Drug interactions between herbal medicines and oral contraceptives
DOI:
https://doi.org/10.33448/rsd-v10i13.21331Keywords:
Oral Contraceptives; Drug Interactions; Phytotherapeutic drugs.Abstract
The use of herbal medicines has grown considerably in recent years, due to the erroneous thought that products of plant origin are harmless, and therefore do not cause adverse effects or have drug interactions. The use of these drugs with oral contraceptives can bring risks to patients. The potential negative clinical effects that can be caused by these drug interactions must be emphasized to prevent risks and ensure the effectiveness of this contraceptive method that is one of the most used by women seeking to prevent pregnancy. The users of herbal medicines usually believe that herbal medicine is a therapeutic alternative free of adverse effects and/or incapable of causing drug interactions, but herbal medicines are composed of several chemical compounds, which, in turn, may be responsible for antagonistic and/or synergistic effects with other drugs. The main interactions that can occur with contraceptives are with popularly used herbal medicines such as licorice, alfalfa, cannabis, cimicifuga, St. John's wort, ginseng, kava-kava, saw palmetto, sene, and soy. The herbal medicines have several chemical compounds, among which we highlight the secondary metabolites, responsible for the pharmacological actions and mechanism of action of drug interactions, which are often similar in plants that have in their composition the same metabolites, as in the case of saponins and isoflavones that reduce the speed of biotransformation of oral contraceptives.
References
Aizpurua-Olaizola, O., Soydaner, U., Öztürk, E., Schibano, D., Simsir, Y., Navarro, P., Etxebarria, N., & Usobiaga, A. (2016). Evolution of the Cannabinoid and Terpene Content during the Growth of Cannabis sativa Plants from Different Chemotypes. Journal of Natural Products, 79(2), 324–331. https://doi.org/10.1021/acs.jnatprod.5b00949
Almeida, A. P. F., & Assis, M. M. (2017). Efeitos colaterais e alterações fisiológicas relacionadas ao uso contínuo de anticoncepcionais hormonais orais. Rev.Eletrôn.Atualiza Saúde, 5(5), 85–93. http://atualizarevista.com.br/wp-content/uploads/2017/01/efeitos-colaterais-e-alterações-fisiológicas-relacionadas-ao-uso-contínuo-de-anticoncepcionais-hormonais-orais-v-5-n-5.pdf
Anke, J., & Ramzan, I. (2004). Pharmacokinetic and pharmacodynamic drug interactions with Kava (Piper methysticum Forst. f.). Journal of Ethnopharmacology, 93(2–3), 153–160. https://doi.org/10.1016/j.jep.2004.04.009
Bahamondes, L., Pinho, F., de Melo, N. R., Oliveira, E., & Bahamondes, M. V. (2011). Fatores associados à descontinuação do uso de anticoncepcionais orais combinados. Revista Brasileira de Ginecologia e Obstetricia, 33(6), 303–309. https://doi.org/10.1590/S0100-72032011000600007
Bahis, S. C. (2001). Antidepressant herbal treatment. Jornal Brasileiro de Psiquiatria, 50(11–12), 389–396.
