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Drug Interactions In The Treatment With Herbal Products

Yıl 2017, Cilt: 31 Sayı: 1, 41 - 50, 26.05.2017

Öz

Herbal
products are used in the prevention and treatment of many chronic diseases such
as hypertension, diabetes, hyperlipidemia and cancer. Herbal products which are
obtained from natural sources does not mean that they are safe. The use of
herbal products with drugs can lead to serious herbal product-drug
interactions. Herbs that are reported to interact with drugs include St. John’s
wort (Hypericum perforatum), Ginkgo (Ginkgo biloba), Ginseng (Panax ginseng), Ginger (Zingiber officinale), Garlic (Allium sativum), Echinasea ve Valerian.
This study was reviewed pharmacokinetic and pharmacodynamic drug interactions
with commonly used herbal products. The use of herbal product can alter the
absorption, distribution, metabolism and excretion of drugs through inhibition
or induction of cytochrome P450 enzymes (CYP450) and P-glycoprotein (P-gp).
Pharmacokinetic interactions may lead to an increase
or a decrease on pharmacological effect of the drug. Also drug-induced side
effect and toxic effect may manifest. Pharmacodynamic 
interactions between
herbal products and drugs may be additive or synergistic which will enhance the
effect of drugs, or antagonistic, which will reduce the efficacy of drugs.
Drugs which interact with herbal products include anticoagulants and
antithrombotics, cardiovascular drugs, immunusuppressants, sedatives,
antidepressants, statins, anticancer drugs and anti-HIV drugs. Herbal
product-drug interactions are especially important for drugs with narrow
therapeutic index. Physicians should inquire about use of herbal products to
their patients when prescribing medicine. Herbal products which have not proven
effectiveness and safety in clinical controlled trials should not be recommended.




