Interactions between herbs and antidiabetics: an overview of the mechanisms, evidence, importance, and management

다국어 초록 (Multilingual Abstract)

Complementary and alternative therapies are quickly gaining importance because they are perceived to be free of side effects due to their natural origin. However, herbal remedies are complex mixtures of bioactive entities, which may interact with prescription drugs through pharmacokinetic or pharmacodynamic mechanisms and sometimes result in life-threatening consequences. In particular, diabetes patients are often treated with multiple medications due to different comorbidities, and such patients use antidiabetic medications for their entire lives; thus, it is important to make the public aware of herb interactions with antidiabetic drugs. In this paper, we summarize the reports available on the interaction of herbal remedies with oral hypoglycemic agents and describe mechanisms, preclinical or clinical evidence, importance, and management strategies.

참고문헌 (Reference)

• 1 Solimene, U., "WHO guidelines for assessing quality of herbal medicines with reference to contaminants and residues"
• 2 Tachjian, A., "Use of herbal products and potential interactions in patients with cardiovascular diseases" 55 : 515-525, 2010
• 3 Scott, G.N., "Update on natural product–drug interactions" 59 : 339-347, 2002
• 4 Yimam, M., "UP780, a chromone-enriched aloe composition improves insulin sensitivity" 11 : 267-275, 2013
• 5 Tseng-Crank, J., "UP780, A chromone-enriched aloe composition, enhances adipose insulin receptor signaling and decreases liver lipid biosynthesis" 3 : 9-, 2013
• 6 Actos (Pioglitazone hydrochloride), "UK summary of product characteristics" Takeda Ltd 2011
• 7 Al-Ali, M., "Tribulus terrestris : Preliminary study of its diuretic and contractile effects and comparison with Zea mays" 85 : 257-260, 2003
• 8 Akhtar, M., "Trial of Momordica charantia Linn(Karela)powder in patients with maturity-onset diabetes" 32 : 106-107, 1982
• 9 Swanston, S.K., "Traditional plant treatments for diabetes. Studies in normal and streptozotocin diabetic mice" 33 : 462-464, 1990
• 10 Gray, A.M., "The traditional plant treatment, Sambucus nigra(elder), exhibits insulin-like and insulin-releasing actions in vitro" 130 : 15-20, 2000
• 11 Fan, L., "The pregnane X receptor agonist St. John’s Wort has no effects on the pharmacokinetics and pharmacodynamics of repaglinide" 50 : 605-611, 2011
• 12 Cermak, R., "The potential of flavonoids to influence drug metabolism and pharmacokinetics by local gastrointestinal mechanisms" 7 : 729-744, 2006
• 13 Hellum, B.H., "The induction of CYP1A2, CYP2D6 and CYP3A4 by six trade herbal products in cultured primary human hepatocytes" 100 : 23-30, 2007
• 14 Yoo, K.M., "The hypoglycemic effects of American red ginseng (Panax quinquefolius L.) on a diabetic mouse model" 77 : H147-H152, 2012
• 15 Amacher, D.E, "The effects of cytochrome P450 induction by xenobiotics on endobiotic metabolism in pre-clinical safety studies" 20 : 159-166, 2010
• 16 Wang, Z., "The effects of St. John’s wort(Hypericum perforatum)on human cytochrome P450 activity" 70 : 317-326, 2001
• 17 Beckert, B.W., "The effect of herbal medicines on platelet function : an in vivo experiment and review of the literature" 120 : 2044-2050, 2007
• 18 Scroggie, D.A., "The effect of glucosamine-chondroitin supplementation on glycosylated hemoglobin levels in patients with type 2 diabetes mellitus: A placebo-controlled, double-blinded, randomized clinical trial" 163 : 1587-, 2003
