Interaction of Carbamazepine with Herbs, Dietary Supplements, and Food: A Systematic Review

Fong, Sophia Yui Kau; Gao, Qiong; Zuo, Zhong

doi:10.1155/2013/898261

Cited by 27 publications

(24 citation statements)

References 65 publications

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“…Serious herb-carbamazepine interactions with clinical evidence were reported. The majority were pharmacokinetic based 13 .…”

Section: Resultsmentioning

confidence: 99%

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2014

IJPSR

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ABSTRACT:The aim of this article was to evaluate the effect of valerian on a single dose kinetic of carbamazepine in rabbits. Five healthy male rabbits in a randomized, two-crossover design were enrolled in this study. Rabbits were divided into two groups; the first received a single dose of 100 mg carbamazepine (CBZ) suspension. The second group received CBZ 100 mg suspension concurrently with valerian (VAL) 25 mg dry extract. After a washout period of one week the doses were given in a reverse manner. Blood samples were collected over a period of 24 hours. Serum was assayed for CBZ using chemiluminescent enzyme immunoassay (CLEIA). Pharmacokinetic (PK) parameters were determined for CBZ in both cases using non-compartmental analysis. Statistically insignificant differences P ≥ 0.05 were found in PK parameters when CBZ was given alone or concurrently with VAL; the values were C max 6.52 ± 1.6 µg/ml versus 5.32 ± 1.4 µg/ml, t max 2.6 ± 0.9 h versus 3.3 ± 0.9 h, AUC 0-24 83.80 ± 28.8 µg·h/ml versus 60.4 ± 12 µg·h/ml, AUC 0-∞ 166.20 ± 74 µg·h/ml versus 104.75 ± 12 µg·h/ml, k e 0.033 ± 0.006 h -1 versus 0.038 ± 0.012 h -1 and t 1/2 21.81 ± 3.96 h versus 20.71 ± 10.09 h respectively. The result of the study demonstrated that valerian does not affect PK of CBZ, there are no cautions, regarding to dose or administration pattern of CBZ with valerian should be taken.

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“…Serious herb-carbamazepine interactions with clinical evidence were reported. The majority were pharmacokinetic based 13 .…”

Section: Resultsmentioning

confidence: 99%

“…It is the most common non-prescription sedative used in europe 11,12 . CBZ-herb interactions were an interesting and important issue for many researchers 13 . Possible pharmacokinetic VAL-CBZ interactions are still un investigated.…”

Section: Introductionmentioning

confidence: 99%

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2014

IJPSR

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“…Melatonin increased the side effects and antiepileptic activity of carbamazepine but did not affect plasma concentration (28). A single oral dose of fluvoxamine, an inhibitor of CYP1A2, increases nocturnal serum melatonin concentrations in healthy subjects (29).…”

Section: Introductionmentioning

confidence: 94%

Melatonin Interaction Resulting in Severe Sedation

et al. 2015

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-Purpose. Natural health products (NHPs), including melatonin, are widely used products. Despite the widespread assumption that all NHPs are safe, they contain pharmacologically active substances and can therefore have adverse effects and/or interact with pharmaceuticals. Objective: To investigate the mechanism underlying NHP interactions identified through the Pharmacy SONAR active surveillance study. Methods: Active surveillance was undertaken in community pharmacies to identify adverse events in patients who had recently taken NHPs together with conventional pharmaceuticals. For suspected NHP-pharmaceutical interactions, the possible mechanism of action was explored by in vitro analysis of samples of different products to identify cytochrome P450 enzyme (CYP) inhibition potential. Results: Active surveillance identified a 19-year-old male taking citalopram, nortriptyline and oxycodone concomitantly and who experienced severe sedation when melatonin was added to this regimen. In vitro analysis involving several melatonin products showed product-dependent inhibition of CYP1A2, CYP2C19 and CYP3A7. Conclusion: The adverse event was likely due to a primary pharmacokinetic interaction between melatonin and citalopram; although mechanistically, interactions affecting cytochrome P450-mediated metabolism may have occurred with all of these health products. A pharmacodynamic interaction may also be possible, but beyond the capacity of this study to establish.

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“…Herb-drug interaction is expected leading to various clinical effects. Moreover, the increased popularity of herbal medicines could explain the high incidence of herb-drug interactions 14 . This can occur when the co-administered herbal preparations modulate the drug metabolism either to be induced or inbibited of specific CYP enzymes 15,16 .…”

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confidence: 99%

“…Several studies showed that PGE induces the activity of CYP3A4 in the liver as well as gastrointestinal tract 21,22 . Moreover, ginsenoside (an active compound in PGE) revealed an induction of CYP3A4 activity in vitro by interacting with CBZ, resulting in an increased CBZ metabolism 14 . The aim of this in-vivo research study is to find out a posible herb-drug interaction between PGE on Carbamazepine disposition.…”

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confidence: 99%

The Effect of Panax Ginseng on Carbamazepine Pharmacokinetics in Rabbits

Abushammala¹,

Ali²,

Shammaleh³

et al. 2020

tjps

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Carbamazepine (CBZ) is a well-known prescribed drug to treat epilepsy and it is trigeminal neuralgia drug of choice. The present study is established for studying the effect of Panax ginseng extract (PGE) on disposition of CYP3A4 substrate Carbamazepine (CBZ) in rabbits. Materials and Methods: An in vivo herb-drug interaction, a randomized, parallel designed study were conducted in 12 male rabbits; that were distributed into two groups. The first group consists of six rabbits (control group) the CBZ suspension (30mg/kg/day) was administrated orally for ten days as a single daily dose while, the second group consists of six rabbits (test group) CBZ was administered concomitantly with a dose of PGE (2.5 mg/kg/day) at the same time schedule as in the first group. Blood under analysis samples were withdrawn from the marginal ear vein of rabbits at the intervals 0.0, 0.5, 1.0, 1.5, 2.0, 2.5, 3.0, 4.0, 6.0, 12.0 and 24.0 hours. Results: Our results showed statistically insignificant differences (P≥0.05) in pharmacokinetic parameters (PK) as Cmax, tmax, AUC0-24, AUC0-∞, t ½ and Ke of CBZ when given alone or concurrently with PGE. Conclusion: Our findings showed that, PGE may not likely to interfere the carbamazepine pharmacokinetics when co-administered with carbamazepine, so it can be used safely without precautions or dose monitoring.

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Interaction of Carbamazepine with Herbs, Dietary Supplements, and Food: A Systematic Review

Cited by 27 publications

References 65 publications

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Melatonin Interaction Resulting in Severe Sedation

The Effect of Panax Ginseng on Carbamazepine Pharmacokinetics in Rabbits

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