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Bernardo J, Valentão P. Herb-drug interactions: A short review on central and peripheral nervous system drugs. Phytother Res 2024; 38:1903-1931. [PMID: 38358734 DOI: 10.1002/ptr.8120] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/18/2023] [Revised: 11/24/2023] [Accepted: 12/27/2023] [Indexed: 02/16/2024]
Abstract
Herbal medicines are widely perceived as natural and safe remedies. However, their concomitant use with prescribed drugs is a common practice, often undertaken without full awareness of the potential risks and frequently without medical supervision. This practice introduces a tangible risk of herb-drug interactions, which can manifest as a spectrum of consequences, ranging from acute, self-limited reactions to unpredictable and potentially lethal scenarios. This review offers a comprehensive overview of herb-drug interactions, with a specific focus on medications targeting the Central and Peripheral Nervous Systems. Our work draws upon a broad range of evidence, encompassing preclinical data, animal studies, and clinical case reports. We delve into the intricate pharmacodynamics and pharmacokinetics underpinning each interaction, elucidating the mechanisms through which these interactions occur. One pressing issue that emerges from this analysis is the need for updated guidelines and sustained pharmacovigilance efforts. The topic of herb-drug interactions often escapes the attention of both consumers and healthcare professionals. To ensure patient safety and informed decision-making, it is imperative that we address this knowledge gap and establish a framework for continued monitoring and education. In conclusion, the use of herbal remedies alongside conventional medications is a practice replete with potential hazards. This review not only underscores the real and significant risks associated with herb-drug interactions but also underscores the necessity for greater awareness, research, and vigilant oversight in this often-overlooked domain of healthcare.
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Affiliation(s)
- João Bernardo
- REQUIMTE/LAQV, Laboratório de Farmacognosia, Departamento de Química, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
| | - Patrícia Valentão
- REQUIMTE/LAQV, Laboratório de Farmacognosia, Departamento de Química, Faculdade de Farmácia, Universidade do Porto, Porto, Portugal
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Zulim Leite AR, Reitz Cardoso FA, Correia Gardenal A, de Mello JCP, Medeiros Marques LL, Ferreira Geraldo Perdoncini MR. Control of fungal spoilage in strawberries using crude plant extracts against the fungus Botrytis cinerea. Nat Prod Res 2023; 37:3122-3135. [PMID: 36342829 DOI: 10.1080/14786419.2022.2142220] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/09/2022] [Revised: 10/21/2022] [Accepted: 10/24/2022] [Indexed: 11/09/2022]
Abstract
The study evaluated the conservation of strawberries treated with crude plant extracts (barbatimão, sibipiruna, guarana, and catuaba) against fungal deterioration and physicochemical characteristics. MIC of 0.125; 0.0156; 0.25 and 0.0312 g/mL were found for barbatimão, sibipiruna, guaraná and catuaba, respectively, against B. cinerea. Treated samples showed no fungal deterioration during 11 days. Analyzes of weight loss, soluble solids, titratable acidity, and pH variation were performed. Sibipiruna showed lower values of mass loss, and the greatest occurred for the catuaba extract. Barbatimão did not change soluble solids and stood out with catuaba in the color parameters L and a*. Small changes in pH were observed with time. Soluble solids maintained values between 6.47 oBrix and 9.90 oBrix for catuaba and sibipiruna extracts at zero and six days. Principal component analysis did not show a strong correlation between the variables. The extracts become alternatives for strawberry conservation, increasing conservation and maintaining physicochemical characteristics.