Kaynakça

  • Referans1 Bent S. Herbal Medicine in the United States: Review of Efficacy, Safety, and Regulation. J Gen Intern Med 2008;23:854–859.
  • Referans2 Türk Tabipler Birliği Merkez Konseyi. Bitkisel ürünler ve sağlık. Bilimsel çerçeve ve etik açısından yaklaşım. 2012;1-35.
  • Referans3 Tilburt JC, Kaptchuk TJJ. Herbal medicine research and global health: An ethical analysis. Bull World Health Organ 2008;86:594–599.
  • Referans4 Stasio MJ, Curry K, Sutton-Skinner KM, Glassman DM. Over -the-Counter Medication and Herbal or Dietary Supplement Use in College: Dose Frequency and Relationship to Self-Reported Distress. J Am Coll Health 2008;56:535-547.
  • Referans5 Tulunay M, Aypak C, Yikilkan H, Gorpelioglu S. Herbal medicine use among patients with chronic diseases. J Intercult Ethnopharmacol 2015;4:217-220.
  • Referans6 Kucukoner M, Bilge Z, Isıkdogan A, Kaplan MA, Inal A, Urakci Z. Complementary and alternative medicine usage in cancer patients in southeast of Turkey. Afr J Tradit Complement Altern Med 2013;10:21-25.
  • Referans7 Merrily A. Kuhn RN. Herbal Remedies: Drug-Herb Interactions. Critical Care Nurse 2002;22:22-35.
  • Referans8 Dulger G. Herbal drugs and drug interactions. Marmara Pharmaceutical Journal 2012;16:9-22.
  • Referans9 Karadağ MG, Türközü D, Kapucu DT. Bitkiler ve ilaç etkileşimleri. Göztepe Tıp Dergisi 2013;8:164-170.
  • Referans10 Krivoy N, Pavlotzky E, Chrubasik S, Eisenberg E, Brook G. Effect of salicis cortex extract on human platelet aggregation. Planta Med 2001;67:209-12.
  • Referans11 Zhou S, Gao Y, Jiang W, Huang M, Xu A, Paxton JW. Interactions of herbs with cytochrome P450. Drug Metab Rev 2003;35:35-98.
  • Referans12 Zhou S, Lim LY, Chowbay B. Herbal modulation of Pglycoprotein. Drug Metab Rev 2004;36:57-104.
  • Referans13 Tarirai C, Viljoen AM, Hamman JH. Herb-drug pharmacokinetic interactions reviewed. Expert Opin Drug Metab Toxicol 2010;6:1515-1538.
  • Referans14 Tirona RG, Bailey DG. Herbal product-drug interactions mediated by induction. Br J Clin Pharmacol 2006;61:677-681.
  • Referans15 Di YM, Li CG, Xue CC, Zhou SF. Clinical drugs that interact with St. John's wort and implication in drug development. Curr Pharm Des 2008;14:1723-1742.
  • Referans16 Chen Y, Ferguson SS, Negishi M, Goldstein JA. Induction of human CYP2C9 by rifampicin, hyperforin, and phenobarbital is mediated by the pregnane X receptor. J Pharmacol Exp Ther 2004;308:495–501.
  • Referans17 Moore LB, Goodwin B, Jones SA et al. St. John’s wort induces hepatic drug metabolism through activation of the pregnane X receptor. Proc Natl Acad Sci USA 2000;97:7500-7502.
  • Referans18 POISINDEX®System: Klasco RK (Ed): POISINDEX® System. Truven Health Analytics, Greenwood Village, Colorado (Vol. 167 expires 3/2016).
  • Referans19 Dannawi M. Possible serotonin syndrome after combination of buspirone and St John's Wort. J Psychopharmacol 2002;16:401.
  • Referans20 Borrelli F, Izzo AA. Herb-drug interactions with St John's wort (Hypericum perforatum):an update on clinical observations. AAPS J 2009;11:710-727.
  • Referans21 Saw JT, Bahari MB, Ang HH, Lim YH. Potential drug-herb interaction with antiplatelet/anticoagulant drugs. Complement Ther Clin Pract 2006;12:236-241.
  • Referans22 Matthews MK. Association of Ginkgo biloba with intracerebral hemorrhage. Neurology 1998; 50:1933-1934.
  • Referans23 Wang LS, Zhu B, Abd El-Aty AM et al.The influence of St John’s Wort on CYP2C19 activity with respect to genotype. J Clin Pharmacol. 2004;44:577–581.
  • Referans24 Markowitz JS, Donovan JL, DeVane CL et al. Effect of St John’s Wort on drug metabolism by induction of cytochrome P450 3A4 enzyme. JAMA 2003;290:1500–1504.
  • Referans25 Dresser GK, Schwarz UI, Wilkinson GR, Kim RB. Coordinate induction of both cytochrome P4503A and MDR1 by St John’s wort in healthy subjects. Clin Pharmacol Ther 2003;73:41–50.
  • Referans26 Johne A, Schmider J, Brockmöller J et al. Decreased plasma levels of amitriptyline and its metabolites on comedication with an extract from St. John’s wort (Hypericum perforatum). J Clin Psychopharmacol 2002;22:46–54.
  • Referans27 Xu H, Williams KM, Liauw WS, Murray M, Day RO, McLachlan AJ. Effects of St John’s wort and CYP2C9 genotype on the pharmacokinetics and pharmacodynamics of gliclazide.Br J Pharmacol 2008;153:1579–1586.
  • Referans28 Jiang X, Williams KM, Liauw WS et al. Effect of St John’s wort and ginseng on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol 2004;57:592–599.
  • Referans29 Johne A, Brockmöller J, Bauer S, Maurer A, Langheinrich M, Roots I. Pharmacokinetic interaction of digoxin with an herbal extract from St John’s wort (Hypericum perforatum). Clin Pharmacol Ther 1999;66:338–645.
