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Herb-drug interactions: a mechanistic approach.

Ajay Kumar Sharma1, Vijay Kumar Kapoor1, Gurjot Kaur1

  • 1School of Pharmaceutical Sciences, Shoolini University, Solan, India.

Drug and Chemical Toxicology
|March 13, 2020
PubMed
Summary

Many Indians use herbal medicines with conventional drugs, unaware of potential interactions. This study identifies common herb-drug interactions, particularly synergistic effects with antibiotics, oral hypoglycemics, and anticonvulsants, and impacts on CYP450 enzymes.

Keywords:
CYP450Herb–drug interactionIndian traditional medicinesynergism

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Area of Science:

  • Pharmacology
  • Traditional Medicine
  • Drug Interactions

Background:

  • Traditional herbal medicines are widely used in India alongside allopathic treatments.
  • Public awareness of potential herb-drug interactions (synergistic or antagonistic) is limited.
  • The safety assumption of herbal drugs often overlooks potential adverse effects when combined with conventional medicine.

Purpose of the Study:

  • To comprehensively understand and identify interaction patterns between common herbs and allopathic drugs in the Indian market.
  • To analyze potential synergistic or antagonistic effects of herb-drug combinations.
  • To highlight the significance of herb-drug interactions for patient safety in India.

Main Methods:

  • Systematic literature review to identify common interacting herbs and allopathic drugs.
  • Categorization of allopathic drugs into therapeutic classes.
  • Alignment of drug classes and herbs to identify interaction patterns.

Main Results:

  • The most frequent interaction categories involved antibiotics, oral hypoglycemics, and anticonvulsants, exclusively showing synergistic effects.
  • Cytochrome P450 (CYP450) enzymes were identified as major interaction points, with both activation and inhibition observed.
  • Herbal products can alter the metabolism of co-administered allopathic drugs that are known CYP substrates, inhibitors, or inducers.

Conclusions:

  • Herb-drug interactions are prevalent and significant, particularly concerning synergistic effects and CYP450 enzyme modulation.
  • The findings underscore the need for greater awareness and detailed study of these interactions within the Indian population.
  • Understanding these interactions is crucial for preventing adverse events and ensuring therapeutic efficacy.