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Affiliation(s)
- Ana Rita Zulim Leite
- Department of Food Engineering and Chemical Engineering, Federal University of Technology (UTFPR)- Paraná, Curitiba, Brazil
| | - Flávia Aparecida Reitz Cardoso
- Post-Graduation Program in Technological Innovations (PPGIT), Federal University of Technology (UTFPR)- Paraná, Curitiba, Brazil
| | - Amanda Correia Gardenal
- Department of Food Engineering and Chemical Engineering, Federal University of Technology (UTFPR)- Paraná, Curitiba, Brazil
| | - João Carlos Palazzo de Mello
- Laboratory of Pharmaceutical Biology, Palafito, Department of Pharmacy, State University of Maringá - UEM, Maringá, Brazil
| | - Leila Larisa Medeiros Marques
- Department of Food Engineering and Chemical Engineering, Federal University of Technology (UTFPR)- Paraná, Curitiba, Brazil
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Anti-Inflammatory and Neuroprotective Effects of Morin in an MPTP-Induced Parkinson’s Disease Model. Int J Mol Sci 2022; 23:ijms231810578. [PMID: 36142491 PMCID: PMC9501291 DOI: 10.3390/ijms231810578] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2022] [Revised: 09/08/2022] [Accepted: 09/08/2022] [Indexed: 11/20/2022] Open
Abstract
Neurodegenerative diseases such as Parkinson’s disease (PD) are known to be related to oxidative stress and neuroinflammation, and thus, modulating neuroinflammation offers a possible means of treating PD-associated pathologies. Morin (2′,3,4′,5,7-pentahydroxy flavone) is a flavonol with anti-oxidative and anti-inflammatory effects found in wines, herbs, and fruits. The present study was undertaken to determine whether a morin-containing diet has protective effects in an MPTP-induced mouse model of PD. Mice were fed a control or morin diet for 34 days, and then MPTP (30 mg/kg, i.p.) was administered daily for 5 days to induce a PD-like pathology. We found that dietary morin prevented MPTP-induced motor dysfunction and ameliorated dopaminergic neuronal damage in striatum (STR) and substantia nigra (SN) in our mouse model. Furthermore, MPTP-induced neuroinflammation was significantly reduced in mice fed morin. In vitro studies showed that morin effectively suppressed glial activations in primary microglia and astrocytes, and biochemical analysis and a docking simulation indicated that the anti-inflammatory effects of morin were mediated by blocking the extracellular signal-regulated kinase (ERK)-p65 pathway. These findings suggest that morin effectively inhibits glial activations and has potential use as a functional food ingredient with therapeutic potential for the treatment of PD and other neurodegenerative diseases associated with neuroinflammation.
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Torres EAFS, Pinaffi-Langley ACDC, Figueira MDS, Cordeiro KS, Negrão LD, Soares MJ, da Silva CP, Alfino MCZ, Sampaio GR, de Camargo AC. Effects of the consumption of guarana on human health: A narrative review. Compr Rev Food Sci Food Saf 2021; 21:272-295. [PMID: 34755935 DOI: 10.1111/1541-4337.12862] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2021] [Revised: 09/22/2021] [Accepted: 09/23/2021] [Indexed: 12/29/2022]
Abstract
Guarana (Paullinia cupana) is a plant from the Amazon region with cultural importance. Despite its early ancestral use by indigenous tribes, the first reports regarding the benefits of guarana consumption for human health were published in the 19th century. Since then, the use of guarana seed in powder and extract forms has been studied for its diverse effects on human health, such as stimulating, anti-inflammatory, antioxidant, anticancer, hypocholesterolemic, and anti-obesity effects. These effects are attributed to the high content of bioactive compounds found in guarana seeds, especially methylxanthines and flavonoids. In fact, the Brazilian Food Supplement Law has officially acknowledged guarana as a source of bioactive compounds. The number and diversity of studies focused on guarana and human health are increasing; thus, organizing and describing the available evidence on guarana and its applications is necessary to provide a framework for future studies. In this narrative review, we have organized the available information regarding guarana and its potential effects on human health. Guarana produces unique fruits with great potential for human health applications. However, the available evidence lacks human studies and mechanistic investigations. Future studies should be designed considering its applicability to human health, including intake levels and toxicity studies.
