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Herbal Interaction With Chemotherapeutic Drugs—A Focus on Clinically Significant Findings

One of the most consequential risks associated with the concomitant use of herbal products and chemotherapeutic agents is herb-drug interactions. The risk is higher in patients with chronic conditions taking multiple medications. Herb-drug interaction is particularly undesirable in cancer management...

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Detalles Bibliográficos
Autores principales: Fasinu, Pius S., Rapp, Gloria K.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6901834/
https://www.ncbi.nlm.nih.gov/pubmed/31850232
http://dx.doi.org/10.3389/fonc.2019.01356
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author Fasinu, Pius S.
Rapp, Gloria K.
author_facet Fasinu, Pius S.
Rapp, Gloria K.
author_sort Fasinu, Pius S.
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description One of the most consequential risks associated with the concomitant use of herbal products and chemotherapeutic agents is herb-drug interactions. The risk is higher in patients with chronic conditions taking multiple medications. Herb-drug interaction is particularly undesirable in cancer management because of the precipitous dose-effect relationship and toxicity of chemotherapeutic agents. The most common mechanism of herb-drug interaction is the herbal-mediated inhibition and/or induction of drug-metabolizing enzymes (DME) and/or transport proteins leading to the alteration in the pharmacokinetic disposition of the victim drug. Most mechanistic research has focused on laboratory-based studies, determining the effects of herbal products on DMEs and extrapolating findings to predict clinical relevance; however, not all DME/transporter protein inhibition/induction results in clinical herb-drug interaction. This study reviews relevant literature and identified six herbal products namely echinacea, garlic, ginseng, grapefruit juice, milk thistle, and St John's wort, which have shown interactions with chemotherapeutic agents in humans. This focus on clinically significant herb-drug interaction, should be of interest to the public including practitioners, researchers, and consumers of cancer chemotherapy.
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spelling pubmed-69018342019-12-17 Herbal Interaction With Chemotherapeutic Drugs—A Focus on Clinically Significant Findings Fasinu, Pius S. Rapp, Gloria K. Front Oncol Oncology One of the most consequential risks associated with the concomitant use of herbal products and chemotherapeutic agents is herb-drug interactions. The risk is higher in patients with chronic conditions taking multiple medications. Herb-drug interaction is particularly undesirable in cancer management because of the precipitous dose-effect relationship and toxicity of chemotherapeutic agents. The most common mechanism of herb-drug interaction is the herbal-mediated inhibition and/or induction of drug-metabolizing enzymes (DME) and/or transport proteins leading to the alteration in the pharmacokinetic disposition of the victim drug. Most mechanistic research has focused on laboratory-based studies, determining the effects of herbal products on DMEs and extrapolating findings to predict clinical relevance; however, not all DME/transporter protein inhibition/induction results in clinical herb-drug interaction. This study reviews relevant literature and identified six herbal products namely echinacea, garlic, ginseng, grapefruit juice, milk thistle, and St John's wort, which have shown interactions with chemotherapeutic agents in humans. This focus on clinically significant herb-drug interaction, should be of interest to the public including practitioners, researchers, and consumers of cancer chemotherapy. Frontiers Media S.A. 2019-12-03 /pmc/articles/PMC6901834/ /pubmed/31850232 http://dx.doi.org/10.3389/fonc.2019.01356 Text en Copyright © 2019 Fasinu and Rapp. http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Oncology
Fasinu, Pius S.
Rapp, Gloria K.
Herbal Interaction With Chemotherapeutic Drugs—A Focus on Clinically Significant Findings
title Herbal Interaction With Chemotherapeutic Drugs—A Focus on Clinically Significant Findings
title_full Herbal Interaction With Chemotherapeutic Drugs—A Focus on Clinically Significant Findings
title_fullStr Herbal Interaction With Chemotherapeutic Drugs—A Focus on Clinically Significant Findings
title_full_unstemmed Herbal Interaction With Chemotherapeutic Drugs—A Focus on Clinically Significant Findings
title_short Herbal Interaction With Chemotherapeutic Drugs—A Focus on Clinically Significant Findings
title_sort herbal interaction with chemotherapeutic drugs—a focus on clinically significant findings
topic Oncology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6901834/
https://www.ncbi.nlm.nih.gov/pubmed/31850232
http://dx.doi.org/10.3389/fonc.2019.01356
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