• 19 Gorski, J.C., "The effect of echinacea(Echinacea purpurea root)on cytochrome P450 activity in vivo" 75 : 89-100, 2004
• 20 Whitten, D., "The effect of St. John’s wort extracts on CYP3A : A systematic review of prospective clinical trials" 62 : 512-526, 2006
• 21 Goey, A.K., "The effect of St. John’s Wort on the pharmacokinetics of docetaxel" 53 : 103-110, 2014
• 22 Dans, A.M, "The effect of Momordica charantia capsule preparation on glycemic control in Type 2 diabetes mellitus needs further studies" 60 : 554-559, 2007
• 23 Ma, X., "Synergistic therapeutic actions of herbal ingredients and their mechanisms from molecular interaction and network perspectives" 14 : 579-588, 2009
• 24 Vale, S., "Subarachnoid haemorrhage associated with Ginkgo biloba" 352 : 36-, 1998
• 25 Williamson, E.M., "Stockley’s herbal medicines interactions" Pharmaceutical Press 2013
• 26 Richard, A.J., "St. John’s wort inhibits insulin signaling in murine and human adipocytes" 1822 : 557-563, 2012
• 27 Moore, L.B., "St. John’s wort induces hepatic drug metabolism through activation of the pregnane X receptor" 97 : 7500-7502, 2000
• 28 Bent, S., "Spontaneous bleeding associated with Ginkgo biloba" 20 : 657-661, 2005
• 29 Rowin, J., "Spontaneous bilateral subdural hematomas associated with chronic Ginkgo biloba ingestion" 46 : 1775-1776, 1996
• 30 Ono, S., "Specificity of substrate and inhibitor probes for cytochrome P450s : evaluation of in vitro metabolism using cDNA-expressed human P450s and human liver microsomes" 26 : 681-693, 1996
• 31 Unger, M., "Simultaneous determination of the inhibitory potency of herbal extracts on the activity of six major cytochrome P450 enzymes using liquid chromatography/mass spectrometry and automated online extraction" 18 : 2273-2281, 2004
• 32 Vuksan, V., "Similar postprandial glycemic reductions with escalation of dose and administration time of American ginseng in type 2 diabetes" 23 : 1221-1226, 2000
• 33 Derosa, G., "Sibutramine and L-carnitine compared to sibutramine alone on insulin resistance in diabetic patients" 49 : 1717-1725, 2010
• 34 Sugiyama, T., "Selective protection of curcumin against carbon tetrachloride-induced inactivation of hepatic cytochrome P450 isozymes in rats" 78 : 2188-2193, 2006
• 35 Kim, H.Y., "Regulation of signaling molecules associated with insulin action, insulin secretion and pancreatic bcell mass in the hypoglycemic effects of Korean red ginseng in Goto-Kakizaki rats" 142 : 53-58, 2012
• 36 Fu, L.X., "Puerarin protects rat pancreatic islets from damage by hydrogen peroxide" 529 : 1-7, 2006
• 37 Menegazzi, M., "Protective effects of St. John’s wort extract and its component hyperforin against cytokine-induced cytotoxicity in a pancreatic b-cell line" 40 : 1509-1521, 2008
• 38 Butterweck, V., "Potential of pharmacokinetic profiling for detecting herbal interactions with drugs" 47 : 383-397, 2008
• 39 Lam, A.Y., "Possible interaction between warfarin and Lycium barbarum L" 35 : 1199-1201, 2001
• 40 Hou, X.L., "Possible inhibitory mechanism of Curcuma drugs on CYP3A4 in 1a, 25 dihydroxyvitamin D-3 treated Caco-2 cells" 337 : 169-177, 2007
• 41 Yagi, A., "Possible efficacy of aloe vera gel metabolites in longterm ingestion to insulin sensitivity" 3 : 996-1005, 2014
• 42 Lee, S.H., "Polysaccharide isolated from Triticum aestivum stimulates insulin release from pancreatic cells via the ATP-sensitive K? channel" 29 : 913-, 2012
• 43 Tongia, A., "Phytochemical determination and extraction of Momordica charantia fruit and its hypoglycemic potentiation of oral hypoglycemic drugs in diabetes mellitus(NIDDM)" 48 : 241-244, 2004