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Affiliation(s)
- Elizabeth A F S Torres
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | | | | | - Karina Silva Cordeiro
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Leonardo Dias Negrão
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Maiara Jurema Soares
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Cintia Pereira da Silva
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | | | - Geni Rodrigues Sampaio
- Department of Nutrition, School of Public Health, University of Sao Paulo, Sao Paulo, Brazil
| | - Adriano Costa de Camargo
- Laboratory of Antioxidants, Nutrition and Food Technology Institute, University of Chile, Santiago, Chile
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Asad M, Asdaq SMB, Mohzari Y, Alrashed A, Alajami HN, Aljohani AO, Mushtawi AAA, Alajmi AN, Alajmi HN, Imran M, Orfali R. Pharmacokinetic and pharmacodynamic interaction of Rosuvastatin calcium with guggulipid extract in rats. Saudi J Biol Sci 2021; 28:3490-3496. [PMID: 34121889 PMCID: PMC8176130 DOI: 10.1016/j.sjbs.2021.03.015] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/03/2021] [Revised: 03/03/2021] [Accepted: 03/03/2021] [Indexed: 01/17/2023] Open
Abstract
Background & objectives Rosuvastatin calcium (RC) is a potent and competitive synthetic inhibitor of HMG-CoA reductase used for the treatment of dyslipidemia. Guggulipid obtained from Commiphora mukul is used in the treatment of a wide variety of diseases such as atherosclerosis, hypercholesterolemia, rheumatism, and obesity. The present study evaluates the pharmacokinetic and pharmacodynamic interactions between RC and the standardized guggulipid extract in rats. Materials and methods The guggulipid extract was standardized for the presence of guggulsterones. The pharmacokinetic interaction was determined after a single dose administration of RC alone or in combination with the guggulipid extract or after multiple-dose administration of RC alone or RC along with the guggulipid extract for 14 days. To determine the pharmacodynamic interaction, RC and guggulipid extract were administered to hyperlipidemic rats for 14 days. The level of significance was determined using unpaired student’s t-test, one way ANOVA, the post-ANOVA Tukey test. Results Standardization of guggulipid extract showed it contains 7.5%w/w of guggulsterones. Guggulipid extract increased the bioavailability of RC in both single-dose and multiple-dose studies. Guggulipid extract reduced the rate of absorption (Ka) of RC but showed an increase in maximum serum concentration (Cmax). An in-vitro study using isolated rat intestine revealed that guggulipid extract decreased the rate of absorption of RC in the intestinal lumen. The hypolipidemic activity of RC was augmented by the guggulipid extract in hyperlipidemic rats. Interpretation & conclusion Therefore it is concluded that guggulipid extract increases the bioavailability of RC by delaying its Ka and augments its hypolipidemic action. However, it is recommended that a combination of RC with guggulipid extract should be used only after an adverse effect(s) of this combination are determined.
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Affiliation(s)
- Mohammed Asad
- Department of Clinical Laboratory Science, College of Applied Medical Sciences, Shaqra University, Shaqra 11911, Saudi Arabia
| | | | - Yahya Mohzari
- Clinical Pharmacy Department, King Saud Medical City, Riyadh 12746, Saudi Arabia
| | - Ahmed Alrashed
- Pharmaceutical Services Administration, Inpatient Department, Main Hospital, KFMC, Riyadh 11564, Saudi Arabia
| | - Hamdan Najib Alajami
- Pharmaceutical Services Administration, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia
| | - Awad Othman Aljohani
- Pharmaceutical Services Administration, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia
| | - Abdullah Ali Al Mushtawi
- Pharmaceutical Services Administration, King Saud Medical City, Ministry of Health, Riyadh, Saudi Arabia
| | - Assil Najib Alajmi
- Pharmaceutical Services Administration, Health Oasis Hospital, Riyadh, Saudi Arabia
| | - Hanan Nageeb Alajmi
- Pharmaceutical Services Administration, Health Oasis Hospital, Riyadh, Saudi Arabia
| | - Mohd Imran
