Kyriacou Nicki M, Gross Annette S, McLachlan Andrew J
Sydney Pharmacy School, Faculty of Medicine and Health, University of Sydney, Sydney, New South Wales, Australia.
Clin Pharmacol Ther. 2025 Jan 2. doi: 10.1002/cpt.3547.
Green tea (Camellia sinensis) is a commonly consumed beverage or dietary supplement. As a natural product with a myriad of proposed health benefits, patients are likely to consume green tea while taking their medications unaware of its potential to interact with drugs and influence drug efficacy and safety. Catechins are the abundant polyphenolic compounds in green tea (e.g., (-)-epigallocatechin-3-gallate), which are reported to influence determinants of drug pharmacokinetics, such as drug solubility and the activity of drug transporters and drug metabolizing enzymes. This review summarized the results of clinical studies investigating the influence of green tea catechins on the pharmacokinetics of clinically used medications. The majority of analyses (72%) reported significant decreases (by 18-99%) in systemic drug exposure with green tea consumption (atorvastatin, celiprolol, digoxin, fexofenadine, folic acid, lisinopril, nadolol, nintedanib, raloxifene, and rosuvastatin). One analysis (6%) reported a 50% increase in drug systemic exposure (sildenafil) and for 22% of analyses drug pharmacokinetics were not affected by green tea consumption (fluvastatin, pseudoephedrine, simvastatin, and tamoxifen). For most drugs reporting an interaction, green tea catechins were proposed to decrease intestinal drug absorption by inhibiting OATP uptake (particularly OATP1A2), enhancing P-gp efflux activity or reducing drug solubility. Case reports have associated changes in drug pharmacokinetics with green tea consumption to changes in drug efficacy or safety (e.g., nadolol and erlotinib). These findings prompt the need for further research in relating evidence from existing literature to predict additional clinically important green tea-drug interactions and to provide appropriate recommendations for patients and clinicians.
绿茶（茶树）是一种常见的饮品或膳食补充剂。作为一种具有众多潜在健康益处的天然产品，患者在服药时可能会饮用绿茶，却未意识到其可能与药物相互作用并影响药物疗效和安全性。儿茶素是绿茶中含量丰富的多酚类化合物（例如，（-）-表没食子儿茶素-3-没食子酸酯），据报道，儿茶素会影响药物药代动力学的决定因素，如药物溶解度、药物转运体活性和药物代谢酶活性。本综述总结了临床研究中关于绿茶儿茶素对临床使用药物药代动力学影响的结果。大多数分析（72%）报告称，饮用绿茶后系统药物暴露量显著降低（降低18%-99%）（阿托伐他汀、塞利洛尔、地高辛、非索非那定、叶酸、赖诺普利、纳多洛尔、尼达尼布、雷洛昔芬和瑞舒伐他汀）。一项分析（6%）报告称药物系统暴露量增加了50%（西地那非），22%的分析表明饮用绿茶对药物药代动力学没有影响（氟伐他汀、伪麻黄碱、辛伐他汀和他莫昔芬）。对于大多数报告有相互作用的药物，绿茶儿茶素被认为是通过抑制有机阴离子转运多肽（OATP）摄取（特别是OATP1A2）、增强P-糖蛋白外排活性或降低药物溶解度来减少肠道药物吸收。病例报告将药物药代动力学的变化与饮用绿茶导致的药物疗效或安全性变化联系起来（例如，纳多洛尔和厄洛替尼）。这些发现促使有必要进一步开展研究，将现有文献中的证据关联起来，以预测更多临床上重要的绿茶-药物相互作用，并为患者和临床医生提供适当的建议。
