Herb-Drug Interactions and Hepatotoxicity.
Mohammad K Parvez1, Vikas Rishi2
1Department of Pharmacognosy, King Saud University College of Pharmacy, Riyadh 11451, Saudi Arabia.
Current Drug Metabolism
|March 28, 2019
Summary
Herbal remedies are popular but often lack safety data, leading to dangerous herb-drug interactions. These interactions, especially with prescription drugs, can cause serious side effects like liver damage (hepatotoxicity).
Area of Science:
- Pharmacology
- Toxicology
- Integrative Medicine
Background:
- Herbal remedies (phytomedicines) are increasingly popular as complementary and alternative medicine.
- Many marketed herbal products lack scientific validation for efficacy and safety.
- This can lead to undocumented herb-drug interactions with adverse clinical outcomes.
Purpose of the Study:
- To review the literature on herb-drug interactions and their association with hepatotoxicity.
- To discuss the mechanisms underlying these interactions, focusing on drug-metabolizing enzymes.
- To highlight the public health implications of herb-drug interactions.
Main Methods:
- Conducted an online literature search on PubMed, Europe PMC, Medline, and Google Scholar.
- Used keywords such as 'herb-drug interaction', 'herbal hepatotoxicity', and 'complementary & alternative medicine'.
- Focused on peer-reviewed articles discussing mechanisms, toxicity, and clinical outcomes.
Main Results:
- Patients often use herbal remedies concurrently with prescription drugs, unaware of potential risks.
- Herb-drug interactions can lead to adverse effects, notably hepatotoxicity, through mechanisms like enzyme inhibition (e.g., cytochrome P450).
- Several cases of herbal-induced hepatotoxicity in viral hepatitis patients have been reported, but data on pharmacokinetics is limited.
Conclusions:
- Herb-drug interaction-induced morbidity is a growing public health concern.
- A standardized system for predicting and evaluating herb-drug interactions is currently lacking.
- Understanding the mechanisms, particularly involving drug-metabolizing enzymes, is crucial for managing these risks.
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