Barnes J. (2003). Pharmacovigilance of herbal medicines: a UK perspective. Drug Saf. https://doi.org/10.2165 / 00002018-200326120-00001
Barnes, J. (2010). Black cohosh. Journal of Primary Health Care, 2(1), 79–80. https://doi.org/10.1071/hc10079
Bethesda. (2012). Phenhyltoloxamine. LiverTox: Clinical and Research Information on Drug-Induced Liver Injury, Bookshelf http://www.ncbi.nlm.nih.gov/pubmed/31643176
Bilia, A. R., Bergonzi, M. C., Lazari, D., & Vincieri, F. F. (2002). Characterization of commercial kava-kava herbal drug and herbal drug preparations by means of nuclear magnetic resonance spectroscopy. Journal of Agricultural and Food Chemistry, 50(18), 5016–5025. https://doi.org/10.1021/jf020049j
Biondi, D. M., Rocco, C., & Ruberto, G. (2005). Dihydrostilbene derivatives from Glycyrrhiza glabra leaves. Journal of Natural Products, 68(7), 1099–1102. https://doi.org/10.1021/np050034q
Bortolini, C. E. (2009). Efeitos Da Administração De Fitoterápico Contendo Glycine Max (L.) Merr Durante O Período De Organogênese Em Ratas Wistar. Universidade Federal Do Rio Grande Do Sul Faculdade De Veterinária Programa De Pós-Graduação Em Ciências Veterináriasprograma De Pós-Graduação Em Ciências Veterinárias, 78. Https://Www.Lume.Ufrgs.Br/Bitstream/Handle/10183/16327/000702157.Pdf?Sequence=1
Brasil. (2004). Resolução-rdc no 48, de 16 de março de 2004. Ministério da Saúde. Agência Nacional de Vigilância Sanitária. 2446-4775. http://revistafitos.far.fiocruz.br/index.php/revista-fitos/article/view/28
Brasil. (2006). Política Nacional de Plantas Medicinais e Fitoterápicos. https://bvsms.saude.gov.br/bvs/publicacoes/politica_nacional_fitoterapicos.pdf
Brasil. (2010). Farmacopeia Brasileira. Agência Nacional De Vigilância Sanitária SIA, 5° Edição. https://www.gov.br/agricultura/pt-br/assuntos/inspecao/produtos-vegetal/legislacao-1/biblioteca-de-normas-vinhos-e-bebidas/farmacopeia_volume-1_2010.pdf
Brasil. (2014). RDC N° 26, de 13 de maio de 2014. 34. https://bvsms.saude.gov.br/bvs/saudelegis/anvisa/2014/rdc0026_13_05_2014.pdf
Brasil. (2015). Política Nacional de Práticas Integrativas e Complementares no SUS. In Diário da República, 2.a série - n.o 102 (27-05-2015). https://bvsms.saude.gov.br/bvs/publicacoes/politica_nacional_praticas_integrativas_complementares_2ed.pdf
Brasil. (2016). Memento Fitoterápico da Farmacopeia Brasileira. Agência Nacional de Vigilância Sanitária, 1–114. https://www.gov.br/anvisa/pt-br/assuntos/farmacopeia/memento-fitoterapico/memento-fitoterapico.pdf/view
Brasil, N. (2001). Self medication. Revista Da Associação Médica Brasileira (1992), 47(4), 269–270. https://doi.org/10.1590/s0104-42302001000400001
Brito, M. B., Nobre, F., & Vieira, C. S. (2011). Hormonal contraception and cardiovascular system. Arquivos Brasileiros de Cardiologia, 96(4). https://doi.org/10.1590/S0066-782X2011005000022
Cook, B G.; Pengelly, BC; Brown, S.; Donnelly, JR; Eagles, D.; Franco, A.; Hanson, J.; Mullen, B.; Partridge, I.; Peters, M.; & Schultze-Kraft, R. (2005). Medicago sativa. In Tropical Forages: uma ferramenta de seleção interativa. http://www.tropicalforages.info/
Cordeiro, C. H. G., Chung, M. C., & Sacramento, L. V. S. do. (2005). Interações medicamentosas de fitoterápicos e fármacos: Hypericum perforatum e Piper methysticum. Revista Brasileira de Farmacognosia, 15(3), 272–278. https://doi.org/10.1590/s0102-695x2005000300019
Coulter, D., Tamayo, C., Sotheeswaran, S., & Ulbricht, C. (2007). Assessment of the risk of hepatotoxicity with kava products. WHO Library Cataloguing-in-Publication Data, 1–82. https://apps.who.int/iris/bitstream/handle/10665/43630/9789241595261_eng.pdf?sequence=1&isAllowed=y
CRF-SP. (2019). Medicinal Plants and Herbal Medicines. 4° Edição, 72. http://www.crfsp.org.br/images/cartilhas/PlantasMedicinais.pdf
Dhariwala, M. Y., & Ravikumar, P. (2019). An overview of herbal alternatives in androgenetic alopecia. Journal of Cosmetic Dermatology, 18(4), 966–975. https://doi.org/10.1111/jocd.12930
Duranti, M. (2006). Grain legume proteins and nutraceutical properties. Fitoterapia, 77(2), 67–82. https://doi.org/10.1016/j.fitote.2005.11.008
Esteves, M. H. S., Leite, B. de C., Vargas, A. M. P., Franco, A. J., & Diniz, R. S. (2020). Principais Interações No Uso De Medicamentos Fitoterápicos. Pesquisa, Produção e Difusão de Conhecimentos Nas Ciências Farmacêuticas 2, 173–178. https://doi.org/10.22533/at.ed.64820201118
Farias, M. R., Leite, S. N., Tavares, N. U. L., Oliveira, M. A., Arrais, P. S. D., Bertoldi, A. D., Pizzol, T. da S. D., Luiza, V. L., Ramos, L. R., & Mengue, S. S. (2016). Use of and access to oral and injectable contraceptives in Brazil. Revista de Saude Publica, 50(2). https://doi.org/10.1590/S1518-8787.2016050006176
Fernandes, A. V. F. (2011). Ginseng (Panax ginseng): Mito ou Verdade Científica? 57.
