1
|
Dibaei M, Hosseini A, Lavasani H, Kiani-Dehkordi B, Rouini M. Assessment of metabolic interaction between curcumin and tramadol using the isolated perfused rat liver. Heliyon 2024; 10:e35070. [PMID: 39170468 PMCID: PMC11336359 DOI: 10.1016/j.heliyon.2024.e35070] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/20/2024] [Revised: 07/20/2024] [Accepted: 07/22/2024] [Indexed: 08/23/2024] Open
Abstract
Introduction The presence of phytochemicals in herbal medicines can lead to herb-drug interactions, altering the levels of these compounds and conventional drugs in the bloodstream by influencing CYP450 activity. Considering curcumin's effect on the CYP enzymes responsible for tramadol metabolism, it is essential to assess the potential interaction between curcumin and tramadol when administered together. Materials and methods The pharmacokinetics of tramadol were examined in rats receiving either single or multiple doses of curcumin (80 mg/kg) compared to rats without curcumin treatment. Tramadol liver perfusion was conducted on all rat groups and perfusate samples were collected at specified intervals. Tramadol and its main metabolite were detected using an HPLC system coupled with a fluorescence detector. Results Tramadol concentrations were notably higher in the co-administered group compared to both the control and treatment groups. Conversely, lower concentrations of M1 were observed in the co-administered and treatment groups compared to the control group. The AUC0-60 parameters for tramadol were as follows: 32944.8 ± 1355.5, 22925.7 ± 1650.1, and 36548.0 ± 2808.4 ng⋅min/ml for the control, treatment, and co-administered groups, respectively. Both the co-administered and treatment groups exhibited a lower AUC0-60 of M1 compared to the control group. The lack of significant difference in Cmax and AUC0-60 of M1 between the treatment and co-administered groups suggests that single and multiple doses of curcumin have comparable effects on CYP2D6. Conclusions These results indicate a potential for drug interactions when curcumin and tramadol are taken together. Furthermore, the influence of curcumin on tramadol metabolism varied between single and multiple oral administrations of curcumin. Hence, it is vital to highlight this interaction in clinical settings and conduct additional research to fully understand the clinical implications of combining curcumin and tramadol.
Collapse
Affiliation(s)
- Maryam Dibaei
- Razi Drug Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Asieh Hosseini
- Razi Drug Research Center, Iran University of Medical Sciences, Tehran, Iran
| | - Hoda Lavasani
- Biopharmaceutics and Pharmacokinetic Division, Department of Pharmaceutics, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Banafsheh Kiani-Dehkordi
- Biopharmaceutics and Pharmacokinetic Division, Department of Pharmaceutics, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| | - Mohammadreza Rouini
- Biopharmaceutics and Pharmacokinetic Division, Department of Pharmaceutics, Faculty of Pharmacy, Tehran University of Medical Sciences, Tehran, Iran
| |
Collapse
|
2
|
Hazra S, Singh PA. Safety Aspects of Herb Interactions: Current Understanding and Future Prospects. Curr Drug Metab 2024; 25:28-53. [PMID: 38482621 DOI: 10.2174/0113892002289753240305062601] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2023] [Revised: 01/11/2024] [Accepted: 02/09/2024] [Indexed: 07/04/2024]
Abstract
BACKGROUND The use of herbal medicines is on the rise throughout the world due to their perceived safety profile. However, incidences of herb-drug, herb-herb and herb-food interactions considering safety aspects have opened new arenas for discussion. OBJECTIVE The current study aims to provide comprehensive insights into the various types of herb interactions, the mechanisms involved, their assessment, and historical developments, keeping herbal safety at the central point of discussion. METHODS The authors undertook a focused/targeted literature review and collected data from various databases, including Science Direct, Wiley Online Library, Springer, PubMed, and Google Scholar. Conventional literature on herbal remedies, such as those by the WHO and other international or national organizations. RESULTS The article considered reviewing the regulations, interaction mechanisms, and detection of herb-herb, herb-drug and herb-food interactions in commonly used yet vital plants, including Glycyrrhiza glabra, Mentha piperita, Aloe barbadensis, Zingiber officinale, Gingko biloba, Withania somnifera, etc. The study found that healthcare professionals worry about patients not informing them about their herbal prescriptions (primarily used with conventional treatment), which can cause herb-drug/herb-food/herb-herb interactions. These interactions were caused by altered pharmacodynamic and pharmacokinetic processes, which might be explained using in-vivo, in-vitro, in-silico, pharmacogenomics, and pharmacogenetics. Nutrivigilance may be the greatest method to monitor herb-food interactions, but its adoption is limited worldwide. CONCLUSION This article can serve as a lead for clinicians, guiding them regarding herb-drug, herb-food, and herb-herb interactions induced by commonly consumed plant species. Patients may also be counseled to avoid conventional drugs, botanicals, and foods with a restricted therapeutic window.
