European Journal of Clinical Pharmacology

, Volume 68, Issue 2, pp 213–217

Repeated administration of berberine inhibits cytochromes P450 in humans

Authors

  • Ying Guo
    • Pharmacogenetics Research Institute, Institute of Clinical PharmacologyCentral South University, XiangYa School of Medicine
    • Department of Pharmacology, Toxicology and TherapeuticsUniversity of Kansas Medical Center
  • Yao Chen
    • Pharmacogenetics Research Institute, Institute of Clinical PharmacologyCentral South University, XiangYa School of Medicine
  • Zhi-rong Tan
    • Pharmacogenetics Research Institute, Institute of Clinical PharmacologyCentral South University, XiangYa School of Medicine
    • Department of Pharmacology, Toxicology and TherapeuticsUniversity of Kansas Medical Center
    • Pharmacogenetics Research Institute, Institute of Clinical PharmacologyCentral South University, XiangYa School of Medicine
Short Communication

DOI: 10.1007/s00228-011-1108-2

Cite this article as:
Guo, Y., Chen, Y., Tan, Z. et al. Eur J Clin Pharmacol (2012) 68: 213. doi:10.1007/s00228-011-1108-2

Abstract

Purpose

Berberine is a plant alkaloid that is widely used to treat gastrointestinal infections, diabetes, hypertension, and hypercholesterolemia. Many studies have reported interactions between berberine-containing products and cytochromes P450 (CYPs), but little is known about whether berberine alters CYP activities in humans, especially after repeated doses.

Methods

A two-phase randomized-crossover clinical study in healthy male subjects was performed. After 2 weeks of berberine (300 mg, t.i.d., p.o.) administration, midazolam, omeprazole, dextromethorphan, losartan, and caffeine were used to evaluate enzyme activities of CYP3A4, 2C19, 2D6, 2C9, and CYP1A2, respectively.

Results

A decrease in CYP2D6 activity was observed as the 0–8 h urinary dextromethorphan/dextrorphan increased ninefold (P < 0.01). In addition, losartan/E-3174 ratio doubled (P < 0.01) after BBR administration, indicating a decrease in CYP2C9 activity. CYP3A4 activity was also inhibited, as the Cmax, AUC0–∞, and AUC0–12 of midazolam were increased 38% (P < 0.05), 40% (P < 0.01), and 37% (P < 0.05) after BBR treatment, respectively. Compared with the placebo period, the Tmax and T1/2 of midazolam during BBR administration were prolonged from 3.03 ± 0.27 to 3.66 ± 0.37 h and 0.66 ± 0.08 to 0.99 ± 0.09 h, respectively; the oral clearance of midazolam was decreased 27% (P < 0.05); and the phenotypic indices of 1 h midazolam/1′-hydroxymidazolam increased 59% (P < 0.01). There were no statistically significant differences in the pharmacokinetic parameters of the other probe drugs between placebo and the BBR-treated group.

Conclusions

Repeated administration of berberine (300 mg, t.i.d., p.o.) decreased CYP2D6, 2C9, and CYP3A4 activities. Drug-drug interactions should be considered when berberine is administered.

Keywords

BerberineCYP2D6CYP2C9CYP3A4Humans

Copyright information

© Springer-Verlag 2011