Greeson, J. M., Sanford, B., & Monti, D. A. (2001). St. John’s wort (Hypericum perforatum): A review of the current pharmacological, toxicological, and clinical literature. Psychopharmacology, 153(4), 402–414. https://doi.org/10.1007/s002130000625
Hall, S. D., Wang, Z., Huang, S. M., Hamman, M. A., Vasavada, N., Adigun, A. Q., Hilligoss, J. K., Miller, M., & Gorski, J. C. (2003). The interaction between St John’s wort and an oral contraceptive. Clinical Pharmacology and Therapeutics, 74(6), 525–535. https://doi.org/10.1016/j.clpt.2003.08.009
Hanan Abramovici, P. D., & Sophie-Anne Lamour, Ph.D. & George Mammen, P. D. (2018). Information for Health Care. https://www.canada.ca/en/health-canada/services/drugs-medication/cannabis/information-medical-practitioners/information-health-care-professionals-cannabis-cannabinoids.html#authorship
Huntley, A., & Ernst, E. (2003). A systematic review of the safety of black cohosh. Menopause, 10(1), 58–64. https://doi.org/10.1097/00042192-200310010-00010
Izzo, A. A., & Ernst, E. (2009). Interactions between herbal medicines and prescribed drugs: An updated systematic review. Drugs, 69(13), 1777–1798. https://doi.org/10.2165/11317010-000000000-00000
Justo, S. C., Silva, C. M., & Silva, C. M. (2008). Piper Methysticum G. Forster (Kava-Kava): Uma Abordagem Geral. Revista Eletrônica de Farmácia, 5(1). https://doi.org/10.5216/ref.v5i1.4617
Lemus Rodríguez, Z.; García Negrín, M. M.; & Chong Quesada, A. (2003). Alfalfe: an excellence remineralizing element in the vegetable world. Medisan. https://pesquisa.bvsalud.org/portal/resource/pt/cum-26604
Lewis, M. M., Yang, Y., Wasilewski, E., Clarke, H. A., & Kotra, L. P. (2017). Chemical Profiling of Medical Cannabis Extracts. ACS Omega, 2(9), 6091–6103. https://doi.org/10.1021/acsomega.7b00996
Lim, T. K. (2016). Glycyrrhiza glabra. In Edible Medicinal and Non-Medicinal Plants (pp. 354–457). Springer Netherlands. https://doi.org/10.1007/978-94-017-7276-1_18
Lucas, C. J., Galettis, P., & Schneider, J. (2018). The pharmacokinetics and the pharmacodynamics of cannabinoids. British Journal of Clinical Pharmacology, 84(11), 2477–2482. https://doi.org/10.1111/bcp.13710
Murphy, P. A., Kern, S. E., Stanczyk, F. Z., & Westhoff, C. L. (2005). Interaction of St. John’s Wort with oral contraceptives: Effects on the pharmacokinetics of norethindrone and ethinyl estradiol, ovarian activity and breakthrough bleeding. Contraception, 71(6), 402–408. https://doi.org/10.1016/j.contraception.2004.11.004
Nassiri Asl, M., & Hosseinzadeh, H. (2008). Review of pharmacological effects of glycyrrhiza sp. and its bioactive compounds. Phytotherapy Research, 22(6), 709–724. https://doi.org/10.1002/ptr.2362