Collapse
Affiliation(s)
- Subhajit Hazra
- University Institute of Pharma Sciences (UIPS), Chandigarh University, Mohali-140413, Punjab, India
| | - Preet Amol Singh
- University Institute of Pharma Sciences (UIPS), Chandigarh University, Mohali-140413, Punjab, India
| |
Collapse
|
3
|
Rasheed H, Ahmed S, Sharma A. Changing Trends Towards Herbal Supplements: An Insight into Safety and Herb-drug Interaction. Curr Pharm Biotechnol 2024; 25:285-300. [PMID: 37464829 DOI: 10.2174/1389201024666230718114606] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/16/2022] [Revised: 06/05/2023] [Accepted: 06/05/2023] [Indexed: 07/20/2023]
Abstract
Herbs have been used as sustenance and medicine for a very long time, often in conjunction with other prescribed medications. Even though they are thought to be natural and secure, many of these herbs can interact with other medications and cause potentially dangerous adverse effects or decrease the benefits of the medication. The complex and diverse pharmacological functions carried out by the active ingredients in herbs unavoidably alter the pharmacokinetics of chemical drugs when administered in vivo. Drug transporter expression has a direct impact on how medications are absorbed, distributed, metabolized, and excreted in living organisms. Changes in substrate pharmacokinetics can affect the effectiveness and toxicity of a drug when the active ingredients of a herb inhibit or stimulate the expression of transporters. By reviewing published clinical and preclinical studies, this review aims to raise awareness of herbdrug interactions and discuss their evidence-based mechanisms and clinical consequences. More clinical information on herb-drug interactions is required to make choices regarding patient safety as the incidence and severity of herb-drug interactions are rising due to an increase in the use of herbal preparations globally.This review seeks to increase understanding of herb-drug interactions and explore their evidence-based mechanisms and clinical implications by reviewing published clinical and preclinical studies. The incidence and severity of herb-drug interactions are on the rise due to an increase in the use of herbal preparations worldwide, necessitating the need for more clinical data on these interactions in order to make decisions regarding patient safety. Healthcare workers and patients will become more alert to potential interactions as their knowledge of pharmacokinetic herb-drug interactions grows. The study's objective is to raise readers' awareness of possible interactions between herbal supplements and prescription medications who regularly take them.
Collapse
Affiliation(s)
- Haamid Rasheed
- Department of Quality Assurance, Indo Soviet Friendship (ISF), College of Pharmacy, Moga, 142001, Punjab, India
| | - Suhail Ahmed
- Department of Quality Assurance, Indo Soviet Friendship (ISF), College of Pharmacy, Moga, 142001, Punjab, India
| | - Alok Sharma
- Department of Pharmaceutical Technology, MIET, Meerut, 250005, U.P., India
| |
Collapse
|
4
|
Fayaz F, Singh K, Gairola S, Ahmed Z, Shah BA. A Comprehensive Review on Phytochemistry and Pharmacology of Rosa Species (Rosaceae). Curr Top Med Chem 2024; 24:364-378. [PMID: 37937578 DOI: 10.2174/0115680266274385231023075011] [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: 07/27/2023] [Revised: 09/14/2023] [Accepted: 09/19/2023] [Indexed: 11/09/2023]
Abstract
The Rosa L. genus is a significant plant family in the Rosaceae group, consisting of around 200 species, primarily shrubs. In India, it has 37 species, most located in the Western Himalayan region of Jammu and Kashmir and Himachal Pradesh. Roses are highly regarded for their beauty and growth and are popular worldwide for their nutritional, therapeutic, ornamental, and cosmetic value. The rose hips are utilized in creating various food and drink items, such as jams, jellies, teas, and alcoholic beverages. The Rosa species has various pharmacological activities, including anti-inflammatory, antidiabetic, hepatoprotective, antimicrobial, anti-proliferative/anticancer, anti-arthritic, neurological, and anti-obesity activity. This review aims to provide an in- -depth overview of the phytochemistry and pharmacology of the Rosa species in India, focusing on Rosa indica L., which has significant potential for future chemical and biological research.