• 44 Anthony, J.B., "Pharmacology Weekly"
• 45 Yin, O.Q., "Pharmacogenetics and herb–drug interactions : Experience with Ginkgo biloba and omeprazole" 14 : 841-850, 2004
• 46 Asdaq, S.M.B, "Pharmacodynamic interaction of captopril with garlic in isoproterenol-induced myocardial damage in rat" 24 : 720-725, 2010
• 47 Nivitabishekam, S.N., "Pharmacodynamic interaction of Momordica charantia with rosiglitazone in rats" 177 : 247-253, 2009
• 48 Gray, A.M., "Pancreatic and extra-pancreatic effects of the traditional anti-diabetic plant, Medicago sativa(lucerne)" 78 : 325-334, 1997
• 49 Derosa, G., "Orlistat and L-carnitine compared to orlistat alone on insulin resistance in obese diabetic patients" 57 : 777-, 2010
• 50 Hannan, J., "Ocimum sanctum leaf extracts stimulate insulin secretion from perfused pancreas, isolated islets and clonal pancreatic b-cells" 189 : 127-136, 2006
• 51 Subhrojit Sen, "North American Ginseng (Panax quinquefolius) Prevents Hyperglycemia and Associated Pancreatic Abnormalities in Diabetes" 한국식품영양과학회 16 (16): 587-592, 2013
• 52 Arold, G., "No relevant interaction with alprazolam, caffeine, tolbutamide, and digoxin by treatment with a low-hyperforin St. John’s wort extract" 71 : 331-337, 2005
• 53 Jellin, J., "Natural medicines comprehensive database" Therapeutic Research Faculty 2014
• 54 Boullata, J, "Natural health product interactions with medication" 20 : 33-51, 2005
• 55 Wang, J.F., "Molecular modeling of cytochrome P450 and drug metabolism" 11 : 342-346, 2010
• 56 Kober, M., "Molecular Mechanisms Underlying St. Johns wort Drug Interactions" 9 : 1027-1037, 2008
• 57 Raza, H., "Modulation of xenobiotic metabolism and oxidative stress in chronic streptozotocin-induced diabetic rats fed with Momordica charantia fruit extract" 14 : 131-139, 2000
• 58 Budzinski, J.W., "Modulation of human cytochrome P450 3A4(CYP3A4)and P-glycoprotein(P-gp)in Caco-2 cell monolayers by selected commercial-source milk thistle and goldenseal products This article is one of a selection of papers published in this special issue(part 1 of 2)on the Safety and Efficacy of Natural Health Products" 85 : 966-978, 2007
• 59 Choi, H.C, "Metabolic effects of aloe vera gel complex in obese prediabetes and early non-treated diabetic patients : Randomized controlled trial" 29 : 1110-1114, 2013
• 60 Lai, D.M., "Mediation of beta-endorphin by ginsenoside Rh2 to lower plasma glucose in streptozotocin-induced diabetic rats" 72 : 9-13, 2006
• 61 Chen, W.C., "Mediation of b-endorphin by the isoflavone puerarin to lower plasma glucose in streptozotocin-induced diabetic rats" 70 : 113-116, 2004
• 62 Yoo, H.H., "Mechanism-based inactivation of cytochrome P450 3A4 by methylenedioxyphenyl lignansfrom Acanthopanaxchiisanensis" 74 : 808-813, 2008
• 63 Yoo, H.H., "Mechanism-based inactivation of cytochrome P450 2A6 by decursinol angelate isolated from Angelica gigas" 35 : 1759-1765, 2007
• 64 Zhong, Z., "Major hypoglycemic ingredients of panax notoginseng saponins for treating diabetes" 45 : 235-239, 2014
• 65 Yu, C., "Liquid chromatography/tandem mass spectrometric determination of inhibition of human cytochrome P450 isozymes by resveratrol and resveratrol-3-sulfate" 17 : 307-313, 2003
• 66 Mingrone, G., "L-Carnitine improves glucose disposal in type 2 diabetic patients" 18 : 77-82, 1999
• 67 Vuksan, V., "Korean red ginseng(Panax ginseng)improves glucose and insulin regulation in well-controlled, type 2 diabetes : Results of a randomized, double-blind, placebocontrolled study of efficacy and safety. Nutrition" 18 : 46-56, 2008
