Effects of Ginkgo biloba Extract Ingestion on the Pharmacokinetics of Talinolol in Healthy Chinese Volunteers

Li, Fan; Tao, Gong-You; Guo, Wei; Chen, Yao; Zhang, Wei; He, Yijing; Li, Qing; Lei, He-Ping; Feng, Jiang; Hu, Dongli; Huang, Yuan‐Fei; Zhou, Hong‐Hao

doi:10.1345/aph.1l656

Cited by 71 publications

(50 citation statements)

References 24 publications

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“…Ginkgo biloba extract and ginkgolides induce the expression of UGT1A1 in human primary hepatocytes, although inhibitory effects on UGT enzymes of ginkgo biloba extract, or one of its components, have been described, as well (16,18,19,29). Other investigations showed that long-term use of ginkgo biloba inhibits P-gp-mediated drug transport, but contrary results have also been reported (1,9,10,30,31).…”

mentioning

confidence: 99%

Effect of Ginkgo Biloba on the Pharmacokinetics of Raltegravir in Healthy Volunteers

Blonk

Colbers

Poirters

et al. 2012

Antimicrob Agents Chemother

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dMedicinal herbs may cause clinically relevant drug interactions with antiretroviral agents. Ginkgo biloba extract is a popular herbal product among HIV-infected patients because of its positive effects on cognitive function. Raltegravir, an HIV integrase inhibitor, is increasingly being used as part of combined antiretroviral therapy. Clinical data on the potential inhibitory or inductive effect of ginkgo biloba on the pharmacokinetics of raltegravir were lacking, and concomitant use was not recommended. We studied the effect of ginkgo biloba extract on the pharmacokinetics of raltegravir in an openlabel, randomized, two-period, crossover phase I trial in 18 healthy volunteers. Subjects were randomly assigned to a regimen of 120 mg of ginkgo biloba twice daily for 15 days plus a single dose of raltegravir (400 mg) on day 15, a washout period, and 400 mg of raltegravir on day 36 or the test and reference treatments in reverse order. Pharmacokinetic sampling of raltegravir was performed up to 12 h after intake on an empty stomach. All subjects (9 male) completed the trial, and no serious adverse events were reported. Geometric mean ratios (90% confidence intervals) of the area under the plasma concentration-time curve from dosing to infinity (AUC 0-ؕ ) and the maximum plasma concentration (C max ) of raltegravir with ginkgo biloba versus raltegravir alone were 1.21 (0.93 to 1.58) and 1.44 (1.03 to 2.02). Ginkgo biloba did not reduce raltegravir exposure. The potential increase in the C max of raltegravir is probably of minor importance, given the large intersubject variability of raltegravir pharmacokinetics and its reported safety profile.

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mentioning

confidence: 99%

Effect of Ginkgo Biloba on the Pharmacokinetics of Raltegravir in Healthy Volunteers

Blonk

Colbers

Poirters

et al. 2012

Antimicrob Agents Chemother

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“…Repeated ingestion of Ginkgo biloba extract by healthy Chinese volunteers was reported to increase talinolol bioavailability significantly without significant changes in elimination halflife and the time to C max (98). These findings suggest that longterm use of Ginkgo biloba extract significantly influences talinolol disposition in humans, most probably by affecting the activity of P-gp and/or other drug transporters.…”

Section: Yeung Et Al (2009) Have Investigated the Effect Of Ethanol mentioning

confidence: 84%

Herbal drugs and drug interactions

Dülger¹

2012

mpj

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Pharmacodynamic interactions may be due to additive or synergistic effects which results in enhanced effect or toxicity, or herbal medicines with antagonistic properties reduce drug efficacy and result in therapeutic failure. For exampla, St John's wort may have synergistic effects with other antidepressant drugs used by the patient, resulting in increased CNS effects.Herbals like ginseng, ginkgo, garlic, ginger were reported to increase bleeding time, thus potentiating the effect of anticoagulant and antithrombotic agents. In conclusion, patients should be warned against the interaction between the herbal products and conventional medicines.

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“…Their effects were reported on structure-activity relationships (Gnabre et al, 2010). It is also interesting to note that Schisandra 15 chinensis extract significantly inhibited P-glycoprotein substrate timolol in humans (Fan et al, 2009). This provides further scientific evidence for the adjuvant effect of Schisandra chinensis on cancer therapy.…”

Section: Anti-cancermentioning

confidence: 96%

“…This provides further scientific evidence for the adjuvant effect of Schisandra chinensis on cancer therapy. However, patients receiving the Schisandra chinensis extract may require dose adjustments when treated with drugs primarily transported by P-glycoprotein (Fan et al, 2009). …”

Section: Anti-cancermentioning

confidence: 99%

Panax ginsengRhodiola roseaandSchisandra chinensis

Chan

2011

International Journal of Food Sciences and Nutrition

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Panax ginseng (Ginseng), Rhodiola rosea (Hong Jing Tian) and Schisandra chinensis (Wu Wei Zi) are well-known herbs in traditional Chinese medicine (TCM). Recently, there have been a number of studies on these 3 herbs. This review discusses their active components and major pharmacological effects. For Panax ginseng, it has been shown to have an anti-inflammatory activity, affects pulmonary function and erectile dysfunction, improves cognition in patients with Alzheimer's disease and promotes sexual arousal in menopausal women as well as prevent cancer. For Rhodiola rosea, its effectiveness on alleviating depression and reducing fatigue are summarized in this review.Additionally, anti-cancer and other clinical effects of Schisandra chinensis are also discussed. These 3 herbs are considered as adaptogens as they bear multiple functions and their effects were found to be very different in subjects depending on the circumstances (age, gender, environment, diet, season, etc.). Thus, in most cases, the art of the TCM practitioner is to prescribe these herbs after a complete evaluation of patients' overall heath status.

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Effects of Ginkgo biloba Extract Ingestion on the Pharmacokinetics of Talinolol in Healthy Chinese Volunteers

Abstract: Our results suggest that long-term use of GBE significantly influenced talinolol disposition in humans, likely by affecting the activity of P-glycoprotein and/or other drug transporters.

Cited by 71 publications

References 24 publications

Effect of Ginkgo Biloba on the Pharmacokinetics of Raltegravir in Healthy Volunteers

Effect of Ginkgo Biloba on the Pharmacokinetics of Raltegravir in Healthy Volunteers

Herbal drugs and drug interactions

Panax ginsengRhodiola roseaandSchisandra chinensis

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