title: A herbal-drug interaction study of keishi-bukuryo-gan, a traditional herbal preparation used for menopausal symptoms, in healthy female volunteers.
abstract: OBJECTIVE
  Many patients use herbal medicines to relieve menopausal symptoms. Keishi-bukuryo-gan contains five herbal components, and has been used for treating hypermenorrhoea, dysmenorrhoea and menopausal symptoms in Asian countries. In this study, we investigated the potential herb-drug interactions of keishi-bukuryo-gan in healthy female subjects.
  
  
  METHODS
  Thirty-one healthy females (20-27 years) were studied to evaluate their baseline activity of cytochrome P450 (CYP) 1A2, CYP2D6, CYP3A, xanthine oxidase (XO) and N-acetyltransferase 2 (NAT2) based on the urinary metabolic indices of an 8-h urine sample collected after a 150-mg dose of caffeine and a 30-mg dose of dextromethorphan, and also the urinary excretion ratio of 6β-hydroxycortisol to cortisol. Thereafter, the subjects received 3.75g of keishi-bukuryo-gan twice daily for seven days, and underwent the same tests on post-dose day 7.
  
  
  RESULTS
  The geometric mean phenotypic index for CYP1A2 significantly decreased by 16% on day 7 compared with the baseline (P=0.026). Keishi-bukuryo-gan did not alter the indices for CYP2D6, CYP3A, XO and NAT2.
  
  
  CONCLUSIONS
  Keishi-bukuryo-gan may inhibit the activity of CYP1A2, which is predominantly involved in oestrogen metabolism. However, TJ-25 is unlikely to participate in herb-drug interactions involving medications predominantly metabolized by CYP2D6, CYP3A, XO and NAT2. K
authors.affiliation: Division of Pharmacology and Therapeutics, Graduate School of Pharmaceutical Sciences, Kumamoto University, Kumamoto, Japan.
authors.forename: Junji
authors.initials: J
authors.lastname: Saruwatari
authors.forename: Chisato
authors.initials: C
authors.lastname: Takaishi
authors.forename: Kousuke
authors.initials: K
authors.lastname: Yoshida
authors.forename: Ayaka
authors.initials: A
authors.lastname: Takashima
authors.forename: Youhei
authors.initials: Y
authors.lastname: Fujimura
authors.forename: Yuichiro
authors.initials: Y
authors.lastname: Umemoto
authors.forename: Tomohiro
authors.initials: T
authors.lastname: Abe
authors.forename: Masataka
authors.initials: M
authors.lastname: Kitamado
authors.forename: Masatsugu
authors.initials: M
authors.lastname: Shimomasuda
authors.forename: Yousuke
authors.initials: Y
authors.lastname: Muramoto
authors.forename: Kazuko
authors.initials: K
authors.lastname: Nakagawa
mesh_terms: D000123:Acetyltransferases / Q000378:metabolism; D000328:Adult; D002110:Caffeine / Q000378:metabolism* / Q000652:urine; D065609:Cytochrome P-450 CYP1A2 Inhibitors; D019389:Cytochrome P-450 CYP2D6 / Q000378:metabolism; D051544:Cytochrome P-450 CYP3A / Q000378:metabolism; D003915:Dextromethorphan / Q000378:metabolism* / Q000652:urine; D004365:Drugs, Chinese Herbal / Q000494:pharmacology* / Q000627:therapeutic use; D004967:Estrogens / Q000378:metabolism; D005260:Female; D041743:Herb-Drug Interactions; D006801:Humans; D006854:Hydrocortisone / Q000378:metabolism* / Q000652:urine; D008593:Menopause; D010641:Phenotype; D008517:Phytotherapy / Q000009:adverse effects; D012016:Reference Values; D014969:Xanthine Oxidase / Q000378:metabolism; D055815:Young Adult
chemical_list: D065609:Cytochrome P-450 CYP1A2 Inhibitors; D004365:Drugs, Chinese Herbal; D004967:Estrogens; C054593:keishibukuryogan; D002110:Caffeine; D003915:Dextromethorphan; D019389:Cytochrome P-450 CYP2D6; D051544:Cytochrome P-450 CYP3A; D014969:Xanthine Oxidase; D000123:Acetyltransferases; D006854:Hydrocortisone