• 68 Hikino, H., "Isolation and hypoglycemic activity of eleutherans A, B, C, D, E, F, and G : Glycans of Eleutherococcus senticosus roots" 49 : 293-297, 1986
• 69 Malati, C.Y., "Influence of Panax ginseng on cytochrome P450(CYP)3A and P-glycoprotein(P-gp)activity in healthy participants" 52 : 932-939, 2012
• 70 Kim, B.H., "Influence of Ginkgo biloba extract on the pharmacodynamic effects and pharmacokinetic properties of ticlopidine : An open-label, randomized, two-period, two-treatment, two-sequence, single-dose crossover study in healthy Korean male volunteers" 32 : 380-390, 2010
• 71 Yeleswaram, K, "Involvement of cytochrome P-450 isozymes in melatonin metabolism and clinical implications" 26 : 190-191, 1999
• 72 Jiang, X., "Investigation of the effects of herbal medicines on warfarin response in healthy subjects : A population pharmacokinetic-pharmacodynamic modeling approach" 46 : 1370-1378, 2006
• 73 Hulin, A., "Intoxication aigue ¨ par Momordica charantia(Sorrossi)(a ` propos de deux cas)" 35 : 671-674, 1988
• 74 Dasgupta, A, "Interference of hawthorn on serum digoxin measurements by immunoassays and pharmacodynamic interaction with digoxin" 134 : 1188-1192, 2010
• 75 Izzo, A.A., "Interactions between herbal medicines and prescribed drugs" 69 : 1777-1798, 2009
• 76 Appiah-Opong, R., "Interactions between cytochromes P450, glutathione S-transferases and Ghanaian medicinal plants" 46 : 3598-3603, 2008
• 77 Aslam, M., "Interaction between curry ingredient(karela)and drug(chlorpropamide)" 313 : 607-, 1979
• 78 Daisy, P., "Insulin mimetic impact of Catechin isolated from Cassia fistula on the glucose oxidation and molecular mechanisms of glucose uptake on streptozotocin-induced diabetic Wistar rats" 17 : 28-36, 2010
• 79 Qiu, F., "Inhibitory effects of seven components of danshen extract on catalytic activity of cytochrome P450 enzyme in human liver microsomes" 36 : 1308-1314, 2008
• 80 Moltke, L.L., "Inhibition of human cytochromes P450 by components of Ginkgo biloba" 56 : 1039-1044, 2004
• 81 Obach, R.S., "Inhibition of human cytochrome P450 enzymes by constituents of St. John’s wort, an herbal preparation used in the treatment of depression" 294 : 88-95, 2000
• 82 Gaudineau, C., "Inhibition of human P450 enzymes by multiple constituents of the Ginkgo biloba extract" 318 : 1072-1078, 2004
• 83 Sugiyama, T, "Induction and recovery of hepatic drug metabolizing enzymes in rats treated with Ginkgo biloba extract" 42 : 953-957, 2004
• 84 Tiwari, J.K., "Indigenous uses of plant species in Nanda Devi Biosphere Reserve, Uttarakhand, India" 2 : 58-61, 2010
• 85 Liu, C., "Increased glucagon-like peptide-1 secretion may be involved in antidiabetic effects of ginsenosides" 217 : 185-196, 2013
• 86 Lee, W.K., "Increase of insulin secretion by ginsenoside Rh2 to lower plasma glucose in Wistar rats" 33 : 27-32, 2006
• 87 Guo, Y.J., "In vivo inhibitory effects of puerarin on selected rat cytochrome P450 isoenzymes" 69 : 367-370, 2014
• 88 Gurley, B.J, "In vivo effects of Goldenseal, kava kava, black cohosh, and valerian on human cytochrome P450 1A2, 2D6, 2E1, and 3A4/5 phenotypes" 77 : 415-426, 2005
• 89 Persiani, S., "In vitro study of the inhibition and inductionof human cytochromesP450 by crystallineglucosamine sulfate" 24 : 195-210, 2009
• 90 Pan, Y., "In vitro modulatory effects of Andrographis paniculata, Centella asiatica and Orthosiphon stamineus on cytochrome P450 2C19(CYP2C19)" 133 : 881-887, 2011
