Jiang Xuemin, Blair Elaine Y L, McLachlan Andrew J
Faculty of Pharmacy, the University of Sydney, NSW 2006, Australia.
J Clin Pharmacol. 2006 Nov;46(11):1370-8. doi: 10.1177/0091270006292124.
Systematic evidence regarding herb-drug interactions is lacking. This study investigated herb-drug interactions with warfarin. S-warfarin concentration and response (prothrombin complex activity) data from healthy subjects (n = 24) who received a single warfarin dose (25 mg) and either St John's wort, Asian ginseng, Ginkgo biloba, or ginger were analyzed using a population pharmacokinetic-pharmacodynamic modeling approach. The ratio of S-warfarin apparent clearance (CL/F) compared to control was 1.39 +/- 0.06 and 1.14 +/- 0.04 after St John's wort and Asian ginseng pretreatment, respectively. Other pharmacokinetic and pharmacodynamic parameters were unaffected. Coadministration of St John's wort significantly increased S-warfarin CL/F, whereas treatment with Asian ginseng produced only a moderate increase in CL/F. Ginkgo and ginger did not affect the pharmacokinetics of warfarin in healthy subjects. None of the herbs studied had a direct effect on warfarin pharmacodynamics. Studies in anticoagulated patients are warranted to assess the clinical significance of these herb-drug interactions.
缺乏关于草药与药物相互作用的系统性证据。本研究调查了草药与华法林之间的相互作用。使用群体药代动力学-药效学建模方法，分析了接受单次华法林剂量（25毫克）以及圣约翰草、亚洲人参、银杏或生姜的健康受试者（n = 24）的S-华法林浓度和反应（凝血酶原复合物活性）数据。在分别接受圣约翰草和亚洲人参预处理后，S-华法林表观清除率（CL/F）与对照组相比的比值分别为1.39±0.06和1.14±0.04。其他药代动力学和药效学参数未受影响。圣约翰草与华法林合用显著增加了S-华法林的CL/F，而亚洲人参治疗仅使CL/F有适度增加。银杏和生姜对健康受试者中华法林的药代动力学没有影响。所研究的草药均对华法林药效学没有直接影响。有必要对接受抗凝治疗的患者进行研究，以评估这些草药-药物相互作用的临床意义。