  • Referans30 Portolés A, Terleira A, Calvo A, Martínez I, Resplandy G. Effects of Hypericum perforatum on ivabradine pharmacokinetics in in healthy volunteers: an open-label,pharmacokinetic interaction clinical trial. J Clin Pharmacol 2006;46:1188-1194.
  • Referans31 Tannergren C, Engman H, Knutson L, Hedeland M, Bondesson U, Lennernäs H. St John’s wort decreases the bioavailability of R- and S-verapamil through induction of the first-pass metabolism. Clin Pharmacol Ther 2004;75:298–309.
  • Referans32 Sugimoto K, Ohmori M, Tsuruoka S et al. Different effects of St John’s wort on the pharmacokinetics of simvastatin and pravastatin. Clin Pharmacol Ther 2001;70:518–524.
  • Referans33 Hebert MF, Park JM, Chen YL, Akhtar S, Larson AM. Effects of St. John’s wort (Hypericum perforatum) on tacrolimus pharmacokinetics in healthy volunteers. J Clin Pharmacol 2004;44:89–94.
  • Referans34 Frye RF, Fitzgerald SM, Lagattuta TF, Hruska MW, Egorin MJ. Effect of St John’s wort on imatinib mesylate pharmacokinetics. Clin Pharmacol Ther 2004;76:323–329.
  • Referans35 Piscitelli SC, Burstein AH, Chaitt D, Alfaro RM, Falloon J. Indinavir concentrations and St John’s wort. Lancet 2000;355:547–548.
  • Referans36 Janetzky K, Morreale AP. Probable interactions between warfarin and ginseng. Am J Health Syst Pharm 1997;54:692–693.
  • Referans37 Yuan CS, Wei G, Dey L et al. Brief communication: American ginseng reduces varfarin's effect in healthy patients: A randomized, controlled trial. Ann Int Med 2004;141:23–27.
  • Referans38 Lesho EP, Saullo L, Udvari-Nagy S. 76-year-old woman with erratic anticoagulation. Cleve Clin J Med 2004;71:651-6.
  • Referans39 Kim YS, Pyo MK, Park KM et al. Antiplatelet and antithrombotic effects of a combination of ticlopidine and ginkgo biloba ext (EGb 761). Thromb Res 1998;91:33-38.
  • Referans40 Hellum BH, Hu Z, Nilsen OG. The induction of CYP1A2,CYP2D6 and CYP3A4 by six trade herbal products in cultured primary human hepatocytes. Basic Clin Pharmacol Toxicol 2007;100:23-30.
  • Referans41 Hellum BH, Hu Z, Nilsen OG. Trade herbal products and induction of CYP2C19 and CYP2E1 in cultured human hepatocytes. Basic Clin Pharmacol Toxicol 2009;105:58-63.
  • Referans42 Kupiec T, Raj V. Fatal seizures due to potential herb-drug interactions with Ginkgo biloba. J Anal Toxicol 2005;29:755-788.
  • Referans43 Mauro VF, Mauro LS, Kleshinski JF, Khuder SA, Wang Y, Erhardt PW. Impact of Ginkgo biloba on the pharmacokinetics of digoxin. Am J Ther 2003;10:247–251.
  • Referans44 Qi LW1, Wang CZ, Du GJ, Zhang ZY, Calway T, Yuan CS. Metabolism of ginseng and its interactions with drugs. Curr Drug Metab 2011;12:818-822.
  • Referans45 Liu Y, Zhang JW, Li W et al. Ginsenoside metabolites, rather than naturally occurring ginsenosides, lead to inhibition of human cytochrome P450 enzymes. Toxicol Sci 2006;91:356–364.
  • Referans46 Bilgi N, Bell K, Ananthakrishnan AN, Atallah E. Imatinib and Panax ginseng: a potential interaction resulting in liver toxicity. Ann Pharmacother 2010;44:926-928.
  • Referans47 Gurley BJ, Gardner SF, Hubbard MA et al. Clinical assessment of effects of botanical supplementation on cytochrome P450 phenotypes in the elderly - St John's wort, garlic oil, Panax ginseng and Ginkgo biloba. Drug Aging 2005;22:525–539.
  • Referans48 Sompon W, Virapong P. Cytochrome P450 enzyme mediated herbal drug interactions (Part 1). EXCLI Journal 2014;13:347-391.
  • Referans49 Foster BC, Foster MS, Vandenhoek S et al. An in- vitro evaluation of human cytochrome P450 3A4 and P-glycoprotein inhibition by garlic. J Pharm Pharm Sci 2001;4:176-184.
  • Referans50 Loizou GD1, Cocker J. The effects of alcohol and diallyl sulphide on CYP2E1 activity in humans: a phenotyping study using chlorzoxazone. Hum Exp Toxicol 2001;20:321-327.
  • Referans51 Hajda J1, Rentsch KM, Gubler C, Steinert H, Stieger B, Fattinger K. Garlic extract induces intestinal P-glycoprotein, but exhibits no effect on intestinal and hepatic CYP3A4 in humans. Eur J Pharm Sci 2010;41:729-735.
  • Referans52 Gorski JC, Huang SM, Pinto A et al. The effect of echinacea (Echinacea purpurea root) on cytochrome P450 activity in vivo. Clin Pharmacol Ther 2004;75:89-100. Referans53 Gurley BJ, Gardner SF, Hubbard MA et al. In vivo assessment of botanical supplementation on human cytochrome P450 phenotypes: Citrus aurantium, Echinacea pur-purea, milk thistle, and saw palmetto. Clin Pharmacol Ther 2004;76:428-440.
  • Referans54 Penzak SR, Robertson SM, Hunt JD et al. Echinacea purpurea significantly induces cytochrome P450 3A activity but does not alter lopinavir-ritonavir exposure in healthy subjects. Pharmacotherapy 2010;30:797-805.
  • Referans55 Kelber O, Nieber K, Kraft K. Valerian: no evidence for clinically relevant interactions. Evid Based Complement Alternat Med 2014;2014:879396. doi: 10.1155/2014/879396.