• 91 Pan, Y., "In vitro determination of the effect of Andrographis paniculata extracts and andrographolide on human hepatic cytochrome P450 activities" 65 : 440-447, 2011
• 92 Hiratsuka, M., "In vitro assessment of the allelic variants of cytochrome P450" 27 : 68-84, 2012
• 93 Langhammer, A.J., "In vitro Inhibition of Human CYP1A2, CYP2D6, and CYP3A4 by six herbs commonly used in pregnancy" 28 : 603-610, 2014
• 94 Leatherdale, B., "Improvement in glucose tolerance due to Momordica charantia (karela)" 282 : 1823-, 1981
• 95 Brown, L., "Impact of traditional medicinal plant extracts on antiretroviral drug absorption" 119 : 588-592, 2008
• 96 Whiting, D.R., "IDF diabetes atlas : Global estimates of the prevalence of diabetes for 2011 and 2030" 94 : 311-321, 2011
• 97 Li, W., "Hypoglycemic effect of protopanaxadiol-type ginsenosides and compound K on Type 2 diabetes mice induced by high-fat diet combining with streptozotocin via suppression of hepatic gluconeogenesis" 83 : 192-198, 2012
• 98 Luo, Q., "Hypoglycemic and hypolipidemic effects and antioxidant activity of fruit extracts from Lycium barbarum" 76 : 137-149, 2004
• 99 Choudhary, M., "Hypoglycemic and hypolipidemic effect of Aloe vera L. in non-insulin dependent diabetics" 51 : 90-96, 2014
• 100 Khanna, P., "Hypoglycemic activity of polypeptide-p from a plant source" 44 : 648-655, 1981
• 101 Borhanuddin, M., "Hypoglycemia effects of Andrographis paniculata Nees on non-diabetic rabbits" 20 : 2-24, 1994
• 102 Singh, K.N., "Hypoglycaemic activity of Albizzia stipulata, Albizzia moluccana and Cassia fistula leguminous seed diets on normal young rats" 7 : 47-, 1975
• 103 Kang, M.H., "Hypertension after ingestion of baked garlic(Allium sativum)in a dog" The Japanese Society of Veterinary Science 72 : 515-, 2010
• 104 Madabushi, R., "Hyperforin in St. John’s wort drug interactions" 62 : 225-233, 2006
• 105 Chatterjee, P., "Human cytochrome P450 inhibition and metabolic-intermediate complex formation by goldenseal extract and its methylenedioxyphenyl components" 31 : 1391-1397, 2003
• 106 Tarirai, C., "Herb–drug pharmacokinetic interactions reviewed" 6 : 1515-1538, 2010
• 107 Meijerman, I., "Herb–drug interactions in oncology : Focus on mechanisms of induction" 11 : 742-752, 2006
• 108 Isnard Bagnis, C., "Herbs and the kidney" 44 : 1-11, 2004
• 109 Walker, P.S., "Herbal remedies : Natural caveats" 38 : 746-748, 1999
• 110 Kuhn, M.A., "Herbal remedies : Drug–herb interactions" 22 : 22-32, 2002
• 111 Hafner-Blumenstiel, V., "Herbal drug–drug interaction and adverse drug reactions. Therapeutische Umschau" 68 : 54-, 2011
• 112 Crosby, E.C., "Herbal diuretic induced dehydration and resting metabolic rate" 33 : S163-, 2001
• 113 Chan, N.N., "Glucosamine sulphate and osteoarthritis" 357 : 1618-1619, 2001
• 114 Cho, W., "Ginsenoside Re of Panax ginseng possesses significant antioxidant and antihyperlipidemic efficacies in streptozotocin-induced diabetic rats" 550 : 173-179, 2006
• 115 Lee, M.S., "Ginsenoside Rc, an active component of Panax ginseng, stimulates glucose uptake in C2C12 myotubes through an AMPK-dependent mechanism" 127 : 771-776, 2010
• 116 Greenblatt, D.J., "Ginkgo biloba does not alter clearance of flurbiprofen, a cytochrome P450-2C9 substrate" 46 : 214-221, 2006
• 117 Mohutsky, M.A., "Ginkgo biloba : evaluation of CYP2C9 drug interactions in vitro and in vivo" 13 : 24-31, 2006
• 118 Gilbert, G.J, "Ginkgo biloba" 48 : 1137-1137, 1997
• 119 Fetrow, C.W., "Fetrow, and Avila professional’s handbook of complementary and alternative medicines" Springhouse Corporation 1999
