Effect ofSchisandra chinensisextract andGinkgo bilobaextract on the pharmacokinetics of talinolol in healthy volunteers

Abstract

The authors investigated the effect of herbal medicine Schisandra chinensis extract (SchE) and Ginkgo biloba extract (GBE) on the oral pharmacokinetics of P-glycoprotein substrate talinolol in humans. Twelve healthy male volunteers took a single 100-mg oral dose of talinolol either alone or after pretreatment with 300 mg SchE twice daily or with 120 mg GBE three times daily for 14 days. On day 14, a single 100-mg oral dose of talinolol was administered. Plasma concentrations of talinolol from zero to 24 h were measured by high-performance liquid chromatography. SchE increased the area under the curve (AUC)(0-24) of talinolol by 47% (90% confidence interval (CI), 18-84%; p = 0.010), and GBE by 21% (90% CI = 11-32%; p = 0.002). The C(max) of talinolol increased by 51% (90% CI = 21-89%; p = 0.007) with SchE treatment and by 33% (90% CI = 18-51%; p = 0.002) with GBE treatment, respectively. The t(1/2) of talinolol increased by 7% (90% CI = -4% to 19%; p = 0.320) with SchE treatment and by 11% (90% CI = -12% to 38%; p = 0.436) with GBE treatment, respectively. The results suggest that both SchE and GBE significantly inhibited P-glycoprotein in humans. Patients receiving either SchE or GBE may require dose adjustments when treated with drugs primarily transported by P-glycoprotein.

Interactions between Herbs and Conventional Drugs: Overview of the Clinical Data

“…Schizandraceae) is used in modern Chinese medicine as an adaptogenic drug [137]. A clinical trial showed that the herb increased the area under the curve and T max of tanilolol, a P-glycoprotein substrate [82]. Thus, patients receiving S. chinensis might require dose adjustments when treated with drugs primarily transported by P-glycoprotein.…”

“…Ginkgoaceae) are used for the treatment of cognitive impairments, dementia, intermittent claudication and tinnitus [2,3,4,5]. The effect of ginkgo on various CYP isoforms as well as on P-glycoprotein has been investigated in a number of clinical trials by using different probe drugs, such as alprazolam, midazolam, diazepam, nifedipine (CYP3A4), caffeine (CYP1A2), chlorzoxazone (CYP2E1), debrisoquine (CYP2D6), tolbutamide, diclofenac, flurbiprofen (CYP2C), omeprazole, voriconazole (CYP2C19), fexofenadine, digoxin and talinolol (P-glycoprotein substrates) [55,56,72,73,74,75,76,77,78,79,80,81,82]. Given the heterogeneity of the results, firm conclusions cannot be drawn.…”

Ginkgo bilobaExtract for Patients with Early Diabetic Nephropathy: A Systematic Review

“…In addition, several clinical studies observed herb drug interactions between Ginkgo biloba extract and conventional medicinals used in early diabetic nephropathy, such as tolbutamide [57, 58], talinolol [59, 60], metformin [61], nifedipine [62], and atorvastatin [63]. It was reported that combined use of Ginkgo biloba extract with tolbutamide [57] or talinolol [59] might affect their efficacy at higher doses (between 320 mg daily and 360 mg daily, resp.).…”

“…It was reported that combined use of Ginkgo biloba extract with tolbutamide [57] or talinolol [59] might affect their efficacy at higher doses (between 320 mg daily and 360 mg daily, resp.). In this review, no study reported herb drug interaction caused by Ginkgo biloba extract.…”

Pharmacokinetic Compatibility of Ginsenosides and Schisandra Lignans in Shengmai-san: From the Perspective of P-Glycoprotein

“…Among them, Panax Ginseng was monarch drug, Ophiopogon Japonicus was minister drug, and Schisandra Chinensis acted as the role of assistant and messenger drug. According to previous reports, several kinds of Schisandra lignans were found can alter pharmacokinetics of substrates of P-gp [17]–[19]. In recent years, several publications have already discussed the relationship between ginsenosides and P-gp [20]–[25], and most of the studies are carried based on the single component of Ginsenosides Extract .…”