Intestinal and Hepatocellular Transporters: Therapeutic Effects and Drug Interactions of Herbal Supplements

Annu Rev Pharmacol Toxicol. 2017 Jan 6:57:399-416. doi: 10.1146/annurev-pharmtox-010716-105010. Epub 2016 Sep 14.

Abstract

Herbal supplements are generally considered safe; however, drug disposition is influenced by the interactions of herbal supplements and food constituents with transport and metabolic processes. Although the interference of herbal supplements with drug metabolism has been studied extensively, knowledge of how they interact with the drug transport processes is less advanced. Therefore, we describe here specific examples of experimental and human interaction studies of herbal supplement components with drug transporters addressing, for example, organic anion transporting polypeptides or P-glycoprotein, as such interactions may lead to severe side effects and altered drug efficacy. Hence, it is clearly necessary to increase the awareness of the clinical relevance of the interference of herbal supplements with the drug transport processes.

Keywords: P-glycoprotein (MDR1); drug interaction; herbal supplements; multidrug resistance-associated protein (MRP); organic anion transporting polypeptide (OATP); pharmacokinetics; transporters.

Publication types

  • Review

MeSH terms

  • ATP Binding Cassette Transporter, Subfamily B / metabolism*
  • ATP Binding Cassette Transporter, Subfamily B, Member 1 / metabolism
  • Animals
  • Drug Interactions / physiology
  • Hepatocytes / drug effects
  • Hepatocytes / metabolism*
  • Humans
  • Intestinal Mucosa / drug effects
  • Intestinal Mucosa / metabolism*
  • Organic Anion Transporters / metabolism*
  • Pharmaceutical Preparations / metabolism
  • Plant Preparations / metabolism*
  • Plant Preparations / pharmacology
  • Plant Preparations / therapeutic use
  • Treatment Outcome

Substances

  • ATP Binding Cassette Transporter, Subfamily B
  • ATP Binding Cassette Transporter, Subfamily B, Member 1
  • Organic Anion Transporters
  • Pharmaceutical Preparations
  • Plant Preparations