HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:
Sign In to gain access to subscriptions and/or personal tools.

This Article Full Text Full Text (PDF) Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Request Permissions Request Reprints Citing Articles Citing Articles via HighWire Citing Articles via Web of Science (12) Citing Articles via Google Scholar Google Scholar Articles by Gurley, B. Articles by Cheboyina, S. Search for Related Content PubMed PubMed Citation Articles by Gurley, B. Articles by Cheboyina, S. Social Bookmarking                         What's this?

Assessing the Clinical Significance of Botanical Supplementation on Human Cytochrome P450 3A Activity: Comparison of a Milk Thistle and Black Cohosh Product to Rifampin and Clarithromycin

From the Department of Pharmaceutical Sciences (Dr Gurley, Ms Hubbard, Mr Tong, and Dr Breen), Department of Biostatistics (Dr Williams), Department of Anesthesiology (Dr Gentry), and the Small Molecule Mass Spectrometry Facility (Dr Thaden), University of Arkansas for Medical Sciences, Little Rock, Arkansas; the Department of Agricultural Engineering (Dr Carrier), University of Arkansas, Fayetteville, Arkansas; and the Department of Pharmaceutics (Dr Cheboyina), University of Mississippi, University, Mississippi.

Phytochemical-mediated modulation of cytochrome P450 enzymes (CYPs) may underlie many herb-drug interactions. This study's purpose was to assess the effects of milk thistle and black cohosh supplementation on CYP3A activity and compare them to a clinically recognized inducer, rifampin, and inhibitor, clarithromycin. Healthy volunteers were randomly assigned to receive a standardized milk thistle (900 mg) or black cohosh (80 mg) supplement for 14 days. Subjects also received rifampin (600 mg) and clarithromycin (1000 mg) for 7 days as positive controls for CYP3A induction and inhibition, respectively. Midazolam was administered orally before and after each supplementation and control period. The effects of milk thistle, black cohosh, rifampin, and clarithromycin on midazolam pharmacokinetics were determined using noncompartmental techniques. Unlike those observed for rifampin and clarithromycin, midazolam pharmacokinetics was unaffected by milk thistle or black cohosh. Milk thistle and black cohosh appear to have no clinically relevant effect on CYP3A activity in vivo.

Key Words: Cytochrome P450s • botanical supplements • pharmacokinetics • drug interactions

Address for reprints: Bill Gurley, University of Arkansas for Medical Sciences, College of Pharmacy, Department of Pharmaceutical Sciences, 4301 West Markham Street, Slot 522-3, Little Rock, AR 72205.

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter    What's this?

This article has been cited by other articles:

				L. Xu, Y. Chen, Y. Pan, G. L. Skiles, and M. Shou Prediction of Human Drug-Drug Interactions from Time-Dependent Inactivation of CYP3A4 in Primary Hepatocytes Using a Population-Based Simulator Drug Metab. Dispos., December 1, 2009; 37(12): 2330 - 2339. [Abstract] [Full Text] [PDF]

				S. S. Shord, K. Shah, and A. Lukose Drug--Botanical Interactions: A Review of the Laboratory, Animal, and Human Data for 8 Common Botanicals Integr Cancer Ther, September 1, 2009; 8(3): 208 - 227. [Abstract] [PDF]

				M. Shou, M. Hayashi, Y. Pan, Y. Xu, K. Morrissey, L. Xu, and G. L. Skiles Modeling, Prediction, and in Vitro in Vivo Correlation of CYP3A4 Induction Drug Metab. Dispos., November 1, 2008; 36(11): 2355 - 2370. [Abstract] [Full Text] [PDF]

				C. Tamayo and S. Diamond Review of Clinical Trials Evaluating Safety and Efficacy of Milk Thistle (Silybum marianum [L.] Gaertn.) Integr Cancer Ther, June 1, 2007; 6(2): 146 - 157. [Abstract] [PDF]