Department of Pharmaceutical Sciences, WA State University, Spokane, Washington, USA.
Drug Metab Rev. 2024 Aug;56(3):285-301. doi: 10.1080/03602532.2024.2386597. Epub 2024 Aug 12.
The growing co-consumption of botanical natural products with conventional medications has intensified the need to understand potential effects on drug safety and efficacy. This review delves into the intricacies of intestinal pharmacokinetic interactions between botanical natural products and drugs, such as alterations in drug solubility, permeability, transporter activity, and enzyme-mediated metabolism. It emphasizes the importance of understanding how drug solubility, dissolution, and osmolality interplay with botanical constituents in the gastrointestinal tract, potentially altering drug absorption and systemic exposure. Unlike reviews that focus primarily on enzyme and transporter mechanisms, this article highlights the lesser known but equally important mechanisms of interaction. Applying the Biopharmaceutics Drug Disposition Classification System (BDDCS) can serve as a framework for predicting and understanding these interactions. Through a comprehensive examination of specific botanical natural products such as byakkokaninjinto, green tea catechins, goldenseal, spinach extract, and quercetin, we illustrate the diversity of these interactions and their dependence on the physicochemical properties of the drug and the botanical constituents involved. This understanding is vital for healthcare professionals to effectively anticipate and manage potential natural product-drug interactions, ensuring optimal patient therapeutic outcomes. By exploring these emerging mechanisms, we aim to broaden the scope of natural product-drug interaction research and encourage comprehensive studies to better elucidate complex mechanisms.
植物药与传统药物共同使用的情况日益增多，这使得人们更加需要了解其对药物安全性和疗效的潜在影响。本文深入探讨了植物药与药物之间肠道药代动力学相互作用的复杂性，包括药物溶解度、通透性、转运体活性和酶介导的代谢变化。本文强调了理解药物在胃肠道中与植物成分之间的溶解度、溶解和渗透压相互作用如何改变药物吸收和全身暴露的重要性。与主要关注酶和转运体机制的综述不同，本文重点介绍了不太为人知但同样重要的相互作用机制。应用生物药剂学药物处置分类系统（BDDCS）可以作为预测和理解这些相互作用的框架。通过对特定植物药的全面研究，如芍药甘草汤、绿茶儿茶素、白毛茛、菠菜提取物和槲皮素，我们说明了这些相互作用的多样性及其对药物和涉及的植物药成分的理化性质的依赖性。这种理解对于医疗保健专业人员有效预测和管理潜在的植物药-药物相互作用，确保患者的最佳治疗效果至关重要。通过探索这些新出现的机制，我们旨在拓宽植物药-药物相互作用研究的范围，并鼓励进行全面的研究以更好地阐明复杂的机制。