- Department of Pharmaceutical Chemistry, Faculty of Pharmacy, Northern Border University, P.O. BOX 840, Rafha 91911, Saudi Arabia
| | - Raha Orfali
- Department of Pharmacognosy, Collage of Pharmacy, King Saud university, P.O.Box 22452, Riyadh 11495, Saudi Arabia
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Ventura S, Rodrigues M, Falcão A, Alves G. Safety evidence on the administration of Fucus vesiculosus L. (bladderwrack) extract and lamotrigine: data from pharmacokinetic studies in the rat. Drug Chem Toxicol 2020; 43:560-566. [PMID: 30332899 DOI: 10.1080/01480545.2018.1518454] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/14/2018] [Revised: 08/12/2018] [Accepted: 08/27/2018] [Indexed: 02/09/2023]
Abstract
Fucus vesiculosus is often incorporated in weight loss dietary supplements to improve weight loss in overweight adults. Obesity is a common condition in epilepsy patients and is indeed increasing in refractory epilepsy and in patients under polytherapy. Since lamotrigine (LTG) is a first-line antiepileptic drug, used in monotherapy or adjunctive therapy, the main objective of this work was to investigate the potential pharmacokinetic-based interactions between F. vesiculosus and LTG in rats. In a first pharmacokinetic study, a single oral dose of F. vesiculosus extract (575 mg/kg, p.o.) was co-administered with a single-dose of LTG (10 mg/kg, p.o.). In a second study, rats were orally pretreated with F. vesiculosus extract (575 mg/kg/day, p.o.) for 14 days and received LTG (10 mg/kg, p.o.) on the 15th day. In the control groups, rats received water instead of the extract. After LTG administration, blood samples were taken until 96 h post-dose, and LTG concentrations measured in plasma were submitted to a non-compartmental pharmacokinetic analysis. The co-administration of F. vesiculosus extract and LTG caused no significant changes in the drug kinetics. However, the repeated pretreatment with F. vesiculosus extract significantly reduced the peak concentrations of LTG and caused a slightly decrease in the extent of systemic drug exposure. Overall, based on these results, no significant clinical impact is expected from the administration of F. vesiculosus dietary supplements and LTG.
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Affiliation(s)
- Sandra Ventura
- CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
- UDI-IPG - Research Unit for Inland Development, Polytechnic Institute of Guarda, Guarda, Portugal
| | - Márcio Rodrigues
- CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
- UDI-IPG - Research Unit for Inland Development, Polytechnic Institute of Guarda, Guarda, Portugal
| | - Amílcar Falcão
- CIBIT - Coimbra Institute for Biomedical Imaging and Translational Research, University of Coimbra, Coimbra, Portugal
- Laboratory of Pharmacology, Faculty of Pharmacy, University of Coimbra, Coimbra, Portugal
| | - Gilberto Alves
- CICS-UBI - Health Sciences Research Centre, University of Beira Interior, Covilhã, Portugal
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Patrick M, Kim HA, Oketch-Rabah H, Marles RJ, Roe AL, Calderón AI. Safety of Guarana Seed as a Dietary Ingredient: A Review. JOURNAL OF AGRICULTURAL AND FOOD CHEMISTRY 2019; 67:11281-11287. [PMID: 31539257 DOI: 10.1021/acs.jafc.9b03781] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/27/2023]
Abstract
The seeds of the guarana plant (Paullinia cupana Kunth, family Sapindaceae) are well-known to many cultures as a stimulant, aphrodisiac, and astringent. Its rhizome was traditionally boiled into a tea by Amazonian cultures. Today, guarana seeds are ground to a fine powder and sold as powder, tablets, and capsules. This review focuses on the traditional uses, phytochemistry, and biological activities of the guarana seed to evaluate its safety as a dietary ingredient. A comprehensive review of published literature was conducted to identify articles that focused on the phytochemistry, pharmacology, and safety of guarana. On the basis of this review, guarana is not currently known to be associated causally with any serious health risks when consumed properly. Overall, guarana is generally recognized as safe as a dietary ingredient marketed for its flavor and caffeine content. If guidelines for caffeine intake are respected, guarana consumption is not likely to be associated with any serious health risks.
