Curcumanoid Interactions with Conventional Drugs
Alan Gaby, MD
Author: Bahramsoltani R, et al
Reference: Pharmacokinetic interactions of curcuminoids with conventional drugs: A review. J Ethnopharmacol 2017;209:1-12.
Design: Literature review
Participants: Experimental animals
Study preparation and dosage: Curcumin in various dosages. Some of the studies used curcumin in dosage ranges commonly used in clinical practice, whereas other studies used higher doses.
Primary outcome measure: Potential interactions with prescription medications
Key findings: Co-administration of curcumin increased the Cmax (peak serum concentration) or total area under the serum concentration-time curve (an indicator of drug bioavailability), or both, for warfarin, clopidogrel, rosuvastatin, loratadine, norfloxacin, paclitaxel, docetaxel, etoposide, and tamoxifen. Co-administration of curcumin decreased the Cmax and total area under the serum concentration-time curve for everolimus. In vitro studies suggested that the mechanisms underlying these interactions include inhibition of cytochrome P450 isoenzymes and inhibition of P-glycoprotein.
Practice implications: A growing body of evidence indicates that curcumin is beneficial in the treatment of inflammatory bowel disease, arthritis, and some other conditions, and for preventing radiation-induced dermatitis in breast cancer patients. While curcumin is relatively safe when administered by itself, the animal research described above raises the possibility that curcumin could interact with various medications. Numerous drugs are metabolized by cytochrome P450 isoenzymes. In addition, some medications are known to inhibit P-glycoprotein (including amiodarone, clarithromycin, colchicine, diltiazem, erythromycin, felodipine, omeprazole and other proton-pump inhibitors, nifedipine, paroxetine, sertraline, tamoxifen, and verapamil). Curcumin should therefore be used with caution in patients taking a medication with which it might interact.