Abstract
Modern drugs are being more replaced by herbal medicines especially for chronic and severe diseases for their fewer side effects, better patient adherence, cost-effectiveness and vast availability. However, an unexpected herb-drug interaction (HDI) can amplify or block the action of drugs which is a detrimental issue to be considered. Some of HDIs may even be fatal. For example, concomitant administration of warfarin with Ginkgo biloba and Allium sativum leads to haemorrhage, precipitation of mania in depression patients consuming antidepressants and Panax ginseng together, induction of hypertension on concurrent administration of tricyclic antidepressants with Pausinystalia yohimbe and therapeutic failure of phenytoin on simultaneous administration with shankhapushpi. Our current knowledge on HDI is limited because of the poor reporting by patients and the failure on part of practitioner to recognise HDIs. Also reports on HDIs are vague since these herbs contain many phytoconstituents and hence difficult to interpret. HDI may be of pharmacokinetic or pharmacodynamics in nature. Pharmacokinetic interactions occur mainly by inhibiting or inducing drug-metabolising enzymes and transporters, which adversely affect absorption, distribution, metabolism and excretion of concurrently administered victim drugs. Pharmacodynamic HDIs such as synergism, additive, agonist and antagonist effect are also known to occur. This chapter provides an insight into the significance of pharmacokinetic and pharmacodynamic interactions that occur on concomitant administration of herbs and conventional drugs.
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Abbreviations
- ATP:
-
Adenosine triphosphate
- BCRP:
-
Breast cancer resistance protein
- CYP:
-
Cytochrome
- HDIs:
-
Herb-drug interactions
- MRP:
-
Multidrug resistance-associated protein
- OATP:
-
Organic anion-transporting polypeptides
- OCT:
-
Organic cation transporters
- P-gp:
-
P-glycoprotein
- SLC:
-
Solute carrier transporters
- UGT:
-
Uridine diphospho-glucuronosyltransferase
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Vimalavathini, R., Shri Hari Subhashri, R., Kavimani, S. (2021). Herb-Drug Interactions. In: Mandal, S.C., Chakraborty, R., Sen, S. (eds) Evidence Based Validation of Traditional Medicines. Springer, Singapore. https://doi.org/10.1007/978-981-15-8127-4_31
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