scholarly journals Pharmacokinetic Interactions between Herbal Medicines and Drugs: Their Mechanisms and Clinical Relevance

Life ◽  
2020 ◽  
Vol 10 (7) ◽  
pp. 106 ◽  
Author(s):  
Laura Rombolà ◽  
Damiana Scuteri ◽  
Straface Marilisa ◽  
Chizuko Watanabe ◽  
Luigi Antonio Morrone ◽  
...  
Keyword(s):  
Herbal Medicine ◽  
Medicinal Plant ◽  
Drug Interactions ◽  
Herbal Medicines ◽  
Drug Bioavailability ◽  
Transporter Protein ◽  
Concurrent Use ◽  
Medicinal Plant Extracts ◽  
High Concentrations

The therapeutic efficacy of a drug or its unexpected unwanted side effects may depend on the concurrent use of a medicinal plant. In particular, constituents in the medicinal plant extracts may influence drug bioavailability, metabolism and half-life, leading to drug toxicity or failure to obtain a therapeutic response. This narrative review focuses on clinical studies improving knowledge on the ability of selected herbal medicines to influence the pharmacokinetics of co-administered drugs. Moreover, in vitro studies are useful to anticipate potential herbal medicine-drug interactions. In particular, they help to elucidate the cellular target (metabolic or transporter protein) and the mechanism (induction or inhibition) by which a single constituent of the herbal medicine acts. The authors highlight the difficulties in predicting herbal–drug interactions from in vitro data where high concentrations of extracts or their constituents are used and pharmacokinetics are missed. Moreover, the difficulty to compare results from human studies where different kinds of herbal extracts are used is discussed. The herbal medicines discussed are among the best sellers and they are reported in the “Herbal Medicines for Human Use” section of the European Medicinal Agency (EMA).

scholarly journals Drug interactions: a review of the unseen danger of experimental COVID-19 therapies

2020 ◽  
Vol 75 (12) ◽  
pp. 3417-3424 ◽  
Author(s):  
Catherine Hodge ◽  
Fiona Marra ◽  
Catia Marzolini ◽  
Alison Boyle ◽  
Sara Gibbons ◽  
...  
Keyword(s):  
Drug Interactions ◽  
Herbal Medicines ◽  
Qt Prolongation ◽  
Critically Ill Patient ◽  
Experimental Drugs ◽  
Mesh Terms ◽  
Experimental Therapies ◽  
Clinically Significant ◽  
Novel Coronavirus

Abstract As global health services respond to the coronavirus pandemic, many prescribers are turning to experimental drugs. This review aims to assess the risk of drug–drug interactions in the severely ill COVID-19 patient. Experimental therapies were identified by searching ClinicalTrials.gov for ‘COVID-19’, ‘2019-nCoV’, ‘2019 novel coronavirus’ and ‘SARS-CoV-2’. The last search was performed on 30 June 2020. Herbal medicines, blood-derived products and in vitro studies were excluded. We identified comorbidities by searching PubMed for the MeSH terms ‘COVID-19’, ‘Comorbidity’ and ‘Epidemiological Factors’. Potential drug–drug interactions were evaluated according to known pharmacokinetics, overlapping toxicities and QT risk. Drug–drug interactions were graded GREEN and YELLOW: no clinically significant interaction; AMBER: caution; RED: serious risk. A total of 2378 records were retrieved from ClinicalTrials.gov, which yielded 249 drugs that met inclusion criteria. Thirteen primary compounds were screened against 512 comedications. A full database of these interactions is available at www.covid19-druginteractions.org. Experimental therapies for COVID-19 present a risk of drug–drug interactions, with lopinavir/ritonavir (10% RED, 41% AMBER; mainly a perpetrator of pharmacokinetic interactions but also risk of QT prolongation particularly when given with concomitant drugs that can prolong QT), chloroquine and hydroxychloroquine (both 7% RED and 27% AMBER, victims of some interactions due to metabolic profile but also perpetrators of QT prolongation) posing the greatest risk. With management, these risks can be mitigated. We have published a drug–drug interaction resource to facilitate medication review for the critically ill patient.

scholarly journals Herbal Medicine for Pain Management: Efficacy and Drug Interactions

Pharmaceutics ◽  
2021 ◽  
Vol 13 (2) ◽  
pp. 251
Author(s):  
Behdad Jahromi ◽  
Iulia Pirvulescu ◽  
Kenneth D. Candido ◽  
Nebojsa Nick Knezevic
Keyword(s):  
Pain Management ◽  
Herbal Medicine ◽  
Drug Interactions ◽  
Synergistic Effects ◽  
Herbal Medicines ◽  
Scientific Data ◽  
Global Market ◽  
Complementary And Alternative Medicines ◽  
Alternative Medicines ◽  
Complementary And Alternative