Collapse
Affiliation(s)
- Faheem Fayaz
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
- Natural Products and Medicinal Division, CSIR-Indian Institute of Integrative Medicine, Canal Road, Jammu, 180001, Jammu and Kashmir, India
| | - Kanwaljeet Singh
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
- Plant Sciences & Agrotechnology Division, CSIR-Indian Institute of Integrative Medicine, Jammu, 180001, Jammu and Kashmir, India
| | - Sumeet Gairola
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
- Plant Sciences & Agrotechnology Division, CSIR-Indian Institute of Integrative Medicine, Jammu, 180001, Jammu and Kashmir, India
| | - Zabeer Ahmed
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
- Natural Products and Medicinal Division, CSIR-Indian Institute of Integrative Medicine, Canal Road, Jammu, 180001, Jammu and Kashmir, India
- Plant Sciences & Agrotechnology Division, CSIR-Indian Institute of Integrative Medicine, Jammu, 180001, Jammu and Kashmir, India
| | - Bhahwal Ali Shah
- Academy of Scientific and Innovative Research (AcSIR), Ghaziabad, 201002, India
- Natural Products and Medicinal Division, CSIR-Indian Institute of Integrative Medicine, Canal Road, Jammu, 180001, Jammu and Kashmir, India
| |
Collapse
|
5
|
Tsele-Tebakang T, Morris-Eyton H, Pretorius E. Concurrent use of herbal and prescribed medicine by patients in primary health care clinics, South Africa. Afr J Prim Health Care Fam Med 2023; 15:e1-e7. [PMID: 37403682 PMCID: PMC10319942 DOI: 10.4102/phcfm.v15i1.3829] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2022] [Revised: 03/04/2023] [Accepted: 03/09/2023] [Indexed: 07/06/2023] Open
Abstract
BACKGROUND The use of herbal medicine (HM) as a self-management practice for treating various diseases has gained popularity worldwide. Consumers co-administer herbal products with conventional medicine without the knowledge of possible herb-drug interaction (HDI). AIM This study aimed to assess patients' perception and use of HM and their knowledge of HDI. SETTING Participants attending primary health care (PHC) clinics in three provinces (Gauteng, Mpumalanga and Free State), South Africa, were recruited. METHODS Focus group discussions comprising a total of thirty (N = 30) participants were conducted using a semi-structured interview guide. Discussions were audio-recorded and then transcribed verbatim. Data were analysed using thematic content analysis. RESULTS Reasons for using HM, sources of information on HM, co-administration of HM and prescribed medicine, disclosure of the use of HM, PHC nurses' attitudes and not having time to engage were frequently discussed. Respondents' lack of knowledge and perceptions about HDI and their dissatisfaction with prescribed medicine because of experienced side effects were also discussed. CONCLUSION Because of the lack of discussions and non-disclosure about HM in PHC clinics, patients are at risk of experiencing HDIs. Primary health care providers should regularly enquire about HM use on every patient, to identify and prevent HDIs. The lack of knowledge about HDIs by patients further compromises the safety of HM.Contribution: The results highlighted the lack of knowledge of HDI by patients thus assisting the healthcare stakeholders in South Africa to implement measures to educate patients attending PHC clinics.
