Department of Pharmaceutical Sciences, Division of Pharmacoepidemiology & Clinical Pharmacology, Utrecht University, Utrecht, The Netherlands.
Br J Clin Pharmacol. 2013 Sep;76(3):467-74. doi: 10.1111/bcp.12159.
The herbal medicine Echinacea purpurea (E. purpurea) has been shown to induce cytochrome P450 3A4 (CYP3A4) both in vitro and in humans. This study explored whether E. purpurea affects the pharmacokinetics of the CYP3A4 substrate docetaxel in cancer patients.
Ten evaluable cancer patients received docetaxel (135 mg, 60 min IV infusion) before intake of a commercially available E. purpurea extract (20 oral drops three times daily) and 3 weeks later after a 14 day supplementation period with E. purpurea. In both cycles, pharmacokinetic parameters of docetaxel were determined.
Before and after supplementation with E. purpurea, the mean area under the plasma concentration-time curve of docetaxel was 3278 ± 1086 and 3480 ± 1285 ng ml(-1) h, respectively. This result was statistically not significant. Nonsignificant alterations were also observed for the elimination half-life (from 30.8 ± 19.7 to 25.6 ± 5.9 h, P = 0.56) and maximum plasma concentration of docetaxel (from 2224 ± 609 to 2097 ± 925 ng ml(-1) , P = 0.30).
The multiple treatment of E. purpurea did not significantly alter the pharmacokinetics of docetaxel in this study. The applied E. purpurea product at the recommended dose may be combined safely with docetaxel in cancer patients.
草药紫锥菊（E. purpurea）已被证明可在体外和体内诱导细胞色素 P450 3A4（CYP3A4）。本研究探讨了紫锥菊是否会影响癌症患者中 CYP3A4 底物多西他赛的药代动力学。
10 名可评估的癌症患者在接受多西他赛（135mg，60 分钟静脉输注）之前，口服市售紫锥菊提取物（20 滴，每日 3 次），并在 14 天补充期后 3 周再次服用。在两个周期中，均测定了多西他赛的药代动力学参数。
在服用紫锥菊提取物前后，多西他赛的平均血浆浓度-时间曲线下面积分别为 3278±1086 和 3480±1285ng ml(-1) h，差异无统计学意义。半衰期（从 30.8±19.7 小时到 25.6±5.9 小时，P=0.56）和最大血浆浓度（从 2224±609 到 2097±925ng ml(-1) ，P=0.30）也无显著变化。
在本研究中，紫锥菊的多次治疗并未显著改变多西他赛的药代动力学。在癌症患者中，以推荐剂量应用紫锥菊产品可能与多西他赛安全联合使用。