Complementary and alternative medicines such as herbal medicines are not currently part of the conventional medical system. As the popularity of and global market for herbal medicine grows among all age groups, with supporting scientific data and clinical trials, specific alternative treatments such as herbal medicine can be reclassified as a practice of conventional medicine. One of the most common conditions for which adults use herbal medicine is pain. However, herbal medicines carry safety concerns and may impact the efficacy of conventional therapies. Unfortunately, mechanisms of action are poorly understood, and their use is unregulated and often underreported to medical professionals. This review aims to compile common and available herbal medicines which can be used as an alternative to or in combination with conventional pain management approaches. Efficacy and safety are assessed through clinical studies on pain relief. Ensuing herb–drug interactions such as cytochrome modulation, additive and synergistic effects, and contraindications are discussed. While self-management has been recognized as part of the overall treatment strategy for patients suffering from chronic pain, it is important for practitioners to be able to also optimize and integrate herbal medicine and, if warranted, other complementary and alternative medicines into their care.

scholarly journals Biological activity from indigenous medicinal plants of Mauritius

2005 ◽  
Vol 77 (1) ◽  
pp. 41-51 ◽  
Author(s):  
A. Gurib-Fakim ◽  
H. Subratty ◽  
F. Narod ◽  
J. Govinden-Soulange ◽  
F. Mahomoodally
Keyword(s):  
Medicinal Plant ◽  
Plant Extracts ◽  
Biological Properties ◽  
Pharmacological Properties ◽  
Plant Materials ◽  
In Vivo Screening ◽  
Medicinal Plant Extracts ◽  
Minor Ailments

The Mauritian population has a long tradition in the use of ethno-medicine, and the practice is still strong, especially in the treatment of minor ailments. Such interest stems from an existing culture, and many “tisanes” are still prepared from plant materials and sold in several markets around the island.This paper will focus on the various chemical/biological screening techniques currently being used to evaluate the biological properties of medicinal plant extracts. Particular emphasis will be put on extraction and various screening for biological/pharmacological properties. Due consideration will be given to the pharmacological approaches that utilize different animal models for the in vitro and in vivo screening of medicinal plant extracts.

scholarly journals In vitro antiviral activity of twenty-seven medicinal plant extracts from Southwest Nigeria against three serotypes of echoviruses

2018 ◽  
Vol 15 (1) ◽  
Author(s):  
Omonike O. Ogbole ◽  
Toluwanimi E. Akinleye ◽  
Peter A. Segun ◽  
Temitope C. Faleye ◽  
Adekunle J. Adeniji
Keyword(s):  
Antiviral Activity ◽  
Medicinal Plant ◽  
Plant Extracts ◽  
Medicinal Plant Extracts ◽  
Southwest Nigeria

scholarly journals Extracts of Korean Medicinal Plant Extracts Alter Lipogenesis of Pig Adipose Tissue and Differentiation of Pig Preadipocytes In vitro

2010 ◽  
Vol 52 (5) ◽  
pp. 383-388 ◽  
Author(s):  
Young-Suk Choi ◽  
Kang-Duk Choi ◽  
Sung-Do Kim ◽  
Owens Phillip ◽  
Chung-Soo Chung
Keyword(s):  
Adipose Tissue ◽  
Medicinal Plant ◽  
Plant Extracts ◽  
Medicinal Plant Extracts

The potential impact of the use of homeopathic and herbal remedies on monitoring the safety of prescription products

2005 ◽  
Vol 24 (5) ◽  
pp. 219-233 ◽  
Author(s):  
K N Woodward
Keyword(s):  
Herbal Medicine ◽  
Drug Interactions ◽  
Adverse Reactions ◽  
Conventional Medicine ◽  
Herbal Medicines ◽  
Adverse Event Reporting ◽  
Herbal Remedies ◽  
Extensive Literature ◽  
Conventional Drug ◽  
Potential Impact

The purpose of this paper is to explore the possibility that adverse reactions and drug interactions arising from the use of homeopathic and herbal medicines could lead to confusion when adverse reactions to conventional medicines are reported. An extensive literature review was conducted on the occurrence of adverse reactions and drug interactions following the use of homeopathic or herbal remedies, and the potential for these to confound adverse event reporting to conventional medicines considered. The survey demonstrates the potential for herbal remedies and homeopathic products, to produce adverse drug reactions or drug interactions, and shows the scope for potential for confusion with those arising from conventional medicines. There is a need for greater awareness that adverse reactions apparently due to a conventional medicine, might in reality be due to a herbal medicine or a drug interaction between a herbal medicine and a conventional drug, particularly when a health professional is unaware of the extent of a patient's selfmedication with alternative therapies.

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