Ginger as a Modulator of Drug Metabolizing Enzymes and Transporters: Potential Implications for Herb-Drug...

Ginger (Zingiber officinale) is one of the most widely used herbs, employed in various food preparations, beverages, and herbal medicines. In recent decades, the demand for commercial formulations of ginger, including herbal medicines, nutraceuticals, and botanical dietary supplements (BDS), has increased significantly, and these products are now readily available. Research indicates that a significant portion of the population regularly consumes ginger and its commercial products, often believing that these products are free from side effects due to their natural origin. However, recent preclinical and clinical studies indicate that ginger can interact substantially with various xenobiotic receptors (e.g. PXR, CAR and AhR), drug-metabolizing cytochrome enzymes (CYP3A4, 2C9, 2D6, 1A2, and GST), and drug transporters (P-gp, BCRP, OATP, and OCT). As a result, over-consumption may lead to herb-drug interactions (HDIs) that are often unnoticed but can sometimes require urgent medical intervention, especially in long-term patients. However, there is limited information available regarding its HDIs. This report outlines the basic concept of HDIs, explores the HDI potential of ginger phytochemicals, and presents clinical cases resulting from the indiscriminate consumption of ginger or its products. We believe this information proves valuable to average consumers, researchers, and policymakers.