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Annual for Hospital Pharmacy

Interactions Between Herbs And Drugs At The Level Of Сytochrome P450

Iliana Yaneva, Tatyana Karanesheva, Valentin Balabanski, Valentina Belcheva

Abstract

Taking drugs simultaneously with plant products, nikotin, alcohol, insecticides can lead to  different drug interaction between them.

A literature review of potential adverse clinical interaction at pharmacokinetic level (cytochrome P450 enzyme superfamily) between plant products and medical products taken concomitantly has been performed. Necessary importance to plant products to cause side effects when taken in a combination with medical products is not given often. They seem to be underestimated by physicians and patients. Leading mechanism of drug interaction at pharmacokinetic level is Cytochrome P450 system (CYP450). CYP450 is one of the most important systems for biotransformation of the drugs. CYP 450 enzymes are responsible for the metabolism of more than 50 percent of the drugs. Among people are found more than 50 isoenzymes which are classified in different classes and families. Isoenzymes which are with most valuable role for metabolism of drugs are CYP 1А2, CYP 2А6, CYP 2В6, CYP 2С9, CYP 2D6, CYP 2Е1, CYP 3А4. Plant ingredients can affect the activity of  the cytochrome P450 enzyme superfamily by ty two mechanisms – induction and inhibition of isoenzymes. The use of in vitro and in vivo approaches in studying the mechanism of action of plants products and of bioactive substances isolated from plants has led to their identification as substrates, inhibitors and/ or inducers of various CYP isoenzymes.

Conclusion. Plant products which are inhibitors or inductors of cytochrome P450 enzymes can modulate the effectiveness of drugs substrates of this system at the pharmacokinetics level in their concomitant use. To avoid such situations in patients taking plant products and drugs is recommended this not to happen concomitantly but at 1.5-2 hours interval.

 


Keywords

plant products, medical products, нerbdrug interactions, сytochrome p450

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DOI: http://dx.doi.org/10.14748/ahp.v6i1.7160

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