Impact of traditional African medicine on drug metabolism and transport.
BACKGROUND
Africa is a continent of rich plant biodiversity with many indigenous plants having a long history of being used for medicinal purposes. A considerable number of patients consult traditional healers in African countries for their primary health-care needs. As Western medicines become more available through governmental programmes to treat diseases such as infections with HIV/AIDS, patients are faced with an increased potential of herb-drug interactions.


METHODS
Several medicinal herbs indigenous to Africa are discussed in terms of their effects on pharmacokinetics of allopathic drugs through modulation of enzymes and active transporters. Clinically relevant herb-drug interactions obtained from in vivo studies are discussed, with data from in vitro studies also included to ensure a complete review.


CONCLUSIONS
Traditional herbal medicines are often used under a false sense of security because of the perception that it is safe due to its natural origin. The potential for interactions between herbal and allopathic drugs is often neglected. Data on clinically relevant herb-drug interactions from clinical trials can be used to educate health-care workers and patients, contributing to improved therapeutic outcomes.
North-West University, Centre of Excellence for Pharmaceutical Sciences , Private Bag X6001, Potchefstroom, 2520 , South Africa +27 18 299 4035 ; +27 87 231 5432 ; sias.hamman@nwu.ac.za.
Carlemi
C
Calitz
Jan H
JH
Steenekamp
Johan D
JD
Steyn
Chrisna
C
Gouws
Joe M
JM
Viljoen
Josias H
JH
Hamman
D000818:Animals; D001692:Biological Transport / Q000187:drug effects; D015658:HIV Infections / Q000188:drug therapy; D041743:Herb-Drug Interactions; D006801:Humans; D016488:Medicine, African Traditional; D004364:Pharmaceutical Preparations / Q000378:metabolism; D028321:Plant Preparations / Q000009:adverse effects* / Q000494:pharmacology; D010946:Plants, Medicinal / Q000737:chemistry
D004364:Pharmaceutical Preparations; D028321:Plant Preparations
efflux; herb–drug interaction; metabolism; pharmacokinetics; traditional African medicines