• 120 Chavez, M.L, "Evidence-based drug–herbal interactions" 78 : 2146-2157, 2006
• 121 Van den Bout-Van Den Beukel, C.J., "Evaluation of cytotoxic, genotoxic and CYP450 enzymatic competition effects of Tanzanian plant extracts traditionally used for treatment of fungal infections" 102 : 515-526, 2008
• 122 Muhammad, I., "Ethnopharmacological survey of plants used for the treatment of stomach, diabetes, and ophthalmic diseases in Sudhan Gali, Kashmir, Pakistan" 28 : 535-542, 2006
• 123 Norlin, M., "Enzymes in the conversion of cholesterol into bile acids" 7 : 199-218, 2007
• 124 Choi, J.S., "Enhanced paclitaxel bioavailability after oral administration of paclitaxel or prodrug to rats pretreated with quercetin" 57 : 313-318, 2004
• 125 Sugiyama, T., "Effects of various Ginkgo biloba extracts and proanthocyanidin on hepatic cytochrome P450 activity in rats" 45 : 295-, 2004
• 126 Zou, L., "Effects of herbal components on cDNA-expressed cytochrome P450 enzyme catalytic activity" 71 : 1579-1589, 2002
• 127 Samson, R., "Effects of dietary garlic and temporal drift on platelet aggregation" 44 : 119-120, 1982
• 128 Matsuda, K., "Effects of continuous ingestion of herbal teas on intestinal CYP3A in the rat" 103 : 214-221, 2007
• 129 Van Dam, R.M., "Effects of coffee consumption on fasting blood glucose and insulin concentrations randomized controlled trials in healthy volunteers" 27 : 2990-2992, 2004
• 130 Kim, I.S., "Effects of an aqueousethanolic extract of ginger on cytochrome P450 enzymemediated drug metabolism" 67 : 1007-1009, 2012
• 131 Xu, H., "Effects of St. John’s wort and CYP2C9 genotype on the pharmacokinetics and pharmacodynamics of gliclazide" 153 : 1579-1586, 2008
• 132 Uchida, S., "Effects of Ginkgo biloba extract on pharmacokinetics and pharmacodynamics of tolbutamide and midazolam in healthy volunteers" 46 : 1290-1298, 2006
• 133 Fan, L., "Effects of Ginkgo biloba extract ingestion on the pharmacokinetics of talinolol in healthy Chinese volunteers" 43 : 944-949, 2009
• 134 Komoroski, B.J, "Effect of the St. John’s wort constituent hyperforin on docetaxel metabolism by human hepatocyte cultures" 11 : 6972-6979, 2005
• 135 Kim, K.A., "Effect of quercetin on the pharmacokinetics of rosiglitazone, a CYP2C8 substrate, in healthy subjects" 45 : 941-946, 2005
• 136 Gonzalez-Ortiz, M., "Effect of oral Lcarnitine administration on insulin sensitivity and lipid profile in type 2 diabetes mellitus patients" 52 : 335-338, 2008
• 137 Nirmala, A., "Effect of hexane extract of Cassia fstula barks on blood glucose and lipid profile in streptozotocin diabetic rats" 4 : 292-296, 2008
• 138 Qiu, F., "Effect of danshen extract on the activity of CYP3A4 in healthy volunteers" 69 : 656-662, 2010
• 139 Raza, H., "Effect of bitter melon(Momordica Charantia)fruit juice on the hepatic cytochrome P450-dependent monooxygenases and glutathione S-transferases in streptozotocininduced diabetic rats" 52 : 1639-1642, 1996
• 140 Gaede, P., "Effect of a multifactorial intervention on mortality in type 2 diabetes" 358 : 580-591, 2008
• 141 Karyekar, C., "Effect of St. John’s Wort extract on intestinal expression of cytochrome P4501A2 : studies in LS180 cells" 48 : 97-, 2002
• 142 Hruska, M, "Effect of St. John’s Wort administration on CYP2C8 mediated rosiglitazone metabolism" 77 : P35-, 2005
• 143 Fan, L., "Effect of Schisandra chinensis extract and Ginkgo biloba extract on the pharmacokinetics oftalinolol in healthy volunteers" 39 : 249-254, 2009
• 144 Welihinda, J, "Effect of Momordica charantia on the glucose tolerance in maturity onset diabetes" 17 : 277-282, 1986
