Abstract

In India, traditional herbal medicines have been an essential part of therapy for the last centuries. However, a large portion of the general populace is using these therapies in combination with allopathy lacking a proper understanding of possible interactions (synergistic or antagonistic) between the herbal product and the allopathic drug. This is based on the assumption that herbal drugs are relatively safe, i.e. without side effects. We have established a comprehensive understanding of the possible herb–drug interactions and identified interaction patterns between the most common herbs and drugs currently in use in the Indian market. For this purpose, we listed common interactors (herbs and allopathic drugs) using available scientific literature. Drugs were then categorized into therapeutic classes and aligned to produce a recognizable pattern present only if interactions were observed between a drug class and herb in the scientific literature. Interestingly, the top three categories (with highest interactors), antibiotics, oral hypoglycemics, and anticonvulsants, displayed synergistic interactions only. Another major interactor category was CYP450 enzymes, a natural component of our metabolism. Both activation and inhibition of CYP450 enzymes were observed. As many allopathic drugs are known CYP substrates, inhibitors or inducers, ingestion of an interacting herb could result in interaction with the co-administered drug. This information is largely unavailable for the Indian population and should be studied in greater detail to avoid such interactions. Although this information is not absolute, the systematic literature review proves the existence of herb–drug interactions in the literature and studies where no interaction was detected are equally important.

摘要

在印度，过去几个世纪以来，传统草药一直是治疗的重要组成部分。然而，大部分普通民众将这些疗法与对抗疗法结合使用，但对草药产品和对抗疗法药物之间可能的相互作用（协同或拮抗）缺乏正确的理解。这是基于草药相对安全，即没有副作用的假设。我们对可能的草药-药物相互作用建立了全面的了解，并确定了印度市场目前使用的最常见草药和药物之间的相互作用模式。为此，我们使用可用的科学文献列出了常见的相互作用物（草药和对抗疗法药物）。然后将药物分类为治疗类别并对齐以产生可识别的模式，只有在科学文献中观察到药物类别和草药之间的相互作用时才会出现。有趣的是，抗生素、口服降糖药和抗惊厥药这三个类别（相互作用最高）仅显示出协同作用。另一个主要的相互作用类别是 CYP450 酶，它是我们新陈代谢的天然成分。观察到 CYP450 酶的活化和抑制。由于许多对抗疗法药物是已知的 CYP 底物、抑制剂或诱导剂，因此摄入相互作用的草药可能会导致与共同给药的药物发生相互作用。印度人口在很大程度上无法获得此信息，应进行更详细的研究以避免此类相互作用。