Rombolà Laura, Scuteri Damiana, Marilisa Straface, Watanabe Chizuko, Morrone Luigi Antonio, Bagetta Giacinto, Corasaniti Maria Tiziana
Preclinical and Translational Pharmacology, Department of Pharmacy, Health and Nutritional Sciences, Section of Preclinical and Translational Pharmacology, University of Calabria, 87036 Rende, Italy.
Pharmacotechnology Documentation and Transfer Unit, Preclinical and Translational Pharmacology, Department of Pharmacy, Health and Nutritional Sciences, University of Calabria, 87036 Rende, Italy.
Life (Basel). 2020 Jul 4;10(7):106. doi: 10.3390/life10070106.
The therapeutic efficacy of a drug or its unexpected unwanted side effects may depend on the concurrent use of a medicinal plant. In particular, constituents in the medicinal plant extracts may influence drug bioavailability, metabolism and half-life, leading to drug toxicity or failure to obtain a therapeutic response. This narrative review focuses on clinical studies improving knowledge on the ability of selected herbal medicines to influence the pharmacokinetics of co-administered drugs. Moreover, in vitro studies are useful to anticipate potential herbal medicine-drug interactions. In particular, they help to elucidate the cellular target (metabolic or transporter protein) and the mechanism (induction or inhibition) by which a single constituent of the herbal medicine acts. The authors highlight the difficulties in predicting herbal-drug interactions from in vitro data where high concentrations of extracts or their constituents are used and pharmacokinetics are missed. Moreover, the difficulty to compare results from human studies where different kinds of herbal extracts are used is discussed. The herbal medicines discussed are among the best sellers and they are reported in the "Herbal Medicines for Human Use" section of the European Medicinal Agency (EMA).
一种药物的治疗效果或其意外的不良副作用可能取决于药用植物的同时使用。特别是，药用植物提取物中的成分可能会影响药物的生物利用度、代谢和半衰期，导致药物毒性或无法获得治疗反应。这篇叙述性综述聚焦于临床研究，以增进对特定草药影响联合使用药物药代动力学能力的认识。此外，体外研究有助于预测潜在的草药-药物相互作用。特别是，它们有助于阐明草药单一成分起作用的细胞靶点（代谢或转运蛋白）和机制（诱导或抑制）。作者强调了根据体外数据预测草药-药物相互作用的困难，这些数据使用了高浓度的提取物或其成分，且未考虑药代动力学。此外，还讨论了比较使用不同种类草药提取物的人体研究结果的困难。所讨论的草药是最畅销的品种之一，并且在欧洲药品管理局（EMA）的“用于人类的草药”部分中有报道。
