A Review of Theophylline's Pharmacological Interactions With Medicinal Herbs

Abstract

Theophylline (TPH) is a bronchodilator with a limited therapeutic index and high interindividual pharmacokinetic (PK) variability. In this paper, the interactions between TPH and medicinal herbs recorded in the literature were summarized. The collected references in the analyzed literature were investigated. A decrease in TPH bioavailability by induction mechanism on CYP1A2 was reported during co-administration of herbs or herbal extracts as (Andrographis paniculata, Commiphora myrrha, Ephedra species, Evodia rutaecarpa, Lepidium sativum, Sophora flavescens, Salvia miltiorrhiza, and Trigonella foenum-graecum). TPH bioavailability was increased by inhibition mechanism on CYP1A2 when co-administered with herbs (Acacia catechu, Angelica species, Astragalus species, Cassia auriculata, Cardiospermum halicacabum and Scutellariae baicalensis. Meanwhile, concomitant use of TPH with (Cassia occidentalis, Glycyrrhiza glabra, Ginkgo biloba, Hypericum perforatum, Nigella sativa, Punica granatum and Rhodiola rosea) was reported to be insignificant. In this review, we focus on the interactions between TPH and medicinal herbs that haven't been covered in prior studies. To reduce the patients' health risks, health professionals involved in their treatment are expected to be thoroughly educated about the interactions between TPH and medicinal plants.