Collapse
Affiliation(s)
- Tebogo Tsele-Tebakang
- Department of Complementary Medicine, Faculty of Health Sciences, University of Johannesburg, Johannesburg.
| | | | | |
Collapse
|
6
|
Haron MH, Dale O, Martin K, Avula B, Chittiboyina AG, Khan IA, Gurley BJ, Khan SI. Evaluation of the Herb-Drug Interaction Potential of Commonly Used Botanicals on the US Market with Regard to PXR- and AhR-Mediated Influences on CYP3A4 and CYP1A2. J Diet Suppl 2022:1-14. [PMID: 36017806 DOI: 10.1080/19390211.2022.2110351] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/15/2022]
Abstract
In this study, hydroethanolic extracts of 30 top-selling botanicals (herbs) commonly used as ingredients of herbal dietary supplements in the US were screened for their potential to activate the human pregnane X receptor (hPXR) and human aryl hydrocarbon receptor (hAhR) and to increase the activities of hPXR- and hAhR-regulated drug metabolizing cytochrome P450 enzymes (i.e., CYP3A4 and CYP1A2, respectively). Of the 30 botanicals tested, 21 induced PXR and 29 induced AhR transcriptional activities. Out of the 21 botanicals that induced hPXR transcriptional activity, 14 yielded >50% induction in CYP3A4 activity at concentrations ranging from 6 to 60 µg/mL and 16 out of the 29 botanicals that activated hAhR yielded >50% induction in CYP1A2 activity at concentrations ranging from 3 to 30 µg/mL. Moreover, eight botanicals (G. gummi-gutta [garcinia], Hemp [low and high CBD content], H. perforatum [St. John's wort], M. vulgare [horehound], M. oleifera [moringa], O. vulgare [oregano], P. johimbe [yohimbe] and W. somnifera [ashwagandha]) yielded >50% induction in both CYP3A4 and CYP1A2 activity. Herbal products are mixtures of phytoconstituents, any of which could modulate drug metabolism. Our data reveals that several top-selling botanicals may pose herb-drug interaction (HDI) risks via CYP450 induction. While in vitro experiments can provide useful guidance in assessing a botanical's HDI potential, their clinical relevance needs to be investigated in vivo. Botanicals whose effects on hPXR/CYP3A4, and hAhR/CYP1A2 activity were most pronounced will be slated for further clinical investigation.
Collapse
Affiliation(s)
- Mona H Haron
- National Center for Natural Products Research, Research Institute of Pharmaceutical Sciences, School of Pharmacy, The University of Mississippi, University, MS, USA
| | - Olivia Dale
- National Center for Natural Products Research, Research Institute of Pharmaceutical Sciences, School of Pharmacy, The University of Mississippi, University, MS, USA
| | - Katherine Martin
- National Center for Natural Products Research, Research Institute of Pharmaceutical Sciences, School of Pharmacy, The University of Mississippi, University, MS, USA
| | - Bharathi Avula
- National Center for Natural Products Research, Research Institute of Pharmaceutical Sciences, School of Pharmacy, The University of Mississippi, University, MS, USA
| | - Amar G Chittiboyina
- National Center for Natural Products Research, Research Institute of Pharmaceutical Sciences, School of Pharmacy, The University of Mississippi, University, MS, USA
| | - Ikhlas A Khan
- National Center for Natural Products Research, Research Institute of Pharmaceutical Sciences, School of Pharmacy, The University of Mississippi, University, MS, USA.,Department of BioMolecular Sciences, School of Pharmacy, The University of Mississippi, University, MS, USA
| | - Bill J Gurley
- National Center for Natural Products Research, Research Institute of Pharmaceutical Sciences, School of Pharmacy, The University of Mississippi, University, MS, USA
| | - Shabana I Khan
- National Center for Natural Products Research, Research Institute of Pharmaceutical Sciences, School of Pharmacy, The University of Mississippi, University, MS, USA.,Department of BioMolecular Sciences, School of Pharmacy, The University of Mississippi, University, MS, USA
| |
Collapse
|