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Affiliation(s)
| | | | - Hellen Oketch-Rabah
- United States Pharmacopeial Convention , Rockville , Maryland 20852 , United States
| | - Robin J Marles
- United States Pharmacopeia Botanical Dietary Supplements and Herbal Medicines Expert Committee , Rockville , Maryland 20852 , United States
| | - Amy L Roe
- United States Pharmacopeia Botanical Dietary Supplements and Herbal Medicines Expert Committee , Rockville , Maryland 20852 , United States
- The Procter & Gamble Company , Cincinnati , Ohio 45040 , United States
| | - Angela I Calderón
- United States Pharmacopeia Botanical Dietary Supplements and Herbal Medicines Expert Committee , Rockville , Maryland 20852 , United States
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Ventura S, Rodrigues M, Falcão A, Alves G. Short-term effects of Garcinia cambogia extract on the pharmacokinetics of lamotrigine given as a single-dose in Wistar rats. Food Chem Toxicol 2019; 128:61-67. [DOI: 10.1016/j.fct.2019.03.051] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2018] [Revised: 03/25/2019] [Accepted: 03/27/2019] [Indexed: 01/18/2023]
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Spanakis M, Sfakianakis S, Sakkalis V, Spanakis EG. PharmActa: Empowering Patients to Avoid Clinical Significant Drug⁻Herb Interactions. MEDICINES (BASEL, SWITZERLAND) 2019; 6:E26. [PMID: 30781500 PMCID: PMC6473432 DOI: 10.3390/medicines6010026] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2019] [Revised: 02/15/2019] [Accepted: 02/15/2019] [Indexed: 12/27/2022]
Abstract
Herbal medicinal products (HMPs) are the subject of increasing interest regarding their benefits for health. However, a serious concern is the potential appearance of clinically significant drug⁻herb interactions in patients. This work provides an overview of drug⁻herb interactions and an evaluation of their clinical significance. We discuss how personalized health services and mobile health applications can utilize tools that provide essential information to patients to avoid drug⁻HMP interactions. There is a specific mention to PharmActa, a dedicated mobile app for personalized pharmaceutical care with information regarding drug⁻HMPs interactions. Several studies over the years have shown that for some HMPs, the potential to present clinically significant interactions is evident, especially for many of the top selling HMPs. Towards that, PharmActa presents how we can improve the way that information regarding potential drug⁻herb interactions can be disseminated to the public. The utilization of technologies focusing on medical information and context awareness introduce a new era in healthcare. The exploitation of eHealth tools and pervasive mobile monitoring technologies in the case of HMPs will allow the citizens to be informed and avoid potential drug⁻HMPs interactions enhancing the effectiveness and ensuring safety for HMPs.
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Affiliation(s)
- Marios Spanakis
- Computational Biomedicine Laboratory, Institute of Computer Science, Foundation for Research and Technology-Hellas, Heraklion, GR-70013 Crete, Greece.
| | - Stelios Sfakianakis
- Computational Biomedicine Laboratory, Institute of Computer Science, Foundation for Research and Technology-Hellas, Heraklion, GR-70013 Crete, Greece.
| | - Vangelis Sakkalis
- Computational Biomedicine Laboratory, Institute of Computer Science, Foundation for Research and Technology-Hellas, Heraklion, GR-70013 Crete, Greece.
| | - Emmanouil G Spanakis
- Computational Biomedicine Laboratory, Institute of Computer Science, Foundation for Research and Technology-Hellas, Heraklion, GR-70013 Crete, Greece.
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Evaluation of the effects of Citrus aurantium (bitter orange) extract on lamotrigine pharmacokinetics: Insights from in vivo studies in rats. Food Chem Toxicol 2018; 121:166-172. [DOI: 10.1016/j.fct.2018.08.069] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/23/2018] [Revised: 08/27/2018] [Accepted: 08/29/2018] [Indexed: 12/11/2022]
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Santana ÁL, Macedo GA. Health and technological aspects of methylxanthines and polyphenols from guarana: A review. J Funct Foods 2018. [DOI: 10.1016/j.jff.2018.05.048] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022] Open
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Bessada SM, Alves RC, Oliveira MBP. Caffeine-based food supplements and beverages: Trends of consumption for performance purposes and safety concerns. Food Res Int 2018; 109:310-319. [DOI: 10.1016/j.foodres.2018.04.050] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2017] [Revised: 04/20/2018] [Accepted: 04/22/2018] [Indexed: 01/12/2023]
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