School of Pharmaceutical Sciences, Shoolini University, Solan, India.
Drug Chem Toxicol. 2022 Mar;45(2):594-603. doi: 10.1080/01480545.2020.1738454. Epub 2020 Mar 12.
In India, traditional herbal medicines have been an essential part of therapy for the last centuries. However, a large portion of the general populace is using these therapies in combination with allopathy lacking a proper understanding of possible interactions (synergistic or antagonistic) between the herbal product and the allopathic drug. This is based on the assumption that herbal drugs are relatively safe, i.e. without side effects. We have established a comprehensive understanding of the possible herb-drug interactions and identified interaction patterns between the most common herbs and drugs currently in use in the Indian market. For this purpose, we listed common interactors (herbs and allopathic drugs) using available scientific literature. Drugs were then categorized into therapeutic classes and aligned to produce a recognizable pattern present only if interactions were observed between a drug class and herb in the scientific literature. Interestingly, the top three categories (with highest interactors), antibiotics, oral hypoglycemics, and anticonvulsants, displayed synergistic interactions only. Another major interactor category was CYP450 enzymes, a natural component of our metabolism. Both activation and inhibition of CYP450 enzymes were observed. As many allopathic drugs are known CYP substrates, inhibitors or inducers, ingestion of an interacting herb could result in interaction with the co-administered drug. This information is largely unavailable for the Indian population and should be studied in greater detail to avoid such interactions. Although this information is not absolute, the systematic literature review proves the existence of herb-drug interactions in the literature and studies where no interaction was detected are equally important.
在印度，传统草药疗法在过去几个世纪一直是治疗的重要组成部分。然而，很大一部分民众在使用这些疗法的同时，还会与对抗疗法药物联合使用，而他们对草药产品和对抗疗法药物之间可能发生的相互作用（协同或拮抗）缺乏正确的理解。这是基于这样一种假设，即草药药物相对安全，即没有副作用。我们已经全面了解了可能的草药-药物相互作用，并确定了目前在印度市场上使用的最常见草药和药物之间的相互作用模式。为此，我们列出了常见的相互作用剂（草药和对抗疗法药物），使用了现有的科学文献。然后将药物分为治疗类别，并进行对齐，以产生仅在药物类别和科学文献中的草药之间观察到相互作用时才存在的可识别模式。有趣的是，排名前三的类别（交互器最多），抗生素、口服降血糖药和抗惊厥药，仅显示协同相互作用。另一个主要的相互作用剂类别是 CYP450 酶，这是我们新陈代谢的天然组成部分。观察到 CYP450 酶的激活和抑制。由于许多对抗疗法药物是已知的 CYP 底物、抑制剂或诱导剂，因此摄入相互作用的草药可能会导致与同时给予的药物相互作用。印度民众对这些信息知之甚少，应该更详细地研究这些信息，以避免这种相互作用。尽管这些信息并不绝对，但系统的文献综述证明了文献中存在草药-药物相互作用，并且同样重要的是，没有检测到相互作用的研究。
