Unit- 2 (Part-2)

HERBS/FOOD – DRUG INTERACTIONS

B. Pharm 6th Sem.

1
INTRODUCTION
When Herbal Medicinal Products and Western drugs
administered together may interact each other in body
leading to kinetic and dynamic alterations

Herbs are often administered in combination with

therapeutic drugs, raising the potential of herb-drug
interactions.

An estimated 5-20% of general people consume

herbal medicines because
1. Naturally available
2. Consideration of safe to use
3. Ready available
 HERB-DRUG INTERACTIONS

PHARMACOKINETIC PHARMACODYNAMIC

Modify metabolic Herb and drug

pathways in body Interactions can be
❖Mainly occur in predicted:
❖Antagonism or
GIT
Synergism
Kidney
Liver
 INCREASED DECREASED

ABSORPTION Ginger Fibres

Green Tea Mucilage herbs
Black Pepper

Guggul Grape fruit

Laxative Liquorice
Diuretic herbs
Reason for Herbs/ food- drug interaction

1. Clinicians lack of adequate knowledge

of combinations

2. No quality assurance for purity and

potency

3. No advancement in research
 GARLIC:
– May ↑ bleeding times with
anticoagulants
– ↓ blood levels and toxicity of protease
inhibitors like ritonavir, indinavir….etc

GINGER:
❑ May ↑ bleeding with anticoagulants
❑↓ effect of antacids
❑Ginger might decrease blood sugar
Insulin, Chlorpropamide , Glipizide, Tolbutamide
❑High blood pressure (Calcium channel blockers)
interacts with GINGER
verapamil , felodipine , amlodipin
▪Black and white pepper might decrease
how quickly the liver breaks down some
medications
❑ lovastatin (Mevacor)
❑ ketoconazole (Nizoral)
❑ Itraconazole (Sporanox), …etc.

▪It will decrease the action of antacids

▪The black pepper majorly shows interaction and
increase the AUC of The drugs are:
❖Phenytoin (Dilantin)
❖Carbamazepine (Tegretol) tranquilizers
in healthy volunteers
❖Propranolol (Inderal)

❖Rifampin
❖Theophylline in patients with pulmonary tuberculosis.
 Ginkgo:
➢May ↑ bleeding with anticoagulants
➢ May ↑ activity and side effects of
MAO inhibitors
➢ Increases blood pressure when
combined with a thiazide diuretic and
even caused coma.
➢ Increases the digoxin plasma levels
GINSENG
(PANAX GINSENG):
Increases the AUC of digoxin
Decreased activity of opioids – clear
mechanism is unknown
Increased CNS side effects due to
additive effect of
▪MAO inhibitors
▪Phenelzine
❖Produce sadation with barbiturates
&benzodiazepines
❖– Contraindicated with hepatotoxic
drugs and alcohol
❖– ↓ efficacy of Parkinson drugs
(L-Dopa)
EPHEDRA