Bitkisel Ürünlerle Tedavilerde İlaç Etkileşmeleri

Yıl 2017, Cilt: 31 Sayı: 1, 41 - 50, 26.05.2017

Öz

Bitkisel ürünler
hipertansiyon, diyabet, hiperlipidemi ve kanser gibi birçok kronik hastalığın önlenmesi
ve tedavisinde kullanılmaktadır. Bitkisel ürünlerin doğal kaynaklı olması
güvenli oldukları anlamına gelmemektedir. Bitkisel ürünlerin ilaçlarla birlikte
kullanımı ciddi bitkisel ürün-ilaç etkileşimlerine yol açabilmektedir.
İlaçlarla etkileştiği rapor edilen bitkiler St. John’s wort (Hypericum perforatum), Ginkgo (Ginkgo biloba), Ginseng (Panax ginseng), Ginger (Zingiber officinale), Garlic (Allium sativum), Echinasea ve
Valerian’dır. Bu çalışmada sık kullanılan bitkisel ürünlerle, farmakokinetik ve
farmakodinamik ilaç etkileşimleri derlenmiştir. Bitkisel ürün kullanımı
sitokrom P450 enzimleri (CYP450) ve P-glikoproteinleri (P-gp) inhibisyonu veya
indüksiyonu ile ilaçların emilim, dağılım, metabolizma ve atılımlarını
değiştirebilir. Farmakokinetik etkileşmeler, ilacın farmakolojik etkisinde
azalma ve artmaya yol açabilir. Ayrıca ilaca bağlı yan etki ve toksik etki
görülebilir. Bitkisel ürünler ve ilaçlar arasındaki farmakodinamik etkileşmeler
ilaç etkisini artıracak aditif ve sinerjistik etkileşimler veya ilaç etkisini
azaltacak antagonistik etkileşimler olabilir. Bitkisel ürünlerle etkileşimi
tanımlanan ilaçlar antikoagülanlar, antitrombotikler, kardiyovasküler ilaçlar,
immunosüpresanlar, sedatifler, antidepresanlar, statinler, antikanser ilaçlar ve
anti-HIV ilaçlardır. Bitkisel ürün-ilaç etkileşmeleri özellikle terapötik
indeksi dar olan ilaçlarda daha önemlidir. Hekimler hastalarına ilaç reçete
ederken bitkisel ürün kullanımını sorgulamalıdır. Etkililiği ve güvenliliği
klinik kontrollü araştırmalarla kanıtlanmamış bitkisel ürünler önerilmemelidir.