Organization, W. H. (2009). WHO Monographs on Selected Medicinal Plants. World Health Organization, 4, 390. http://books.google.com/books?hl=en&lr=&id=qWP4aG-wXAQC&oi=fnd&pg=PR5&am p;dq=WHO+monogra phs+on+select ed+medic inal+plants&ots=RJt-DVSuko&sig=-WVSUOWRMzrFVcq1wUaLCfVkaHE
Pereira, C. D. (2015). Medicago sativa em homeopatia: revisão de literatura. Centro Alpha De Ensino Associação Paulista De Homeopatia, 66. http://homeopatia.bvs.br/lildbi/docsonline/get.php?id=044
Pfrunder, A., Schiesser, M., Gerber, S., Haschke, M., Bitzer, J., & Drewe, J. (2003). Interaction of St John’s wort with low-dose oral contraceptive therapy: A randomized controlled trial. British Journal of Clinical Pharmacology, 56(6), 683–690. https://doi.org/10.1046/j.1365-2125.2003.02005.x
Piao, X. M., Huo, Y., Kang, J. P., Mathiyalagan, R., Zhang, H., Yang, D. U., Kim, M., Yang, D. C., Kang, S. C., & Wang, Y. P. (2020). Diversity of ginsenoside profiles produced by various processing technologies. Molecules, 25(19). https://doi.org/10.3390/molecules25194390
Queiroz, S. C. N., Nogueira, R. T., & Scramin, S. (2006). Importância dos fitoestrógenos, presentes na soja, para a saúde humana. 4. https://www.agencia.cnptia.embrapa.br/recursos/Queiroz_Nogueira_Scramin_importanciaID-5nX98pWTxk.pdf
Rathke, A. F., Poester, D., & Lorenzatto, J. F. (2001). Contracepção hormonal contendo apenas progesterona. Adolesc. Latinoam, 2(2), 90–96. http://redece.org/Contracepcaohormonal2014.pdf
Rätz, A. E., Von Moos, M., & Drewe, J. (2001). Johanniskraut: Ein phytopharmakon mit potentiell gefährlichen interaktionen. Praxis, 90(19), 843–849.
Rodrigues, I. M. C., Souza Filho, A. P. S., & Ferreira, F. A. (2009). Phytochemical study of Senna alata using two methodologies. Planta Daninha, 27(3), 507–513. https://doi.org/10.1590/s0100-83582009000300011
Rossato, A. E., Pierini, M. M., Amaral, P. A., Santos, R. R., & Citadini-Zanette, V. (2012). Fitoterapia racional: aspectos taxonômicos, agroecológicos, etnobotânicos e terapêuticos. In Fitoterapia racional. http://scholar.google.com/scholar?hl=en&btnG=Search&q=intitle:Fitoterapia+Racional+:#0
Schwarz, U. I., Büschel, B., & Kirch, W. (2003). Unwanted pregnancy on self-medication with St John’s wort despite hormonal contraception. British Journal of Clinical Pharmacology, 55(1), 112–113. https://doi.org/10.1046/j.1365-2125.2003.01716.x
Shahidi, F.; & Ho, C.-T. (2005). Phenolic compounds in foods and natural health products. American Chemical Society.
Shahidi, F.; & Naczk, M. (2003). Phenolics in foods and nutraceuticals. Boca Raton.
