by the ingredients of BST and may not be related to other factors such as increased excretion of MDZ by P-glycoprotein. CONCLUSIONS: The altered pharmacokinetics of midazolam caused by co-administration with BST in vivo could be attributed to a decrease in pH and subsequent reduction of MDZ absorption rate. |
format | Online Article Text |
id | pubmed-5080787 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2016 |
publisher | The Korean Society of Environmental Health and Toxicology |
record_format | MEDLINE/PubMed |
spelling | pubmed-50807872016-11-04 Decreased absorption of midazolam in the stomach due to low pH induced by co-administration of Banha-sasim-tang Jo, Jun Hyeon Kim, Sun Joo Nam, Woong Shik Seung, Eun Ji Lee, Sangkyu Environ Health Toxicol Original Article OBJECTIVES: Banha-sasim-tang (BST), which consists of seven different herbs, is one of the most popular herbal formulae for treating gastrointestinal disorders in Eastern Asia. The commonly used herbal medicine is often co-administered with other therapeutic drugs, which raises the possibility of herb–drug interactions and may modify the clinical safety profile of therapeutic drugs. METHODS: We investigated the potential herb–drug interactions between BST extract and midazolam (MDZ) in mice. The area under the plasma concentration-time curve (AUC) of MDZ and 1ʹ-hydroxymidazolam (1ʹ-OH-MDZ) was evaluated for both oral and intraperitoneal administration of MDZ, following oral administration of BST (0.5 and 1 g/kg). RESULTS: It was found that the AUC of MDZ and 1ʹ-OH-MDZ was lower in case of oral administration of MDZ. Administration of BST extract was not associated with hepatic cytochrome P450 activity. BST extract induced a strong reduction in pH and it has been reported that oral mucosal absorption of MDZ is lower at low pH. The decreased absorption rate of MDZ might be caused by the ingredients of BST and may not be related to other factors such as increased excretion of MDZ by P-glycoprotein. CONCLUSIONS: The altered pharmacokinetics of midazolam caused by co-administration with BST in vivo could be attributed to a decrease in pH and subsequent reduction of MDZ absorption rate. The Korean Society of Environmental Health and Toxicology 2016-08-09 /pmc/articles/PMC5080787/ /pubmed/27503469 http://dx.doi.org/10.5620/eht.e2016016 Text en Copyright © 2016 The Korean Society of Environmental Health and Toxicology This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Original Article Jo, Jun Hyeon Kim, Sun Joo Nam, Woong Shik Seung, Eun Ji Lee, Sangkyu Decreased absorption of midazolam in the stomach due to low pH induced by co-administration of Banha-sasim-tang |
title | Decreased absorption of midazolam in the stomach due to low pH induced by co-administration of Banha-sasim-tang |
title_full | Decreased absorption of midazolam in the stomach due to low pH induced by co-administration of Banha-sasim-tang |
title_fullStr | Decreased absorption of midazolam in the stomach due to low pH induced by co-administration of Banha-sasim-tang |
title_full_unstemmed | Decreased absorption of midazolam in the stomach due to low pH induced by co-administration of Banha-sasim-tang |
title_short | Decreased absorption of midazolam in the stomach due to low pH induced by co-administration of Banha-sasim-tang |
title_sort | decreased absorption of midazolam in the stomach due to low ph induced by co-administration of banha-sasim-tang |
topic | Original Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5080787/ https://www.ncbi.nlm.nih.gov/pubmed/27503469 http://dx.doi.org/10.5620/eht.e2016016 |
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