Kaynakça

  • Referans1 Bent S. Herbal Medicine in the United States: Review of Efficacy, Safety, and Regulation. J Gen Intern Med 2008;23:854–859.
  • Referans2 Türk Tabipler Birliği Merkez Konseyi. Bitkisel ürünler ve sağlık. Bilimsel çerçeve ve etik açısından yaklaşım. 2012;1-35.
  • Referans3 Tilburt JC, Kaptchuk TJJ. Herbal medicine research and global health: An ethical analysis. Bull World Health Organ 2008;86:594–599.
  • Referans4 Stasio MJ, Curry K, Sutton-Skinner KM, Glassman DM. Over -the-Counter Medication and Herbal or Dietary Supplement Use in College: Dose Frequency and Relationship to Self-Reported Distress. J Am Coll Health 2008;56:535-547.
  • Referans5 Tulunay M, Aypak C, Yikilkan H, Gorpelioglu S. Herbal medicine use among patients with chronic diseases. J Intercult Ethnopharmacol 2015;4:217-220.
  • Referans6 Kucukoner M, Bilge Z, Isıkdogan A, Kaplan MA, Inal A, Urakci Z. Complementary and alternative medicine usage in cancer patients in southeast of Turkey. Afr J Tradit Complement Altern Med 2013;10:21-25.
  • Referans7 Merrily A. Kuhn RN. Herbal Remedies: Drug-Herb Interactions. Critical Care Nurse 2002;22:22-35.
  • Referans8 Dulger G. Herbal drugs and drug interactions. Marmara Pharmaceutical Journal 2012;16:9-22.
  • Referans9 Karadağ MG, Türközü D, Kapucu DT. Bitkiler ve ilaç etkileşimleri. Göztepe Tıp Dergisi 2013;8:164-170.
  • Referans10 Krivoy N, Pavlotzky E, Chrubasik S, Eisenberg E, Brook G. Effect of salicis cortex extract on human platelet aggregation. Planta Med 2001;67:209-12.
  • Referans11 Zhou S, Gao Y, Jiang W, Huang M, Xu A, Paxton JW. Interactions of herbs with cytochrome P450. Drug Metab Rev 2003;35:35-98.
  • Referans12 Zhou S, Lim LY, Chowbay B. Herbal modulation of Pglycoprotein. Drug Metab Rev 2004;36:57-104.
  • Referans13 Tarirai C, Viljoen AM, Hamman JH. Herb-drug pharmacokinetic interactions reviewed. Expert Opin Drug Metab Toxicol 2010;6:1515-1538.
  • Referans14 Tirona RG, Bailey DG. Herbal product-drug interactions mediated by induction. Br J Clin Pharmacol 2006;61:677-681.
  • Referans15 Di YM, Li CG, Xue CC, Zhou SF. Clinical drugs that interact with St. John's wort and implication in drug development. Curr Pharm Des 2008;14:1723-1742.
  • Referans16 Chen Y, Ferguson SS, Negishi M, Goldstein JA. Induction of human CYP2C9 by rifampicin, hyperforin, and phenobarbital is mediated by the pregnane X receptor. J Pharmacol Exp Ther 2004;308:495–501.
  • Referans17 Moore LB, Goodwin B, Jones SA et al. St. John’s wort induces hepatic drug metabolism through activation of the pregnane X receptor. Proc Natl Acad Sci USA 2000;97:7500-7502.
  • Referans18 POISINDEX®System: Klasco RK (Ed): POISINDEX® System. Truven Health Analytics, Greenwood Village, Colorado (Vol. 167 expires 3/2016).
  • Referans19 Dannawi M. Possible serotonin syndrome after combination of buspirone and St John's Wort. J Psychopharmacol 2002;16:401.
  • Referans20 Borrelli F, Izzo AA. Herb-drug interactions with St John's wort (Hypericum perforatum):an update on clinical observations. AAPS J 2009;11:710-727.
  • Referans21 Saw JT, Bahari MB, Ang HH, Lim YH. Potential drug-herb interaction with antiplatelet/anticoagulant drugs. Complement Ther Clin Pract 2006;12:236-241.
  • Referans22 Matthews MK. Association of Ginkgo biloba with intracerebral hemorrhage. Neurology 1998; 50:1933-1934.
