| Abstrak/Abstract |
Introduction: Herb–drug interactions (HDIs) in pharmacokinetics and pharmacodynamics can
Review
occur when natural compounds are used in combination with drugs. This study aimed to review
the potential interaction of Andrographis paniculata (Burm. f.) extract (APE) and its primary
compound andrographolide (AND) with several drugs exhibiting various pharmacological
activities.
Methods: In this systematic review, articles were collected from international databases such as
PubMed, Science Direct, Springer Link, and Scopus until August 2021. The following keywords
were used: Andrographis paniculata, andrographolide, HDI, drug interaction, pharmacokinetics,
and pharmacology. This review was written in accordance with the guidelines of the Preferred
Reporting Items for Systematic Reviews and Meta-analyses (PRISMA), SYRCLE’s risk of bias (RoB)
tool for animal intervention studies, and Cochrane RoB 2 tool to analyze the RoB for qualitative
assessment.
Results: Twelve articles were included in accordance with the inclusion and exclusion criteria of
this study. Five studies explored the potential of HDIs for combining APE with drugs and AND with
theophylline, etoricoxib, nabumetone, naproxen, and tolbutamide. Five studies focused on AND in
combination with aminophylline and doxofylline, meloxicam, glyburide, glimepiride, metformin,
and warfarin. Two studies tested the combination of APE with gliclazide and midazolam. The
HDI mechanism involving the inhibition or induction of cytochrome P450 enzyme expression
was dominant in influencing the drug’s pharmacokinetic profile. Pharmacological studies on the
combination of several drugs, particularly anti-inflammatory and antidiabetic drugs, showed a
synergistic activity.
Conclusion: APE and AND have potential pharmacokinetic and pharmacodynamic HDIs with
various drugs. This study can be used as a therapeutic consideration in clinical aspects related to
the possibility of HDIs of A. paniculata (Burm. f.) |