Silva, A. G., Brandão, A. B., Cacciari, R. S., & Soares, W. H. (2009). Advances on the elucidation of mechanisms of action of Cimicifuga racemosa (L.) Nutt. in climacteric symptoms. Revista Brasileira de Plantas Medicinais, 11(4), 455–464. https://doi.org/10.1590/s1516-05722009000400015
Silva, L. M. da S., & Rocha, M. R. (2013). Interações medicamentosas dos anticoncepcionais com outros fármacos. Revista Oswaldo Cruz, 11. http://revista.oswaldocruz.br/Content/pdf/Edicao_09_SILVA_Luma_Meirelles_da_Silva_-_ROCHA_Marcia_Rocha.pdf
Silva, N. C. de S., Thomaz, A. P. S., Melo, J. A., & Martins, S. B. M. (2017). Interações Medicamentosas com Contraceptivos Hormonais Orais. 1–7. http://co.unicaen.com.br:89/periodicos/index.php/UNICA/article/view/57
Simões, C. M. O., & Schenkel, E. P. (2002). A pesquisa e a produção brasileira de medicamentos a partir de plantas medicinais: a necessária interação da indústria com a academia. Revista Brasileira de Farmacognosia, 12(1), 35–40. https://doi.org/10.1590/s0102-695x2002000100005
Souza, A. A. F. de, Silva, A. F. M. da, Abreu, L. R. de, Silva, T. F. da, Greco, G., Santos, S. da S., & Gonzaga, R. V. (2021). Medicinal uses of Cannabis sp. Research, Society and Development, 10(7), e58010716930. https://doi.org/10.33448/rsd-v10i7.16930
Taiz, L.; & Zeiger, E. (2006). Plant physiology. Sinauer Associates Inc. (4a ed.).
Unger, M., Holzgrabe, U., Jacobsen, W., Cummins, C., & Benet, L. Z. (2002). Inhibition of cytochrome P450 3A4 by extracts and kavalactones of Piper methysticum (Kava-Kava). Planta Medica, 68(12), 1055–1058. https://doi.org/10.1055/s-2002-36360
Vibha, J. B., Choudhary, K., Singh, M., & Shekhawat, N. S. (2009). A Study on Pharmacokinetics and Therapeutic Efficacy of Glycyrrhiza glabra: A Miracle Medicinal Herb. Botany Research International, 2(3), 157–163.
Vincent, A., & Fitzpatrick, L. A. (2000). Soy isoflavones: Are they useful in menopause? Mayo Clinic Proceedings, 75(11), 1174–1184. https://doi.org/10.4065/75.11.1174
Waterman, P. G. (1992). Roles for secondary metabolites in plants. Ciba Foundation Symposium, 171. https://doi.org/10.1002/9780470514344.ch15
Will-Shahab, L., Bauer, S., Kunter, U., Roots, I., & Brattström, A. (2009). St John’s wort extract (Ze 117) does not alter the pharmacokinetics of a low-dose oral contraceptive. European Journal of Clinical Pharmacology, 65(3), 287–294. https://doi.org/10.1007/s00228-008-0587-2
Williamson, E. M. (2001). Synergy and other interactions in phytomedicines. Phytomedicine, 8(5), 401–409. https://doi.org/10.1078/0944-7113-00060
Wittschier, N., Faller, G., & Hensel, A. (2009). Aqueous extracts and polysaccharides from Liquorice roots (Glycyrrhiza glabra L.) inhibit adhesion of Helicobacter pylori to human gastric mucosa. Journal of Ethnopharmacology, 125(2), 218–223. https://doi.org/10.1016/j.jep.2009.07.009
Wobser, R. W., & Pellegrini, M. V. (2018). Black Cohosh (Actaea Racemosa, Black Bugbane, Black Snakeroot, Fairy Candle). StatPearls. http://www.ncbi.nlm.nih.gov/pubmed/29261886
World Health Organization. (2002). Herba Andrographidis. In WHO monographs on selected medicinal plants, 2, 12–24.
World Health Organization Geneva. (2017). Depression and Other Common Mental Disorders: Global Health Estimates. World Health Organization, 24. https://apps.who.int/iris/bitstream/handle/10665/254610/W?sequence=1
Zou, L., Henderson, G. L., Harkey, M. R., Sakai, Y., & Li, A. (2004). Effects of Kava (Kava-kava, ’Awa, Yaqona, Piper methysticum) on c-DNA-expressed cytochrome P450 enzymes and human cryopreserved hepatocytes. Phytomedicine, 11(4), 285–294. https://doi.org/10.1078/0944711041495263
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