• 145 Zhao, R, "Effect of Lycium barbarum polysaccharide on the improvement of insulin resistance in NIDDM rats" 125 : 981-988, 2005
• 146 Rahbar, A., "Effect of L-carnitine on plasma glycemic and lipidemic profile in patients with type II diabetes mellitus" 59 : 592-596, 2005
• 147 Ahmed, M., "Effect of Berberis lycium Royle on lipid profile in alloxan induced diabetic rabbits" 13 : 702-708, 2009
• 148 Skalli, S., "Drug interactions with herbal medicines" 29 : 679-686, 2007
• 149 Anderson, G.D., "Drug interaction potential of soy extract and Panax ginseng" 43 : 643-648, 2003
• 150 Walker, B.R., "Davidson’s principles and practice of medicine" Elsevier 2013
• 151 Nowack, R., "Cytochrome P450 enzyme, and transport protein mediated herb–drug interactions in renal transplant patients: Grapefruit juice, St. John’s wort—and beyond!" 13 : 337-347, 2008
• 152 Marchetti, S., "Concise review : clinical relevance of drug–drug and herb–drug interactions mediated by the ABC transporter ABCB1(MDR1, P-glycoprotein)" 12 : 927-941, 2007
• 153 Kim, D.Y., "Compound K, intestinal metabolite of ginsenoside, attenuates hepatic lipid accumulation via AMPK activation in human hepatoma cells" 57 : 1532-1537, 2009
• 154 Caughey, G.E, "Comorbidity in the elderly with diabetes : Identification of areas of potential treatment conflicts" 87 : 385-393, 2010
• 155 Van Dam, R., "Coffee and type 2 diabetes : From beans to betacells. Nutrition" 16 : 69-77, 2006
• 156 Cordero-Herrera, I., "Cocoa flavonoids improve insulin signalling and modulateglucose production via AKT and AMPK in HepG2 cells" 57 : 974-985, 2013
• 157 Baldwa, V., "Clinical trial in patients with diabetes mellitus of an insulin-like compound obtained from plant source" 82 : 39-41, 1977
• 158 Nebert, D.W., "Clinical importance of the cytochromes P450" 360 : 1155-1162, 2002
• 159 Gurley, B.J., "Clinical assessment of CYP2D6-mediated herb–drug interactions in humans : Effects of milk thistle, black cohosh, goldenseal, kava kava, St. John’s Wort, and Echinacea" 52 : 755-763, 2008
• 160 Ratnasooriya, W.D., "Cassia fistula and hypoglycaemia" 16 : 8-, 2004
• 161 Jain, R.K., "Can glucosamine supplements be applied for all patients with type 2 diabetes with osteoarthritis?" 164 : 807-, 2004
• 162 National Institutes of Health Office of Dietary Supplements, "Botanical dietary supplements: Background information"
• 163 Yimam, M., "Blood glucose lowering activity of aloe based composition, UP780, in alloxan induced insulin dependent mice diabetes model" 6 : 61-, 2014
• 164 Narendhirakannan, R., "Biochemical evaluation of antidiabetogenic properties of some commonly used Indian plants on streptozotocin-induced diabetes in experimental rats" 33 : 1150-1157, 2006
• 165 Dusane, M.B., "Beneficial effect of flax seeds in streptozotocin(STZ)induced diabetic mice : isolation of active fraction having islet regenerative and glucosidase inhibitory properties" 91 : 325-331, 2013
• 166 Bertram, G.K., "Basic and clinical pharmacology" Editorial Mc Graw Hill 2012
• 167 Xiong, Y., "Antiobesity and antihyperglycemic effects of ginsenoside Rb1 in rats" 59 : 2505-2512, 2010
• 168 Virdi, J., "Antihyperglycemic effects of three extracts from Momordica charantia" 88 : 107-111, 2003
• 169 Hsu, F.L., "Antihyperglycemic effect of puerarin in streptozotocininduced diabetic rats" 66 : 788-792, 2003
• 170 Yu, B.C., "Antihyperglycemic effect of andrographolide in streptozotocin-induced diabetic rats" 69 : 1075-1079, 2003
