Please use this identifier to cite or link to this item: https://doi.org/10.2174/138161206779010440
Title: Drug-herb interactions: Eliminating toxicity with hard drug design
Authors: Yang, X.-X.
Hu, Z.-P.
Duan, W.
Zhu, Y.-Z.
Zhou, S.-F. 
Keywords: Cytochrome P450
Drug design
Drug-herb interaction
Herbs
P-glycoprotein
Issue Date: Dec-2006
Citation: Yang, X.-X., Hu, Z.-P., Duan, W., Zhu, Y.-Z., Zhou, S.-F. (2006-12). Drug-herb interactions: Eliminating toxicity with hard drug design. Current Pharmaceutical Design 12 (35) : 4649-4664. ScholarBank@NUS Repository. https://doi.org/10.2174/138161206779010440
Abstract: By searching the literatures, it was found that a total of 32 drugs interacting with herbal medicines in humans. These drugs mainly include anticoagulants (warfarin, aspirin and phenprocoumon), sedatives and antidepressants (midazolam, alprazolam and amitriptyline), oral contraceptives, anti-HIV agents (indinavir, ritonavir and saquinavir), cardiovascular drug (digoxin), immunosuppressants (cyclosporine and tacrolimus) and anticancer drugs (imatinib and irinotecan). Most of them are substrates for cytochrome P450s (CYPs) and/or P-glycoprotein (PgP) and many of which have narrow therapeutic indices. However, several drugs including acetaminophen, carbamazepine, mycophenolic acid, and pravastatin did not interact with herbs. Both pharmacokinetic (e.g. induction of hepatic CYPs and intestinal PgP) and/or pharmacodynamic mechanisms (e.g. synergistic or antagonistic interaction on the same drug target) may be involved in drug-herb interactions, leading of altered drug clearance, response and toxicity. Toxicity arising from drug-herb interactions may be minor, moderate, or even fatal, depending on a number of factors associated with the patients, herbs and drugs. Predicting drug-herb interactions, timely identification of drugs that interact with herbs, and therapeutic drug monitoring may minimize toxic drug-herb interactions. It is likely to predict pharmacokinetic herb-drug interactions by following the pharmacokinetic principles and using proper models that are used for predicting drug-drug interactions. Identification of drugs that interact with herbs can be incorporated into the early stages of drug development. A fourth approach for circumventing toxicity arising from drug-herb interactions is proper design of drugs with minimal potential for herbal interaction. So-called "hard drugs" that are not metabolized by CYPs and not transported by PgP are believed not to interact with herbs due to their unique pharmacokinetic properties. More studies are needed and new approached are required to minimize toxicity arising from drug-herb interactions. © 2006 Bentham Science Publishers Ltd.
Source Title: Current Pharmaceutical Design
URI: http://scholarbank.nus.edu.sg/handle/10635/106647
ISSN: 13816128
DOI: 10.2174/138161206779010440
Appears in Collections:Staff Publications

Show full item record
Files in This Item:
There are no files associated with this item.

SCOPUSTM   
Citations

54
checked on Jun 16, 2018

WEB OF SCIENCETM
Citations

46
checked on May 30, 2018

Page view(s)

36
checked on May 11, 2018

Google ScholarTM

Check

Altmetric


Items in DSpace are protected by copyright, with all rights reserved, unless otherwise indicated.