Title:Assessment of Herb-drug Interactions Based on the Pharmacokinetic Changes of Probe Drug, Midazolam
Volume: 14
Issue: 1
Author(s): Sarvesh Sabarathinam*Thangavel M. Vijayakumar*
Affiliation:
- Department of Pharmacy Practice, SRM College of Pharmacy, SRM IST, Kattankulathur, Kancheepuram, Tamil Nadu,India
- Department of Pharmacy Practice, SRM College of Pharmacy, SRM IST, Kattankulathur, Kancheepuram, Tamil Nadu,India
Keywords:
CYP3A4, herb-drug interactions, healthy volunteers, midazolam, metabolism, pharmacokinetics, probe drug, substrates.
Abstract:
Background: In healthy volunteers, the probe drug method is widely practised to assess
the pharmacokinetic mediated herb-drug interactions (HDI). We analyzed the clinical evidence of
CYP3 A4 probe drug, Midazolam.
Methods: Literatures, where Midazolam was used as a probe drug for prediction of herb-drug interaction,
were surveyed through an online database such as google scholar, Scopus, Cochrane,
PubMed and clinicaltrials.gov.
Results: Midazolam was considered a sensitive probe for CYP3A4 substrates due to its bioavailability.
We observed that not all the herbs are causing drug interaction. However, significant
changes of the Midazolam pharmacokinetics were found after high-dose and long-term intake of
some herbs and food supplements, suggesting the induction and/or inhibition of CYP activities.
Conclusion: Probe drug technique is one of the easiest ways for predicting CYP enzyme-mediated
herb-drug interactions. Midazolam shows a good response in clinical studies because of short halflife
and low harmfulness compared with other probe drugs.
