The effect of garlic supplements and phytochemicals on the ADMET properties of drugs.
BACKGROUND
Garlic supplements have received wide public attention because of their health-beneficial effects. Although these products are considered as innocuous, several case reports and studies have shown the capacity of individual garlic phytochemicals/supplements to interfere with drug pharmacokinetics.


METHODS
This review covers recently published literature on garlic chemistry and composition, and provides a thorough review of published studies evaluating drug-garlic interactions. The authors illustrate the mechanisms underlying pharmacokinetic interactions, which could serve as important highlights in further research to explain results for drugs with narrow therapeutic indices or for drugs, utilizing multiple absorption, distribution and metabolism pathways.


CONCLUSIONS
To increase the relevance of further research on safety and efficacy of garlic supplements and phytochemicals, their composition should be addressed before conducting in vitro or in vivo research. It is also strongly recommended to characterize in vitro formulation performance to assess the rate and extent of garlic phytochemical release in order to anticipate the in vivo impact on the pharmacokinetics of concomitantly consumed drugs. The main conclusion of this review is that the impact of garlic on different stages of pharmacokinetics, especially on drug absorption and metabolism, is drug specific and dependent on the type/quality of utilized supplement.
University of Ljubljana, Faculty of Pharmacy, Aškerčeva 7, 1000 Ljubljana, Slovenia.
Katja
K
Berginc
Albin
A
Kristl
D000818:Animals; D001711:Biotransformation; D002626:Chemistry, Pharmaceutical; D019587:Dietary Supplements / Q000009:adverse effects; D004355:Drug Stability; D064420:Drug-Related Side Effects and Adverse Reactions; D019317:Evidence-Based Medicine; D005737:Garlic; D041743:Herb-Drug Interactions; D006801:Humans; D007408:Intestinal Absorption; D004364:Pharmaceutical Preparations / Q000008:administration & dosage / Q000378:metabolism*; D008517:Phytotherapy / Q000009:adverse effects; D028321:Plant Preparations / Q000008:administration & dosage / Q000009:adverse effects / Q000493:pharmacokinetics*; D010946:Plants, Medicinal; D018570:Risk Assessment; D012307:Risk Factors; D012995:Solubility
D004364:Pharmaceutical Preparations; D028321:Plant Preparations