Effect of Concurrent Administration of Herbs on the Pharmacokinetics of Drugs: A Review
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Date
2023
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Advances in Pharmacology and Clinical Trials
Abstract
Herbal medicines are currently in high demand, and their popularity is steadily increasing as an alternative medicine. This
is as a result of their perceived effectiveness, fewer side effects and relatively low cost. They are being used simultaneously
with therapeutic drugs for the treatment and management of numerous medical conditions, but due to the complex mixture
of bioactive constituents they are capable of affecting the pharmacokinetics and pharmacodynamics of conventional drugs
when administered concurrently. Of serious concern is the concurrent consumption of herbal products and conventional
drugs. Herb–drug inter-action (HDI) is the single most important clinical consequence of this practice. Using a structured
assessment procedure, the evidence of HDI presents with varying degree of clinical significance. While the potential
for HDI for a number of herbal products is inferred from non-human studies, certain HDIs are well established through
human studies and documented case reports. This herb-drug interactions (HDIs) may lead to modifications in plasma drug
levels resulting in therapeutic failure of the drug or, alternatively, it may cause drug-induced toxicity. The main routes
proposed for HDIs include cytochrome P450 (CYP450)-mediated inhibition or induction and transport and flow proteins.
In our review, some herbal medicines used for the treatment of various diseases were highlighted and case reports of their
pharmacokinetics and pharmacodynamics herb-drug interactions were analyzed. Therefore, this review can be a quick
reference tool for physicians, pharmacists and other healthcare professionals involved in therapy, and counseling towards
appropriate use of drugs to maximize clinical outcomes.