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      • Drug-herb interactions: Mechanisms involved and clinical implications of five commonly and traditionally used herbs

        Chin Eng Ong,Yan Pan 셀메드 세포교정의약학회 2014 셀메드 (CellMed) Vol.4 No.3

        Herbal remedies are commonly used by patients worldwide. Because these herbal preparations share the same metabolic and transport proteins with prescribed medicines, the potential for a drug-herb interaction is substantial and is an issue of significant concern. This review paper summarizes drug-herb interactions involving inhibition or induction of cytochrome P450 enzymes, drug transporters as well as modulation of drug pharmacodynamics. An increasing number of in vitro and animal studies, case reports and clinical trials evaluating such interactions have been reported, and implications of these studies are discussed in this review. The most commonly implicated drugs in the interaction include anticoagulants, antiplatelets, immunosuppressants, anti-neoplastics, protease inhibitors, and some antidepressants. Pharmacokinetic and/or pharmacodynamic interactions of five commonly used herbal remedies (danshen, garlic, Ginkgo biloba, ginseng, and St John’s wort) with these drugs are presented, with focus of discussion being the potentials for interaction, their mechanisms and clinical implications. There is a necessity for adequate pharmacovigilance to be carried out in minimizing unanticipated but often preventable drug-herb interactions.

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        The use of natural remedies to treat osteoarthritis

        Boon Hooi Tan,Chin Eng Ong 셀메드 세포교정의약학회 2016 셀메드 (CellMed) Vol.6 No.1

        Osteoarthritis (OA) is the leading medical condition for which patients use alternative treatments including the natural remedies. The aim of this review is to describe the dietary supplements and herbal remedies most commonly used in patients with osteoarthritis with an emphasis on the efficacy and safety of these natural remedies. Glucosamine and chondroitin sulfate, two of the molecular building blocks found in articular cartilage, are the most commonly used remedies in OA treatment. Most clinical researches suggest that glucosamine and chondroitin show efficacy in reducing or improving symptoms and their ability to arrest progression of the disease or regenerate damaged cartilage. Patented formulations of both remedies are recommended by several therapeutic guidelines for use as first line background OA treatment. Reliable evidence that the combination is more effective than either agent alone is however still lacking. Several other herbs or remedies are promoted for treating osteoarthritis such as S-adenosylmethionine, methylsulfonylmethane, Harpagophytum procumbens (devil’s claw), Curcuma longa (turmeric), Zingiber officinale (ginger), and capsaicin but there is no reliable evidence on long-term efficacy or safety. The clinical usefulness of these remedies is therefore rather limited currently.

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