Pharmacokinetic interactions of curcuminoids with conventional drugs: A review

Journal of Ethnopharmacology Volume 209, 14 September 2017, Pages 1-12 Journal of Ethnopharmacology Review . Author links open the author workspace.RoodabehBahramsoltania. Numbers and letters correspond to the affiliation list. Click to expose these in author workspaceb. Numbers and letters correspond to the affiliation list. Click to expose these in author workspaceOpens the author workspace. Author links open the author workspace.RojaRahimia. Numbers and letters correspond to the affiliation list. Click to expose these in author workspaceb. Numbers and letters correspond to the affiliation list. Click to expose these in author workspaceOpens the author workspace. Author links open the author workspace.Mohammad HoseinFarzaeic. Numbers and letters correspond to the affiliation list. Click to expose these in author workspaced. Numbers and letters correspond to the affiliation list. Click to expose these in author workspaceOpens the author workspaceOpens the author workspace a Department of Traditional Pharmacy, School of Traditional Medicine, Tehran University of Medical Sciences, Tehran 1417614411, Iran b PhytoPharmacology Interest Group (PPIG), Universal Scientific Education and Research Network (USERN), Tehran, Iran c Pharmaceutical Sciences Research Center, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran d Medical Biology Research Center, Kermanshah University of Medical Sciences, Kermanshah 6734667149, Iran Received 27 December 2016, Revised 14 July 2017, Accepted 15 July 2017, Available online 19 July 2017. crossmark-logo Show less https://doi.org/10.1016/j.jep.2017.07.022Get rights and content Abstract Ethnopharmacological relevance Herb–drug interactions are of great concern in health practices. Curcumin is a natural polyphenol extracted from turmeric, a spice widely used all over the world. Curcumin is clinically used due to its acceptable safety profile and therapeutic efficacy. Aim of the study Current paper aims to highlight the effect of curcumin on concomitantly used drugs. Methods Electronic databases including PubMed, Scopus and Science Direct were searched with the keywords "curcumin" in the title/abstract and "drug interaction," "drug metabolism," "cytochrome," "P-glycoprotein" and "P450" in the whole text. Results Curcumin can induce pharmacokinetic alterations such as changes in Cmax and AUC when concomitantly used with pharmacological agents like cardiovascular drugs, antidepressants, anticoagulants, antibiotics, chemotherapeutic agents, and antihistamines. The underlying mechanisms of these interactions include inhibition of cytochrome (CYP) isoenzymes and P-glycoprotein. There is only one clinical trial which proved a significant alteration of conventional drugs in concomitant use with curcumin indicating the need for further human studies. Conclusions Although in vitro and in vivo studies do not provide enough evidence to judge the clinical drug interactions of curcumin, physicians must remain cautious and avoid drug combinations which may lead to curcumin-drug interactions. Graphical abstract CYP: cytochrome P450, CL: clearance, OATP: organic anion-transporting polypeptide, AUC: area under the plasma concentration-time curve, Cmax: maximum plasma concentration, GST: glutathione-S-transferase, P-gp: P-glycoprotein, UDPG: Uridine dinucleotide phosphate glucuronosyltransferases. fx1 Download high-res image (203KB)Download full-size image Abbreviations OTCover the counterAUCarea under the plasma concentration-time curveAUMCarea under first moment of plasma drug concentration-time curveMRTmean residence timeVdareaapparent volume of distributionCLclearanceCYPcytochromeP-gpP-glycoproteinCmaxmaximum plasma concentrationkaabsorption rate constantOATPorganic anion transporting polypeptide Keywords CurcuminCurcuminoidsDrug interactionCytochromeP-glycoprotein