  • Referans23 Wang LS, Zhu B, Abd El-Aty AM et al.The influence of St John’s Wort on CYP2C19 activity with respect to genotype. J Clin Pharmacol. 2004;44:577–581.
  • Referans24 Markowitz JS, Donovan JL, DeVane CL et al. Effect of St John’s Wort on drug metabolism by induction of cytochrome P450 3A4 enzyme. JAMA 2003;290:1500–1504.
  • Referans25 Dresser GK, Schwarz UI, Wilkinson GR, Kim RB. Coordinate induction of both cytochrome P4503A and MDR1 by St John’s wort in healthy subjects. Clin Pharmacol Ther 2003;73:41–50.
  • Referans26 Johne A, Schmider J, Brockmöller J et al. Decreased plasma levels of amitriptyline and its metabolites on comedication with an extract from St. John’s wort (Hypericum perforatum). J Clin Psychopharmacol 2002;22:46–54.
  • Referans27 Xu H, Williams KM, Liauw WS, Murray M, Day RO, McLachlan AJ. Effects of St John’s wort and CYP2C9 genotype on the pharmacokinetics and pharmacodynamics of gliclazide.Br J Pharmacol 2008;153:1579–1586.
  • Referans28 Jiang X, Williams KM, Liauw WS et al. Effect of St John’s wort and ginseng on the pharmacokinetics and pharmacodynamics of warfarin in healthy subjects. Br J Clin Pharmacol 2004;57:592–599.
  • Referans29 Johne A, Brockmöller J, Bauer S, Maurer A, Langheinrich M, Roots I. Pharmacokinetic interaction of digoxin with an herbal extract from St John’s wort (Hypericum perforatum). Clin Pharmacol Ther 1999;66:338–645.
  • Referans30 Portolés A, Terleira A, Calvo A, Martínez I, Resplandy G. Effects of Hypericum perforatum on ivabradine pharmacokinetics in in healthy volunteers: an open-label,pharmacokinetic interaction clinical trial. J Clin Pharmacol 2006;46:1188-1194.
  • Referans31 Tannergren C, Engman H, Knutson L, Hedeland M, Bondesson U, Lennernäs H. St John’s wort decreases the bioavailability of R- and S-verapamil through induction of the first-pass metabolism. Clin Pharmacol Ther 2004;75:298–309.
  • Referans32 Sugimoto K, Ohmori M, Tsuruoka S et al. Different effects of St John’s wort on the pharmacokinetics of simvastatin and pravastatin. Clin Pharmacol Ther 2001;70:518–524.
  • Referans33 Hebert MF, Park JM, Chen YL, Akhtar S, Larson AM. Effects of St. John’s wort (Hypericum perforatum) on tacrolimus pharmacokinetics in healthy volunteers. J Clin Pharmacol 2004;44:89–94.
  • Referans34 Frye RF, Fitzgerald SM, Lagattuta TF, Hruska MW, Egorin MJ. Effect of St John’s wort on imatinib mesylate pharmacokinetics. Clin Pharmacol Ther 2004;76:323–329.
  • Referans35 Piscitelli SC, Burstein AH, Chaitt D, Alfaro RM, Falloon J. Indinavir concentrations and St John’s wort. Lancet 2000;355:547–548.
  • Referans36 Janetzky K, Morreale AP. Probable interactions between warfarin and ginseng. Am J Health Syst Pharm 1997;54:692–693.
  • Referans37 Yuan CS, Wei G, Dey L et al. Brief communication: American ginseng reduces varfarin's effect in healthy patients: A randomized, controlled trial. Ann Int Med 2004;141:23–27.
  • Referans38 Lesho EP, Saullo L, Udvari-Nagy S. 76-year-old woman with erratic anticoagulation. Cleve Clin J Med 2004;71:651-6.
  • Referans39 Kim YS, Pyo MK, Park KM et al. Antiplatelet and antithrombotic effects of a combination of ticlopidine and ginkgo biloba ext (EGb 761). Thromb Res 1998;91:33-38.
