Echinacea and Truth in Labeling

Gilroy, Christine; Steiner, John F.; Byers, Tim; Shapiro, Howard; Georgian, William S.

doi:10.1001/archinte.163.6.699

Cited by 109 publications

(59 citation statements)

References 13 publications

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“…Second, etravirine is a CYP3A4 inducer itself, and it could have masked potential induction of CYP3A by echinacea. Third, discrepancies between the labeled and the actual content of active constituents have been reported for many botanical preparations, to the extent that commercial products have not contained the labeled herb at all in some cases (7,9). To avoid an effect of this potential limitation within our study, we purchased a single lot of E. purpurea from Arkopharma, which is a leader in the botanical supplement market in Europe.…”

Section: Discussionmentioning

confidence: 99%

Herb-Drug Interaction between Echinacea purpurea and Etravirine in HIV-Infected Patients

Moltó

Valle

Miranda

et al. 2012

Antimicrob Agents Chemother

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The aim of this open-label, fixed-sequence study was to investigate the potential of the botanical supplement Echinacea purpurea to interact with etravirine, a nonnucleoside reverse transcriptase inhibitor of HIV. Fifteen HIV-infected patients receiving antiretroviral therapy with etravirine (400 mg once daily) for at least 4 weeks were included. E. purpurea root/extract-containing capsules were added to the antiretroviral treatment (500 mg every 8 h) for 14 days. Etravirine concentrations in plasma were determined by high-performance liquid chromatography immediately before and 1, 2, 4, 6, 8, 10, 12, and 24 h after a morning dose of etravirine on day 0 and etravirine plus E. purpurea on day 14. Individual etravirine pharmacokinetic parameters were calculated by noncompartmental analysis and compared between days 0 and 14 by means of the geometric mean ratio (GMR) and its 90% confidence interval (CI). The median age was 46 years (interquartile range, 41 to 50), and the median body weight was 76 kg (interquartile range, 68 to 92). Echinacea was well tolerated, and all participants completed the study. The GMR for etravirine coadministered with E. purpurea relative to etravirine alone was 1.07 (90% CI, 0.81 to 1.42) for the maximum concentration, 1.04 (90% CI, 0.79 to 1.38) for the area under the concentration-time curve from 0 to 24 h, and 1.04 (90% CI, 0.74 to 1.44) for the concentration at the end of the dosing interval. In conclusion, the coadministration of E. purpurea with etravirine was safe and well tolerated in HIV-infected patients; our data suggest that no dose adjustment for etravirine is necessary.

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Section: Discussionmentioning

confidence: 99%

Herb-Drug Interaction between Echinacea purpurea and Etravirine in HIV-Infected Patients

Moltó

Valle

Miranda

et al. 2012

Antimicrob Agents Chemother

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“…Furthermore, labeling is often inaccurate. [80][81][82] To conduct research, the quality of product must be guaranteed, and to compare clinical trials, the similarity of product must be ensured.…”

Section: Common Cam Therapiesmentioning

confidence: 99%

The Use of Complementary and Alternative Medicine in Pediatrics

Kemper¹,

Vohra²,

Walls³

2008

Pediatrics

280

185

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The American Academy of Pediatrics is dedicated to optimizing the well-being of children and advancing family-centered health care. Related to these goals, the American Academy of Pediatrics recognizes the increasing use of complementary and alternative medicine in children and, as a result, the need to provide information and support for pediatricians. From 2000 to 2002, the American Academy of Pediatrics convened and charged the Task Force on Complementary and Alternative Medicine to address issues related to the use of complementary and alternative medicine in children and to develop resources to educate physicians, patients, and families. One of these resources is this report describing complementary and alternative medicine services, current levels of utilization and financial expenditures, and associated legal and ethical considerations. The subject of complementary and alternative medicine is large and diverse, and consequently, an in-depth discussion of each method of complementary and alternative medicine is beyond the scope of this report. Instead, this report will define terms; describe epidemiology; outline common types of complementary and alternative medicine therapies; review medicolegal, ethical, and research implications; review education and training for complementary and alternative medicine providers; provide resources for learning more about complementary and alternative medicine; and suggest communication strategies to use when discussing complementary and alternative medicine with patients and families.

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“…Quality control in TCM with NMR-based metabolomics has been investigated in Ephedra plants [70] and ginseng products [71,72]. We used a comparative metabolomics study [23] integrating supercritical fluid extraction, GC-MS, and data mining to classify easily the three most-used medicinal Echinacea species, E. purpurea, E. pallida, and E. angustifolia, which are frequently misidentified or substituted in commercial Echinacea products [73,74]. We provided new insight into the use of emerging metabolomics coupled with bioactivity assays for medicinal/nutritional plant species classification, quality control, and the identification of novel botanical agents for inflammatory disorders [23].…”

Section: Applicationsmentioning

confidence: 99%