Clinically significant interaction between warfarin and popular cough lozenges 'Fisherman's Friend'

Boyle, Stephen; Walters, Matthew

doi:10.1136/bcr.09.2011.4791

Cited by 2 publications

(2 citation statements)

References 8 publications

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“…Some of the zinc lozenges have been reported with adverse effects like acute bad taste, which is commonly found to be reversed after discontinue of taking the same [22]. Potential drug interaction has been suspected between the common ingredients found in the cough drops such as eucalyptus oil, menthol and licorice with warferin due to their affinity towards cytochrome P450 and their ability to bind with albumin [23]. Moreover, other limitation are the comparatively small surface area available for drug absorption, shorter residence time of the dosage form in oral cavity due to simultaneous swallowing of drug with saliva.…”

Section: Advantages Of Hard Boiled Lozengesmentioning

confidence: 99%

The Research Updates and Prospects of Herbal Hard-Boiled Lozenges: A Classical Platform With Promising Drug Delivery Potential

Sahoo¹,

Male²,

Varier³

2021

Int J App Pharm

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Over the past decades major focus has been given towards innovative drug delivery systems and new dosage forms. This is due to highly expensive process and high attrition rates of existing marketed drugs. Hard-boiled lozenges (HBLs) are one of the solid dosage form designed to release the drug in saliva for either local or systemic effects. Typical application of lozenegs includes throat infection, pharyngitis, cough suppressant, nasal-decongestant, expectorants, and smoking cessation. The drug delivery through the hard-boiled candies has an easy marketing advantage due to its attractive appearance and patient compliance. As a part of the drug is absosrbed into systemic circulation, gastrointestinal degradation and fast pass effects are avoided. Further, drug delivery through hard-boiled lozenges can be potential platform for some of the suitable drug candidates. This review on hard-boiled lozenges discusses manufacturing process, characterization techniques, quality control, research studies and market potential of hard-boiled lozenges. The major databases searched were, PubMed, Wiley Online, Medline, Elsevier, Google scholar, Scopus, ACS, The Royal Society of Chemistry, SciFinder, Baidu Scholars, CNKI, web of science, Cochrane database, US Patents, Espacenet and various business reviews. This review provides comprehensive information on hard-boiled lozenges that will help the pharmaceutical scientist from academia as well pharmaceutical industry to leverage the potential of this conventional dosage form for various herbal drugs and other pharmaceutical actives.

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Section: Advantages Of Hard Boiled Lozengesmentioning

confidence: 99%

The Research Updates and Prospects of Herbal Hard-Boiled Lozenges: A Classical Platform With Promising Drug Delivery Potential

Sahoo¹,

Male²,

Varier³

2021

Int J App Pharm

View full text Add to dashboard Cite

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“…129 Mango also contains high concentrations of retinol, which can inhibit CYP2C19. However, the exact mechanism remains unknown Menthol cough drops Decrease anticoagulant effect Minor 3 case reports 126,130,131 In vitro evidence suggests that peppermint oil (which contains menthol) can inhibits CYP2C9, which primarily is involved in the metabolism of warfarin. Conflicting evidence as case studies described decreased effect, while in vitro studies have suggested increased activities…”

Section: Ginkgo Bilobamentioning

confidence: 99%

Warfarin and food, herbal or dietary supplement interactions: A systematic review

Tan¹,

Lee

2020

Brit J Clinical Pharma

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Aims To present an updated overview on the safety of concurrent use of food, herbal or dietary supplement and warfarin. Methods A systematic literature review was performed on 5 databases from inception up to 31 December 2019. These interactions were classified depending on the likelihood of interaction and supporting evidences. Results A total of 149 articles describing 78 herbs, food or dietary supplements were reported to interact with warfarin. These reports described potentiation with 45 (57.7%) herbs, food or dietary supplements while 23 (29.5%) reported inhibition and 10 (12.8%) reported limited impact on warfarin pharmacokinetics and pharmacodynamics. Twenty unique herb and dietary supplements also reported to result in minor bleeding events, such as purpura and gum bleeding as well as major events such as intracranial bleeding that led to death. Conclusion While most food, herbs and supplements can be safely taken in moderation, healthcare professionals should be aware of the increased risk of bleeding when taking several food and herbs. These include Chinese wolfberry, chamomile tea, cannabis, cranberry, chitosan, green tea, Ginkgo biloba, ginger, spinach, St. John's Wort, sushi and smoking tobacco. Patients should be counselled to continue to seek advice from their healthcare professionals when starting any new herbs, food or supplement.

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Clinically significant interaction between warfarin and popular cough lozenges 'Fisherman's Friend'

Abstract: BACKGROUNDThis case highlights a probable and clinically relevant drug interaction between warfarin and a freely available commercial cough remedy and could conceivably have implications for other patients who take warfarin.

Cited by 2 publications

References 8 publications

The Research Updates and Prospects of Herbal Hard-Boiled Lozenges: A Classical Platform With Promising Drug Delivery Potential

The Research Updates and Prospects of Herbal Hard-Boiled Lozenges: A Classical Platform With Promising Drug Delivery Potential

Warfarin and food, herbal or dietary supplement interactions: A systematic review

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