Influence Factors of the Pharmacokinetics of Herbal Resourced Compounds in Clinical Practice

Abstract

Herbal medicines have been used to prevent and cure diseases in eastern countries for thousands of years. In recent decades, these phytotherapies are becoming more and more popular in the West. As being nature-derived is the essential attribute of herbal medicines, people believe that taking them for diseases treatment is safe enough and has no side-effects. However, the efficacy of herbal resourced compounds (HRC) depends on the multiple constituents absorbed in the body and their pharmacokinetics. Thus, many factors will influence the clinical practice of HRC, i.e., their absorption, distribution, metabolism, and excretion (ADME). Among these factors, herb-drug interaction has been widely discussed, as these compounds may share the same drug-metabolizing enzymes and drug transporters. Meanwhile there are many other potential factors that can also change the ADME of HRC, including herb pretreatment, herb-herb interactions, pathological status, gender, age of patient, and chemical and physical modification of certain ingredients. With the aim of ensuring the efficacy of HRC and minimizing their clinical risks, this review provides and discusses the influence factors and artificial improvement of the pharmacokinetics of HRC.

The Influence of Plant Extracts and Phytoconstituents on Antioxidant Enzymes Activity and Gene Expression in the Prevention and Treatment of Impaired Glucose Homeostasis and Diabetes Complications

“…Identifying the bioavailability of bioactive plant extracts/food compounds is essential for evaluation of their potential health benefits. Bioavailability of plant extracts or phytoconstituents is the most important for their full efficacy in organism and implies deliverance, absorption, distribution, metabolism, and elimination phases of extract/constituent [ 101 ]. In addition, many crude plant extracts or phytoconstituents demonstrated good biological activities (e.g., antioxidant activities) in in vitro assays, while slightly reduced activity was determined in in vivo studies.…”

Consumption of Raw Herbal Medicines Is Associated with Major Public Health Risks amongst Ugandans

“…is may be an indicator of poor access to conventional healthcare [43], or chronic weaknesses in legislation to monitor herbal medicines in developing countries [44]. Most of the people in the herbal manufacturing and consumption industry rely on indigenous knowledge and lack access to information on pharmacodynamics and pharmacokinetics of most herbal therapies [41,45,46]. Studies in Uganda recommend that phytochemical investigations are necessary to determine active compounds in herbal medicines [4]; however, policy to support this remains weak.…”

Multifaceted Factors Causing Conflicting Outcomes in Herb-Drug Interactions

“…However, herbal products of interest are generally assumed to be perpetrators (i.e., an inhibitor or inducer), whereas a drug is often considered to be a substrate (a victim drug) for metabolic enzymes or transporters when evaluating HDIs. This comes from the fact that most herbal products contain a mixture of numerous chemical constituents and sometimes even unknown compounds [20][21][22]. It is not easy to analyze the concentration changes of all chemicals in herbal products representing their PK properties, therefore herbal products are primarily considered to be perpetrators in many PK-based HDI evaluations [1,15,[21][22][23].…”

“…This comes from the fact that most herbal products contain a mixture of numerous chemical constituents and sometimes even unknown compounds [20][21][22]. It is not easy to analyze the concentration changes of all chemicals in herbal products representing their PK properties, therefore herbal products are primarily considered to be perpetrators in many PK-based HDI evaluations [1,15,[21][22][23]. In addition, most pharmacological effects of a drug as a single treatment are well known, and the changes to the drug by co-administered herbal product can definitely be clarified.…”