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. 2018 Oct 1:2018:4259603.
doi: 10.1155/2018/4259603. eCollection 2018.

Inhibitory Effect of Japanese Traditional Kampo Formula Frequently Prescribed in Gynecological Clinics on CYP3A4

Hao Ni  1 , Takashi Matsumoto  2 , Junko Watanabe  2 , Toshiaki Makino  1
Affiliations

Inhibitory Effect of Japanese Traditional Kampo Formula Frequently Prescribed in Gynecological Clinics on CYP3A4

Hao Ni et al. Evid Based Complement Alternat Med. .

Abstract

Recently, the use of herbal medicines has become popular, and information on drug interactions between herbal medicines and chemical drugs is needed in clinics. In Japan, the number of patients taking Japanese traditional Kampo medicines has been increasing, and the proper drug information about herb-drug interaction is highly demanded. The most established herb-drug interaction is the case of grapefruit juice (GFJ) via the inhibition on CYP3A4 expressed in the small intestine. In the present study, we compared the inhibitory titer on CYP3A4 between the target Kampo products and GFJ used as positive control. We evaluated the inhibitory effects of GFJ and three extracts of Kampo formulas frequently used in gynecological clinics on CYP3A4 in vitro and calculated the related titer of one-time dosage of Kampo formulas to GFJ in order to predict its effect on clinics. Although the extracts of these three Kampo formulas and the most of crude drug components in the formulas exhibited the inhibitory effects on CYP3A4 in some levels, the possibilities of tokishakuyakusan and keishibukuryogan to cause drug interaction can be quite low; however, it is possible that the excessive dosage of kamishoyosan may cause drug interaction with the substrate of CYP3A4 in clinics.

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Figures

Figure 1
Figure 1
Inhibitory effect of the grapefruit juice (GFJ) used in this study on CYP3A4. Data are expressed as the mean ± SD (n = 3).
Figure 2
Figure 2
Inhibitory effect of tokishakuyakusan, kamishoyosan, and keishibukuryogan extracts on CYP3A4. (a) Each extract of Kampo formula was prepared from crude drug mixture described in Materials and Methods. (b) Each extract of Kampo formula was original dried extract of ethical Kampo extract formulation supplied from Tsumura Co., Ltd. Data are expressed as the mean ± SD (n = 3).
Figure 3
Figure 3
Inhibitory effect of the extracts of crude drugs composing tokishakuyakusan, kamishoyosan, and keishibukuryogan extracts on CYP3A4. Data are expressed as the mean ± SD (n = 3).
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