Drug Interactions in the Treatment With Herbal Products
Journal Title: Dokuz Eylul Universitesi Tip Fakultesi Dergisi - Year 2017, Vol 31, Issue 1
Abstract
Herbal products are used in the prevention and treatment of many chronic diseases such as hypertension, diabetes, hyperlipidemia and cancer. Herbal products which are obtained from natural sources does not mean that they are safe. The use of herbal products with drugs can lead to serious herbal product-drug interactions. Herbs that are reported to interact with drugs include St. John’s wort (Hypericum perforatum), Ginkgo (Ginkgo biloba), Ginseng (Panax ginseng), Ginger (Zingiber officinale), Garlic (Allium sativum), Echinasea ve Valerian. This study was reviewed pharmacokinetic and pharmacodynamic drug interactions with commonly used herbal products. The use of herbal product can alter the absorption, distribution, metabolism and excretion of drugs through inhibition or induction of cytochrome P450 enzymes (CYP450) and P-glycoprotein (P-gp). Pharmacokinetic interactions may lead to an increase or a decrease on pharmacological effect of the drug. Also drug-induced side effect and toxic effect may manifest. Pharmacodynamic interactions between herbal products and drugs may be additive or synergistic which will enhance the effect of drugs, or antagonistic, which will reduce the efficacy of drugs. Drugs which interact with herbal products include anticoagulants and antithrombotics, cardiovascular drugs, immunusuppressants, sedatives, antidepressants, statins, anticancer drugs and anti-HIV drugs. Herbal product-drug interactions are especially important for drugs with narrow therapeutic index. Physicians should inquire about use of herbal products to their patients when prescribing medicine. Herbal products which have not proven effectiveness and safety in clinical controlled trials should not be recommended.
Authors and Affiliations
Şule KALKAN
Keywords
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