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KMID : 0616120180490020085
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Korean Journal of Pharmacognosy
2018 Volume.49 No. 2 p.85 ~ p.102
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A Systematic Review on Potential Drug Interactions of Korean Ginseng Based upon Cytochrome P450 and P-Glycoprotein
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Nam Ki-Yeul
Yang Byung-Wook
Shin Wang-Soo
Park Jong-Dae
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Abstract
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A drug interaction is a situation in which a substance affects the activity of a drug, synergistically or antagonistically, when both are administered together. It has been shown that orally taken ginsenosides are deglycosylated by intestinal bacteria to give ginsenosides metabolites, which has been considered to be genuine pharmacological constituents and to exhibit drug interactions. Animal experimental results demonstrated that ginsenoside metabolites play an important role in the inhibitory or inductive action of both CYPs (cytochrome p450) and P-gp (p-glycoprotein), thereby can be applied as metabolic modulator to drug interactions. Very few are known on the possibility of drug interaction if taken the recommended dose of ginseng, but it has been found to act as CYPs inductor and P-gp inhibitor in any clinical trial, suggesting the risk that side effects will occur. It has been recently reported that interactions might also exist between ginseng and drugs such as warfarin, phenelzine, imatinib and raltegravir. Moreover, medicinal plants are increasingly being taken in a manner more often associated with prescription medicines. Therefore, considering the extensive applications of ginseng for safety, the aim of this review is to present a comprehensive overview of ginseng and drug interactions based upon pharmacodynamic and pharmacokinetic evidences.
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KEYWORD
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Panax ginseng, Ginsenosides, Drug interaction, Cytochrome P450, P-Glycoprotein, Pharmacokinetics, Pharmacodynamics
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