Drug interaction potential of resveratrol.
Resveratrol is a naturally occurring polyphenol that is often used as a food supplement. Many positive health effects, including cardio protection, tumor suppression, and immune modulation, are associated with the intake of resveratrol. Resveratrol is well tolerated in healthy subjects without any comedication. However, supplemental doses of resveratrol in the range of 1 g/day or above by far exceed the natural intake through food. Whether resveratrol-drug interactions can be harmful in patients taking additional medications remains unknown. Recent in vivo studies and clinical trials indicate a possible drug-drug interaction potential using high-dosage formulations. In this review, the known in vitro and in vivo effects of resveratrol on various cytochrome P450 (CYP) isoenzymes are summarized. They are discussed in relation to clinically relevant plasma concentrations in humans. We conclude that resveratrol may lead to interactions with various CYPs, especially when taken in high doses. Aside from systemic CYP inhibition, intestinal interactions must also be considered. They can potentially lead to reduced first-pass metabolism, resulting in higher systemic exposure to certain coadministrated CYP substrates. Therefore, patients who ingest high doses of this food supplement combined with additional medications may be at risk of experiencing clinically relevant drug-drug interactions.
Division of Pharmaceutical Technology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland.
Pascal
P
Detampel
Mareike
M
Beck
Stephan
S
Krähenbühl
Jörg
J
Huwyler
D000818:Animals; D016588:Anticarcinogenic Agents / Q000009:adverse effects; D002316:Cardiotonic Agents / Q000009:adverse effects*; D065607:Cytochrome P-450 Enzyme Inhibitors; D003577:Cytochrome P-450 Enzyme System / Q000378:metabolism; D019587:Dietary Supplements / Q000009:adverse effects*; D004791:Enzyme Inhibitors / Q000009:adverse effects; D018565:Food-Drug Interactions; D006801:Humans; D007155:Immunologic Factors / Q000009:adverse effects; D000077185:Resveratrol; D013267:Stilbenes / Q000009:adverse effects*; D014665:Vasodilator Agents / Q000009:adverse effects; D014920:Wine / Q000009:adverse effects / Q000032:analysis
D016588:Anticarcinogenic Agents; D002316:Cardiotonic Agents; D065607:Cytochrome P-450 Enzyme Inhibitors; D004791:Enzyme Inhibitors; D007155:Immunologic Factors; D013267:Stilbenes; D014665:Vasodilator Agents; D003577:Cytochrome P-450 Enzyme System; D000077185:Resveratrol