  • Referans40 Hellum BH, Hu Z, Nilsen OG. The induction of CYP1A2,CYP2D6 and CYP3A4 by six trade herbal products in cultured primary human hepatocytes. Basic Clin Pharmacol Toxicol 2007;100:23-30.
  • Referans41 Hellum BH, Hu Z, Nilsen OG. Trade herbal products and induction of CYP2C19 and CYP2E1 in cultured human hepatocytes. Basic Clin Pharmacol Toxicol 2009;105:58-63.
  • Referans42 Kupiec T, Raj V. Fatal seizures due to potential herb-drug interactions with Ginkgo biloba. J Anal Toxicol 2005;29:755-788.
  • Referans43 Mauro VF, Mauro LS, Kleshinski JF, Khuder SA, Wang Y, Erhardt PW. Impact of Ginkgo biloba on the pharmacokinetics of digoxin. Am J Ther 2003;10:247–251.
  • Referans44 Qi LW1, Wang CZ, Du GJ, Zhang ZY, Calway T, Yuan CS. Metabolism of ginseng and its interactions with drugs. Curr Drug Metab 2011;12:818-822.
  • Referans45 Liu Y, Zhang JW, Li W et al. Ginsenoside metabolites, rather than naturally occurring ginsenosides, lead to inhibition of human cytochrome P450 enzymes. Toxicol Sci 2006;91:356–364.
  • Referans46 Bilgi N, Bell K, Ananthakrishnan AN, Atallah E. Imatinib and Panax ginseng: a potential interaction resulting in liver toxicity. Ann Pharmacother 2010;44:926-928.
  • Referans47 Gurley BJ, Gardner SF, Hubbard MA et al. Clinical assessment of effects of botanical supplementation on cytochrome P450 phenotypes in the elderly - St John's wort, garlic oil, Panax ginseng and Ginkgo biloba. Drug Aging 2005;22:525–539.
  • Referans48 Sompon W, Virapong P. Cytochrome P450 enzyme mediated herbal drug interactions (Part 1). EXCLI Journal 2014;13:347-391.
  • Referans49 Foster BC, Foster MS, Vandenhoek S et al. An in- vitro evaluation of human cytochrome P450 3A4 and P-glycoprotein inhibition by garlic. J Pharm Pharm Sci 2001;4:176-184.
  • Referans50 Loizou GD1, Cocker J. The effects of alcohol and diallyl sulphide on CYP2E1 activity in humans: a phenotyping study using chlorzoxazone. Hum Exp Toxicol 2001;20:321-327.
  • Referans51 Hajda J1, Rentsch KM, Gubler C, Steinert H, Stieger B, Fattinger K. Garlic extract induces intestinal P-glycoprotein, but exhibits no effect on intestinal and hepatic CYP3A4 in humans. Eur J Pharm Sci 2010;41:729-735.
  • Referans52 Gorski JC, Huang SM, Pinto A et al. The effect of echinacea (Echinacea purpurea root) on cytochrome P450 activity in vivo. Clin Pharmacol Ther 2004;75:89-100. Referans53 Gurley BJ, Gardner SF, Hubbard MA et al. In vivo assessment of botanical supplementation on human cytochrome P450 phenotypes: Citrus aurantium, Echinacea pur-purea, milk thistle, and saw palmetto. Clin Pharmacol Ther 2004;76:428-440.
  • Referans54 Penzak SR, Robertson SM, Hunt JD et al. Echinacea purpurea significantly induces cytochrome P450 3A activity but does not alter lopinavir-ritonavir exposure in healthy subjects. Pharmacotherapy 2010;30:797-805.
  • Referans55 Kelber O, Nieber K, Kraft K. Valerian: no evidence for clinically relevant interactions. Evid Based Complement Alternat Med 2014;2014:879396. doi: 10.1155/2014/879396.
Toplam 54 adet kaynakça vardır.

Ayrıntılar

Bölüm Makaleler
Yazarlar

Şule Kalkan

Yayımlanma Tarihi 26 Mayıs 2017
Gönderilme Tarihi 3 Ağustos 2016
Yayımlandığı Sayı Yıl 2017 Cilt: 31 Sayı: 1

Kaynak Göster

Vancouver Kalkan Ş. Bitkisel Ürünlerle Tedavilerde İlaç Etkileşmeleri. DEU Tıp Derg. 2017;31(1):41-50.