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Pharmacokinetic Herb-Drug Interactions: Insight into Mechanisms and Consequences

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Abstract

Herbal medicines are currently in high demand, and their popularity is steadily increasing. Because of their perceived effectiveness, fewer side effects and relatively low cost, they are being used for the management of numerous medical conditions. However, they are capable of affecting the pharmacokinetics and pharmacodynamics of coadministered conventional drugs. These interactions are particularly of clinically relevance when metabolizing enzymes and xenobiotic transporters, which are responsible for the fate of many drugs, are induced or inhibited, sometimes resulting in unexpected outcomes. This article discusses the general use of herbal medicines in the management of several ailments, their concurrent use with conventional therapy, mechanisms underlying herb-drug interactions (HDIs) as well as the drawbacks of herbal remedy use. The authors also suggest means of surveillance and safety monitoring of herbal medicines. Contrary to popular belief that “herbal medicines are totally safe,” we are of the view that they are capable of causing significant toxic effects and altered pharmaceutical outcomes when coadministered with conventional medicines. Due to the paucity of information as well as sometimes conflicting reports on HDIs, much more research in this field is needed. The authors further suggest the need to standardize and better regulate herbal medicines in order to ensure their safety and efficacy when used alone or in combination with conventional drugs.

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Authors and Affiliations

  1. School of Pharmacy and Biomedical Sciences, University of Central Lancashire, Preston, Lancashire, PR1 2HE, UK

    Enoche F. Oga

  2. Department of Biopharmaceutics, Chiba University, Chiba, Japan

    Shuichi Sekine

  3. Pharmacokinetics Laboratory, Meiji Seika Pharma Co., Ltd, Yokohama, Japan

    Yoshihisa Shitara

  4. Department of Biopharmaceutics and Molecular Toxicology, Teikyo Heisei University, Tokyo, Japan

    Toshiharu Horie

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  1. Enoche F. Oga
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  2. Shuichi Sekine
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  3. Yoshihisa Shitara
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  4. Toshiharu Horie
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Correspondence to Enoche F. Oga.

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Oga, E.F., Sekine, S., Shitara, Y. et al. Pharmacokinetic Herb-Drug Interactions: Insight into Mechanisms and Consequences. Eur J Drug Metab Pharmacokinet 41, 93–108 (2016). https://doi.org/10.1007/s13318-015-0296-z

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