PHARMACOKINETICS AND PHARMACODYNAMICS INTERACTIONS OF SPIRONOLACTONE AND HERBS

Tun-Pin Hsueh, Chang Gung Memorial Hospital, Kaohsiung, Taiwan (melaopin@gmail.com)

Artemisia capillaris Thunb, Gardenia jasminoides Ellis, and Rheum officinale Baill are together constituted the herbal formula Yin-Chen-Hao-Tang (YCHT) that has been proved anti-hepatic fibrosis, anti-hepatic apoptosis, and anti-hepatic oxidative stress [1]. Patient with cirrhosis is recommended to be given the diuretic strategy as spironolactone [2]. However, potential interaction happens between a multivariable component herbal product and a single drug is essential that both pharmacokinetic and pharmacodynamics effects should be concerned in practice. The aim of the work is to discover the herbal-drug interactions between the herbal formula and spironolactone. The interaction study was collecting urine sample after administrated spironolactone (20 mg/kg, p.o.) with or without the pretreatment of herbal formula YCHT (1 g/kg/day or 3 g/kg/day p.o.) for 5 days in common bile duct ligation (CBDL) rats. Urinary pharmacokinetics was analyzed by high-performance liquid chromatography (HPLC). The results showed a significant decreasing of the cumulative amounts, mean excretion rate, and the area under the rate curve (AURC) of the metabolite canrenone by the high dose pretreatment of the formula. The urine weight and volume over 32 hours were also decreased in a dose-dependent manner as the formula applied. The urinary Na+/K+ ratio of the first four hours did not show significant among these groups. The current study initiates a pharmacokinetic interaction and potential anti-diuretic effect exists under the high dose of the formula against the treatment of spironolactone. The pharmacokinetic interaction between these three-composed herbs and spironolactone is closely related to the metabolites of spironolactone.

---

Abstract Reference & Short Personal Biography of Presenting Author

References:

[1] Zhang H, Wang X., Hu P., Zhou W., Zhang M., Liu J., Wang Y., Liu P., Luo G., Molecules., 2016, Vol.21, E126. 

[2] Ginès P., Cárdenas A., Arroyo V., Rodés J., N. Engl. J. Med., 2004, Vol.350, 1646-54.

Tun-Pin Hsueh is a medical doctor at Kaohsiung Chang Gung Memorial Hospital of the Department of Chinese Medicine. He received a bachelor’s degree in medicine and Chinese medicine from China Medical University and a doctor's degree from the Institute of Traditional Medicine, National Yang-Ming University in Taiwan. He also has diplomate of acupuncture from National Certification Commission for Acupuncture and Oriental Medicine. With a Ph.D. in traditional medicine, Tun-Pin Hsueh concerns in the field of herbal pharmacokinetics and safety.