• 171 Zhang, X.F., "Antihyperglycemic and antioxidant properties of Andrographis paniculata in normal and diabetic rats" 27 : 358-363, 2000
• 172 Sun, C., "Antihyperglycemic and anti-oxidative activities of ginseng polysaccharides in STZ-induced diabetic mice" 5 : 845-848, 2014
• 173 Ali, M.A., "Antihyperglycemic and analgesic activities of ethanolic extract of Cassia fistula(L. )stem bark" 3 : 416-423, 2012
• 174 Liu, Z., "Antidiabetic effects of malonyl ginsenosides from Panax ginseng on type 2 diabetic rats induced by high-fat diet and streptozotocin" 145 : 233-240, 2013
• 175 Srivastava, Y, "Antidiabetic and adaptogenic properties of Momordica charantia extract : An experimental and clinical evaluation" 7 : 285-289, 1993
• 176 Malpani, S.N., "Antidiabetic activity of Cassia fistula Linn. bark in alloxan induced diabetic rats" 2 : 382-385, 2010
• 177 Yongchaiyudha, S., "Antidiabetic activity of Aloe vera L. juice. I. Clinical trial in new cases of diabetes mellitus" 3 : 241-243, 1996
• 178 Bunyapraphatsara, N, "Antidiabetic activity of Aloe vera L. juice II. Clinical trial in diabetes mellitus patients in combination with glibenclamide" 3 : 245-248, 1996
• 179 Raman, A., "Anti-diabetic properties and phytochemistry of Momordica charantia L. (Cucurbitaceae)" 2 : 349-362, 1996
• 180 Reyes, B., "Anti-diabetic potentials of Momordica charantia and Andrographis paniculata and their effects on estrous cyclicity of alloxan-induced diabetic rats" 105 : 196-200, 2006
• 181 Ooi, J.P., "Andrographolide and 14-deoxy-11, 12-didehydroandrographolide inhibit cytochrome P450s in HepG2 hepatoma cells" 88 : 447-454, 2011
• 182 Yale, S.H., "Analysis of the inhibitory potential of Ginkgo biloba, Echinacea purpurea, and Serenoa repens on the metabolic activity of cytochrome P450 3A4, 2D6, and 2C9" 11 : 433-439, 2005
• 183 Smith, M., "An open trial of nifedipineherb interactions: Nufedipine with St. John’s wort, Ginseng or Ginko biloba" Mosby, Inc P86-, 2001
• 184 Budzinski, J., "An in vitro evaluation of human cytochrome P450 3A4 inhibition by selected commercial herbal extracts and tinctures" 7 : 273-282, 2000
• 185 Foster, B.C., "An in vitro evaluation of human cytochrome P450 3A4 and P-glycoprotein inhibition by garlic" 4 : 176-184, 2001
• 186 Etheridge, A.S., "An in vitro evaluation of cytochrome P450 inhibition and P-glycoprotein interaction with goldenseal, Ginkgo biloba, grape seed, milk thistle, and ginseng extracts and their constituents" 73 : 731-741, 2007
• 187 Zhou, S.F., "An Update on Clinical Drug Interactions with the Herbal Antidepressant St. John’s wort" 9 : 394-409, 2008
• 188 Vuksan, V., "American ginseng improves glycemia in individuals with normal glucose tolerance : Effect of dose and time escalation" 19 : 738-744, 2000
• 189 Vuksan, V., "American ginseng (Panax quinquefolius L.) reduces postprandial glycemia in nondiabetic subjects and subjects with type 2 diabetes mellitus" 160 : 1009-, 2000
• 190 Djuv, A., "Aloe vera juice : IC50 and dual mechanistic inhibition of CYP3A4 and CYP2D6" 26 : 445-451, 2012
• 191 Gray, A.M., "Actions of the traditional antidiabetic plant, Agrimony eupatoria(agrimony) : effects on hyperglycaemia, cellular glucose metabolism and insulin secretion" 80 : 109-114, 1998
• 192 Sun, H., "A ‘‘highthroughput’’ cocktail method for screening the effect of herbal product on liver isozyme activities: Experience with Ginkgo biloba" 71 : P100-, 2002
• 193 Ahn, E.K., "1bHydroxy-2-oxopomolic acid isolated from Agrimonia pilosa extract inhibits adipogenesis in 3T3-L1 cells" 35 : 643-649, 2011