Abstract
BackgroundThe prevalence and therapeutic effects of the use of herbal remedies for chronic liver diseases make the combined administration of herbal products with conventional treatment unable to be ignored. This study investigated the pharmacokinetic and pharmacodynamic herb-drug interactions between the herbal formula Yin-Chen-Hao-Tang (YCHT) and spironolactone.MethodsA selective high-performance liquid chromatography (HPLC) method was developed and validated for the detection of spironolactone and its metabolite canrenone in rat urine. The interaction study was conducted by collecting urine samples after oral administration of spironolactone alone or in combination with YCHT for 5 days. Urine pharmacokinetic parameters and urinary sodium, potassium, volume, and weight were analyzed.ResultsThe results revealed significant increases in the cumulative amount and the area under the rate curve (AURC) of the metabolite canrenone after pretreatment with the high dose of YCHT. The urine weight and volume were significantly reduced dose-dependently as a result of pretreatment with YCHT. The urinary sodium-to-potassium ratio, which indicates diuretic effects, was also reduced in the high-dose YCHT condition.ConclusionsHerb-drug pharmacokinetic and pharmacodynamic interactions between YCHT and spironolactone were observed in the study. The herb-drug interaction that appeared with a single dose of spironolactone should be considered when patients are being treated with a continuous administration of this drug.
Highlights
The prevalence and therapeutic effects of the use of herbal remedies for chronic liver diseases make the combined administration of herbal products with conventional treatment unable to be ignored
The pharmaceutical herbal powder formula Yin-Chen-Hao-Tang was purchased from Kaiser Pharmaceutical Co., Ltd. and was quantified by a Shimadzu UHPLC system coupled to an electrospray ionization (ESI) source equipped with an LCMS-8030 triple quadrupole mass spectrometer to guarantee the consistent quality of the herbal formula powder [33]
The experimental results showed that the pharmacokinetic parameters of the cumulative amount and area under the rate curve (AURC) of canrenone were significantly increased by pretreatment with high-dose YCHT
Summary
The prevalence and therapeutic effects of the use of herbal remedies for chronic liver diseases make the combined administration of herbal products with conventional treatment unable to be ignored. The main causes of chronic liver disease in Europe are viral hepatitis B and C, excessive alcohol consumption, and metabolic syndrome combined with obesity [1]. Paracentesis is faster, is associated with fewer adverse events and has been shown to be more effective for large volume ascites in randomized trials, diuretics should be administered as maintenance therapy to prevent ascites recurrence, and no difference was observed in long-term mortality between the two strategies [8, 9]. Spironolactone is the first-line treatment for ascites due to cirrhosis unless it fails to result in a response [12]
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